NCLEX Practice Exam 3 (10 Questions)

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Questions: 10 | Attempts: 13,168 | Updated: Aug 22, 2023

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NCLEX Practice Exam 3 (10 Questions) - Quiz

All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.

Questions and Answers

1.

A triage nurse has these four (4) clients arrive in the emergency department within 15 minutes. Which client should the triage nurse send back to be seen first?
- A.
  
  A 2-month-old infant with a history of rolling off the bed and has bulging fontanels with crying
- B.
  
  A teenager who got a singed beard while camping
- C.
  
  An elderly client with complaints of frequent liquid brown colored stools
- D.
  
  A middle-aged client with intermittent pain behind the right scapula
Correct Answer
B. A teenager who got a singed beard while camping

Explanation
This client is in the greatest danger with a potential of respiratory distress. Any client with singed facial hair has been exposed to heat or fire in close range that could have caused serious damage to the interior of the lungs. Note that the interior linings of the lungs have no nerve fibers so the client will not be aware of swelling.

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2.

While planning care for a toddler. the nurse teaches the parents about the expected developmental changes for this age. Which statement by the mother shows that she understands the child’s developmental needs?
- A.
  
  “I want to protect my child from any falls.”
- B.
  
  “I will set limits on exploring the house.”
- C.
  
  “I understand the need to use those new skills.”
- D.
  
  “I intend to keep control over our child.”
Correct Answer
C. “I understand the need to use those new skills.”

Explanation
Erikson describes the stage of the toddler as being the time when there is normally an increase in autonomy. The child needs to use motor skills to explore the environment.

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3.

The nurse is preparing to administer an enteral feeding to a client via a nasogastric feeding tube. The most important action of the nurse is
- A.
  
  Verify correct placement of the tube
- B.
  
  Check that the feeding solution matches the dietary order
- C.
  
  Aspirate abdominal contents to determine the amount of last feeding remaining in stomach
- D.
  
  Ensure that feeding solution is at room temperature
Correct Answer
A. Verify correct placement of the tube

Explanation
Proper placement of the tube prevents aspiration.

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2
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4.

The nurse is caring for a client with a serum potassium level of 3.5 mEq/L. The client is placed on a cardiac monitor and receives 40 mEq KCL in 1000 ml of 5% dextrose in water IV. Which of the following EKG patterns indicates to the nurse that the infusions should be discontinued?
- A.
  
  Narrowed QRS complex
- B.
  
  Shortened “PR” interval
- C.
  
  Tall peaked “T” waves
- D.
  
  Prominent “U” waves
Correct Answer
C. Tall peaked “T” waves

Explanation
A tall peaked T wave is a sign of hyperkalemia. The health care provider should be notified regarding discontinuing the medication.

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5.

A nurse prepares to care for a 4-year-old newly admitted for rhabdomyosarcoma. The nurse should alert the staff to pay more attention to the function of which area of the body?
- A.
  
  All striated muscles
- B.
  
  The cerebellum
- C.
  
  The kidneys
- D.
  
  The leg bones
Correct Answer
A. All striated muscles

Explanation
Rhabdomyosarcoma is the most common children’s soft tissue sarcoma. It originates in striated (skeletal) muscles and can be found anywhere in the body. The clue is in the middle of the word and is “myo” which typically means muscle.

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6.

The nurse anticipates that for a family who practices Chinese medicine the priority goal would be to:
- A.
  
  Achieve harmony
- B.
  
  Maintain a balance of energy
- C.
  
  Respect life
- D.
  
  Restore yin and yang
Correct Answer
D. Restore yin and yang

Explanation
For followers of Chinese medicine. health is maintained through the balance between the forces of yin and yang.

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1
1
7.

During an assessment of a client with cardiomyopathy. the nurse finds that the systolic blood pressure has decreased from 145 to 110 mm Hg and the heart rate has risen from 72 to 96 beats per minute and the client complains of periodic dizzy spells. The nurse instructs the client to
- A.
  
  Increase fluids that are high in protein
- B.
  
  Restrict fluids
- C.
  
  Force fluids and reassess blood pressure
- D.
  
  Limit fluids to non-caffeine beverages
Correct Answer
C. Force fluids and reassess blood pressure

Explanation
Postural hypotension. a decrease in systolic blood pressure of more than 15 mmHg and an increase in heart rate of more than 15 percent usually accompanied by dizziness indicate volume depletion. inadequate vasoconstrictor mechanisms. and autonomic insufficiency.

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8.

The nurse prepares the client for insertion of a pulmonary artery catheter (Swan-Ganz catheter). The nurse teaches the client that the catheter will be inserted to provide information about:
- A.
  
  Stroke volume
- B.
  
  Cardiac output
- C.
  
  Venous pressure
- D.
  
  Left ventricular functioning
Correct Answer
D. Left ventricular functioning

Explanation
The catheter is placed in the pulmonary artery. Information regarding left ventricular function is obtained when the catheter balloon is inflated.

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9.

A nurse enters a client’s room to discover that the client has no pulse or respirations. After calling for help. the first action the nurse should take is:
- A.
  
  Start a peripheral IV
- B.
  
  Initiate high-quality chest compressions
- C.
  
  Establish an airway
- D.
  
  Obtain the crash cart
Correct Answer
B. Initiate high-quality chest compressions

Explanation
As per new guidelines. the American Heart Association recommends beginning CPR with chest compression (rather than checking for the airway first). Start CPR with 30 chest compressions before checking the airway and giving rescue breaths. Starting with chest compressions first applies to adults. children. and infants needing CPR. but not newborns. CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm.

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10.

A client is receiving digoxin (Lanoxin) 0.25 mg daily. The health care provider has written a new order to give metoprolol (Lopressor) 25 mg B.I.D. In assessing the client prior to administering the medications. which of the following should the nurse report immediately to the health care provider?
- A.
  
  Blood pressure 94/60
- B.
  
  Heart rate 76
- C.
  
  Urine output 50 ml/hour
- D.
  
  Respiratory rate 16
Correct Answer
A. Blood pressure 94/60

Explanation
Both medications decrease the heart rate. Metoprolol affects blood pressure. Therefore. the heart rate and blood pressure must be within normal range (HR 60-100; systolic BP over 100) in order to safely administer both medications.

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Current Version
Aug 22, 2023

Quiz Edited by
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Apr 30, 2017

Quiz Created by
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NCLEX Practice Exam 3 (10 Questions)

A triage nurse has these four (4) clients arrive in the emergency department within 15 minutes. Which client should the triage nurse send back to be seen first?

While planning care for a toddler. the nurse teaches the parents about the expected developmental changes for this age. Which statement by the mother shows that she understands the child’s developmental needs?

The nurse is preparing to administer an enteral feeding to a client via a nasogastric feeding tube. The most important action of the nurse is

The nurse is caring for a client with a serum potassium level of 3.5 mEq/L. The client is placed on a cardiac monitor and receives 40 mEq KCL in 1000 ml of 5% dextrose in water IV. Which of the following EKG patterns indicates to the nurse that the infusions should be discontinued?

A nurse prepares to care for a 4-year-old newly admitted for rhabdomyosarcoma. The nurse should alert the staff to pay more attention to the function of which area of the body?

The nurse anticipates that for a family who practices Chinese medicine the priority goal would be to:

During an assessment of a client with cardiomyopathy. the nurse finds that the systolic blood pressure has decreased from 145 to 110 mm Hg and the heart rate has risen from 72 to 96 beats per minute and the client complains of periodic dizzy spells. The nurse instructs the client to

The nurse prepares the client for insertion of a pulmonary artery catheter (Swan-Ganz catheter). The nurse teaches the client that the catheter will be inserted to provide information about:

A nurse enters a client’s room to discover that the client has no pulse or respirations. After calling for help. the first action the nurse should take is:

A client is receiving digoxin (Lanoxin) 0.25 mg daily. The health care provider has written a new order to give metoprolol (Lopressor) 25 mg B.I.D. In assessing the client prior to administering the medications. which of the following should the nurse report immediately to the health care provider?