NURSING CAREER & JOBS: July 2008

NCLEX Study Tips

If you are going to prepare for taking the NCLEX exam and still don't know what to do i would like to share some effective advices for you.

Picking review courses:

the best choice for review courses is Kaplan or NCSBN (National Council State Boards of Nursing). Kaplan teaches effective techniques on how to answer exam questions with ease and teaches you to land with the correct answer.

NCSBN sure is another top choice for review course because the contents are very close to the actual exam itself.

Never Cram

Cramming is never effective in preparing for the NCLEX. Give yourself at least 3 months to study for the exam.

References

Lipincott is known to be the best review book for preparing yourself for the exam.
Some naysayers say that the NCLEX structured questions are based on lipincott.

Do alot of practice testing and never sleep late before the exam day. Just relax you will do fine. NCLEX could be re-taken after 91 days from taking the first exam.

How To Apply For NCLEX Testing

Here are the guidelines on how to apply for NCLEX Testing in the US:

In order to receive a US nursing license, you must pick a state, complete the application and meet their requirements and if they find you eligible, you will have to undergo testing also commonly known as NCLEX, before you can work as an RN in the USA.

Each State Nursing Board has its own fee schedule and specific requirements (e.g. CGFNS, CES, TOEFL, TSE)
The time it takes to approve your credentials and process your application varies from state to state.

All nurses must pass NCLEX .

The Board will supply you with an NCLEX application which could be downlowded in their webpages.

The current fee to register with NCLEX is $200 and you must indicate at the time of application which Board you've chosen.Processing times vary from state to state from (4-16 weeks)

After you have met the requirements, been approved by the Board and applied for NCLEX you will be issued an ATT (Authorization to Test) and can schedule your NCLEX exam at your convinience.

You must have an ATT before you can to take the exam.

The NCLEX exam can be scheduled anywhere in the US or it's territories, and other countries like the Philippines and Hong Kong and is offered year-round.

You do not have to take the NCLEX exam in the State where you applied.

At some testing centers the appointments go very quickly so plan to schedule your appointment early.

US Boards Of Nursing For NCLEX Application

Hospital Job Listings For Nurses In Florida

Hospital Nursing Jobs in Florida

Atlantis
JFK Medical Center
Boca Raton
Boca Raton Community Hospital
Boynton Beach
Bethesda Memorial Hospital
Clearwater
Morton Plant Mease Health Care
Daytona Beach
Halifax Hospital Medical Center
Greater Ft. Lauderdale
North Broward Hospital District
Gainesville
Shands Hospital (University of Florida)
Hollywood
Memorial Healthcare Systems
Jacksonville
Mayo Clinics & Medical Center
Martin/St. Lucie Co.
Martin Memorial Health System
Miami
Kernan Hospital
Miami
Miami Heart Institute
Miami
Miami Childrens Hospital
Miami Beach
Mount Sinai Medical Center of Greater Miami
Naples
Naples Community & North Collier Hospitals
Orlando
Orlando Regional Healthcare System
Orlando
Florida Hospital Medical Centers
Orlando
Kernan Hospital
Pensacola
Sacred Heart Hospital
Sarasota
Sarasota Memorial Hospital
Sebring
Florida Hospital Heartland Division
St. Petersburg
All Children's Hospital
St. Petersburg
Bayfront Medical Center
Tallahassee
Tallahassee Memorial Reg. Medical Center
Titusville
Parrish Medical Center
Vero Beach
Indian River Memorial Hospital
Wauchula
Florida Institute for Neurologic Rehabilitation, Inc.

Hospital Job Listings For Nurses In Texas

Hospital Nursing Jobs in Texas

Amarillo
Baptist St. Anthony's Health System
Amarillo
Northwest Texas Healthcare System
Austin
Austin State Hospital
Austin
Seton Medical Center
Dallas
Baylor Health Care System
Dallas
Children's Medical Center
Dallas
Parkland Memorial Hospital
Galveston
University of Texas Medical Branch
Graham
Graham General Hospital
Harlingen
Valley Baptist Medical Center
Houston
Memorial Healthcare System
Houston
Methodist Health Care System
Houston
Saint Luke's Episcopal Hospital
Houston
Shriners Hospitals for Children
Houston
University of Texas M.D. Anderson Cancer Center
Humble
Northeast Medical Center Hospital
Longview
Good Shepherd Medical Center
Nacogdoches
Nacogdoches Medical Center
Paris
Paris Regional Medical Center
Richmond
Polly Ryon Memorial Hospital
San Angelo
Shannon Health System
San Antonio
Methodist Healthcare System of San Antonio
San Antonio
University of Texas Health Sciences Center
Temple
Scott and White Memorial Hospital
Tyler
Trinity Mother Frances Health System
Waco
Hillcrest Health System
Waco
Providence Medical

Hospital Job Listings For Nurses In California

These are city listings of Hospitals around California. Check out the links for job listings specific for each hopitals.

Alameda
Alameda Hospital
Bay Area
Seton Medical Center
Berkeley
Alta Bates Medical Center
Davis
University of California Davis Medical Center
Covina
Citrus Valley Health Partners
Duarte
City of Hope
Encino
Encino-Tarzana Regional Medical Center
Fresno
Saint Agnes Medical Center
Glendale
Glendale Memorial Hospital and Health Center
Lakeport
Sutter Lakeside Hospital
Lakewood
Lakewood Regional Medical Center
Lancaster
Antelope Valley Hospital
Loma Linda
Loma Linda University Children's Hospital
Loma Linda
Loma Linda University Medical Center
Los Alamitos
Los Alamitos Medical Center
Los Angeles
Barlow Respiratory Hospital
Los Angeles
California Hospital Medical Center
Los Angeles
Cedars-Sinai Medical Center
Los Angeles
Good Samaritan Hospital
Los Angeles
UCLA Medical Center
Los Angeles
Century City Hospital
Los Gatos
Community Hospital of Los Gatos
Mammoth Lakes
Mammoth Hospital
Mission Viejo
Mission Hospital Regional Medical Center
Montebello
Beverly Hospital
Monterey
Community Hospital of the Monterey Penisula
Monterey Park
Garfield Medical Center
Moss Beach
Seton Medical Center Coastside
Newport Beach
Hoag Memorial Hospital Presbyterian
Oakland
Summit Medical Center
Orange County
Children's Hospital of Orange County
Palo Alto
Lucile Salter Packard Children's Hospital at Stanford
Placentia
Placentia Linda Hospital
Rancho Mirage
Eisenhower Medical Center
Redding
Mercy Medical Center
Redding
Redding Medical Center
Salinas
Natividad Medical Center
San Diego
Alvarado Hospital Medical Center
San Diego
Children's Hospital and Health Center
San Diego
Palomar Pomerado Health System
San Diego
ScrippsHealth
San Diego
Sharp HealthCare
San Francisco
Saint Francis Memorial Hospital
San Francisco
St. Mary's Medical Center
San Francisco
UCSF Stanford Healthcare
San Gabriel
San Gabriel Valley Medical Center
Santa Barbara
Cottage Hospital
Santa Barbara
Lompoc Healthcare District
Sherman Oaks
Sherman Oaks Hospital and Health Center
Sonoma
Sonoma Valley Hospital
Stockton
Saint Joseph's Medical Center
Truckee
Tahoe Forest Hospital
Turlock
Emanuel Medical Center
Upland
San Antonio Community Hospital
Visalia
Kaweah Delta District Hospital

LVN Nursing Jobs In California

LVN, part time (Torrance)
Dependable, LVN needed one day a week (Tuesdays) 8:30am-12:30pm to administer an IV to patients needing CT scans. Private practice. Great work environment and pay. For immediate consideration, please e-mail or fax resume to 949-642-3202

Vocational Nurse Instructors (North Hollywood, CA)
Concorde Career Colleges, Inc. is a nationally recognized, for-profit education company that provides career training in the field of allied health. We currently have full time and part time openings at our North Hollywood, CA campus to teach Vocational Nursing.

Candidates must possess the following:
- Current and active RN license in the state of California
- Must have one of the following: Bachelor’s degree from an accredited school, valid teaching credential, completed a minimum of 1 year full time teaching in a state accredited or approved RN program, or met community college or state university teaching requirements in California
- Minimum 3 years clinical experience as an RN in the last 5 years
- Teaching experience preferred

For more then 30 years, Concorde Career Colleges, Inc. has prepared thousands of people for rewarding careers. . We specialize in education with a sharply defined purpose. Our goal is to concentrate instruction on developing high-demand job capabilities. With 12 campuses across the United States, Concorde is among the very best post-secondary career training institutions in the country. Within every department of the organization, Concorde associates work toward a mutual mission: delivering quality allied health education and training that enhances the lives of our students and the communities they serve. EOE/M/F/D/V

Notice of Availability of the Campus Security Program and Annual Report. This report includes statistics for the previous three years concerning reported crimes that occurred on or near buildings or property owned or controlled by Concorde Career Colleges, Inc. The report also includes institutional policies concerning campus security, such as policies concerning sexual assault, and other matters. You can obtain a copy of this report by contacting the Campus President at the Concorde Career Colleges, Inc. campus location or accessing the following web site: http://www.concorde.edu/campussecurity.asp

LVN's NEEDED for WEEKENDs (12 Hour Shifts) (SFV, Santa Monica, LA)
We currently have many cases that all need LVN's for 12 hour shifts, 7p-7a on the weekends. Also full-time or part-time cases during the week as well.

The cases are in Los Angeles and the San Fernando Valley. They all involve G-Tubes and Trache care, mostly for pediatric patients.

If you are an LVN, RN or CHHA looking for work, we also have other shift and cases available all over Los Angeles and the San Fernando Valley.

Please call Ronit for more information at 818.345.1111 or you can email at:
bshokri@fantasiahealthcare.com

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Free NCLEX-RN Sample Test Questions For Nursing Review (Pharmacology Set 2)

A nurse is assigned to perform well-child assessments at a day care center. A staff member interrupts the examinations to ask for assistance. They find a crying 3 year-old child on the floor with mouth wide open and gums bleeding. Two unlabeled open bottles lie nearby. The nurse's first action should be
A) call the poison control center, then 911
B) administer syrup of Ipecac to induce vomiting
C) give the child milk to coat her stomach
D) ask the staff about the contents of the bottles

Review Information: The correct answer is D: ask the staff about the contents of the bottles
The nurse needs to assess what the child ingested before determining the next action. Once the substance is identified, the poison control center and emergency response team should be called.

Question 2
A client with atrial fibrillation is receiving digoxin (Lanoxin). Which of these assessments is most important for the nurse to perform?
A) Monitor blood pressure every 4 hours
B) Measure apical pulse prior to administration
C) Maintain accurate intake and output records
D) Record an EKG strip after administration

Review Information: The correct answer is B: Measure apical pulse prior to administration
Digitoxin decreases conduction velocity through the AV node and prolongs the refractory period. If the apical heart rate is less than 60 beats/minute, withhold the drug. The apical pulse should be taken with a stethoscope so that there will be no mistake about what the heart rate actually is.

Question 3
The nurse is administering an intravenous vesicant chemotherapeutic agent to a client. Which assessment would require the nurse's immediate action?
A) Stomatitis lesion in the mouth
B) Severe nausea and vomiting
C) Complaints of pain at site of infusion
D) A rash on the client's extremities

Review Information: The correct answer is C: Complaints of pain at site of infusion
A vesicant is a chemotherapeutic agent capable of causing blistering of tissues and possible tissue necrosis if there is extravasation. These agents are irritants which cause pain along the vein wall, with or without inflammation.

Question 4
The nurse practicing in a long term care facility recognizes that elderly clients are at greater risk for drug toxicity than younger adults because of which of the following physiological changes of advancing age?
A) Drugs are absorbed more readily from the GI tract
B) Elders have less body water and more fat
C) The elderly have more rapid hepatic metabolism
D) Older people are often malnourished and anemic

Review Information: The correct answer is B: Elders have less body water and more fat
Because elderly persons have decreased lean body tissue/water in which to distribute medications, more drug remains in the circulatory system with potential for drug toxicity. Increased body fat results in greater amounts of fat-soluble drugs being absorbed, leaving less in circulation, thus increasing the duration of action of the drug

Question 5
The nurse is assessing a client who is on long term glucocorticoid therapy. Which of the following findings would the nurse expect?
A) Buffalo hump
B) Increased muscle mass
C) Peripheral edema
D) Jaundice

Review Information: The correct answer is A: Buffalo hump
With high doses of glucocorticoid, iatrogenic Cushing''s syndrome develops. The exaggerated physiological action causes abnormal fat distribution which results in a moon-shaped face, a intrascapular pad on the neck (buffalo hump) and truncal obesity with slender limbs.

Question 6
The health care provider has written "Morphine sulfate 2 mgs IV every 3-4 hours prn for pain" on the chart of a child weighing 22 lb. (10 kg). What is the nurse's initial action?
A) Check with the pharmacist
B) Hold the medication and contact the provider
C) Administer the prescribed dose as ordered
D) Give the dose every 6-8 hours

Review Information: The correct answer is B: Hold the medication and contact the provider
The usual pediatric dose of morphine is 0.1 mg/kg every 3 to 4 hours. At 10 kg, this child typically should receive 1.0 mg every 3 to 4 hours.

Question 7
A client is ordered atropine to be administered preoperatively. Which physiological effect should the nurse monitor for?
A) Elevate blood pressure
B) Drying up of secretions
C) Reduce heart rate
D) Enhance sedation

Review Information: The correct answer is B: Drying up of secretions
Atropine dries secretions which may get in the way during the operative procedure.

Question 8
A client is receiving digitalis. The nurse should instruct the client to report which of the following side effects?
A) Nausea, vomiting, fatigue
B) Rash, dyspnea, edema
C) Polyuria, thirst, dry skin
D) Hunger, dizziness, diaphoresis

Review Information: The correct answer is A: Nausea, vomiting, fatigue
Side effects of digitalis toxicity include fatigue, nausea, vomiting, anorexia, and bradycardia. Digitalis inhibits the sodium potassium ATPase, which makes more calcium available for contractile proteins, resulting in increased cardiac output.

Question 9
A client is receiving dexamethasone (Decadron) therapy. What should the nurse plan to monitor in this client?
A) Urine output every 4 hours
B) Blood glucose levels every 12 hours
C) Neurological signs every 2 hours
D) Oxygen saturation every 8 hours

Review Information: The correct answer is B: Blood glucose levels every 12 hours
The drug Decadron increases glycogenesis. This may lead to hyperglycemia. Therefore the blood sugar level and acetone production must be monitored.

Question 10
The nurse is caring for a client with schizophrenia who has been treated with quetiapine (Seroquel) for 1 month. Today the client is increasingly agitated and complains of muscle stiffness. Which of these findings should be reported to the health care provider?
A) Elevated temperature and sweating.
B) Decreased pulse and blood pressure.
C) Mental confusion and general weakness.
D) Muscle spasms and seizures.

Review Information: The correct answer is A: Elevated temperature and sweating.
Neuroleptic malignant syndrome (NMS) is a rare disorder that can occur as a side effect of antipsychotic medications. It is characterized by muscular rigidity, tachycardia, hyperthermia, sweating, altered consciousness, autonomic dysfunction, and increase in CPK. This is a life-threatening complication.

Question 11
A child presents to the Emergency Department with documented acetaminophen poisoning. In order to provide counseling and education for the parents, which principle must the nurse understand?
A) The problem occurs in stages with recovery within 12-24 hours
B) Hepatic problems may occur and may be life-threatening
C) Full and rapid recovery can be expected in most children
D) This poisoning is usually fatal, as no antidote is available

Review Information: The correct answer is B: Hepatic problems may occur and may be life-threatening
Clinical manifestations associated with acetaminophen poisoning occurs in 4 stages. The third stage is hepatic involvement which may last up to 7 days and be permanent. Clients who do not die in the hepatic stage gradually recover.

Question 12
A client has been receiving dexamethasone (Decadron) for control of cerebral edema. Which of the following assessments would indicate that the treatment is effective?
A) A positive Babinski's reflex
B) Increased response to motor stimuli
C) A widening pulse pressure
D) Temperature of 37 degrees Celsius

Review Information: The correct answer is B: Increased response to motor stimuli
Decadron is a corticosteroid that acts on the cell membrane to decrease inflammatory responses as well as stabilize the blood-brain barrier. Once Decadron reaches a therapeutic level, there should be a decrease in symptomology with improvement in motor skills.

Question 13
The provider has ordered transdermal nitroglycerin patches for a client. Which of these instructions should be included when teaching a client about how to use the patches?
A) Remove the patch when swimming or bathing
B) Apply the patch to any non-hairy area of the body
C) Apply a second patch with chest pain
D) Remove the patch if ankle edema occurs

Review Information: The correct answer is B: Apply the patch to any non-hairy area of the body
The patch application sites should be rotated.

Question 14
A newly admitted client has a diagnosis of depression. She complains of “twitching muscles” and a “racing heart”, and states she stopped taking Zoloft a few days ago because it was not helping her depression. Instead, she began to take her partner's Parnate. The nurse should immediately assess for which of these adverse reactions?
A) Pulmonary edema
B) Atrial fibrillation
C) Mental status changes
D) Muscle weakness

Review Information: The correct answer is C: Mental status changes
Use of serotonergic agents may result in Serotonin Syndrome with confusion, nausea, palpitations, increased muscle tone with twitching muscles, and agitation. Serotonin syndrome is most often reported in patients taking 2 or more medications that increase CNS serotonin levels by different mechanisms. The most common drug combinations associated with serotonin syndrome involve the MAOIs, SSRIs, and the tricyclic antidepressants.

Question 15
A client with bi-polar disorder is taking lithium (Lithane). What should the nurse emphasize when teaching about this medication?
A) Take the medication before meals
B) Maintain adequate daily salt intake
C) Reduce fluid intake to minimize diuresis
D) Use antacids to prevent heartburn

Review Information: The correct answer is B: Maintain adequate daily salt intake
Salt intake affects fluid volume, which can affect lithium (Lithane) levels; therefore, maintaining adequate salt intake is advised.

Question 16
A client with anemia has a new prescription for ferrous sulfate. In teaching the client about diet and iron supplements, the nurse should emphasize that absorption of iron is enhanced if taken with which substance?
A) Acetaminophen
B) Orange juice
C) Low fat milk
D) An antacid

Review Information: The correct answer is B: Orange juice
Ascorbic acid enhances the absorption of iron.

Question 17
A client with an aplastic sickle cell crisis is receiving a blood transfusion and begins to complain of "feeling hot." Almost immediately, the client begins to wheeze. What is the nurse's first action?
A) Stop the blood infusion
B) Notify the health care provider
C) Take/record vital signs
D) Send blood samples to lab

Review Information: The correct answer is A: Stop the blood infusion
If a reaction of any type is suspected during administration of blood products, stop the infusion immediately, keep the line open with saline, notify the health care provider, monitor vital signs and other changes, and then send a blood sample to the lab.

Question 18
A client confides in the RN that a friend has told her the medication she takes for depression, Wellbutrin, was taken off the market because it caused seizures. What is an appropriate response by the nurse?
A) "Ask your friend about the source of this information."
B) "Omit the next doses until you talk with the doctor."
C) "There were problems, but the recommended dose is changed."
D) "Your health care provider knows the best drug for your condition."

Review Information: The correct answer is C: "There were problems, but the recommended dose is changed."
Wellbutrin was introduced in the U.S. in 1985 and then withdrawn because of the occurrence of seizures in some patients taking the drug. The drug was reintroduced in 1989 with specific recommendations regarding dose ranges to limit the occurrence of seizures. The risk of seizure appears to be strongly associated with dose.

Question 19
When providing discharge teaching to a client with asthma, the nurse will warn against the use of which of the following over-the-counter medications?
A) Cortisone ointments for skin rashes
B) Aspirin products for pain relief
C) Cough medications containing guaifenesin
D) Histamine blockers for gastric distress

Review Information: The correct answer is B: Aspirin products for pain relief
Aspirin is known to induce asthma attacks. Aspirin can also cause nasal polyps and rhinitis. Warn individuals with asthma about signs and symptoms resulting from complications due to aspirin ingestion.

Question 20
The nurse is caring for a client who is receiving procainamide (Pronestyl) intravenously. It is important for the nurse to monitor which of the following parameters?
A) Hourly urinary output
B) Serum potassium levels
* C) Continuous EKG readings
D) Neurological signs

Review Information: The correct answer is C: Continuous EKG readings
Procainamide (Pronestyl) is used to suppress cardiac arrhythmias. When administered intravenously, it must be accompanied by continuous cardiac monitoring by ECG.

Question 21
The nurse is providing education for a client with newly diagnosed tuberculosis. Which statement should be included in the information that is given to the client?
A) "Isolate yourself from others until you are finished taking your medication."
B) "Follow up with your primary care provider in 3 months."
C) "Continue to take your medications even when you are feeling fine."
D) "Continue to get yearly tuberculin skin tests."

Review Information: The correct answer is C: "Continue to take your medications even when you are feeling fine."
The most important piece of information the tuberculosis client needs is to understand the importance of medication compliance, even if no longer experiencing symptoms. Clients are most infectious early in the course of therapy. The numbers of acid-fast bacilli are greatly reduced as early as 2 weeks after therapy begins.

Question 22
The nurse is applying silver sulfadiazine (Silvadene) to a child with severe burns to arms and legs. Which side effect should the nurse be monitoring for?
A) Skin discoloration
B) Hardened eschar
C) Increased neutrophils
D) Urine sulfa crystals

Review Information: The correct answer is D: Urine sulfa crystals
Silver sulfadiazine is a broad spectrum anti-microbial, especially effective against pseudomonas. When applied to extensive areas, however, it may cause a transient neutropenia, as well as renal function changes with sulfa crystals production and kernicterus.

Question 23
The nurse is monitoring a client receiving a thrombolytic agent, alteplase (Activase tissue plasminogen activator), for treatment of a myocardial infarction. What outcome indicates the client is receiving adequate therapy within the first hours of treatment?
A) Absence of a dysrhythmia (or arrhythmia)
B) Blood pressure reduction
C) Cardiac enzymes are within normal limits
D) Return of ST segment to baseline on ECG

Review Information: The correct answer is D: Return of ST segment to baseline on ECG
Improved perfusion should result from this medication, along with the reduction of ST segment elevation.

Question 24
The provider has ordered daily high doses of aspirin for a client with rheumatoid arthritis. The nurse instructs the client to discontinue the medication and contact the provider if which of the following symptoms occur?
A) Infection of the gums
B) Diarrhea for more than one day
C) Numbness in the lower extremities
D) Ringing in the ears

Review Information: The correct answer is D: Ringing in the ears
Aspirin stimulates the central nervous system which may result in ringing in the ears.
Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition). Philadelphia: F.A. Davis Company.
Key, J.L. and Hayes, E.R. (2003). Pharmacology, a nursing process approach. (4th edition). Philadelphia: Saunders.

Question 25
A nurse is caring for a client who is receiving methyldopa hydrochloride (Aldomet) intravenously. Which of the following assessment findings would indicate to the nurse that the client may be having an adverse reaction to the medication?
A) Headache
B) Mood changes
C) Hyperkalemia
D) Palpitations

Review Information: The correct answer is B: Mood changes
The nurse should assess the client for alterations in mental status such as mood changes. These symptoms should be reported promptly.
Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition). Philadelphia: F.A. Davis Company.
Wilson, B.A., Shannon, M.T., and Stang, C.L. (2004). Nurse’s drug guide. Upper Saddle River, New Jersey: Pearson Prentice Hall.

Question 26
The nurse is teaching a child and the family about the medication phenytoin (Dilantin) prescribed for seizure control. Which of the following side effects is most likely to occur?
A) Vertigo
B) Drowsiness
C) Gingival hyperplasia
D) Vomiting

Review Information: The correct answer is C: Gingival hyperplasia
Swollen and tender gums occur often with use of phenytoin. Good oral hygiene and regular visits to the dentist should be emphasized.

Question 27
The use of atropine for treatment of symptomatic bradycardia is contraindicated for a client with which of the following conditions?
A) Urinary incontinence
B) Glaucoma
C) Increased intracranial pressure
D) Right sided heart failure

Review Information: The correct answer is B: Glaucoma
Atropine is contraindicated in clients with angle-closure glaucoma because it can cause pupillary dilation with an increase in aqueous humor, leading to a resultant increase in optic pressure.

Question 28
A pregnant woman is hospitalized for treatment of pregnancy induced hypertension (PIH) in the third trimester. She is receiving magnesium sulfate intravenously. The nurse understands that this medication is used mainly for what purpose?
A) Maintain normal blood pressure
B) Prevent convulsive seizures
C) Decrease the respiratory rate
D) Increase uterine blood flow

Review Information: The correct answer is B: Prevent convulsive seizures
Magnesium sulfate is a central nervous system depressant. While it has many systemic effects, it is used in the client with pregnancy induced hypertension (PIH) to prevent seizures.

Question 29
The nurse is teaching a group of women in a community clinic about prevention of osteoporosis. Which of the following over-the-counter medications should the nurse recognize as having the most elemental calcium per tablet?
A) Calcium chloride
B) Calcium citrate
C) Calcium gluconate
D) Calcium carbonate

Review Information: The correct answer is D: Calcium carbonate
Calcium carbonate contains 400mg of elemental calcium in 1 gram of calcium carbonate.

Question 30
The nurse is administering diltiazem (Cardizem) to a client. Prior to administration, it is important for the nurse to assess which parameter?
A) Temperature
B) Blood pressure
C) Vision
D) Bowel sounds

Review Information: The correct answer is B: Blood pressure
Diltiazem (Cardizem) is a calcium channel blocker that causes systemic vasodilation resulting in decreased blood pressure.

Question 31
The nurse is instructing a client with moderate persistent asthma on the proper method for using MDIs (multi-dose inhalers). Which medication should be administered first?
A) Steroid
B) Anticholinergic
C) Mast cell stabilizer
D) Beta agonist

Review Information: The correct answer is D: Beta agonist
The beta-agonist drugs help to relieve bronchospasm by relaxing the smooth muscle of the airway. These drugs should be taken first so that other medications can reach the lungs.

Question 32
A post-operative client has a prescription for acetaminophen with codeine. What should the nurse recognizes as a primary effect of this combination?
A) Enhanced pain relief
B) Minimized side effects
C) Prevention of drug tolerance
D) Increased onset of action

Review Information: The correct answer is A: Enhanced pain relief
Combination of analgesics with different mechanisms of action can afford greater pain relief.

Question 33
A client is receiving erythromycin 500mg IV every 6 hours to treat a pneumonia. Which of the following is the most common side effect of the medication?
A) Blurred vision
B) Nausea and vomiting
C) Severe headache
D) Insomnia

Review Information: The correct answer is B: Nausea and vomiting
Nausea is a common side-effect of erythromycin in both oral and intravenous forms.

Question 34
The health care provider orders an IV aminophylline infusion at 30 mg/hr. The pharmacy sends a 1,000 ml bag of D5W containing 500 mg of aminophylline. In order to administer 30 mg per hour, the RN will set the infusion rate at:
A) 20 ml per hour
B) 30 ml per hour
C) 50 ml per hour
D) 60 ml per hour

Review Information: The correct answer is D: 60 ml per hour
Using the ratio method to calculate infusion rate: mg to be given (30) : ml to be infused (X) :: mg available (500) : ml of solution (1,000). Solve for X by cross-multiplying: 30 x 1,000 = 500 x X (or cancel), 30,000 = 500 X, X = 30,000/500, X = 60ml per hour.

Question 35
The nurse is assessing a 7 year-old after several days of treatment for a documented strep throat. Which of the following statements suggests that further teaching is needed?
A) "Sometimes I take my medicine with fruit juice."
B) "My mother makes me take my medicine right after school."
C) "Sometimes I take the pills in the morning and other times at night."
D) "I am feeling much better than I did last week."

Review Information: The correct answer is C: "Sometimes I take the pills in the morning and other times at night."
Inconsistency in taking the prescribed medication indicates more teaching is needed.

Question 36
The nurse is caring for a 10 year-old client who will be placed on heparin therapy. Which assessment is critical for the nurse to make before initiating therapy
A) Vital signs
B) Weight
C) Lung sounds
D) Skin turgor

Review Information: The correct answer is B: Weight
Check the client''s weight because dosage is calculated on the basis of weight.

Question 37
In providing care for a client with pain from a sickle cell crisis, which one of the following medication orders for pain control should be questioned by the nurse?
A) Demerol
B) Morphine
C) Methadone
D) Codeine

Review Information: The correct answer is A: Demerol
Meperidine is not recommended in clients with sickle cell disease. Normeperidine, a metabolite of meperidine, is a central nervous system stimulant that produces anxiety, tremors, myoclonus, and generalized seizures when it accumulates with repetitive dosing. Clients with sickle cell disease are particularly at risk for normeperidine-induced seizures.

Question 38
A 5 year-old has been rushed to the emergency room several hours after acetaminophen poisoning. Which laboratory result should receive attention by the nurse?
A) Sedimentation rate
B) Profile 2
C) Bilirubin
D) Neutrophils

Review Information: The correct answer is C: Bilirubin
Bilirubin, along with liver enzymes ALT and AST, may rise in the second stage (1-3 days) after a significant overdose, indicating cellular necrosis and liver dysfunction. A prolonged prothrombin time may also be found.

Question 39
An elderly client is on an anticholinergic metered dose inhaler (MDI) for chronic obstructive pulmonary disease. The nurse would suggest a spacer to
A) enhance the administration of the medication
B) increase client compliance
C) improve aerosol delivery in clients who are not able to coordinate the MDI
D) prevent exacerbation of COPD

Review Information: The correct answer is C: improve aerosol delivery in clients who are not able to coordinate the MDI
Spacers improve the medication delivery in clients who are unable to coordinate the movements of administering a dose with an MDI.

Question 40
The nurse is teaching a parent how to administer oral iron supplements to a 2 year-old child. Which of the following interventions should be included in the teaching?
A) Stop the medication if the stools become tarry green
B) Give the medicine with orange juice and through a straw
C) Add the medicine to a bottle of formula
D) Administer the iron with your child's meals

Review Information: The correct answer is B: Give the medicine with orange juice and through a straw
Absorption of iron is facilitated in an environment rich in Vitamin C. Since liquid iron preparation will stain teeth, a straw is preferred.

Free NCLEX-RN Sample Test Questions For Nursing Review (Pharmacology Set 1)

Question 1
A client has an order for antibiotic therapy after hospital treatment of a staph infection. Which of the following should the nurse emphasize?
A) Scheduling follow-up blood cultures
B) Completing the full course of medications
C) Visiting the provider in a few weeks
D) Monitoring for signs of recurrent infection

Review Information: The correct answer is B: Completing the full course of medications
In order for antibiotic therapy to be effective in eradicating an infection, the client must compete the entire course of prescribed therapy. When findings subside, stopping the medication early may lead to recurrence or subsequent drug resistance.

Question 2
A 72 year-old client is admitted for possible dehydration. The nurse knows that older adults are particularly at risk for dehydration because they have
A) an increased need for extravascular fluid
B) a decreased sensation of thirst
C) an increase in diaphoresis
D) higher metabolic demands

Review Information: The correct answer is B: a decreased sensation of thirst
The elderly have a reduction in thirst sensation causing them to consume less fluid. Other risk factors may include fear of incontinence, inability to drink fluids independently and lack of motivation.

Question 3
A male client is admitted with a spinal cord injury at level C4. The client asks the nurse how the injury is going to affect his sexual function. The nurse would respond
A) "Normal sexual function is not possible."
B) "Sexual functioning will not be impaired at all."
C) "Erections will be possible."
D) "Ejaculation will be normal."

Review Information: The correct answer is C: "Erections will be possible."
Because they are a reflex reaction, erections can be stimulated by stroking the genitalia.

Question 4
An 82 year-old client complains of chronic constipation. To improve bowel function, the nurse should first suggest
A) Increasing fiber intake to 20-30 grams daily
B) Daily use of laxatives
C) Avoidance of binding foods such as cheese and chocolate
D) Monitoring a balance between activity and rest

Review Information: The correct answer is A: Increasing fiber intake to 20-30 grams daily
The incorporation of high fiber into the diet is an effective way to promote bowel elimination in the elderly.

Question 5
A 4 year-old child is admitted with burns on his legs and lower abdomen. When assessing the child’s hydration status, which of the following indicates a less than adequate fluid replacement?
A) Decreasing hematocrit and increasing urine volume
B) Rising hematocrit and decreasing urine volume
C) Falling hematocrit and decreasing urine volume
D) Stable hematocrit and increasing urine volume

Review Information: The correct answer is B: Rising hematocrit and decreasing urine volume
A rising hematocrit indicates a decreased total blood volume, a finding consistent with dehydration.

Question 6
A client receiving chemotherapy has developed sores in his mouth. He asks the nurse why this happened. What is the nurse’s best response?
A) "It is a sign that the medication is working."
B) "You need to have better oral hygiene."
C) "The cells in the mouth are sensitive to the chemotherapy."
D) "This always happens with chemotherapy."

Review Information: The correct answer is C: "The cells in the mouth are sensitive to the chemotherapy."
The epithelial cells in the mouth are very sensitive to chemotherapy due to their high rate of cell turnover.

Question 7
You are caring for a client with deep vein thrombosis who is on Heparin IV. The latest APTT is 50 seconds. If the laboratory normal range is 16-24 seconds, you would anticipate
A) maintaining the current heparin dose
B) increasing the heparin as it does not appear therapeutic.
C) giving protamine sulfate as an antidote.
D) repeating the blood test 1 hour after giving heparin.

Review Information: The correct answer is A: maintaining the current heparin dose
The range for a therapeutic APTT is 1.5-2 times the control. Therefore the client is receiving a therapeutic dose of Heparin.

Question 8
A client is admitted with a diagnosis of nodal bigeminy. The nurse knows that the atrioventricular (AV) node has an intrinsic rate of
A) 60-100 beats/minute
B) 10-30 beats/minute
C) 40-70 beats/minute
D) 20-50 beats/minute

Review Information: The correct answer is C: 40-70 beats/minute
The intrinsic rate of the AV node is within the range of 40-70 beats per minute.

Question 9
A client is to receive 3 doses of potassium chloride 10 mEq in 100cc normal saline to infuse over 30 minutes each. Which of the following is a priority assessment to perform before giving this medication?
A) Oral fluid intake
B) Bowel sounds
C) Grip strength
D) Urine output

Review Information: The correct answer is D: Urine output
Potassium chloride should only be administered after adequate urine output (>20cc/hour for 2 consecutive hours) has been established. Impaired ability to excrete potassium via the kidneys can result in hyperkalemia.

Question 10
The unlicensed assistive personnel (UAP) reports to the nurse that a client with cirrhosis who had a paracentesis yesterday has become more lethargic and has musty smelling breath. A critical assessment for increasing encephalopathy is
A) monitor the client's clotting status
B) assess upper abdomen for bruits
C) assess for flap-like tremors of the hands
D) measure abdominal girth changes

Review Information: The correct answer is C: assess for flap-like tremors of the hands
A client with cirrhosis of the liver who develops subtle changes in mental status and has a musty odor to the breath is at risk for developing more advanced signs of encephalopathy.

Question 11
A client is scheduled for an intravenous pyelogram (IVP). After the contrast material is injected, which of the following client reactions should be reported immediately?
A) Feeling warm
B) Face flushing
C) Salty taste
D) Hives

Review Information: The correct answer is D: Hives
This is a sign of anaphylaxis and should be reported immediately. The other reactions are considered normal and the client should be informed that they may occur.
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Question 12
A client is prescribed an inhaler. How should the nurse instruct the client to breathe in the medication?
A) As quickly as possible
B) As slowly as possible
C) Deeply for 3-4 seconds
D) Until hearing whistling by the spacer

Review Information: The correct answer is C: Deeply for 3-4 seconds
The client should be instructed to breath in the medication for 3-4 seconds in order to receive the correct dosage of medication.

Question 13
The nurse is caring for clients over the age of 70. The nurse knows that due to age-related changes, the elderly clients tolerate diets that are
A) high protein
B) high carbohydrates
C) low fat
D) high calories

Review Information: The correct answer is C: low fat
Due to age related changes, the diet of the elderly should include a lower quantity and higher quality of food. Fewer carbohydrates and fats are required in their diets.

Question 14
A woman with a 28 week pregnancy is on the way to the emergency department by ambulance with a tentative diagnosis of abruptio placenta. Which should the nurse do first when the woman arrives?
A) administer oxygen by mask at 100%
B) start a second IV with an 18 gauge cannula
C) check fetal heart rate every 15 minutes
D) insert urethral catheter with hourly urine outputs

Review Information: The correct answer is A: administer oxygen by mask at 100%
Administering oxygen in this situation would increase the circulating oxygen in the mother’s circulation to the fetus’s circulation. This action will minimize complications.

Question 15
A client in respiratory distress is admitted with arterial blood gas results of: PH 7.30; PO2 58, PCO2 34; and HCO3 19. The nurse determines that the client is in
A) metabolic acidosis
B) metabolic alkalosis
C) respiratory acidosis
D) respiratory alkalosis

Review Information: The correct answer is A: metabolic acidosis
These lab values indicate metabolic acidosis: the PH is low, PCO2 is normal, and bicarbonate level is low.

Question 16
A client is diagnosed with gastroesophageal reflux disease (GERD). The nurse's instruction to the client regarding diet should be to
A) avoid all raw fruits and vegetables
B) increase intake of milk products
C) decrease intake of fatty foods
D) focus on 3 average size meals a day

Review Information: The correct answer is C: decrease intake of fatty foods
GERD may be aggravated by a fatty diet. A diet low in fat would decrease the symptoms of GERD. Other agents which should also be decreased or avoided are: cigarette smoking, caffeine, alcohol, chocolate, and meperidine (Demerol).

Question 17
After surgery, a client with a nasogastric tube complains of nausea. What action would the nurse take?
A) Call the health care provider
B) Administer an antiemetic
C) Put the bed in Fowler’s position
D) Check the patency of the tube

Review Information: The correct answer is D: Check the patency of the tube
An indication that the nasogastric tube is obstructed is a client’s complaint of nausea. Nasogastric tubes may become obstructed with mucus or sediment.

Question 18
A client with testicular cancer has had an orchiectomy. Prior to discharge the client expresses his fears related to his prognosis. Which principle should the nurse base the response on?
A) Testicular cancer has a cure rate of 90% with early diagnosis
B) Testicular cancer has a cure rate of 50% with early diagnosis
C) Intensive chemotherapy is the treatment of choice
D) Testicular cancer is usually fatal

Review Information: The correct answer is A: Testicular cancer has a cure rate of 90% with early diagnosis
With aggressive treatment and early detection/diagnosis the cure rate is 90%.

Question 19
A client newly diagnosed with Type I Diabetes Mellitus asks the purpose of the test measuring glycosylated hemoglobin. The nurse should explain that the purpose of this test is to determine:
A) The presence of anemia often associated with Diabetes
B) The oxygen carrying capacity of the client's red cells
C) The average blood glucose for the past 2-3 months
D) The client's risk for cardiac complications

Review Information: The correct answer is C: The average blood glucose for the past 2-3 months
By testing the portion of the hemoglobin that absorbs glucose, it is possible to determine the average blood glucose over the life span of the red cell, 120 days.

Question 20
A client is admitted for a possible pacemaker insertion. What is the intrinsic rate of the heart's own pacemaker?
A) 30-50 beats/minute
B) 60-100 beats/minute
C) 20-60 beats/minute
D) 90-100 beats/minute

Review Information: The correct answer is B: 60-100 beats/minute
This is the intrinsic rate of the SA node.

Question 21
The nurse discusses nutrition with a pregnant woman who is iron deficient and follows a vegetarian diet. The selection of which foods indicates the woman has learned sources of iron?
A) Cereal and dried fruits
B) Whole grains and yellow vegetables
C) Leafy green vegetables and oranges
D) Fish and dairy products

Review Information: The correct answer is A: Cereal and dried fruits
Both of these foods would be a good source of iron.

Question 22
Prior to administering Alteplase (TPA) to a client admitted for a cerebral vascular accident (CVA), it is critical that the nurse assess:
A) Neuro signs
B) Mental status
C) Blood pressure
D) PT/PTT

Review Information: The correct answer is D: PT/PTT
TPA is a potent thrombolytic enzyme. Because bleeding is the most common side effect, it is most essential to evaluate clotting studies including PT, PTT, APTT, platelets, and hematocrit before beginning therapy.

Question 23
The nurse enters the room of a client diagnosed with COPD. The client’s skin is pink, and respirations are 8 per minute. The client’s oxygen is running at 6 liters per minute. What should be the nurse’s first action?
A) Call the health care provider
B) Put the client in Fowler’s position
C) Lower the oxygen rate
D) Take the vital signs

Review Information: The correct answer is C: Lower the oxygen rate
In client’s diagnosed with COPD, the drive to breathe is hypoxia. If oxygen is delivered at too high of a concentration, this drive will be eliminated and the client’s depth and rate of respirations will decrease. Therefore the first action should be to lower the oxygen rate.

Question 24
The client with goiter is treated with potassium iodide preoperatively. What should the nurse recognize as the purpose of this medication?
A) Reduce vascularity of the thyroid
B) Correct chronic hyperthyroidism
C) Destroy the thyroid gland function
D) Balance enzymes and electrolytes

Review Information: The correct answer is A: Reduce vascularity of the thyroid
Potassium iodide solution, or Lugol''s solution may be used preoperatively to reduce the size and vascularity of the thyroid gland.

Question 25
One hour before the first treatment is scheduled, the client becomes anxious and states he does not wish to go through with electroconvulsive therapy. Which response by the nurse is most appropriate?
A) "I’ll go with you and will be there with you during the treatment."
B) "You’ll be asleep and won’t remember anything."
C) "You have the right to change your mind. You seem anxious. Can we talk about it?"
D) "I’ll call the health care provider to notify them of your decision."

Review Information: The correct answer is C: "You have the right to change your mind. You seem anxious. Can we talk about it?"
This response indicates acknowledgment of the client’s rights and the opportunity for the client to clarify and ventilate concerns. After this, if the client continues to refuse, the provider should be notified.

Question 26
A nurse who has been named in a lawsuit can use which of these factors for the best protection in a court of law?
A) Clinical specialty certification in the associated area of practice
B) Documentation on the specific client record with a focus on the nursing process
C) Yearly evaluations and proficiency reports prepared by nurse’s manager
D) Verification of provider's orders for the plan of care with identification of outcomes

Review Information: The correct answer is B: Documentation on the specific client record with a focus on the nursing process
Documentation is the key to protect nurses when a lawsuit is filed. The thorough documentation should include all steps of the nursing process – assessment, analysis, plan, intervention, evaluation. In addition, it should include pertinent data such as times, dosages and sites of actions, assessment data, the nurse’s response to a change in the client’s condition, specific actions taken, if and when the notification occurred to the provider or other health care team members, and what was prescribed along with the client’s outcomes.

Question 27
The nurse is caring for clients over the age of 70. The nurse is aware that when giving medications to older clients, it is best to
A) start low, go slow
B) avoid stopping a medication entirely
C) avoid drugs with side effects that impact cognition
D) review the drug regimen yearly

Review Information: The correct answer is A: start low, go slow
Due to physiological changes in the elderly, as well as conditions such as dehydration, hyperthermia, immobility and liver disease, the effective metabolism of drugs may decrease. As a result, drugs can accumulate to toxic levels and cause serious adverse reactions.

Question 28
You are caring for a hypertensive client with a new order for captopril (Capoten). Which information should the nurse include in client teaching?
A) Avoid green leafy vegetables
B) Restrict fluids to 1000cc/day
C) Avoid the use of salt substitutes
D) Take the medication with meals

Review Information: The correct answer is C: Avoid the use of salt substitutes
Captopril can cause an accumulation of potassium or hyperkalemia. Clients should avoid the use of salt substitutes, which are generally potassium-based.

Question 29
A client has bilateral knee pain from osteoarthritis. In addition to taking the prescribed non-steroidal anti-inflammatory drug (NSAID), the nurse should instruct the client to
A) start a regular exercise program
B) rest the knees as much as possible to decrease inflammation
C) avoid foods high in citric acid
D) keep the legs elevated when sitting

Review Information: The correct answer is A: start a regular exercise program
A regular exercise program is beneficial in treating osteoarthritis. It can restore self-esteem and improve physical functioning.

Question 30
An arterial blood gases test (ABG) is ordered for a confused client. The respiratory therapist draws the blood and then asks the nurse to apply pressure to the area so the therapist can take the specimen to the lab. How long should the nurse apply pressure to the area?
A) 3 minutes
B) 5 minutes
C) 8 minutes
D) 10 minutes

Review Information: The correct answer is B: 5 minutes
It is necessary to apply pressure to the area for 5 minutes to prevent bleeding and the formation of hematomas.

Question 31
Which of these clients should the charge nurse assign to the registered nurse (RN)?
A) A 56 year-old with atrial fibrillation receiving digoxin
B) A 60 year-old client with COPD on oxygen at 2 L/min
C) A 24 year-old post-op client with type 1 diabetes in the process of discharge
D) An 80 year-old client recovering 24 hours post right hip replacement

Review Information: The correct answer is C: A 24 year-old post-op client with type 1 diabetes in the process of discharge
Discharge teaching must be done by an RN. Practical nurses (PNs) or unlicensed assistive personnel (UAPs) can reinforce education after the RN does the initial teaching.

Question 32
A hypertensive client is started on atenolol (Tenormin). The nurse instructs the client to immediately report which of these findings?
A) Rapid breathing
B) Slow, bounding pulse
C) Jaundiced sclera
D) Weight gain

Review Information: The correct answer is B: Slow, bounding pulse
Atenolol (Tenormin) is a beta-blocker that can cause side effects including bradycardia and hypotension.

Question 33
An 80 year-old client is admitted with a diagnosis of malnutrition. In addition to physical assessments, which of the following lab tests should be closely monitored?
A) Urine protein
B) Urine creatinine
C) Serum calcium
D) Serum albumin

Review Information: The correct answer is D: Serum albumin
Serum albumin is a valuable indicator of protein deficiency and, later, nutritional status in adults. A normal reading for an elder’s serum albumin is between 3.0-5.0 g/dl.

Question 34
Upon admission to an intensive care unit, a client diagnosed with an acute myocardial infarction is ordered oxygen. The nurse knows that the major reason that oxygen is administered in this situation is to
A) saturate the red blood cells
B) relieve dyspnea
C) decrease cyanosis
D) increase oxygen level in the myocardium

Review Information: The correct answer is D: increase oxygen level in the myocardium
Anoxia of the myocardium occurs in myocardial infarction. Oxygen administration will help relieve dyspnea and cyanosis associated with the condition but the major purpose is to increase the oxygen concentration in the damaged myocardial tissue.
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Question 35
The nurse is teaching a client with chronic renal failure (CRF) about medications. The client questions the purpose of aluminum hydroxide (Amphojel) in her medication regimen. What is the best explanation for the nurse to give the client about the therapeutic effects of this medication?
A) It decreases serum phosphate
B) It will reduce serum calcium
C) Amphojel increases urine output
D) The drug is taken to control gastric acid secretion

Review Information: The correct answer is A: It decreases serum phosphate
Aluminum binds phosphates that tend to accumulate in the patient with chronic renal failure due to decreased filtration capacity of the kidney. Antacids such as Amphojel are commonly used to accomplish this.

Question 36
A 66 year-old client is admitted for mitral valve replacement surgery. The client has a history of mitral valve regurgitation and mitral stenosis since her teenage years. During the admission assessment, the nurse should ask the client if as a child she had
A) measles
B) rheumatic fever
C) hay fever
D) encephalitis

Review Information: The correct answer is B: rheumatic fever
Clients that present with mitral stenosis often have a history of rheumatic fever or bacterial endocarditis.

Question 37
During nursing rounds which of these assessments would require immediate corrective action and further instruction to the practical nurse (PN) about proper care?
A) The weights of the skin traction of a client are hanging about 2 inches from the floor
B) A client with a hip prosthesis 1 day post operatively is lying in bed with internal rotation and adduction of the affected leg
C) The nurse observes that the PN moves the extremity of a client with an external fixation device by picking up the frame
D) A client with skeletal traction states "The other nurse said that the clear, yellow and crusty drainage around the pin site is a good sign"

Review Information: The correct answer is B: A client with a hip prosthesis 1 day post operatively is lying in bed with internal rotation and adduction of the affected leg
This position should be prevented in order to prevent dislodgment of the hip prosthesis, especially in the first 48 to 72 hours post-op. The other assessments are not of concern.

Question 38
A client diagnosed with gouty arthritis is admitted with severe pain and edema in the right foot. When the nurse develops a plan of care, which intervention should be included?
A) high protein diet
B) salicylates
C) hot compresses to affected joints
D) intake of at least 3000cc/day

Review Information: The correct answer is D: intake of at least 3000cc/day
Fluid intake should be increased to prevent precipitation of urate in the kidneys.

Question 39
A 55 year-old woman is taking Prednisone and aspirin (ASA) as part of her treatment for rheumatoid arthritis. Which of the following would be an appropriate intervention for the nurse?
A) Assess the pulse rate q 4 hours
B) Monitor her level of consciousness q shift
C) Test her stools for occult blood
D) Discuss fiber in the diet to prevent constipation

Review Information: The correct answer is C: Test her stools for occult blood
Both Prednisone and ASA can lead to GI bleeding, therefore monitoring for occult blood would be appropriate.

Question 40
A client with testicular cancer is scheduled for a right orchiectomy. The nurse knows that an orchiectomy is the
A) surgical removal of the entire scrotum
B) surgical removal of a testicle
C) dissection of related lymph nodes
D) partial surgical removal of the penis

Review Information: The correct answer is B: surgical removal of a testicle
The affected testicle is surgically removed along with its tunica and spermatic cord.

Free NCLEX-RN Sample Test Questions For Nursing Review (Part 5)

Question 1
A client complains of some discomfort after a below the knee amputation. Which action by the nurse is most appropriate initially?
A) Conduct guided imagery or distraction
B) Ensure that the stump is elevated the first day post-op
C) Wrap the stump snugly in an elastic bandage
D) Administer opioid narcotics as ordered

Review Information: The correct answer is B: Ensure that the stump is elevated the first day post-op
This priority intervention prevents pressure caused by pooling of blood, thus minimizing the pain. Without this measure, a firm elastic bandage, opioid narcotics, or guided imagery will have little effect. Opioid narcotics are given for severe pain.

Question 2
A 78 year-old client with pneumonia has a productive cough, but is confused. Safety protective devices (restraints) have been ordered for this client. How can the nurse prevent aspiration?
A) Suction the client frequently while restrained
B) Secure all 4 restraints to 1 side of bed
C) Obtain a sitter for the client while restrained
D) Request an order for a cough suppressant

Review Information: The correct answer is C: Obtain a sitter for the client while restrained
The plan to use safety devices (restraints) should be rethought. Restraints are used to protect the client from harm caused by removing tubes or getting out of bed. In the event that this restricted movement could cause more harm, such as aspiration, then a sitter should be requested. These are to be provided by the facility in the event the family cannot do so. This client needs to cough and be watched rather than restricted. Suctioning will not prevent aspiration in this situation. Cough suppressants should be avoided for this client.

Question 3
A couple trying to conceive asks the nurse when ovulation occurs. The woman reports a regular 32 day cycle. Which response by the nurse is correct?
A) Days 7-10
B) Days 10-13
C) Days 14-16
D) Days 17-19

Review Information: The correct answer is D: Days 17-19
Ovulation occurs 14 days prior to menses. Considering that the woman''s cycle is 32 days, subtracting 14 from 32 suggests ovulation is at about the 18th day.

Question 4
A newborn is having difficulty maintaining a temperature above 98 degrees Fahrenheit and has been placed in an incubator. Which action is a nursing priority?
A) Protect the eyes of the neonate from the heat lamp
B) Monitor the neonate’s temperature
C) Warm all medications and liquids before giving
D) Avoid touching the neonate with cold hands

Review Information: The correct answer is B: Monitor the neonate’s temperature
When using a warming device the neonate’s temperature should be continuously monitored for undesired elevations. The use of heat lamps is not safe as there is no way to regulate their temperature. Warming medications and fluids is not indicated. While touching with cold hands can startle the infant it does not pose a safety risk.

Question 5
Which oxygen delivery system would the nurse apply that would provide the highest concentrations of oxygen to the client?
A) Venturi mask
B) Partial rebreather mask
C) Non-rebreather mask
D) Simple face mask

Review Information: The correct answer is C: Non-rebreather mask
The non-rebreather mask has a one-way valve that prevents exhales air from entering the reservoir bag and one or more valves covering the air holes on the face mask itself to prevent inhalation of room air but to allow exhalation of air. When a tight seal is achieved around the mask up to 100% of the oxygen is available.

Question 6
At a senior citizens meeting a nurse talks with a client who has Type 1 diabetes mellitus. Which statement by the client during the conversation is most predictive of a potential for impaired skin integrity?
A) "I give my insulin to myself in my thighs."
B) "Sometimes when I put my shoes on I don't know where my toes are."
C) "Here are my up and down glucose readings that I wrote on my calendar."
D) "If I bathe more than once a week my skin feels too dry."

Review Information: The correct answer is B: "Sometimes when I put my shoes on I don''t know where my toes are."
Peripheral neuropathy can lead to lack of sensation in the lower extremities. Clients who do not feel pressure and/or pain are at high risk for skin impairment.

Question 7
A client returns from surgery after an open reduction of a femur fracture. There is a small bloodstain on the cast. Four hours later, the nurse observes that the stain has doubled in size. What is the best action for the nurse to take?
A) Call the health care provider
B) Access the site by cutting a window in the cast
C) Simply record the findings in the nurse's notes only
D) Outline the spot with a pencil and note the time and date on the cast

Review Information: The correct answer is D: Outline the spot with a pencil and note the time and date on the cast
This is a good way to assess the amount of bleeding over a period of time. The bleeding does not appear to be excessive and some bleeding is expected with this type of surgery. The bleeding should also be documented in the nurse’s notes.

Question 8
The nurse is caring for a 1 year-old child who has 6 teeth. What is the best way for the nurse to give mouth care to this child?
A) Using a moist soft brush or cloth to clean teeth and gums
B) Swabbing teeth and gums with flavored mouthwash
C) Offering a bottle of water for the child to drink
D) Brushing with toothpaste and flossing each tooth

Review Information: The correct answer is A: Using a moist soft brush or cloth to clean teeth and gums
The nurse should use a soft cloth or soft brush to do mouth care so that the child can adjust to the routine of cleaning the mouth and teeth.

Question 9
In addition to standard precautions, a nurse should implement contact precautions for which client?
A) 60 year-old with herpes simplex
B) 6 year-old with mononucleosis
C) 45 year-old with pneumonia
D) 3 year-old with scarlet fever

Review Information: The correct answer is A: 60 year-old with herpes simplex
Clients who have herpes simplex infections must have contact precautions in addition to standard precautions because of the associated, potentially weeping, skin lesions. Contact precautions are used for clients who are infected by microorganisms that are transmitted by direct contact with the client, including hand or skin-to-skin contact.

Question 10
Which of the following situations is most likely to produce sepsis in the neonate?
A) Maternal diabetes
B) Prolonged rupture of membranes
C) Cesarean delivery
D) Precipitous vaginal birth

Review Information: The correct answer is B: Prolonged rupture of membranes
Premature rupture of the membranes (PROM) is a leading cause of newborn sepsis. After 12-24 hours of leaking fluid, measures are taken to reduce the risk to mother and the fetus/newborn.

Question 11
The nurse is teaching a parent about side effects of routine immunizations. Which of the following must be reported immediately?
A) Irritability
B) Slight edema at site
C) Local tenderness
D) Seizure activity

Review Information: The correct answer is D: Seizure activity
Other reactions that should be reported include crying for >3 hours, temperature over 104.8 degrees Fahrenheit following DPT immunization, and tender, swollen, reddened areas.

Question 12
The nurse is at the community center speaking with retired people about glaucoma. Which comment by one of the retirees would the nurse support to reinforce correct information?
A) "I usually avoid driving at night since lights sometimes seem to make things blur."
B) "I take half of the usual dose for my sinuses to maintain my blood pressure."
C) "I have to sit at the side of the pool with the grandchildren since I can't swim with this eye problem."
D) "I take extra fiber and drink lots of water to avoid getting constipated."

Review Information: The correct answer is D: "I take extra fiber and drink lots of water to avoid getting constipated."
Any activity that involves straining should be avoided in clients with glaucoma. Such activities would increase intraocular pressure.

Question 13
A newborn has hyperbilirubinemia and is undergoing phototherapy with a fiberoptic blanket. Which safety measure is most important during this process?
A) Regulate the neonate’s temperature using a radiant heater
B) Withhold feedings while under the phototherapy
C) Provide water feedings at least every 2 hours
D) Protect the eyes of neonate from the phototherapy lights

Review Information: The correct answer is C: Provide water feedings at least every 2 hours
Protecting the eyes of the neonates is very important to prevent damage when under the ultraviolet lights, but since the blanket is used, extra protection of the eyes is unnecessary. It is recommended that the neonate remain under the lights for extended periods. The neonate’s skin is exposed to the light and the temperature is monitored, but a heater may not be necessary. There is no reason to withhold feedings. Frequent water or feedings are given to help with the excretion of the bilirubin in the stool.
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Question 14
A nurse is performing the routine daily cleaning of a tracheostomy. During the procedure, the client coughs and displaces the tracheostomy tube. This negative outcome could have avoided by
A) placing an obturator at the client’s bedside
B) having another nurse assist with the procedure
C) fastening clean tracheostomy ties before removing old ties
D) placing the client in a flat, supine position

Review Information: The correct answer is C: fastening clean tracheostomy ties before removing old ties
Fastening clean tracheostomy ties before removing old ones will ensure that the tracheostomy is secured during the entire cleaning procedure. The obturator is useful to keep the airway open only after the tracheostomy outer tube is coughed out. A second nurse is not needed. Changing the position may not prevent a dislodged tracheostomy.

Question 15
A 4 year-old hospitalized child begins to have a seizure while playing with hard plastic toys in the hallway. Of the following nursing actions, which one should the nurse do first?
A) Place the child in the nearest bed
B) Administer IV medication to slow down the seizure
C) Place a padded tongue blade in the child's mouth
D) Remove the child's toys from the immediate area

Review Information: The correct answer is D: Remove the child''s toys from the immediate area
Nursing care for a child having a seizure includes, maintaining airway patency, ensuring safety, administering medications, and providing emotional support. Since the seizure has already started, nothing should be forced into the child''s mouth and the child should not be moved. Of the choices given, the first priority would be to provide a safe environment.

Question 16
The nurse is teaching home care to the parents of a child with acute spasmodic croup. The most important aspects of this care is/are
A) sedation as needed to prevent exhaustion
B) antibiotic therapy for 10 to 14 days
C) humidified air and increased oral fluids
D) antihistamines to decrease allergic response

Review Information: The correct answer is C: humidified air and increased oral fluids
The most important aspects of home care for a child with acute spasmodic croup are humidified air and increased oral fluids. Moisture soothes inflamed membranes. Adequate systemic hydration aids is mucociliary clearance and keeps secretions thin, white, watery, and easily removed with minimal coughing.

Question 17
The nurse is assigned to care for a client who has a leaking intracranial aneurysm. To minimize the risk of rebleeding, the nurse should plan to
A) restrict visitors to immediate family
B) avoid arousal of the client except for family visits
C) keep client's hips flexed at no less than 90 degrees
D) apply a warming blanket for temperatures of 98 degrees Fahrenheit or less

Review Information: The correct answer is A: restrict visitors to immediate family
Maintaining a quiet environment will assist in minimizing cerebral rebleeding. When family visit, the client should not be disturbed. If the client is awake, topics of a general nature are better choices for discussion than topics that result in emotional or physiological stimulation.

Question 18
A client who is 12 hour post-op becomes confused and says: “Giant sharks are swimming across the ceiling.” Which assessment is necessary to adequately identify the source of this client's behavior?
A) Cardiac rhythm strip
B) Pupillary response
C) Pulse oximetry
D) Peripheral glucose stick

Review Information: The correct answer is C: Pulse oximetry
A sudden change in mental status in any post-op client should trigger a nursing intervention directed toward respiratory evaluation. Pulse oximetry would be the initial assessment. If available, arterial blood gases would be better. Acute respiratory failure is the sudden inability of the respiratory system to maintain adequate gas exchange which may result in hypercapnia and/or hypoxemia. Clinical findings of hypoxemia include these finding which are listed in order of initial to later findings: restlessness, irritability, agitation, dyspnea, disorientation, confusion, delirium, hallucinations, and loss of consciousness. While there may be other factors influencing the client''s behavior, the first nursing action should be directed toward maintaining oxygenation. Once respiratory or oxygenation issues are ruled out then significant changes in glucose would be evaluated.

Question 19
A newborn delivered at home without a birth attendant is admitted to the hospital for observation. The initial temperature is 95 degrees Fahrenheit (35 degrees Celsius) axillary. The nurse recognizes that cold stress may lead to what complication?
A) Lowered BMR
B) Reduced PaO2
C) Lethargy
D) Metabolic alkalosis

Review Information: The correct answer is B: Reduced PaO2
Cold stress causes increased risk for respiratory distress. The baby delivered in such circumstances needs careful monitoring. In this situation, the newborn must be warmed immediately to increase its temperature to at least 97 degrees Fahrenheit (36 degrees Celsius).

Question 20
Which contraindication should the nurse assess for prior to giving a child immunizations?
A) Mild cold symptoms
B) Chronic asthma
C) Depressed immune system
D) Allergy to eggs

Review Information: The correct answer is C: Depressed immune system
Children who have a depressed immune system related to HIV or chemotherapy should not be given routine immunizations.

Question 21
The nurse is caring for a client with a myocardial infarction. Which finding requires the nurse's immediate action?
A) Periorbital edema
B) Dizzy spells
C) Lethargy
D) Shortness of breath

Review Information: The correct answer is B: Dizzy spells
Cardiac dysrhythmias may cause a transient drop in cardiac output and decreased blood flow to the brain. Near syncope refers to lightheartedness, dizziness, temporary confusion. Such "spells" may indicate runs of ventricular tachycardia or periods of asystole and should be reported immediately.

Question 22
Decentralized scheduling is used on a nursing unit. A chief advantage of this management strategy is that it:
A) considers client and staff needs
B) conserves time spent on planning
C) frees the nurse manager to handle other priorities
D) allows requests for special privileges

Review Information: The correct answer is A: considers client and staff needs
Decentralized staffing takes into consideration specific client needs and staff interests and abilities.

Question 23
Included in teaching the client with tuberculosis taking isoniazid (INH) about follow-up home care, the nurse should emphasize that a laboratory appointment for which of the following lab tests is critical?
A) Liver function
B) Kidney function
C) Blood sugar
D) Cardiac enzymes

Review Information: The correct answer is A: Liver function
INH can cause hepatocellular injury and hepatitis. This side effect is age-related and can be detected with regular assessment of liver enzymes, which are released into the blood from damaged liver cells.

Question 24
A woman in her third trimester complains of severe heartburn. What is appropriate teaching by the nurse to help the woman alleviate these symptoms?
A) Drink small amounts of liquids frequently
B) Eat the evening meal just before retiring
C) Take sodium bicarbonate after each meal
D) Sleep with head propped on several pillows

Review Information: The correct answer is D: Sleep with head propped on several pillows
Heartburn is a burning sensation caused by regurgitation of gastric contents. It is best relieved by sleeping position, eating small meals, and not eating before bedtime.

Question 25
A 16 year-old boy is admitted for Ewing's sarcoma of the tibia. In discussing his care with the parents, the nurse understands that the initial treatment most often includes
A) amputation just above the tumor
B) surgical excision of the mass
C) bone marrow graft in the affected leg
D) radiation and chemotherapy

Review Information: The correct answer is D: radiation and chemotherapy
The initial treatment of choice for Ewing''s sarcoma is a combination of radiation and chemotherapy.

Question 26
A new nurse manager is responsible for interviewing applicants for a staff nurse position. Which interview strategy would be the best approach?
A) Vary the interview style for each candidate to learn different techniques
B) Use simple questions requiring "yes" and "no" answers to gain definitive information
C) Obtain an interview guide from human resources for consistency in interviewing each candidate
D) Ask personal information of each applicant to assure he/she can meet job demands

Review Information: The correct answer is C: Obtain an interview guide from human resources for consistency in interviewing each candidate
An interview guide used for each candidate enables the nurse manager to be more objective in the decision making. The nurse should use resources available in the agency before attempts to develop one from scratch. Certain personal questions are prohibited, and HR can identify these for novice managers.

Question 27
What is the best way that parents of pre-schoolers can begin teaching their child about injury prevention?
A) Set good examples themselves
B) Protect their child from outside influences
C) Make sure their child understands all the safety rules
D) Discuss the consequences of not wearing protective devices

Review Information: The correct answer is A: Set good examples themselves
The preschool years are the time for parents to begin emphasizing safety principles as well as providing protection. Setting a good example themselves is crucial because of the imitative behaviors of pre-schoolers; they are quick to notice discrepancies between what they see and what they are told.

Question 28
A nurse assessing the newborn of a mother with diabetes understands that hypoglycemia is related to what pathophysiological process?
A) Disruption of fetal glucose supply
B) Pancreatic insufficiency
C) Maternal insulin dependency
D) Reduced glycogen reserves

Review Information: The correct answer is A: Disruption of fetal glucose supply
After delivery, the high glucose levels which crossed the placenta to the fetus are suddenly stopped. The newborn continues to secrete insulin in anticipation of glucose. When oral feedings begin, the newborn will adjust insulin production within a day or two.

Question 29
The nurse is caring for a client with extracellular fluid volume deficit. Which of the following assessments would the nurse anticipate finding?
A) bounding pulse
B) rapid respirations
C) oliguria
D) neck veins are distended

Review Information: The correct answer is C: oliguria
Kidneys maintain fluid volume through adjustments in urine volume.

Question 30
A 70 year-old woman is evaluated in the emergency department for a wrist fracture of unknown causes. During the process of taking client history, which of these items should the nurse identify as related to the client’s greatest risk factors for osteoporosis?
A) History of menopause at age 50
B) Taking high doses of steroids for arthritis for many years
C) Maintaining an inactive lifestyle for the past 10 years
D) Drinking 2 glasses of red wine each day for the past 30 years

Review Information: The correct answer is B: Taking high doses of steroids for arthritis for many years
The use of steroids, especially at high doses over time, increases the risk for osteoporosis. The other options also predispose to osteoporosis, as do low bone mass, poor calcium absorption and moderate to high alcohol ingestion. Long-term steroid treatment is the most significant risk factor, however.

Question 31
The nurse is caring for a 2 year-old who is being treated with chelation therapy, calcium disodium edetate, for lead poisoning. The nurse should be alert for which of the following side effects?
A) Neurotoxicity
B) Hepatomegaly
C) Nephrotoxicity
D) Ototoxicity

Review Information: The correct answer is C: Nephrotoxicity
Nephrotoxicity is a common side effect of calcium disodium edetate, in addition to lead poisoning in general.

Question 32
The parents of a toddler ask the nurse how long their child will have to sit in a car seat while in the automobile. What is the nurse’s best response to the parents?
A) "Your child must use a care seat until he weighs at least 40 pounds."
B) "The child must be 5 years of age to use a regular seat belt."
C) "Your child must reach a height of 50 inches to sit in a seat belt."
D) "The child can use a regular seat belt when he can sit still."

Review Information: The correct answer is A: "Your child must use a care seat until he weighs at least 40 pounds."
Children should use car seats until they weigh 40 pounds.

Question 33
A client asks the nurse to explain the basic ideas of homeopathic medicine. The response that best explains this approach is that such remedies
A) destroy organisms causing disease
B) maintain fluid balance
C) boost the immune system
D) increase bodily energy

Review Information: The correct answer is C: boost the immune system
The practitioner treats with minute doses of plant, mineral or animal substances which provide a gentle stimulus to the body''s own defenses.

Question 34
A client with a fractured femur has been in Russell’s traction for 24 hours. Which nursing action is associated with this therapy?
A) Check the skin on the sacrum for breakdown
B) Inspect the pin site for signs of infection
C) Auscultate the lungs for atelectasis
D) Perform a neurovascular check for circulation

Review Information: The correct answer is D: Perform a neurovascular check for circulation
While each of these is an important assessment, the neurovascular integrity check is most associated with this type of traction. Russell’s traction is Buck’s traction with a sling under the knee.

Question 35
When suctioning a client's tracheostomy, the nurse should instill saline in order to
A) decrease the client's discomfort
B) reduce viscosity of secretions
C) prevent client aspiration
D) remove a mucus plug

Review Information: The correct answer is D: remove a mucus plug
While no longer recommended for routine suctioning, saline may thin and loosen viscous secretions that are very difficult to move, perhaps making them easier to suction.

Question 36
The nurse is performing a gestational age assessment on a newborn delivered 2 hours ago. When coming to a conclusion using the Ballard scale, which of these factors may affect the score?
A) Birth weight
B) Racial differences
C) Fetal distress in labor
D) Birth trauma

Review Information: The correct answer is C: Fetal distress in labor
The effects of earlier distress may alter the findings of reflex responses as measured on the Ballard tool. Other physical characteristics that estimate gestational age, such as amount of lanugo, sole creases and ear cartilage are unaffected by the other factors.

Question 37
A nurse is caring for a client who had a closed reduction of a fractured right wrist followed by the application of a fiberglass cast 12 hours ago. Which finding requires the nurse’s immediate attention?
A) Capillary refill of fingers on right hand is 3 seconds
B) Skin warm to touch and normally colored
C) Client reports prickling sensation in the right hand
D) Slight swelling of fingers of right hand

Review Information: The correct answer is C: Client reports prickling sensation in the right hand
A prickling sensation is an indication of compartment syndrome and requires immediate action by the nurse. The other findings are normal for a client in this situation.

Question 38
A client is admitted with the diagnosis of pulmonary embolism. While taking a history, the client tells the nurse he was admitted for the same thing twice before, the last time just 3 months ago. The nurse would anticipate the provider ordering
A) pulmonary embolectomy
B) vena caval interruption
C) increasing the Coumadin therapy to an INR of 3-4
D) thrombolytic therapy

Review Information: The correct answer is B: vena caval interruption
Clients with contraindications to Heparin, recurrent PE or those with complications related to the medical therapy may require vena caval interruption by the placement of a filter device in the inferior vena cava. A filter can be placed transvenously to trap clots before they travel to the pulmonary circulation.

Question 39
Which client is at highest risk for developing a pressure ulcer?
A) 23 year-old in traction for fractured femur
B) 72 year-old with peripheral vascular disease, who is unable to walk without assistance
C) 75 year-old with left sided paresthesia who is incontinent of urine and stool
D) 30 year-old who is comatose following a ruptured aneurysm

Review Information: The correct answer is C: 75 year-old with left sided paresthesia who is incontinent of urine and stool
Risk factors for pressure ulcers include: immobility, absence of sensation, decreased LOC, poor nutrition and hydration, skin moisture, incontinence, increased age, decreased immune response. This client has the greatest number of risk factors.

Question 40
The nurse is teaching the mother of a 5 month-old about nutrition for her baby. Which statement by the mother indicates the need for further teaching?
A) "I'm going to try feeding my baby some rice cereal."
B) "When he wakes at night for a bottle, I feed him."
C) "I dip his pacifier in honey so he'll take it."
D) "I keep formula in the refrigerator for 24 hours."

Review Information: The correct answer is C: "I dip his pacifier in honey so he''ll take it."
Honey has been associated with infant botulism and should be avoided. Older children and adults have digestive enzymes that kill the botulism spores.

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