NCLEX Practice Test For Medical Surgical Nursing 3 (Exam Mode) By Rnpedia.Com
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- 1.The nurse is assisting in planning care for a client with a diagnosis of immune deficiency. The nurse would incorporate which of the ff. as a priority in the plan of care?
- A.
Providing emotional support to decrease fear
- B.
Protecting the client from infection
- C.
Encouraging discussion about lifestyle changes
- D.
Identifying factors that decreased the immune function
- 2.Joy, an obese 32 year old, is admitted to the hospital after an automobile accident. She has a fractured hip and is brought to the OR for surgery. After surgery Joy is to receive a piggy-back of Clindamycin phosphate (Cleocin) 300 mg in 50 ml of D5W. The piggyback is to infuse in 20 minutes. The drop factor of the IV set is 10 gtt/ml. The nurse should set the piggyback to flow at:
- A.
25 gtt/min
- B.
30 gtt/min
- C.
35 gtt/min
- D.
45 gtt/min
- 3.The day after her surgery Joy asks the nurse how she might lose weight. Before answering her question, the nurse should bear in mind that long-term weight loss best occurs when:
- A.
Fats are controlled in the diet
- B.
Eating habits are altered
- C.
Carbohydrates are regulated
- D.
Exercise is part of the program
- 4.The nurse teaches Joy, an obese client, the value of aerobic exercises in her weight reduction program. The nurse would know that this teaching was effective when Joy says that exercise will:
- A.
Increase her lean body mass
- B.
Lower her metabolic rate
- C.
Decrease her appetite
- D.
Raise her heart rate
- 5.The physician orders non-weight bearing with crutches for Joy, who had surgery for a fractured hip. The most important activity to facilitate walking with crutches before ambulation begun is:
- A.
Exercising the triceps, finger flexors, and elbow extensors
- B.
Sitting up at the edge of the bed to help strengthen back muscles
- C.
Doing isometric exercises on the unaffected leg
- D.
Using the trapeze frequently for pull-ups to strengthen the biceps muscles
- 6.The nurse recognizes that a client understood the demonstration of crutch walking when she places her weight on:
- A.
The palms and axillary regions
- B.
Both feet placed wide apart
- C.
The palms of her hands
- D.
Her axillary regions
- 7.Joey is a 46 year-old radio technician who is admitted because of mild chest pain. He is 5 feet, 8 inches tall and weighs 190 pounds. He is diagnosed with a myocardial infarct. Morphine sulfate, Diazepam (Valium) and Lidocaine are prescribed. The physician orders 8 mg of Morphine Sulfate to be given IV. The vial on hand is labeled 1 ml/ 10 mg. The nurse should administer:
- A.
8 minims
- B.
10 minims
- C.
12 minims
- D.
15 minims
- 8.Joey asks the nurse why he is receiving the injection of Morphine after he was hospitalized for severe anginal pain. The nurse replies that it:
- A.
Will help prevent erratic heart beats
- B.
Relieves pain and decreases level of anxiety
- C.
Decreases anxiety
- D.
Dilates coronary blood vessels
- 9.Oxygen 3L/min by nasal cannula is prescribed for Joey who is admitted to the hospital for chest pain. The nurse institutes safety precautions in the room because oxygen:
- A.
Converts to an alternate form of matter
- B.
Has unstable properties
- C.
Supports combustion
- D.
Is flammable
- 10.Myra is ordered laboratory tests after she is admitted to the hospital for angina. The isoenzyme test that is the most reliable early indicator of myocardial insult is:
- A.
SGPT
- B.
LDH
- C.
CK-MB
- D.
AST
- 11.An early finding in the EKG of a client with an infarcted mycardium would be:
- A.
Disappearance of Q waves
- B.
Elevated ST segments
- C.
Absence of P wave
- D.
Flattened T waves
- 12.Jose, who had a myocardial infarction 2 days earlier, has been complaining to the nurse about issues related to his hospital stay. The best initial nursing response would be to:
- A.
Allow him to release his feelings and then leave him alone to allow him to regain his composure
- B.
Refocus the conversation on his fears, frustrations and anger about his condition
- C.
Explain how his being upset dangerously disturbs his need for rest
- D.
Attempt to explain the purpose of different hospital routines
- 13.Twenty four hours after admission for an Acute MI, Jose’s temperature is noted at 39.3 C. The nurse monitors him for other adaptations related to the pyrexia, including:
- A.
Shortness of breath
- B.
Chest pain
- C.
Elevated blood pressure
- D.
Increased pulse rate
- 14.Jose, who is admitted to the hospital for chest pain, asks the nurse, “Is it still possible for me to have another heart attack if I watch my diet religiously and avoid stress?” The most appropriate initial response would be for the nurse to:
- A.
Suggest he discuss his feelings of vulnerability with his physician.
- B.
Tell him that he certainly needs to be especially careful about his diet and lifestyle.
- C.
Avoid giving him direct information and help him explore his feelings
- D.
Recognize that he is frightened and suggest he talk with the psychiatrist or counselor.
- 15.Ana, 55 years old, is admitted to the hospital to rule out pernicious anemia. A Schilling test is ordered for Ana. The nurse recognizes that the primary purpose of the Schilling test is to determine the client’s ability to:
- A.
Store vitamin B12
- B.
Digest vitamin B12
- C.
Absorb vitamin B12
- D.
Produce vitamin B12
- 16.Ana is diagnosed to have Pernicious anemia. The physician orders 0.2 mg of Cyanocobalamin (Vitamin B12) IM. Available is a vial of the drug labeled 1 ml= 100 mcg. The nurse should administer:
- A.
0.5 ml
- B.
1.0 ml
- C.
1.5 ml
- D.
2.0 ml
- 17.Health teachings to be given to a client with Pernicious Anemia regarding her therapeutic regimen concerning Vit. B12 will include:
- A.
Oral tablets of Vitamin B12 will control her symptoms
- B.
IM injections are required for daily control
- C.
IM injections once a month will maintain control
- D.
Weekly Z-track injections provide needed control
- 18.The nurse knows that a client with Pernicious Anemia understands the teaching regarding the vitamin B12 injections when she states that she must take it:
- A.
When she feels fatigued
- B.
During exacerbations of anemia
- C.
Until her symptoms subside
- D.
For the rest of her life
- 19.Arthur Cruz, a 45 year old artist, has recently had an abdominoperineal resection and colostomy. Mr. Cruz accuses the nurse of being uncomfortable during a dressing change, because his “wound looks terrible.” The nurse recognizes that the client is using the defense mechanism known as:
- A.
Reaction Formation
- B.
Sublimation
- C.
Intellectualization
- D.
Projection
- 20.When preparing to teach a client with colostomy how to irrigate his colostomy, the nurse should plan to perform the procedure:
- A.
When the client would have normally had a bowel movement
- B.
After the client accepts he had a bowel movement
- C.
Before breakfast and morning care
- D.
At least 2 hours before visitors arrive
- 21.When observing an ostomate do a return demonstration of the colostomy irrigation, the nurse notes that he needs more teaching if he:
- A.
Stops the flow of fluid when he feels uncomfortable
- B.
Lubricates the tip of the catheter before inserting it into the stoma
- C.
Hangs the bag on a clothes hook on the bathroom door during fluid insertion
- D.
Discontinues the insertion of fluid after only 500 ml of fluid has been instilled
- 22.When doing colostomy irrigation at home, a client with colostomy should be instructed to report to his physician :
- A.
Abdominal cramps during fluid inflow
- B.
Difficulty in inserting the irrigating tube
- C.
Passage of flatus during expulsion of feces
- D.
Inability to complete the procedure in half an hour
- 23.A client with colostomy refuses to allow his wife to see the incision or stoma and ignores most of his dietary instructions. The nurse on assessing this data, can assume that the client is experiencing:
- A.
A reaction formation to his recent altered body image.
- B.
A difficult time accepting reality and is in a state of denial.
- C.
Impotency due to the surgery and needs sexual counseling
- D.
Suicide thoughts and should be seen by psychiatrist
- 24.The nurse would know that dietary teaching had been effective for a client with colostomy when he states that he will eat:
- A.
Food low in fiber so that there is less stool
- B.
Everything he ate before the operation but will avoid those foods that cause gas
- C.
Bland foods so that his intestines do not become irritated
- D.
Soft foods that are more easily digested and absorbed by the large intestines
- 25.Eddie, 40 years old, is brought to the emergency room after the crash of his private plane. He has suffered multiple crushing wounds of the chest, abdomen and legs. It is feared his leg may have to be amputated. When Eddie arrives in the emergency room, the assessment that assume the greatest priority are:
- A.
Level of consciousness and pupil size
- B.
Abdominal contusions and other wounds
- C.
Pain, Respiratory rate and blood pressure
- D.
Quality of respirations and presence of pulsesQuality of respirations and presence of pulses
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