1201 - 1250 Solved NCLEX Styled Practical MCQ Test Questions Bank

1201. A client scheduled for a carotid endarterectomy requires insertion of an intra-arterial blood pressure-monitoring device. The nurse plans to perform the Allen test. Which observation indicates patency of the ulnar artery?
A. Blanching of the hand on compression and release of the ulnar artery
B. Muscular twitching of the bicep muscle with use of a tourniquet at the wrist
C. Hand turning pink after the nurse releases the pressure on the ulnar artery
D. Flexion of the wrist when tapping the ulnar artery with a reflex hammer

1202. A client’s chest tube drainage device has continuous bubbling in the water seal chamber. What is the nurse checking for when she clamps different areas of the tube to find out where the bubbling stops?
A. An air leak in the system
B. The suction being too high
C. The suction being too low
D. A tension pneumothorax

1203. The nurse should be particularly alert for which one of the following problems in a client with barbiturate overdose?
A. Oliguria
B. Cardiac tamponade
C. Apnea
D. Hemorrhage

1204. A client taking the drug disulfiram (Antabuse) is admitted to the ER. Which clinical manifestations are most indicative of recent alcohol ingestion?
A. Vomiting, heart rate 120, chest pain
B. Nausea, mild headache, bradycardia
C. Respirations 16, heart rate 62, diarrhea
D. Temp 101°F, tachycardia, respirations 20

1205. A client with cancer and metastasis to the bone is admitted to the hospital. Which symptom of hypercalcemia causes the nurse the most concern?
A. Weakness
B. Anorexia
C. Flaccid muscles
D. Cardiac changes

1206. The nurse expects that a client with cocaine addiction would most likely be placed on which medication?
A. Bromocriptine (Parlodel)
B. Methadone
C. THC
D. Disulfiram (Antabuse)

1207. The nurse is reviewing the laboratory values of a client with a myocardial infarction. Which laboratory test is used to identify injury to the myocardium and can remain elevated for up to three weeks?
A. Total CK
B. CK-MB
C. Myoglobulin
D. Troponin T or I

1208. A client with newly diagnosed epilepsy tells the nurse, “If I keep having seizures, I’m scared my husband will feel differently toward me.” Which response by the nurse would be most appropriate?
A. “You don’t know if you’ll ever have another seizure. Why don’t you wait and see what happens?”
B. “You seem to be concerned that there could be a change in the relationship with your husband.”
C. “You should focus on your children. They need you.”
D. “Let’s see how your husband reacts before getting upset.”

1209. While interviewing a client who abuses alcohol, the nurse learns that the client has experienced “blackouts.” The wife asks what this means. What is the nurse’s best response at this time?
A. “Your husband has experienced short-term memory amnesia.”
B. “Your husband has experienced loss of remote memory.”
C. “Your husband has experienced a loss of consciousness.”
D. “Your husband has experienced a fainting spell.”

1210. Which would the nurse include in the nursing care plan of a client experiencing severe delirium tremens?
A. Placing the client in a darkened room
B. Keeping the closet and bathroom doors closed
C. Administering a diuretic to decrease fluid excess
D. Checking vital signs every eight hours

1211. The nurse is caring for a client admitted with a diagnosis of epilepsy. The client begins to have a seizure. Which action by the nurse is contraindicated?
A. Turning the client to the side-lying position
B. Inserting a padded tongue blade and oral airway
C. Loosening restrictive clothing
D. Removing the pillow and raising padded side rails

1212. A client has been placed on the drug valproic acid (Depakene). Which would indicate to the nurse that the client is experiencing an adverse reaction to this medication?
A. Photophobia
B. Poor skin turgor
C. Lethargy
D. Reported visual disturbances

1213. A client has an order for vancomycin (Vancocin) 1 gram IVPB in 250 mL normal saline to infuse over 60 minutes. The nurse would set the IV drop rate to deliver how many drops per minute if the IV set delivers 15gtts/mL?

Fill in the blank .... Gtts/minute
A. 63 gtts/minute
B. 17 gtts/minute
C. 54 gtts/minute
D. 3 gtts/minute

1214. The nurse is performing fluid resuscitation on a burn client. Which piece of assessment data is the best indicator that it is effective?
A. Respirations 24, unlabored
B. Urine output of 30ml/hr
C. Capillary refill < 4 seconds
D. Apical pulse of 110/min

1215. A client diagnosed with COPD is receiving theophylline (Theodur). Morning laboratory values reveal a theophylline level of 38mcg/mL. Which is the most appropriate nursing action?
A. Take no action; this is within normal range.
B. Notify the physician of the level results.
C. Administer Narcan 2mg IV push stat.
D. Give the client an extra dose of the medication.

1216. A client has suffered a severe electrical burn. Which medication would the nurse expect to have ordered for application to the burned area?
A. Mafenide acetate (Sulfamylon)
B. Silver nitrate
C. Povidone-iodine ointment
D. Silver sulfadiazine (Silvadene)

1217. A client with a head injury develops syndrome of inappropriate antidiuretic hormone (SIADH). Which physician prescription would the nurse question?
A. D5W at 200mL/hr
B. Demeclocycline (Declomycin) 150mg Q6h
C. Daily weights
D. Monitor intake and output

1218. A client with essential tremors has been prescribed the drug primidone (Mysoline). Which of the following will the nurse teach the patient about the drug?
A. Avoid alcohol while taking the drug.
B. The drug causes hyperactivity.
C. The drug can be stopped abruptly without effects.
D. Euphoria is a side effect of taking the drug.

1219. The nurse is caring for a postpartum client two hours post-delivery who is unable to void. Which of the following nursing interventions should be considered first?
A. Insert a straight catheter for residual.
B. Encourage oral intake of fluids.
C. Check perineum for swelling or hematoma.
D. Palpate bladder for distention and position.

1220. A client is admitted to the intensive care unit after falling on an icy sidewalk and striking the right side of the head. An MRI revealed a right-sided epidural hematoma. Which physical force explains the location of the client’s injury?
A. Coup
B. Contrecoup
C. Deceleration
D. Acceleration

1221. The nurse is preparing to teach a client about phenytoin sodium (Dilantin). Which fact would be most important to teach the client regarding why the drug should not be stopped suddenly?
A. Physical dependence can develop over time.
B. Status epilepticus can develop.
C. A hypoglycemic reaction can develop.
D. Heart block can develop.

1222. The nurse on the neurological unit admits a patient with a newly diagnosed amyotrophic lateral sclerosis (ALS) disorder. Which does the nurse expect to assess in this patient?

Select all that apply.
I. Drooling
II. Weakness
III. Spasticity
IV. Diarrhea
V. Depression
VI. Pain
A. I, II, III, V and VI
B. IV only
C. I, II, III, IV and VI
D. All of the Above

1223. A client is admitted with suspected Guillain-Barre syndrome. The nurse would expect the cerebrospinal fluid (CSF) analysis to reveal which of the following to confirm the diagnosis?
A. CSF protein of 10mg/dL and WBC 2 cells/mm3
B. CSF protein of 60mg/dL and WBC 0 cells/mm3
C. CSF protein of 50mg/dL and WBC 20 cells/mm3
D. CSF protein of 5mg/dL and WBC 20 cells/mm3

1224. A client with burns is admitted and fluid resuscitation has begun. The client’s CVP reading is 14cm/H2O. Which evaluation by the nurse would be most accurate?
A. The client has received enough fluid.
B. The client’s fluid status is unaltered.
C. The client has inadequate fluids.
D. The client has a volume excess.

1225. The nurse is working on a neurological unit. If the following events occur simultaneously, which would receive RN priority?
A. A client with a cerebral aneurysm complains of sudden weakness on the right side.
B. A client with a suspected brain tumor complains of a frontal type headache.
C. A client post-op lumbar laminectomy vomits.
D. A client with Guillain-Barré syndrome has a temperature elevation.

1226. The nurse assesses a client’s fundal height every 15 minutes during the first hour postpartum. What should the height of the fundus be during this hour ?
A. 1–2 fingerbreadths under the umbilicus
B. Four fingerbreadths under the umbilicus
C. One fingerbreadth above the umbilicus
D. Four fingerbreadths above the umbilicus

1227. A patient arrives in the ER with a possible Zika virus diagnosis. Which clinical manifestation(s) would the nurse expect the patient to exhibit? Select all that apply.
A. Hypothermia
B. Abdominal pain
C. Waist pain
D. Conjunctivitis

1228. A client with chronic obstructive pulmonary disease (COPD) is admitted to the respiratory unit. Which physician prescription should the nurse question?
A. O2 at 5L/min by nasal cannula
B. Solu Medrol 125mg IV push every six hours
C. Ceftriaxone (Rocephin) 1gram IVPB daily
D. Darvocet N 100 po prn pain

1229. A burn client begins treatments with silver sulfadiazine (Silvadene) applied to the wounds. The nurse should carefully monitor for which adverse affect associated with this drug?
A. Hypokalemia
B. Leukopenia
C. Hyponatremia
D. Thrombocytopenia

1230. The nurse is presenting a workshop on the Zika virus infection. Which is included in the teaching plan?

Select all that apply.
I. The virus is spread primarily by rodent contact.
II. Sexual transmission can spread the virus.
III. The virus can cause brain defects to the fetus of pregnant women.
IV. There is no specific treatment for Zika.
V. Zika virus should be nationally reported.
A. I, III, IV and V
B. II, III, IV and V
C. II and III only
D. II, IV and V only

1231. The nurse is assessing a client for tactile fremitus. Which of the following diagnoses would most likely reveal a decrease in tactile fremitus?
A. Emphysema
B. Bronchial pneumonia
C. Tuberculosis
D. Lung tumor

1232. A client who has been diagnosed with lung cancer is starting a smoking-cessation program. Which of the following drugs would the nurse expect to be included in the program’s plan?
A. Bupropion SR (Zyban)
B. Metaproterenol (Alupent)
C. Oxitropuim (Oxivent)
D. Alprazolam (Xanax)

1233. A client delivered a nine-pound infant two hours ago. The client has an IV of D5W with oxytocin. The nurse determines that the medication is achieving the desired effect when which of the following is assessed?
A. A rise in blood pressure
B. A decrease in pain
C. An increase in lochia rubra
D. A firm uterine fundus

1234. The nurse is evaluating cerebral perfusion outcomes for a client with a subdural hematoma. The nurse evaluates which of the following as a favorable outcome for this client?
A. Arterial blood gas PO2 of 98
B. Increase in lethargy
C. Pupils slow to react to light
D. Temperature of 101°F

1235. The nurse is caring for a client with a chronic airway disease. Which of the associated disorders has changes that are reversible?
A. Bronchiectasis
B. Emphysema
C. Asthma
D. Chronic bronchitis

1236. A client experienced a major burn over 55% of his body 36 hours ago. The client is restless and anxious, and states, “I am in pain.” There is a physician prescription for intravenous morphine. What should the nurse do first?
A. Administer the morphine.
B. Assess respirations.
C. Assess urine output.
D. Check serum potassium levels.

1237. The nurse is caring for a client seven days post-burn injury with 60% body surface area involved. What should be the primary focus of nursing care during this time period?
A. Meticulous infection-control measures
B. Fluid-replacement evaluation
C. Psychological adjustment to the wound
D. Measurement and application of a pressure garment

1238. The nurse is preparing a teaching plan for a client beginning external radiation treatments. Which of the following will be included in the teaching plan?

Select all that apply.
I. Space activities with rest periods.
II. Avoid spicy and hot foods.
III. Expose radiated areas to sunlight daily.
IV. Wash the skin with plain water.
V. Expect to have difficulty swallowing.
A. III only
B. IV and V only
C. I, II, and IV
D. All of the Above

1239. The nurse is performing discharge teaching for a client after a cardiac catheterization. Which statement by the client indicates a need for further teaching?
A. “I should not bend, strain, or lift heavy objects for one day.”
B. “If bleeding occurs, I should place an ice bag on the site for 10 minutes.”
C. “I need to call the doctor if my temperature goes above 101°F.”
D. “I should talk to the doctor to find out when I can go back to work.”

1240. A burn client is in the acute phase of burn care. The nurse assesses jugular vein distention, edema, urine output of 20 mL in two hours, and crackles on auscultation. Which order would the nurse anticipate from the physician?
A. Furosemide (Lasix) 40 mg IV push
B. Irrigate the Foley catheter
C. Increase the IV fluids to 200mL/hr
D. Place the client in Trendelenburg position

1241. The nurse is suctioning a tracheostomy, what is the maximum suction pressure the nurse should use?
A. 120mmHg
B. 145mmHg
C. 160mmHg
D. 185mmHg

1242. A client admitted with transient ischemia attacks has returned from a cerebral arteriogram. The nurse performs an assessment and finds a newly formed hematoma in the right groin area. What is the nurse’s initial action?
A. Apply direct pressure to the site.
B. Check the pedal pulses on the right leg.
C. Notify the physician.
D. Turn the client to the prone position.

1243. The nurse is assessing an ECG strip of a 42-year-old client and finds a regular rate greater than 100, a normal QRS complex, a normal P wave in front of each QRS, a PR interval between 0.12 and 0.20 seconds, and a P: QRS ratio of 1:1. What is the nurse’s interpretation of this rhythm?
A. Premature atrial complex
B. Sinus tachycardia
C. Atrial flutter
D. Supraventricular tachycardia

1244. A nurse is caring for a client in the critical care unit who is complaining of chest pain. Nursing assessment reveals a BP of 78/40, shortness of breath, and third-degree AV block on the heart monitor. What is the most appropriate initial action?
A. Provide trancutaneous pacing.
B. Turn the client on his side.
C. Reassess the blood pressure.
D. Consult with cardiology.

1245. The nurse is discussing cigarette smoking with an emphysema client. The client states, “I don’t know why I should worry about smoking.” The nurse’s response is based on the fact that smoking has which of the following negative effects to the emphysematous lung?
A. Affects peripheral blood vessels
B. Causes vasoconstriction to occur
C. Destroys the lung parenchyma
D. Paralyzes ciliary activity

1246. The nurse is caring for a client admitted with congestive heart failure. Which finding would the nurse expect if the failure was on the right side of the heart?
A. Jugular vein distention
B. Dry, nonproductive cough
C. Dyspneic when supine
D. Crackles on chest auscultation

1247. A client with chest pain is scheduled for a heart catheterization. Which of the following would the nurse include in the client’s care plan?
A. Keep the client NPO for 12 hours afterward.
B. Inform the client that general anesthesia will be administered throughout the procedure.
C. Assess the site for bleeding or hematoma once per shift.
D. Instruct the client that he might be asked to cough and breathe deeply during the procedure.

1248. The nurse is caring for a COPD client who is discharged on p.o. Theophylline. Which of the following statements by the client would indicate a correct understanding of discharge instructions?
A. “A slow, regular pulse could be a side effect.”
B. “Take the pill with antacid or milk and crackers.”
C. “The doctor might order it intravenously if symptoms worsen.”
D. “Hold the drug if symptoms decrease.”

1249. The nurse has just admitted a client with emphysema. Arterial blood gas results indicate hypoxia. Which physician prescription would the nurse implement for the best improvement in the client’s hypoxia?
A. Elevate the head of the bed 45°.
B. Encourage diaphragmatic breathing.
C. Initiate an Alupent nebulizer treatment.
D. Start O2 at 2L/min.

1250. The nurse is assessing the chart of a client with a stroke. MRI results reveal a hemorrhagic stroke to the brain. Which physician prescription would the nurse question?
A. Normal saline IV at 50mL/hr
B. O2 at 3L/min by nasal cannula
C. Heparin infusion per pharmacist protocol
D. Insert a Foley catheter to bedside drainage