It's Real NCLEX 3B
It's Real NCLEX 3B
It's Real NCLEX 3B
1. Which of the following obstetric clients should the nurse see first?
A. The client who is 40 weeks gestation having contractions every 5 minute lasting
50 seconds
B. The client who is 32 weeks gestation with terbutaline (brethinc) intravenously
C. The one-day postpartum client who has changed two peri-pads in the last six
hours
D. The diabetic obstetric client with a glucose level of 90mg/dL
2. The client visits the prenatal clinic stating she believes she is pregnant. A pregnancy
test is done to detect elevated levels of:
A. Prolactin
B. Human chorionic gonadotropin
C. Lecithin-sphingomyelin
D. Estriol
4. The pregnant client with AIDS is diagnosed with cytomegalovirus. The nurse is aware
that the client probably contracted cytomegalovirus from:
A. Blood or body fluid exposure to the virus
B. Emptying her cat’s litter box
C. Contaminated food or water
D. Pigeon feces
5. Which test is most diagnostic for syphilis?
A. Culture
B. VDRL
C.RPR
D. FTA-ABS
6. The client is diagnosed with genital herpes. Which medication is used to treat genital
herpes?
A. Acyclovir (zovirax)
B. Podophyllin
C. AZT (retrovir)
D. Isoniazid (lanzid
2. Answer B is correct. HCG levels elevate rapidly and can be detected as early two days
after the missed period. Answer A is incorrect because prolactin is elevated with a
prolactinoma, a type of pituitary tumor. Answer C is incorrect because
lecithin/sphingomyelin (L/S ratio) is indicative of lung maturity. Answer D is incorrect
because estriol levels indicate fetal well-being.
3. Answer C is correct. The client that has experienced a hydatidiform mole should avoid
becoming pregarent again for one year because chorionic carcinoma is associated with
hydatidiform mole. If the client does become pregnat and there are cells for chorionic
carcinoma, the hormonal stimulation can cause rapid cell proliferation and growth of the
cancer. Answer A is incorrect because a urinalysis in six weeks is not necessary. Answer
B is incorrect because exercise is not contraindicated after a hydatidiform mole. Answer
D is incorrect because checking liver enzymes in six months is not necessary after a
hydatidiform mole.
PEDIATRIC CARE
1. The nurse is caring for a child with neutropenia. Which beverage is unsuitable for the
A. 2% milk
B. Fresh squeezed lemonade
C. Kool-Aid
D. Ginger ale
Answer B is correct.
Rational:
Clients with a low neutrophil count should adhere to a low bacteria diet. Fresh squeezed
lemonade can be contaminated from bacteria on the lemon rind. Answers A,C, and D are
suitable for the client with neutropenia therefore they are incorrect.
2. The physician has ordered a sweat test a child suspected of having cystic fibrosis. A
A. Chloride level
B. Potassium transport
C. Serum sodium
D. Calcium level
Answer A is correct.
Rational:
A positive sweat testis reflected by elevations in the chloride level. Answers B, C and D
are not measured by the sweat test; therefore they are incorrect.
3. The nurse is conducting a scoliosis screening clinic at the local school. The nurse knows
A. Adolescent males
B. Preteen males
C. Preteen females
D. Adolescent females
Answer D is correct.
Rational:
The most likely group to have scoliosis is adolescent girls. The groups in answers A, B,
and C are not as likely to have scoliosis; therefore, those answers are incorrect.
4. During a routine well-child check-up, the mother of a toddler asks when she should
schedule her child’s first dental visit. The nurse’s response is based on the knowledge
A. 12 months
B. 18 months
C. 24 months
D. 30 months
Answer D is correct.
Rational:
Most children have all their primary teeth by age 30 months. Answers A, B, and C are
a. Ribavirin
b. Respigam
c. Sandimmune
d. Synagis
Rasional.
Answer A is correct. The only effective treatment of bronchiolitis
(respiratori synctial virus) is ribavirin. Answers B dan D are incorrect
because they are used prophylactically, not as a treatment for
bronchiolitis. Sandimmune, an immunosupperssive drug, is not used for
treating bronchiolitis; therefore, Answer C is incorrect.
PHSYCIATRIC
When assessing the risk of suicide for a depressed client, the nurse knows that :
A. People who talk about suicide are not likely to harm themselves.
B. The availability of means is essential to even the simplest suicide plan.
C. Clients who survive unsuccessful suicide attempts are not likely to try
again.
D. An overdose of pills is never as lethal as injury by firearms.
2. The diagnoses of conduct disorder and antisocial personality are both caracterized by :
c. Consistent parenting
Answer A is correct. The child with conduct disorder and the adult with antisocial personality
disorder are characterized by lack of guilt or remorse for wrongdoings. Answer B is incorrect
because both can have a higher than average IQ. Answer C is incorrect because both have a
history of parental neglect or inconsistent parenting. Answer D is incorrect because both lack
close friendships.
3. The physician has ordered a sweat test for a child suspected of having cysticfibrosis. A positive
sweat test is based on :
a. Chloride level
b. Potassium transport
c. serum sodium
d. calcium level
Answer A is correct. A positive sweat test is reflected by elevations in the chloride level. Answers
B,C, and D are not measured by the sweat test; therefore, they are incorrect.
5. A client with depression and suicidal ideation is admitted to the behavioral healthunit
for observation. Which of the followinginterventions provides best for the client’s safety?
a. Hyponatremia
b. Hypercalcemia
c. Hypocalcemia
d. Hypernatremia
Answer A is correct. The client who is taking lithium needs an adequate intake of sodium
and fluid to prevent the development of lithium toxicity. Answer B, C, and D are
incorrect.
7. a client schedule for electroconvulsive theraphy asks the nurse how the theraphy helps relieve
her depresiion. The nurse’s response is based on an understanding that ECT:
Answer:
1. The nurse is triaging four clients injured in a train derailment. Which client
should receive priority treatment?
Answer :A
Rationale :
Answer A is correct. Following the ABCDs of basic emergency care, the client
with dyspnea and asymmetrical chest should be cared for first because these
symptoms are assosiated with flail chest. Answer D is incorrect because he should
cared for second because of the likehood of organ damage and bleeding. Answer
B is incorrect because he should be cared for after the client with abdominal
trauma. Answer C is incorrect because he should receive care last because his
injuries are less severe.
2. Direct pressure to adeep laceration on the client’s lower leg has failed to stop
the bleeding. The nurse’s next action should be able to:
Answer :B
Rationale :
Answer B is correct. If bleeding does not subside with direct pressure, the nurse
should elevate the extremity above the level of the heart. Answer A and D are
done only if other measures are ineffective, so they are incorrect. Answer C would
slow the bleeding, but will not stop it, so it’s incorrect.
Answer :A
Rationale :
Naswer A is correct. Warming the intarvenous fluid helps to prevent further stress
on the vascular system. Thirst is a sign of hypovolemia; homever, oral fluids alone
will not meet the fluid needs of the client in hypovolemic shock, so anwer B is
incorrect. Answer C and D are wrong because they can be used for baseline
information but will not help stabilize the client.
4. A client with a history of severe depression has been brought to the emergency
room with an overdose of barbiturates. The nurse should pay careful attention
to the client’s:
A. Urinary output
B. Respirations
C. Temperature
D. Verbal responsiveness
Answer :B
Rationale :
A. Acetylcystein
B. Deferoxamine
D. British anti-lewisite
Answer :B
Rationale :
Answer :B
Rationale :
Answer B is correct. The nurse should perform the skin or eye test before
administering antivenin. Answer A and D ar unnecessary and therefore incorrect.
Answer C would help calm the client but is not a priority before giving the
antivenin, making it incorrect.
LEGAL ISSUES
1. Wich information should be reported to the state board of nursing?
b. The narcotic count has been incorrect on the unit for the fast three days.
c. The client fails to receive an intemized account of his bills and services received
during his hospital stay.
d. The nursin assistan assigned to the client hepatitis fails to feed the client and
give him a bath.
Answer B is correct. The Joint Commission on Accreditation of Hospital will probably be
interested in the problems in answer A and C, so they are incorrect. The failure of the nursing
assistan to assist the client with hepatitis should be reported to the charge nurse. If the behavior
continues, termination can result, but it doesn’t need to be reported to the board. So answer D
is incorrect.
2. The charge nurse witnesses the nursing assistant being abusive to a client in the nursing
home facility. The nursing assistant can be charged with which of the following ?
a. Negligence
b. Tort
c. Assault
d. Malpractice
Rational
3. which nurse should be assigned to care for the client with preeclampsia?
a. The RN with 2 weeks experience on postpartum
b. The RN with 3 years experience in labor and delivery
c. The RN with 10 years experience in surgery
d. The RN with 1 year experience in the neonatal intensive care unit
Answer:
Answer B is correct. The nurse in answer B has the most experience in knowing
the possible complications involved with preeclampsia. The nurse in answer A is a new
nurse to this unit, so the answer is incorrect. The nurse in experience with postpartal
client, so the answer is incorrect. The nurse in answer D also has no experience with
postpartal clients, so the answer is incorrect.
4. Which assigment is outside the realm of nusing practice for the licensed practical
nurse?
A. Inserting a foley catheter
B. Discontinuing a nasogastric tube
C. Obtaining a sputum specimen
D. Starting a blood transfusion
The Answer is:
D
Rational:
The LPN can be assigned to insert Foley and French urinary catheters, discontinue Levin
and gavage gastric tubes, and obtain all types of specimens.
5. The client returns to the unit from surgery with a blood pressure of 100/50,
pulse 122, and respiration 30. Which action by the nurse should receive
priority?
• A. Continue to monitor the vital signs
• B. Contact the physician
• C. ask the client how he feels
• D. Ask the LPN to continue the post op care
Answer B is correct.
• RATIONAL: The vital signs are abnormal and should be reported’
immediately. Continuing to monitor the vital signs can result in
deterioration of the client’s condition, so answer A is incorrect. Asking
the client how he feels would supply only subjective data, so answer C is
incorrect. The LPN is not the best answer to be assigned to this client
because he is unstable, so answer D is incorrect
•
( CULTURAL PRACTICES INFLUENCING NURSING CARE )
1. a japanese client refuse ton eat the ice cream or drink the milk on his tray. which
action by the nurse would indicate an undestanding of the client's needs ?
c. she removes the milk from the tray and says nothing to the client
d. she asks the client why he will not drink the milk
answer : B is correct . many of Japanese descent are lactose intolerant- it is not that milk
not allowed in their culture. Yogurt also causes gas and bloating, so answer A is
incorrect. Removing the items from the tray does not provide the needed calcium in the
diet, so answer C is incorrect. It is inappropriate to ask “why” in most cultures, so answer
D is incorrect
a. Insulin
b. Cough syrup
c. NSAIDs
d. Antacida
Answer : B is correct . most cough syrup contain alcohol, which is forbidden in the
Islamic religion. Attempts should be made to obtain cough suppressant that does
not contain alcohol. The client will most will most likely take insulin, nonsteroidal
anti imflamatory drugs, and antacids, so answer A,C, and D is incorrect
3. The client is practicing Hindu. Which food should be removed from the clients tray
a. Bread
b. Cabbage
c. Steak
d. Apple
Answer : C is correct. In the Hindu religion , beef prohibited. All breads, vegetables,
and fruits are allowed, so answer A,B and D are incorrect
4. The condition of an Arab client who is terminally ill deteriorates and death seems
imminent. If the client is hospitalized in the mainland Inited States, the nurse should
position the bed facing which direction ?
a. Northeast
b. Southeast
c. West
d. South
Answer : answer B is correct . at the time of death, the Muslim client will wish to be
positioned facing Mecca, which is to the southeast of the United States. Answer A,C,
and D are therefore incorrect .
A. Beef
B. Pork
C. Synthetic
D. Fish
Rational :
1. The nurse observes that a hispanic client and his family have been late for their appointment
the last three times. Which of the following is the best explaination for this behavior :
d. the client and family view time differently than does the nurse
Answer D is correct. If the client misses and appointment or is late for the appointment, it is not
necessarily true that the client is disinterested or forgot. Mny in the hispanic culture see time as
a relative thing and live in the present.
Answer B
Primata facilities government and non government facilities that provisi basis out-patient service
A. Community organizing .
B. Nursing, process
C. Community diagnosis
D. Epidemiologic process
5. Which of the following is the most prominent feature of public health nursing?
• A. It involves providing home care to sick people who are not confined in
the hospital.
• B. Services are provided free of charge to people within the catchment area.
• C. The public health nurse functions as part of a team providing a public
health nursing services.
• D. Public health nursing focuses on preventive, not curative, services
•
• (D) Public health nursing focuses on preventive, not curative, services.
•
• Rational : the catchment area in public health nursing consists of a
residential community, many of whom are well individuals who have
greater need for preventive rather than curative services.