Third set of the NCLEX-PN review series. Another 50 items to sharpen your critical thinking skills for the actual exams.
Topics or concepts included in this exam are:
- Various topics
- Read each question carefully and choose the best answer.
- You are given one minute per question. Spend your time wisely!
- Answers and rationales (if any) are given below. Be sure to read them.
- If you need more clarifications, please direct them to the comments section.
In Exam Mode: All questions are shown but the results, answers, and rationales (if any) will only be given after you’ve finished the quiz. You are given 1 minute per question.
NCLEX-PN Review Quiz 3 (50 Questions)
Practice Mode: This is an interactive version of the Text Mode. All questions are given in a single page and correct answers, rationales or explanations (if any) are immediately shown after you have selected an answer. No time limit for this exam.
NCLEX-PN Review Quiz 3 (50 Questions)
In Text Mode: All questions and answers are given for reading and answering at your own pace. You can also copy this exam and make a print out.
a. Withholding intake after midnight
b. Telling the client that no special preparation is needed
c. Explaining that a small dose of radioactive isotope will be used
d. Giving an oral suspension of glucose 1 hour before the test
3. The nurse is preparing to give an oral potassium supplement. The nurse should:
a. Give the medication without diluting it
b. Give the medication with 4oz. of juice
c. Give the medication with water only
d. Give the medication on an empty stomach
4. The physician has ordered cultures for cytomegalovirus (CMV). Which statement is true regarding collection of cultures for cytomegalovirus?
a. Stool cultures are preferred for definitive diagnosis.
b. Pregnant caregivers may obtain cultures.
c. Collection of one specimen is sufficient.
d. Accurate diagnosis depends on fresh specimens.
5. A pediatric client with burns to the hands and arms has dressing changes with Sulfamylon (mafenide acetate) cream. The nurse is aware that the medication:
a. Will cause dark staining of the surrounding skin
b. Produces a cooling sensation when applied
c. Can alter the function of the thyroid
d. Produces a burning sensation when applied
6. The physician has ordered Dilantin (phenytoin) for a client with generalized seizures. When planning the client’s care, the nurse should:
a. Maintain strict intake and output
b. Check the pulse before giving the medication
c. Administer the medication 30 minutes before meals
d. Provide oral hygiene and gum care every shift
8. The physician has ordered cortisporin ear drops for a 2-year-old. To administer the ear drops, the nurse should:
a. Pull the ear down and back
b. Pull the ear straight out
c. Pull the ear up and back
d. Leave the ear undisturbed
a. The client complains of thirst
b. The client has gained 4 pounds in the past 2 months
c. The client complains of a sore throat
d. The client naps throughout the day
10. A client with iron-deficiency anemia is taking an oral iron supplement. The nurse should tell the client to take the medication with:
a. Orange juice
b. Water only
d. Apple juice
11. A client is admitted with burns of the right arm, chest, and head. According to the Rule of Nines, the percent of burn injury is:
12. A client who was admitted with chest pain and shortness of breath has a standing order for oxygen via mask. Standing orders for oxygen mean that the nurse can apply oxygen at:
a. 2L per minute
b. 6L per minute
c. 10L per minute
d. 12L per minute
13. The nurse is caring for a client with an ileostomy. The nurse should pay careful attention to care around the stoma because:
a. Digestive enzymes cause skin breakdown.
b. Stools are less watery and contain more solid matter.
c. The stoma will heal more slowly than expected.
d. It is difficult to fit the appliance to the stoma site.
15. A client is admitted to the emergency room with symptoms of delirium tremens. After admitting the client to a private room, the priority nursing intervention is to:
a. Obtain a history of his alcohol use
b. Provide seizure precautions
c. Keep the room cool and dark
d. Administer thiamine and zinc
16. The nurse is providing dietary teaching for a client with gout. Which dietary selection is suitable for the client with gout?
a. Broiled liver, macaroni and cheese, spinach
b. Stuffed crab, steamed rice, peas
c. Baked chicken, pasta salad, asparagus casserole
d. Steak, baked potato, tossed salad
c. On either side
d. With the head elevated
18. The mother of a 3-month-old with esophageal reflux asks the nurse what she can do to lessen the baby’s reflux. The nurse should tell the mother to:
a. Feed the baby only when he is hungry
b. Burp the baby after the feeding is completed
c. Place the baby supine with head elevated
d. Burp the baby frequently throughout the feeding
19. A child is hospitalized with a fractured femur involving the epiphysis. Epiphyseal fractures are serious because:
a. Bone marrow is lost through the fracture site.
b. Normal bone growth is affected.
c. Blood supply to the bone is obliterated.
d. Callus formation prevents bone healing.
20. Before administering a nasogastric feeding to a client hospitalized following a CVA, the nurse aspirates 40mL of residual. The nurse should:
a. Replace the aspirate and administer the feeding
b. Discard the aspirate and withhold the feeding
c. Discard the aspirate and begin the feeding
d. Replace the aspirate and withhold the feeding
21. A client has an order for Dilantin (phenytoin) .2g orally twice a day. The medication is available in 100mg capsules. For the morning medication, the nurse should administer:
a. 1 capsule
b. 2 capsules
c. 3 capsules
d. 4 capsules
22. The LPN is reviewing the lab results of an elderly client when she notes a specific gravity of 1.006. The nurse recognizes that:
23. A client with pancreatitis has requested pain medication. Which pain medication is indicated for the client with pancreatitis?
24. A client with a hiatal hernia has been taking magnesium hydroxide for relief of heartburn. Overuse of magnesium-based antacids can cause the client to have:
25. When performing a newborn assessment, the nurse measures the circumference of the neonate’s head and chest. Which assessment finding is expected in the normal newborn?
a. The head and chest circumference are the same.
b. The head is 2cm larger than the chest.
c. The head is 3cm smaller than the chest.
d. The head is 4cm larger than the chest.
26. The nurse is caring for an 8-year-old following a routine tonsillectomy. Which finding should be reported immediately?
a. Reluctance to swallow
b. Drooling of blood-tinged saliva
c. An axillary temperature of 99°F
d. Respiratory stridor
27. The nurse is admitting a client with a suspected duodenal ulcer. The client will most likely report that his abdominal discomfort lessens when he:
a. Skips a meal
b. Rests in recumbent position
c. Eats a meal
d. Sits upright after eating
28. Which of the following meal selections is appropriate for the client with celiac disease?
a. Toast, jam, and apple juice
b. Peanut butter cookies and milk
c. Rice Krispies bar and milk
d. Cheese pizza and Kool-Aid
29. A client with hyperthyroidism is taking lithium carbonate to inhibit thyroid hormone release. Which complaint by the client should alert the nurse to a problem with the client’s medication?
a. The client complains of blurred vision.
b. The client complains of increased thirst and increased urination.
c. The client complains of increased weight gain over the past year.
d. The client complains of ringing in the ears.
30. A 2-month-old infant has just received her first Tetramune injection. The nurse should tell the mother that the immunization:
a. Will need to be repeated when the child is 4 years of age
b. Is given to determine whether the child is susceptible to pertussis
c. Is one of a series of injections that protects against dpt and Hib
d. Is a one-time injection that protects against MMR and varicella
31. The nurse is caring for a client hospitalized with bipolar disorder, manic phase. Which of the following snacks would be best for the client with mania?
a. Potato chips
b. Diet cola
a. “Currant jelly” stools
b. Projectile vomiting
c. “Ribbon-like” stools
d. Palpable mass over the flank
33. A client is being treated for cancer with linear acceleration radiation. The physician has marked the radiation site with a blue marking pen. The nurse should:
a. Remove the unsightly markings with acetone or alcohol
b. Cover the radiation site with loose gauze dressing
c. Sprinkle baby powder over the irradiated area
d. Refrain from using soap or lotion on the marked area
34. The nurse is caring for a client with acromegaly. Following a transsphenoidal hypophysectomy, the nurse should:
35. A client newly diagnosed with diabetes is started on Precose (acarbose). The nurse should tell the client that the medication should be taken:
a. 1 hour before meals
b. 30 minutes after meals
c. With the first bite of a meal
d. Daily at bedtime
36. A client with a deep decubitus ulcer is receiving therapy in the hyperbaric oxygen chamber. Before therapy, the nurse should:
a. Apply a lanolin-based lotion to the skin
b. Wash the skin with water and pat dry
c. Cover the area with a petroleum gauze
d. Apply an occlusive dressing to the site
a. Prevent swelling and dysphagia
b. Decompress the stomach via suction
c. Prevent contamination of the suture line
d. Promote healing of the oral mucosa
38. The chart indicates that a client has expressive aphasia following a stroke. The nurse understands that the client will have difficulty with:
a. Speaking and writing
b. Comprehending spoken words
c. Carrying out purposeful motor activity
d. Recognizing and using an object correctly
39. A camp nurse is applying sunscreen to a group of children enrolled in swim classes. Chemical sunscreens are most effective when applied:
a. Just before sun exposure
b. 5 minutes before sun exposure
c. 15 minutes before sun exposure
d. 30 minutes before sun exposure
40. A postoperative client has an order for Demerol (meperidine) 75mg and Phenergan (promethazine) 25mg IM every 3–4 hours as needed for pain. The combination of the two medications produces a/an:
a. Agonist effect
b. Synergistic effect
c. Antagonist effect
d. Excitatory effect
a. Record the pulse rate and administer the medication
b. Administer the medication and monitor the heart rate
c. Withhold the medication and notify the doctor
d. Withhold the medication until the heart rate increases
42. What information should the nurse give a new mother regarding the introduction of solid foods for her infant?
a. Solid foods should not be given until the extrusion reflex disappears, at 8–10 months of age.
b. Solid foods should be introduced one at a time, with 4- to 7-day intervals.
c. Solid foods can be mixed in a bottle or infant feeder to make feeding easier.
d. Solid foods should begin with fruits and vegetables.
a. Withholding all morning medications
b. Ordering a CBC and CPK
c. Administering prescribed anti-Parkinsonian medication
d. Transferring the client to a medical unit
44. A client with human immunodeficiency syndrome has gastrointestinal symptoms, including diarrhea. The nurse should teach the client to avoid:
a. Calcium-rich foods
b. Canned or frozen vegetables
c. Processed meat
d. Raw fruits and vegetables
45. A 4-year-old is admitted with acute leukemia. It will be most important to monitor the child for:
46. A 5-month-old is diagnosed with atopic dermatitis. Nursing interventions will focus on:
a. Preventing infection
b. Administering antipyretics
c. Keeping the skin free of moisture
d. Limiting oral fluid intake
47. The nurse is caring for a client with a history of diverticulitis. The client complains of abdominal pain, fever, and diarrhea. Which food was responsible for the client’s symptoms?
a. Mashed potatoes
b. Steamed carrots
c. Baked fish
d. Whole-grain cereal
48. The physician has scheduled a Whipple procedure for a client with pancreatic cancer. The nurse recognizes that the client’s cancer is located in:
a. The tail of the pancreas
b. The head of the pancreas
c. The body of the pancreas
d. The entire pancreas
a. Weight gain
b. Hair loss
c. Sore throat
d. Brittle nails
50. The doctor has ordered Percocet (oxycodone) for a client following abdominal surgery. The primary objective of nursing care for the client receiving an opiate analgesic is to:
a. Prevent addiction
b. Alleviate pain
c. Facilitate mobility
d. Prevent nausea
Answers and Rationale
1. Answer C is correct. Apricots are low in potassium; therefore, it is a suitable snack of the client on a potassium-restricted diet. Raisins, oranges, and bananas are all good sources of potassium; therefore, answers A, B, and C are incorrect.
2. Answer B is correct. No special preparation is needed for the blood test for H. pylori. Answer A is incorrect because the client is not NPO before the test. Answer C is incorrect because it refers to preparation for the breath test. Answer D is incorrect because glucose is not administered before the test.
3. Answer B is correct. Oral potassium supplements should be given in at least 4oz. of juice or other liquid, to prevent gastric upset and to disguise the unpleasant taste. Answers A, C, and D are incorrect because they cause gastric upset.
4. Answer D is correct. Fresh specimens are essential for accurate diagnosis of CMV. Answer A is incorrect because cultures of urine, sputum, and oral swab are preferred. Answer B is incorrect because pregnant caregivers should not be assigned to care for clients with suspected or known infection with CMV. Answer C is incorrect because a convalescent culture is obtained 2–4 weeks after diagnosis.
5. Answer D is correct. The client should receive pain medication 30 minutes before the application of Sulfamylon. Answer A is incorrect because it refers to silver nitrate. Answer B is incorrect because it refers to Silvadene. Answer C is incorrect because it refers to Betadine.
6. Answer D is correct. Gingival hyperplasia is a side effect of Dilantin; therefore, the nurse should provide oral hygiene and gum care every shift. Answers A, B, and C do not apply to the medication; therefore, they are incorrect.
7. Answer C is correct. Zofran is given before chemotherapy to prevent nausea. Answers A, B, and D are not associated with the medication; therefore, they are incorrect.
8. Answer A is correct. When administering ear drops to a child under 3 years of age, the nurse should pull the ear down and back to straighten the ear canal. Answers B and D are incorrect positions for administering ear drops. Answer C is used for administering ear drops to an adult client.
9. Answer C is correct. The nurse should carefully monitor the client taking Thorazine for signs of infection that can quickly become overwhelming. Answers A, B, and C are incorrect because they are expected side effects of the medication.
10. Answer A is correct. Iron is better absorbed when taken with ascorbic acid. Orange juice is an excellent source of ascorbic acid. Answer B is incorrect because the medication should be taken with orange juice or tomato juice. Answer C is incorrect because iron should not be taken with milk because it interferes with absorption. Answer D is incorrect because apple juice does not contain high amounts of ascorbic acid.
11. Answer B is correct. Burn injury of the arm (9%), chest (9%), and head (9%) accounts for burns covering 27% of the total body surface area. Answers A, C, and D are incorrect percentages.
12. Answer B is correct. With standing orders, the nurse can administer oxygen at 6L per minute via mask. Answer A is incorrect because the amount is too low to help the client with chest pain and shortness of breath. Answers C and D have oxygen levels requiring a doctor’s order.
13. Answer A is correct. Stool from the ileostomy contains digestive enzymes that can cause severe skin breakdown. Answer B contains contradictory information; therefore, it is incorrect. Answers C and D contain inaccurate statements; therefore, they are incorrect.
14. Answer C is correct. Tinnitus is a sign of aspirin toxicity. Answers A, B, and D are not related to aspirin toxicity; therefore, they are incorrect.
15. Answer B is correct. The client with delirium tremens has an increased risk for seizures; therefore, the nurse should provide seizure precautions. Answer A is not a priority in the client’s care; therefore, it is incorrect. Answer C is incorrect because the client should be kept in a dimly lit, not dark, room. Answer D is incorrect because thiamine and multivitamins are given to prevent Wernicke’s encephalopathy, not delirium tremens.
16. Answer D is correct. Steak, baked potato, and tossed salad are lower in purine than the other choices. Liver, crab, and chicken are high in purine; therefore, answers A, B, and C are incorrect.
17. Answer C is correct. Placing the newborn in a side-lying position helps the urine to drain from the exposed bladder. Answer A is incorrect because it would position the child on the exposed bladder. Answers B and D are incorrect because they would allow the urine to pool.
18. Answer D is correct. Burping the baby frequently throughout the feeding will help prevent gastric distention that contributes to esophageal reflux. Answers A and B are incorrect because they allow air to collect in the baby’s stomach, which contributes to reflux. Answer C is incorrect because the baby should be placed side-lying with the head elevated, to prevent aspiration.
19. Answer B is correct. Growth plates located in the epiphysis can be damaged by epiphyseal fractures. Answers A, B, and C are untrue statements; therefore, they are incorrect.
20. Answer A is correct. The nurse should replace the aspirate and administer the feeding because the amount aspirated was less than 50mL. Answers B and C are incorrect because the aspirate should not be discarded. Answer D is incorrect because the feeding should not be withheld.
21. Answer B is correct. The nurse should administer two capsules. Answers A, C, and D contain inaccurate amounts; therefore, they are incorrect.
22. Answer B is correct. The normal specific gravity is 1.005-1.030. Answers A, C, and D are inaccurate statements; therefore, they are incorrect.
23. Answer A is correct. To prevent spasms of the sphincter of Oddi, the client with pancreatitis should receive nonopiate analgesics for pain. Answer B is incorrect because the client with pancreatitis might be prone to bleed; therefore, Toradol is not a drug of choice for pain control. Morphine and codeine, opiate analgesics, are contraindicated for the client with pancreatitis; therefore, answers C and D are incorrect.
24. Answer D is correct. Overuse of magnesium-containing antacids results in diarrhea. Antacids containing calcium and aluminum cause constipation; therefore, answer A is incorrect. Answers B and C are not associated with the use of magnesium antacids; therefore, they are incorrect.
25. Answer B is correct. The head circumference of the normal newborn is approximately 33cm, while the chest circumference is 31cm. Answer A is incorrect because the head and chest are not the same circumference. Answer C is incorrect because the head is larger in circumference than the chest. Answer D is incorrect because the difference in head circumference and chest circumference is too great
26. Answer D is correct. Respiratory stridor is a symptom of partial airway obstruction. Answers A, B, and C are expected with a tonsillectomy; therefore, they are incorrect.
27. Answer C is correct. Pain associated with duodenal ulcers is lessened if the client eats a meal or snack. Answer A is incorrect because it makes the pain worse. Answer B refers to dumping syndrome; therefore, it is incorrect. Answer D refers to gastroesophageal reflux; therefore, it is incorrect.
28. Answer C is correct. Foods containing rice or millet are permitted on the diet of the client with celiac disease. Answers A, B, and D are not permitted because they contain flour made from wheat, which exacerbates the symptoms of celiac disease; therefore, they are incorrect.
29. Answer B is correct. Increased thirst and increased urination are signs of lithium toxicity. Answers B and D do not relate to the medication; therefore, they are incorrect. Answer C is an expected side effect of the medication; therefore, it is incorrect.
30. Answer C is correct. The immunization protects the child against diphtheria, pertussis, tetanus, and H. influenza b. Answer A is incorrect because a second injection is given before 4 years of age. Answer B is not a true statement; therefore, it is incorrect. Answer D is incorrect because it is not a one-time injection, nor does it protect against measles, mumps, rubella, or varicella.
31. Answer D is correct. The milkshake will provide needed calories and nutrients for the client with mania. Answers A and B are incorrect because they are high in sodium, which causes the client to excrete the lithium. Answer C has some nutrient value, but not as much as the milkshake.
32. Answer A is correct. The child with intussusception has stools that contain blood and mucus, which are described as “currant jelly” stools. Answer B is a symptom of pyloric stenosis; therefore, it is incorrect. Answer C is a symptom of Hirschsprung’s; therefore, it is incorrect. Answer D is a symptom of Wilms tumor; therefore, it is incorrect.
33. Answer D is correct. The nurse should not use water, soap, or lotion on the area marked for radiation therapy. Answer A is incorrect because it would remove the marking. Answers B and C are not necessary for the client receiving radiation; therefore, they are incorrect.
34. Answer A is correct. Growth hormone levels generally fall rapidly after a hypophysectomy, allowing insulin levels to rise. The result is hypoglycemia. Answer B is incorrect because it traumatizes the oral mucosa. Answer C is incorrect because the client’s head should be elevated to reduce pressure on the operative site. Answer D is incorrect because it increases pressure on the operative site that can lead to a leak of cerebral spinal fluid.
35. Answer C is correct. Precose (acarbose) is to be taken with the first bite of a meal. Answers A, B, and D are incorrect because they specify the wrong schedule for medication administration.
36. Answer B is correct. The client going for therapy in the hyperbaric oxygen chamber requires no special skin care; therefore, washing the skin with water and patting it dry are suitable. Lotions, petroleum products, perfumes, and occlusive dressings interfere with oxygenation of the skin; therefore, answers A, C, and D are incorrect.
37. Answer C is correct. The primary reason for the NG to is to allow for nourishment without contamination of the suture line. Answer A is not a true statement; therefore, it is incorrect. Answer B is incorrect because there is no mention of suction. Answer D is incorrect because the oral mucosa was not involved in the laryngectomy.
38. Answer A is correct. The client with expressive aphasia has trouble forming words that are understandable. Answer B is incorrect because it describes receptive aphasia. Answer C refers to apraxia; therefore, it is incorrect. Answer D is incorrect because it refers to agnosia.
39. Answer D is correct. Sunscreens of at least an SPF of 15 should be applied 20–30 minutes before going into the sun. Answers A, B, and C are incorrect because they do not allow sufficient time for sun protection.
40. Answer B is correct. The combination of the two medications produces an effect greater than that of either drug used alone. Agonist effects are similar to those produced by chemicals normally present in the body; therefore, answer A is incorrect. Antagonist effects are those in which the actions of the drugs oppose one another; therefore, answer C is incorrect. Answer D is incorrect because the drugs would have a combined depressing, not excitatory, effect.
41. Answer C is correct. The medication should be withheld and the doctor should be notified. Answers A, B, and D are incorrect because they do not provide for the client’s safety.
42. Answer B is correct. Solid foods should be added to the diet one at a time, with 4- to 7-day intervals between new foods. The extrusion reflex fades at 3–4 months of age; therefore, answer A is incorrect. Answer C is incorrect because solids should not be added to the bottle and the use of infant feeders is discouraged. Answer D is incorrect because the first food added to the infant’s diet is rice cereal.
43. Answer C is correct. The client’s symptoms suggest an adverse reaction to the medication known as neuroleptic malignant syndrome. Answers A, B, and D are not appropriate.
44. Answer D is correct. The client with HIV should adhere to a low-bacteria diet by avoiding raw fruits and vegetables. Answers A, B, and C are incorrect because they are permitted in the client’s diet.
45. Answer C is correct. The child with leukemia has low platelet counts, which contribute to spontaneous bleeding. Answers A, B, and D, common in the child with leukemia, are not life-threatening.
46. Answer A is correct. The nurse should prevent the infant with atopic dermatitis (eczema) from scratching, which can lead to skin infections. Answer B is incorrect because fever is not associated with atopic dermatitis. Answers C and D are incorrect because they increase dryness of the skin, which worsens the symptoms of atopic dermatitis.
47. Answer D is correct. Symptoms associated with diverticulitis are usually reported after eating popcorn, celery, raw vegetables, whole grains, and nuts. Answers A, B, and C are incorrect because they are allowed in the diet of the client with diverticulitis.
48. Answer B is correct. The Whipple procedure is performed for cancer located in the head of the pancreas. Answers A, C, and D are not correct because of the location of the cancer.
49. Answer C is correct. Side effects of Pulmozyme include sore throat, hoarseness, and laryngitis. Answers A, B, and C are not associated with Pulmozyme; therefore, they are incorrect.
50. Answer B is correct. The nurse should be concerned with alleviating the client’s pain. Answers A, B, and C are not primary objectives in the care of the client receiving an opiate analgesic; therefore, they are incorrect.