NCLEX Practice Test 3

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Quizzes Created: 3 | Total Attempts: 451
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NCLEX Practice Exam Quizzes & Trivia

Questions and Answers
  • 1. 

    1. A patient is admitted to the hospital with a diagnosis of primary hyperparathyroidism. A nurse checking the patient's lab results would expect which of the following changes in laboratory findings? 

    • A. 

      A. Elevated serum calcium.

    • B. 

      B. Low serum parathyroid hormone (PTH).

    • C. 

      C. Elevated serum vitamin D.

    • D. 

      D. Low urine calcium.

    Correct Answer
    A. A. Elevated serum calcium.
    Explanation
    In primary hyperparathyroidism, there is an overproduction of parathyroid hormone (PTH) by the parathyroid glands. PTH increases the release of calcium from the bones into the bloodstream and enhances the reabsorption of calcium by the kidneys. As a result, there is an elevated level of serum calcium in the blood. Therefore, option A is the correct answer.

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  • 2. 

    2. A patient with Addison's disease asks a nurse for nutrition and diet advice. Which of the following diet modifications is NOT recommended? 

    • A. 

      A. A diet high in grains.

    • B. 

      B. A diet with adequate caloric intake.

    • C. 

      C. A high protein diet.

    • D. 

      D. A restricted sodium diet.

    Correct Answer
    D. D. A restricted sodium diet.
    Explanation
    A patient with Addison's disease has a deficiency in adrenal hormones, specifically cortisol and aldosterone. Cortisol helps regulate blood pressure and sodium levels, while aldosterone helps regulate sodium and potassium levels. Therefore, a restricted sodium diet is not recommended because it can further lower sodium levels in the body, potentially leading to low blood pressure and electrolyte imbalances.

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  • 3. 

    3. A patient with a history of diabetes mellitus is in the second post-operative day following cholecystectomy. She has complained of nausea and isn't able to eat solid foods. The nurse enters the room to find the patient confused and shaky. Which of the following is the most likely explanation for the patient's symptoms? 

    • A. 

      A. Anesthesia reaction.

    • B. 

      B. Hyperglycemia.

    • C. 

      Hypoglycemia

    • D. 

      D. Diabetic ketoacidosis.

    Correct Answer
    C. Hypoglycemia
    Explanation
    The patient's symptoms of confusion and shakiness are consistent with hypoglycemia, which is low blood sugar. Since the patient has a history of diabetes mellitus, it is possible that her blood sugar levels have dropped too low, leading to these symptoms. Anesthesia reaction is less likely as the symptoms are more specific to hypoglycemia. Hyperglycemia and diabetic ketoacidosis would present with different symptoms such as increased thirst, frequent urination, and high blood sugar levels. Therefore, hypoglycemia is the most likely explanation for the patient's symptoms.

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  • 4. 

    4. A nurse assigned to the emergency department evaluates a patient who underwent fiberoptic colonoscopy 18 hours previously. The patient reports increasing abdominal pain, fever, and chills. Which of the following conditions poses the most immediate concern? 

    • A. 

      A. Bowel perforation.

    • B. 

      B. Viral gastroenteritis.

    • C. 

      C. Colon cancer.

    • D. 

      D. Diverticulitis.

    Correct Answer
    A. A. Bowel perforation.
    Explanation
    The symptoms of increasing abdominal pain, fever, and chills after fiberoptic colonoscopy suggest a potential complication, such as bowel perforation. Bowel perforation is a serious condition that requires immediate medical attention as it can lead to peritonitis and sepsis. Viral gastroenteritis, colon cancer, and diverticulitis may cause abdominal pain, but they are not typically associated with fever and chills immediately after a colonoscopy.

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  • 5. 

    5. A patient is admitted to the same day surgery unit for liver biopsy. Which of the following laboratory tests assesses coagulation? 

    • A. 

      A. Partial thromboplastin time.

    • B. 

      B. Prothrombin time.

    • C. 

      C. Platelet count.

    • D. 

      D. Hemoglobin

    Correct Answer
    A. A. Partial thromboplastin time.
    Explanation
    A,B, and C are correct

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  • 6. 

    6. A nurse is assessing a clinic patient with a diagnosis of hepatitis A. Which of the following is the most likely route of transmission? 

    • A. 

      A. Sexual contact with an infected partner.

    • B. 

      B. Contaminated food.

    • C. 

      C. Blood transfusion.

    • D. 

      D. Illegal drug use.

    Correct Answer
    B. B. Contaminated food.
    Explanation
    Hepatitis A is primarily transmitted through the fecal-oral route, which means that it is most commonly spread through contaminated food or water. This can occur when food or water is contaminated with the feces of an infected person. Sexual contact with an infected partner, blood transfusion, and illegal drug use are not typical routes of transmission for hepatitis A.

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  • 7. 

    7. A leukemia patient has a relative who wants to donate blood for transfusion. Which of the following donor medical conditions would prevent this? 

    • A. 

      A. A history of hepatitis C five years previously.

    • B. 

      B. Cholecystitis requiring cholecystectomy one year previously.

    • C. 

      C. Asymptomatic diverticulosis.

    • D. 

      D. Crohn's disease in remission.

    Correct Answer
    A. A. A history of hepatitis C five years previously.
    Explanation
    A history of hepatitis C five years previously would prevent the relative from donating blood for transfusion because hepatitis C is a viral infection that can be transmitted through blood transfusion. Even if the relative's infection is no longer active, there is still a risk of residual virus in their blood, which could potentially infect the leukemia patient. Therefore, it is important to exclude individuals with a history of hepatitis C from donating blood to ensure the safety of the recipient.

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  • 8. 

    8. A physician has diagnosed acute gastritis in a clinic patient. Which of the following medications would be contraindicated for this patient? 

    • A. 

      A. Naproxen sodium (Naprosyn).

    • B. 

      B. Calcium carbonate.

    • C. 

      C. Clarithromycin (Biaxin).

    • D. 

      D. Furosemide (Lasix).

    Correct Answer
    A. A. Naproxen sodium (Naprosyn).
    Explanation
    Naproxen sodium (Naprosyn) would be contraindicated for a patient diagnosed with acute gastritis because it is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the stomach lining and worsen the inflammation and symptoms of gastritis. NSAIDs can increase the risk of gastrointestinal bleeding and ulcers, which is why they should be avoided in patients with gastritis. Calcium carbonate, clarithromycin, and furosemide do not have the same irritating effects on the stomach and would not be contraindicated for this patient.

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  • 9. 

    9. The nurse is conducting nutrition counseling for a patient with cholecystitis. Which of the following information is important to communicate? 

    • A. 

      A. The patient must maintain a low calorie diet.

    • B. 

      B. The patient must maintain a high protein/low carbohydrate diet.

    • C. 

      C. The patient should limit sweets and sugary drinks.

    • D. 

      D. The patient should limit fatty foods.

    Correct Answer
    D. D. The patient should limit fatty foods.
    Explanation
    The correct answer is D. The patient should limit fatty foods. Cholecystitis is inflammation of the gallbladder, and fatty foods can trigger symptoms such as pain and discomfort in patients with this condition. Limiting fatty foods can help reduce the workload on the gallbladder and alleviate symptoms.

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  • 10. 

    10. A patient admitted to the hospital with myocardial infarction develops severe pulmonary edema. Which of the following symptoms should the nurse expect the patient to exhibit? 

    • A. 

      A. Slow, deep respirations.

    • B. 

      B. Stridor.

    • C. 

      C. Bradycardia.

    • D. 

      D. Air hunger.

    Correct Answer
    D. D. Air hunger.
    Explanation
    A patient with severe pulmonary edema is likely to exhibit symptoms of air hunger. This is because pulmonary edema is the accumulation of fluid in the lungs, which can lead to difficulty breathing and a sensation of not getting enough air. Slow, deep respirations (option A) are not typically seen in pulmonary edema, as the patient may be struggling to breathe. Stridor (option B) is a high-pitched sound that occurs with upper airway obstruction, not pulmonary edema. Bradycardia (option C) refers to a slow heart rate, which is not directly related to pulmonary edema.

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  • 11. 

    11. A nurse caring for several patients on the cardiac unit is told that one is scheduled for implantation of an automatic internal cardioverter-defibrillator. Which of the following patients is most likely to have this procedure? 

    • A. 

      A. A patient admitted for myocardial infarction without cardiac muscle damage.

    • B. 

      B. A post-operative coronary bypass patient, recovering on schedule.

    • C. 

      C. A patient with a history of ventricular tachycardia and syncopal episodes.

    • D. 

      D. A patient with a history of atrial tachycardia and fatigue.

    Correct Answer
    C. C. A patient with a history of ventricular tachycardia and syncopal episodes.
    Explanation
    A patient with a history of ventricular tachycardia and syncopal episodes is most likely to have an implantation of an automatic internal cardioverter-defibrillator. Ventricular tachycardia is a potentially life-threatening arrhythmia that can lead to sudden cardiac arrest. Syncopal episodes indicate that the patient has experienced loss of consciousness, which could be due to the arrhythmia. An automatic internal cardioverter-defibrillator is a device that can detect and treat dangerous arrhythmias by delivering an electric shock to restore normal heart rhythm. Therefore, this patient would benefit the most from this procedure to prevent future cardiac events.

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  • 12. 

    12. A patient is scheduled for a magnetic resonance imaging (MRI) scan for suspected lung cancer. Which of the following is a contraindication to the study for this patient? 

    • A. 

      A. The patient is allergic to shellfish.

    • B. 

      B. The patient has a pacemaker.

    • C. 

      C. The patient suffers from claustrophobia.

    • D. 

      D. The patient takes anti-psychotic medication.

    Correct Answer
    B. B. The patient has a pacemaker.
    Explanation
    A pacemaker is a contraindication for an MRI scan because the strong magnetic fields and radio waves used in an MRI can interfere with the functioning of the pacemaker, potentially causing harm to the patient.

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  • 13. 

    13. A nurse calls a physician with the concern that a patient has developed a pulmonary embolism. Which of the following symptoms has the nurse most likely observed? 

    • A. 

      A. The patient is somnolent with decreased response to the family.

    • B. 

      B. The patient suddenly complains of chest pain and shortness of breath.

    • C. 

      C. The patient has developed a wet cough and the nurse hears crackles on auscultation of the lungs.

    • D. 

      D. The patient has a fever, chills, and loss of appetite.

    Correct Answer
    B. B. The patient suddenly complains of chest pain and shortness of breath.
    Explanation
    The nurse most likely observed the patient suddenly complaining of chest pain and shortness of breath. This is indicative of a pulmonary embolism, as it is a common symptom. A pulmonary embolism occurs when a blood clot travels to the lungs and blocks the blood flow. This can cause chest pain and difficulty in breathing. The other options do not align with the symptoms of a pulmonary embolism.

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  • 14. 

    14. A patient comes to the emergency department with abdominal pain. Work-up reveals the presence of a rapidly enlarging abdominal aortic aneurysm. Which of the following actions should the nurse expect? 

    • A. 

      A. The patient will be admitted to the medicine unit for observation and medication.

    • B. 

      B. The patient will be admitted to the day surgery unit for sclerotherapy.

    • C. 

      C. The patient will be admitted to the surgical unit and resection will be scheduled.

    • D. 

      D. The patient will be discharged home to follow-up with his cardiologist in 24 hours.

    Correct Answer
    C. C. The patient will be admitted to the surgical unit and resection will be scheduled.
    Explanation
    The correct answer is C because a rapidly enlarging abdominal aortic aneurysm is a surgical emergency. Immediate intervention is required to prevent rupture and potentially fatal complications. The patient will be admitted to the surgical unit for further evaluation and a resection procedure will be scheduled to repair or remove the aneurysm. Observation and medication (option A) or sclerotherapy (option B) are not appropriate management options for a rapidly enlarging abdominal aortic aneurysm. Discharging the patient home (option D) would be unsafe and could lead to a life-threatening situation.

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  • 15. 

    15. A patient with leukemia is receiving chemotherapy that is known to depress bone marrow. A CBC (complete blood count) reveals a platelet count of 25,000/microliter. Which of the following actions related specifically to the platelet count should be included on the nursing care plan? 

    • A. 

      A. Monitor for fever every 4 hours.

    • B. 

      B. Require visitors to wear respiratory masks and protective clothing.

    • C. 

      C. Consider transfusion of packed red blood cells.

    • D. 

      D. Check for signs of bleeding, including examination of urine and stool for blood.

    Correct Answer
    D. D. Check for signs of bleeding, including examination of urine and stool for blood.
    Explanation
    A platelet count of 25,000/microliter indicates severe thrombocytopenia, which increases the risk of bleeding. Checking for signs of bleeding, including examining urine and stool for blood, is important in monitoring the patient's condition and detecting any potential bleeding. Monitoring for fever (option A) is not directly related to the platelet count. Requiring visitors to wear respiratory masks and protective clothing (option B) is not necessary for platelet count monitoring. Transfusion of packed red blood cells (option C) is not indicated for thrombocytopenia.

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  • 16. 

    16. A nurse in the emergency department is observing a 4-year-old child for signs of increased intracranial pressure after a fall from a bicycle, resulting in head trauma. Which of the following signs or symptoms would be cause for concern? 

    • A. 

      A. Bulging anterior fontanel.

    • B. 

      B. Repeated vomiting.

    • C. 

      C. Signs of sleepiness at 10 PM.

    • D. 

      D. Inability to read short words from a distance of 18 inches.

    Correct Answer
    B. B. Repeated vomiting.
    Explanation
    Repeated vomiting after a head trauma in a child is a cause for concern as it can be a sign of increased intracranial pressure. Increased intracranial pressure can occur due to bleeding or swelling in the brain, and can be life-threatening if not promptly treated. Therefore, the nurse should closely monitor the child for this symptom and report it to the healthcare provider. The other options, such as bulging anterior fontanel, signs of sleepiness at 10 PM, and inability to read short words from a distance of 18 inches, may not necessarily indicate increased intracranial pressure and may have other explanations.

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  • 17. 

    17. A nonimmunized child appears at the clinic with a visible rash. Which of the following observations indicates the child may have rubeola (measles)? 

    • A. 

      A. Small blue-white spots are visible on the oral mucosa.

    • B. 

      B. The rash begins on the trunk and spreads outward.

    • C. 

      C. There is low-grade fever.

    • D. 

      D. The lesions have a "tear drop on a rose petal" appearance.

    Correct Answer
    A. A. Small blue-white spots are visible on the oral mucosa.
    Explanation
    The presence of small blue-white spots on the oral mucosa is a characteristic sign of rubeola (measles). This is known as Koplik spots and is a specific feature of measles. The rash of measles typically starts on the face and spreads downward to the trunk and extremities. Low-grade fever is also commonly associated with measles. However, the "tear drop on a rose petal" appearance of lesions is not a characteristic finding of measles.

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  • 18. 

    18. A child is seen in the emergency department for scarlet fever. Which of the following descriptions of scarlet fever is NOT correct? 

    • A. 

      A. Scarlet fever is caused by infection with group A Streptococcus bacteria.

    • B. 

      B. "Strawberry tongue" is a characteristic sign.

    • C. 

      C. Petechiae occur on the soft palate.

    • D. 

      D. The pharynx is red and swollen.

    Correct Answer
    C. C. Petechiae occur on the soft palate.
    Explanation
    Scarlet fever is a bacterial infection caused by group A Streptococcus bacteria. It is characterized by symptoms such as a red and swollen pharynx, a characteristic sign known as "strawberry tongue," and the presence of petechiae, which are small red or purple spots, on the skin. However, petechiae do not occur on the soft palate, making option C incorrect.

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  • 19. 

    19. A child weighing 30 kg arrives at the clinic with diffuse itching as the result of an allergic reaction to an insect bite. Diphenhydramine (Benadryl) 25 mg 3 times a day is prescribed. The correct pediatric dose is 5 mg/kg/day. Which of the following best describes the prescribed drug dose? 

    • A. 

      A. It is the correct dose.

    • B. 

      B. The dose is too low.

    • C. 

      C. The dose is too high.

    • D. 

      D. The dose should be increased or decreased, depending on the symptoms.

    Correct Answer
    B. B. The dose is too low.
    Explanation
    The correct pediatric dose for Diphenhydramine is 5 mg/kg/day. In this case, the child weighs 30 kg, so the correct dose would be 150 mg/day (30 kg x 5 mg/kg/day). However, the prescribed dose is only 25 mg 3 times a day, which amounts to only 75 mg/day. Therefore, the prescribed dose is too low and should be increased to reach the correct dosage.

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  • 20. 

    20. The mother of a 2-month-old infant brings the child to the clinic for a well baby check. She is concerned because she feels only one testis in the scrotal sac. Which of the following statements about the undescended testis is the most accurate? 

    • A. 

      A. Normally, the testes are descended by birth.

    • B. 

      B. The infant will likely require surgical intervention.

    • C. 

      C. The infant probably has with only one testis.

    • D. 

      D. Normally, the testes descend by one year of age.

    Correct Answer
    D. D. Normally, the testes descend by one year of age.
    Explanation
    Normally, the testes descend into the scrotum by one year of age. It is not uncommon for one or both testes to be undescended at birth, but they usually descend on their own within the first year. Surgical intervention is not typically necessary unless the testes have not descended by one year of age. The presence of only one testis in the scrotal sac is not necessarily indicative of a problem, as it is possible for one testis to be undescended while the other has descended normally.

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