NCLEX 8

1. Which of the following medical terms means, “surgical fixation of the stomach”?

A. Abdominorrhaphy.

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B. Gastroplasty.

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C. Gastropexy.

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D. Abdominorrhexis.

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2. The mitral valve is synonymous with the term:

A. Left ventricle.

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B. Right atrium.

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C. Bicuspid valve.

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D. Tricuspid valve.

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3. A mother who has been breastfeeding her infant since birth wants to transition her baby to solid foods. The child is now 6 months old. Which of the following is the most appropriate response of the nurse?

A. You should breastfeed exclusively until your baby is 12 months old."

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B. You can start solid foods and change to formula feeding."

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C. You can start with rice cereal and continue with breastfeeding."

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D. You can start with feeding meats and vegetables."

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4. A nurse is assessing the ability of a 17 year old patient to perform self-care upon discharge to home. The patient is newly diagnosed with type I diabetes mellitus on this admission. The physician has ordered Lantus insulin, regular insulin and a sliding scale for discharge. Which would be the best method to evaluate the patient’s understanding of the nurse’s instructions?

A. Teach-back method.

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B. Return demonstration.

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C. Quiz.

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D. All of the above.

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5. A mother brings her 6-year old daughter in to a clinic for a routine physical. The family follows a vegan diet and the child has only eaten grain or plant products since birth. Which of the following vitamin deficiencies is this child most likely at risk for?

A. Vitamin C.

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B. Vitamin B-6.

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C. Vitamin K.

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D. Vitamin B-12.

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6. Which of the following is an example of a fine motor skill?

A. Jumping on a trampoline.

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B. Brushing hair.

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C. Standing on one foot.

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D. Climbing a ladder.

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7. A nurse is preparing to administer an oral glucose tolerance test to a woman who is 28 weeks’ pregnant. What is the first step the nurse should perform to administer this test?

A. Give the woman a sweetened drink that contains 75 g of glucose.

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B. Check the fetal heart tones for the baby.

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C. Check a fasting glucose on the mother.

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D. Tell the mother to eat an 800-calorie meal and return for a glucose check.

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8. A nurse is examining a 36-hour old infant when she notices the child’s skin has a yellowish tint. The yellow skin appears on the baby’s face and chest but the skin on the feet and legs appears pink. What is the next action of the nurse?

A. Check a stat bilirubin level.

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B. Begin phototherapy with eye protection.

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C. Monitor the condition and notify the physician during rounds.

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D. Transfer the infant to the neonatal intensive care unit.

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9. A nurse is caring for an aging client who has developed sarcopenia. Which of the following symptoms would this nurse most likely see in this client?

A. Loss of muscle mass.

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B. Low oxygen saturations.

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C. Decreased white blood cell count.

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D. Diminished reflexes.

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10. Which of Erikson’s stages of psychosocial development is associated with a preschool-aged child?

A. Trust vs. Mistrust.

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B. Industry vs. Inferiority.

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C. Initiative vs. Guilt.

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D. Identity vs. Role Confusion.

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11. What is the relationship between HIPPA and technological advances?

A. Technology helps to foster HIPPA confidentiality.

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B. Computers help us to share information with others.

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C. Computer screens are not visible to others in the area.

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D. Technology places us at risk for HIPPA violations.

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12. Which technological advance is MOST likely to place you at risk for HIPPA violations?

A. Social media.

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B. Word processing programs.

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C. Spreadsheets.

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D. Clouds and SOEs.

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13. A physician is explaining a procedure to a patient that may cure her recurring Staph infection. The doctor explains how the procedure is done, what to expect, the odds of the procedure curing the infection, and possible side effects and risks. The physician is:

A. Preparing the patient to give informed consent.

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B. Protecting HIPAA by listing all of the steps of the procedure with the risks involved.

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C. Not required to inform the patient of any alternative therapies.

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D. None of the above.

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14. After a lengthy explanation of a medical procedure, the patient asks many questions. The physician answers all of the questions to the best of her ability. The patient then gives consent for treatment. The costly equipment and supplies are put into place and the patient is prepared. Two minutes before the procedure is to start, the patient begins panicking and changes her mind. Which of the following situations would be the best way to avoid litigation?

A. Document that the patient originally gave consent and proceed if the benefits of the procedure outweigh the patient's wishes.

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B. Have the patient sign a form that she is refusing consent. If she refuses to sign, proceed with the procedure.

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C. Repeat the explanation of the procedure until the patient understands that having the procedure done is the best form of treatment. Proceed with the procedure.

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D. Do not proceed. Document the patient's refusal, have the patient sign a refusal to consent to treatment. If the patient refuses to sign the form, have a witness available to sign.

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15. Who of the following wrote a medical code of ethics?

A. Hammurabi.

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B. Tomas Percival.

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C. Hippocrates.

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D. All of the above.

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16. In which of the following examples would informed consent be required?

A. A patient is apprehensive about an upcoming surgery and chooses not to learn of the risks involved with the procedure.

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B. A child is rushed to the Emergency Room after falling from a third story window.

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C. An adult in a coma in a mental health institution with no listed next of kin.

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D. None of the above require informed consent.

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17. A woman has died as a result of a motor vehicle accident. She is listed as an organ donor and her family is considering whether to comply with her wishes. Which of the following is true?

A. The woman would have had to list herself as an organ donor and notify her family prior to her death that she has considered donating her organs.

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B. The Uniform Anatomical Gift Act requires the physician caring for the patient to inform the family who receives the donor organs.

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C. Physicians can choose to go against the deceased's wishes if the family decides that organ donation is not an acceptable choice.

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D. Physicians have the legal responsibility to inform patients of the risks involved in donating organs.

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18. Which of the following choices would best answer the question, “Who owns a patient’s medical record?”

A. The patient.

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B. The physician.

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C. The Legal Counsel of the Office.

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D. No one owns a medical record.

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19. Which of the following choices would best answer the question, “Who owns a patient’s x-rays?”?

A. The patient.

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B. The doctor.

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C. The facility that performed the procedure.

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D. None of the above.

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20. Which of the following reasons would be legal when considering a patient’s medical record?

A. Allowing a patient's brother to view her chart to find out her birthdate and address so that he can mail her a card.

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B. Not allowing a patient to view her own chart because the physician feels this information would be detrimental to her wellbeing.

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C. Not allowing a patient to view her chart because she is behind on her payments.

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D. All of the above are legal.

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21. Choose the BEST answer. To ensure adequate protection for legal issues, offices should maintain patients’ charts for:

A. 10 years.

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B. Forever.

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C. until the age of majority.

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D. 2 years after the patient was last seen in the office.

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22. If a doctor’s order calls for the administration of 500 mg of medication, how many grams should be given?

A. 500

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B. 50

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C. 0.5.

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D. 5

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23. Which of the following medications would be given to treat vomiting?

A. Simvistatin.

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B. Acetaminophen.

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C. Lisinopril.

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D. Promethazine.

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24. Which of the following drugs would be used to treat GERD?

A. Claritin.

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B. Nexium.

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C. Nuprin.

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D. Celebrex.

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25. Of the following medications, which is not used to treat depression?

A. sertraline hydrochloride.

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B. paroxetine hydrochloride.

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C. Citalopram.

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D. Nifedipine.

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26. A doctor’s order is written to give a patient a medication using a non-parenteral route. Which of the following is a non-parenteral route of medication administration?

A. Rectal Suppository.

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B. Intracardiac.

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C. IV drip.

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D. IM injection.

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27. A patient is morbidly obese. Which of the following needles would be best to give an IM injection in the deltoid?

A. 25 gauge 5/8 inch.

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B. 27 gauge 1/2 inch.

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C. 21 gauge needle 1 1/2 inches.

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D. 16 gauge needle 3 inch.

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28. When giving an injection of insulin, which of the following is TRUE?

A. The deltoid muscle is the preferred injection site for insulin.

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B. The angle of the needle should be 90 degrees.

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C. The site should not be massaged after medication administration.

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D. All of the above are true.

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29. If a medication order states that 300 mg of medication are to be given q.i.d. for 10 days, how many total milligrams of medication will be given over those 10 days?

A. 3000 mg.

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B. 9000 mg.

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C. 12000 mg.

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D. None of the above.

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30. A doctor orders 500 mg of medication. Available in stock are one gram tablets. How many tablets should be given to the patient?

A. One.

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B. Two.

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C. One half.

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D. Three quarters.

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31. Which class of medications is foundational to treating the patient with delirium tremens (DTs)?

A. Phenothiazines.

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B. Butyrophenones.

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C. Benzodiazepines.

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D. Anticonvulsants.

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32. Septic, anaphylactic and neurogenic shock are all categorized as:

A. Hypovolemic shock.

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B. Cardiogenic shock.

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C. Distributive shock.

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D. Obstructive shock.

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33. Which of the following is TRUE about shock?

A. A patient with severe shock always has an abnormally low blood pressure.

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B. Confusion and deteriorating mentation are indicative of hypotensive shock.

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C. Patients with compensated shock may be unable to maintain a normal blood pressure.

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D. A normal blood pressure implies that the patient is stable.

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34. Signs and symptoms of stroke may include all of following EXCEPT:

A. Sudden weakness or numbness of the face, arm or leg.

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B. Sudden confusion.

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C. Sudden headache with no known cause.

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D. Hypotension.

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35. Which of the following may cause coup-contrecoup injuries?

A. Rotational forces.

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B. Deformation forces.

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C. Deceleration forces.

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D. Acceleration forces.

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36. Meningitis that is fatal in half of the infected patients is caused by a:

A. Virus.

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B. Bacteria.

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C. Fungus.

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D. Noninfectious agent.

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37. Which of the following may alter the level of consciousness in a patient?

A. Alcohol.

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B. Electrolytes.

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C. Infection.

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D. All of the above may cause altered level of consciousness.

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38. The term used to define uterine bleeding in which there is no menstruation in a 24-year-old woman is:

A. Oligomenorrhea.

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B. Amenorrhea.

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C. Menorrhagia.

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D. Metrorrhagia.

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39. Which of the following diseases, or disorders, is acute?

A. Pneumonia.

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B. Paralysis.

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C. Alzheimer's disease.

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D. Diabetes.

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40. The major difference between a grand mal and petit mal seizure is that a person with a grand mal seizure will have _______________ and the person with a petit mal seizure will not.

A. convulsive movements.

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B. sleep apnea.

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C. atonic movement.

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D. flaccidity.

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41. Your patient has shown the following signs and symptoms : Feeling very thirsty Large amount of water intake Dryness of the mouth Urinary frequency What physical disorder does this patient most likely have?

A. Diabetes.

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B. Angina.

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C. Hypertension.

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D. Hypotension.

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42. You are providing mouth care to a patient who is in a coma. You should________________ to provide good and safe mouth care.

A. keep the head of the bed up so that the patient does not aspirate.

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B. brush the teeth and rinse the mouth with a cup of water.

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C. use a special foam swab to brush only the tongue.

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D. use a special foam swab to brush the tongue and teeth.

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43. This particular gland of the endocrine system secretes a hormone that is known to assist with the sleep/ wake cycle. What gland is it?

A. Pituitary.

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B. Pineal.

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C. Pancreas.

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D. Hypothalamus.

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44. Digestion, elimination and ___________ are the three functions of the digestive system.

A. constriction.

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B. relaxation.

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C. adsorption.

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D. peristalsis.

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45. Which of the following is an example of restorative care?

A. A nurse teaches a new mother how to breastfeed her infant.

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B. A nurse helps a client with developing a bladder-retraining program.

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C. A nurse places an allergy wristband on a client's wrist to notify other providers of potential reactions.

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D. A nurse contacts the family of a client to tell them he will be out of surgery soon.

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46. Your patient has been diagnosed with a left ankle sprain. On the discharge instructions, the physician has prescribed the RICE protocol. This acronym stands for:

A. Rest, Ice, Compression, Elevation.

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B. Radiology, Ice, Compression, Elevation.

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C. Rest, Ice, Cast, Elevation.

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D. Radiology, Ice, Cast, Elevation.

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47. Which of the following interventions is most appropriate when working with the family of a client who is being treated for substance abuse?

A. Advocate for the client before the family.

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B. Provide referrals for community resources and support groups.

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C. Take the side of the family before the client.

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D. Both b and c.

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48. Which of the following is a nursing intervention for a client who is having an acute panic attack?

A. Encourage the client to sit down in a quiet environment.

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B. Allow the client to direct the situation.

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C. Try to focus the client on one aspect of care, such as regulating breathing patterns.

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D. Speak in a commanding tone of voice to get the client's attention.

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49. A nurse is assisting a client who has been diagnosed with depression. Which of the following is an example of a short-term outcome as part of the nursing process for this client?

A. Client will verbalize that depression symptoms have lifted.

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B. Client will identify life stressors that may be contributing to depression.

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C. Client's insomnia will be resolved as evidenced by 8 hours of sleep each night.

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D. Client will identify a mental health counselor in the community with whom she can meet for ongoing therapy.

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50. Which of the following is an example of passive aggression?

A. Clenched fists.

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B. Yelling.

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C. Jealousy.

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D. Intimidation.

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51. A client is being treated for anxiety and desires to be free from anxious feelings and despair. According to Maslow’s hierarchy of needs, which level does this client need to meet?

A. Physiological.

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B. Safety.

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C. Belonging.

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D. Self esteem.

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52. Which of the following examples indicates that the nurse is giving recognition as a form of therapeutic communication?

A. You need to take your medicine now, Adam."

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B. Jill, your father is trying to make amends with you."

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C. The physician wants to meet with you and your husband, Amy."

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D. Linda, you brushed your hair this morning."

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53. During her shift at the hospital, a nurse receives a stern reprimand from a physician over something which she had no control. The nurse does not respond. When she returns home that evening, she sees her children’s toys all over the floor, gets mad, and begins to yell at them. Which form of defense mechanism is this nurse using?

A. Symbolization.

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B. Suppression.

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C. Displacement.

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D. Projection.

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54. A client is receiving treatment for delusional behavior. He believes that his neighbor is purposefully poisoning his water system in an attempt to make him sick. Which of the following responses of the nurse is most appropriate?

A. Did you have the water tested to be sure?"

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B. Why do you feel like your neighbor is trying to poison you?"

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C. Let's just sit here and watch this television program."

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D. Don't be silly; your neighbor would do no such thing."

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55. Which of the following people is at highest risk of suicide?

A. An 80-year old man who lost his wife last year.

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B. A 36-year old woman whose former neighbor committed suicide.

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C. A 40-year old married businessman.

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D. A 46-year old former alcoholic who has been sober for 12 years.

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56. Mrs. J is in the adult ICU on a ventilator. The nurse caring for her recognizes that her endotracheal tube needs suctioning. Based on the nurse’s understanding of this procedure, what level of pressure should the nurse apply while suctioning?

A. 70-80 mmHg.

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B. 100-120 mmHg.

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C. 150-170 mmHg.

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D. 200 mmHg.

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57. The nurse caring for Mrs. J is prepared to suction her endotracheal tube. Which of the following interventions will reduce hypoxia during this procedure?

A. Hyperoxygenate Mrs. J for up to 60 seconds prior to starting.

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B. Administer 15 cc of sterile fluid into the tube prior to suctioning.

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C. Suction for no longer than 30 seconds at a time.

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D. Wait 30 seconds after suctioning before attempting again.

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58. Which of the following conditions is a contraindication for performing a diagnostic peritoneal lavage?

A. A client who is 9 weeks' pregnant.

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B. A client with a femur fracture.

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C. A morbidly obese client.

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D. A client with hypertension.

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59. A nurse is preparing to change a client’s dressing for a burn wound on his foot. Which of the following interventions is appropriate for this process?

A. Wash the wound with cleanser, rinse, and pat dry.

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B. Bind the wound tightly, secure with tape, and elevate the foot.

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C. Contact the physician after the dressing change is complete.

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D. Provide analgesics for the client after the procedure.

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60. A client in end-stage renal disease is receiving peritoneal dialysis at home. The nurse must educate the client about potential complications associated with this procedure. All of the following are complications associated with peritoneal dialysis EXCEPT:

A. Hypotriglyceridemia.

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B. Abdominal hernia.

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C. Anorexia.

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D. Peritonitis.

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61. A nurse is assisting Mr. L, a client who has a new colostomy after a bowel resection. The nurse is teaching this client how to care for his colostomy bag. Which of the following statements from Mr. L indicates the need for more education?

A. I can clean the skin around the ostomy site with soap and water when I change the bag."

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B. I should irrigate the stoma regularly to avoid buildup of gas and odor."

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C. I need to wait Â½ hour after I irrigate to replace the colostomy bag."

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D. I should change the bag when it is one-third to one-fourth full."

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62. Which of the following clients is most appropriate for receiving telemetry?

A. A client with syncope potentially related to cardiac dysrhythmia.

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B. A client with unstable angina.

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C. A client with sinus rhythm and PVCs.

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D. A client who had a myocardial infarction 6 hours ago.

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63. Mr. B is recovering from a surgical procedure that was performed four days ago. The nurseâ€™s assessment finds this client coughing up rust-colored sputum; his respiratory rate is 28/minute with expiratory grunting, and his lung sounds have coarse crackles on auscultation. Which of the following conditions is the most likely cause of these symptoms?

A. Tuberculosis.

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B. Pulmonary edema.

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C. Pneumonia.

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D. Histoplasmosis.

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64. Based on Mr. B’s assessment, what is the first action of the nurse after assessing his condition?

A. Immediately place the client in a negative-pressure room.

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B. Set the client up to receive a bronchoscopy.

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C. Contact the physician for antifungal medications.

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D. Administer oxygen and assist the client to sit in the semi-Fowler's position.

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65. A nurse is dismissing a 5-year old boy from the pediatrics unit to go home with his parents. The parents drive their car to the front door of the hospital and the nurse helps the child get into the car. What type of seat belt restraint should this child wear?

A. A 5-point restraint in the back seat, facing backward.

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B. A booster seat with a lap and shoulder belt in the back seat.

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C. A lap belt in the back seat.

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D. A lap and shoulder belt in the front seat.

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66. A nurse is employed at a district health department and must spend several hours each day sitting at a desk. Which principle of ergonomics will most likely help her to reduce the risk of injury or pain in this situation?

A. Adjust the chair height to keep the legs bent at the hips at a 90-degree angle.

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B. Maintain the position of the computer monitor just below eye level.

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C. Stand up and take a walk or stretch every 4 hours.

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D. Rest wrists on the edge of the desk while typing.

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67. Which of the following indicates the need to file an incident report?

A. The neon sign directing parking for visitors has burned out.

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B. A nurse must send a syringe pump to maintenance for annual service.

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C. A client's blood pressure dropped to 90/55 after receiving a dose of morphine.

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D. A client's spouse becomes angry and is asked to leave the premises.

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68. Which of the following actions of the nurse is most appropriate to reduce the risk of infection during the post-operative period?

A. Flush the central line with heparin at least every four hours.

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B. Administer narcotic analgesics prn.

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C. Remove the urinary catheter as soon as the client is ambulatory.

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D. Order a high-protein diet for the client.

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69. Which of the following is an example of an environmental hazard that may put the nurse at risk of injury?

A. Loud noise from the hospital maintenance system.

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B. Airborne powder that contains latex.

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C. Chemicals containing ethylene oxide.

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D. All of the above.

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70. A nurse is caring for a client’s wound that has started to bleed. After providing wound care, the nurse removes her gloves and notes that a small amount of the client’s blood has come in contact with her hand. What is the next action of the nurse?

A. Use an alcohol-based hand sanitizer to disinfect the hands.

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B. Wash hands with soap and water using appropriate technique.

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C. Notify the occupational health nurse about an exposure to a client's blood.

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D. Sample some of the client's blood to determine the presence of diseases.

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71. A nurse must attend a high-risk delivery in a client’s room. After the infant has been delivered, the nurse immediately takes him to a warmer for assessment. What is the minimum amount of personal protective equipment for the nurse when working with this newborn?

A. Sterile gown, gloves.

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B. Mask, gown, shoe covers.

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C. Gloves.

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D. Hat, mask, gloves, gown, shoe covers.

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72. Which of the following diseases would require the nurse to wear an N95 respirator as part of personal protective equipment?

A. Human immunodeficiency virus.

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B. Clostridium difficile enterocolitis.

Correct Incorrect Correct answer

C. Vancomycin-resistant enterococcus.

Correct Incorrect Correct answer

D. Measles.

Correct Incorrect Correct answer

73. A 62-year-old male client presents to the emergency department via EMS after the wife reported that the client experienced a sudden onset of shortness of breath, chest pain, and restlessness. Upon arrival, the client is restless, reporting, “I can’t breathe.”

A. Metabolic alkalosis without compensation.

Correct Incorrect Correct answer

B. Respiratory acidosis without compensation.

Correct Incorrect Correct answer

C. Respiratory alkalosis with compensation.

Correct Incorrect Correct answer

D. Metabolic acidosis with compensation.

Correct Incorrect Correct answer

74. The monitor begins alarming, and the nurse looks up and observes the client’s heart rate dropping to 30 bpm and then to 0. Which action should the nurse perform next?

A. Pause the ventilator and begin CPR.

Correct Incorrect Correct answer

B. Prepare 1 mg of Epinephrine.

Correct Incorrect Correct answer

C. Call the healthcare provider.

Correct Incorrect Correct answer

D. Check the client for a femoral pulse.

Correct Incorrect Correct answer

75. The nurse determines the client has a pulse and transfers the client to CT, where it is confirmed the client has a saddle pulmonary embolism. The healthcare provider prescribes a Fibrinolytic alteplase after the client becomes hypotensive. Which intervention should the nurse perform while the client is receiving this medication?

A. Monitor the amount and color of urine hourly.

Correct Incorrect Correct answer

B. Utilize a sheet to slide the client for transfers.

Correct Incorrect Correct answer

C. Obtain multiple sites of venous access.

Correct Incorrect Correct answer

D. Document bruising as an expected finding.

Correct Incorrect Correct answer

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NCLEX 8

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