Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow
Student Elements

NCLEX Review

Please read each question and select your answer from the choices provided. You must complete all of the questions in order to view your results. At the end of each exam, you have the option to e-mail your results to your instructor.

1:  A patient is hospitalized for an acute exacerbation of ulcerative colitis. The patient is experiencing 14 to 16 bloody stools per day as well as cramping and abdominal pain. The physician orders the patient to have nothing by mouth (NPO) on admission. What is the rationale for the NPO order?
A: To prevent nausea and vomiting.
B: To decrease abdominal distention.
C: To promote bowel rest and healing.
D: To prepare the patient for diagnostic testing.

2:  Which intervention should the nurse anticipate implementing during the emergency care of a patient with diabetic ketoacidosis?
A: Administer NPH insulin by subcutaneous injection.
B: Administer regular insulin by intramuscular injection.
C: Administer regular insulin by the intravenous route.
D: Administer glargine insulin by inhalation.

3:  A patient reports having clay-colored stools. What is the pathophysiologic basis for the finding?
A: Bile is not being broken down by the bacterial flora of the intestine.
B: There is a lack of bilirubin in the intestine to color the feces.
C: A decrease in the amount of cholecystokinin prevents the release of lipase.
D: There is too much bilirubin in the intestine, causing discoloration of stools.

4:  A 21-year-old female patient is seen in the clinic with complaints of dyspnea, fatigue, and lightheadedness. She reports that her menstrual periods are heavy. Laboratory findings show a low hemoglobin, hematocrit, and red blood cell (RBC) count. The RBC smear revealed microcytic, hypochromic cells. With which type of anemia are these findings consistent?
A: Folic acid-deficiency anemia.
B: Vitamin B12 anemia.
C: Iron-deficiency anemia.
D: Acute blood loss.

5:  A patient is admitted with a diagnosis of ruptured cerebral aneurysm. The condition is most often manifested by which patient finding?
A: "I was unable to speak for about 30 minutes."
B: "This is the worst headache I have ever had."
C: "I lost control of my bowels and bladder."
D: "I am unable to move my left side."

6:  Given four CD4 T-cell values for patients diagnosed with an HIV infection, identify the patient who is at greatest risk for the development of an opportunistic infection?
A: 100 cells/mm3.
B: 400 cells/mm3.
C: 800 cells/mm3.
D: 1,200 cells/mm3.

7:  A meat cutter lacerates a finger. The healthcare provider sutures the wound closed. Wound healing will occur by which process?
A: Primary intention.
B: Secondary intention.
C: Granulation.
D: Proliferation.

8:  Which skin disorder develops on sun-exposed areas, is seen in elderly patients, and would be considered a pre-malignant skin lesion?
A: Solar lentigines.
B: Actinic keratoses.
C: Nevocellular nevi.
D: Seborrheic keratoses.

9:  Identify a clinical manifestation of the early or first stage of Alzheimer's disease?
A: Difficulty with problem solving.
B: Inability to recognize family or friends.
C: Short-term memory loss.
D: Wandering.

10:  Which finding is characteristic of diabetes insipidus?
A: Delayed development.
B: Hyperglycemia.
C: Virilization of females.
D: Copious, dilute urine.

11:  The nurse is assessing an adult male patient with no significant past medical history who was admitted to the Emergency Department. The assessment findings include a decrease in level of consciousness; rapid, shallow respirations; nasal flaring; sternal and intercostal retractions; and cyanosis around the lips and oral mucosa. The ABG reveals pH 7.24, pCO2 55, and PaO2 50. Which statement best describes these findings?
A: Acute respiratory distress with respiratory acidosis and hypoxemia.
B: Mild respiratory distress with a acidosis and hypoxemia.
C: Acute respiratory distress with respiratory alkalosis and hypoxemia.
D: No distress; ABG is normal.

12:  Upon assessment of a burn victim, the nurse finds reddened skin with mild edema. Thin-walled blisters are present, and the patient complains of pain. These assessment findings are indicative of which type of burn injury?
A: Superficial.
B: Superficial partial thickness.
C: Deep partial thickness.
D: Full thickness.

13:  A patient has swelling in the ankles and feet associated with prolonged standing. Which description best explains the reason for the swelling?
A: Increased hydrostatic pressure.
B: Decreased osmotic pressure.
C: Increased capillary permeability.
D: Altered lymph channels.

14:  The nurse is developing a case study about Graves' disease. When explaining the pathophysiology, what should be discussed as the cause of Graves' disease?
A: Hypersecretion of thyroid hormone.
B: Hyposecretion of thyroid hormone.
C: Hyposecretion of thyroid-stimulating hormone.
D: Hypersecretion of adrenocorticotrophic hormone (ACTH).

15:  Because of hypoxia, a patient's cells have converted to anaerobic metabolism. Which substance accumulates in the cells as a result of anaerobic metabolism?
A: Free radicals.
B: Lactic acid.
C: Myoglobin.
D: Lipofuscin.

16:  The nurse in the newborn nursery is discussing the genotype of Down syndrome with a nursing student. Which statement should the nurse include in the discussion?
A: "Down syndrome is caused by a missing X chromosome."
B: "Down syndrome is caused by the trisomy of chromosome 21."
C: "A characteristic of Down syndrome is mental retardation."
D: "Microencephaly is associated with Down syndrome."

17:  The nurse is preparing a staff conference on the care of patients with head injuries. When discussing interventions used to minimize or treat increased intracranial pressure, which intervention should the nurse include in the presentation?
A: Administration of beta blockers to decrease the buildup of excitatory amino acids.
B: Induction of a coma state using barbiturates to reduce the patient's metabolic rate.
C: Administration of furosemide (Lasix) to reduce cerebral edema.
D: Increasing the PaCO2 level to promote cerebral vasodilation.

18:  Cullen's sign may be indicative of which condition?
A: Basilar skull fracture.
B: Hemothorax.
C: Pelvic fracture.
D: Hemorrhagic pancreatitis.

19:  What clinical manifestation would the nurse expect to find in a patient diagnosed with heat stroke?
A: Hot, dry, ashen skin.
B: Profuse perspiration.
C: Muscle cramps.
D: Thirst.

20:  With asthma, what is the primary cause of airway constriction?
A: Thick mucus produced by hypertrophied glands.
B: Viral infection that produces a toxin.
C: Bronchospasm secondary to the inflammatory response.
D: Thinning of the smooth muscle in the bronchioles.

21:  A teenage patient presents to the outpatient clinic with complaints of pharyngitis, fever, and fatigue. The physical examination reveals splenomegaly and swollen anterior and posterior cervical lymph nodes. The history reveals a recent exposure to a virus. Which clinical condition should the nurse suspect?
A: Non-Hodgkin's lymphoma.
B: Acute myelocytic leukemia.
C: Mononucleosis.
D: Agranulocytosis.

22:  Which agent of bioterrorism has no established treatment?
A: Bacillus anthracis (anthrax).
B: Clostridium botulinum (botulism).
C: Francisella tularensis (tularemia).
D: Ebola virus (hemorrhagic fever).

23:  A patient presents to the emergency room with a productive cough, elevated white blood cell (WBC) count, and fever. A chest x-ray reveals consolidation in the left lower lobe. Pneumonia is diagnosed. Which term most accurately describes this type of infection?
A: Community-acquired infection.
B: Prodromal infection.
C: Atypical infection.
D: Nosocomial infection.

24:  Upon review of the interdisciplinary progress notes, the nurse finds that a patient is neutropenic. The nurse understands that the patient care plan should reflect observations for what problem?
A: Gastrointestinal bleeding.
B: Pulmonary emboli.
C: Respiratory infections.
D: Venous thrombosis.

25:  A patient had a respiratory arrest and required endotracheal intubation. Which auscultory findings would indicate correct placement of the tube?
A: Auscultate bilateral breath sounds, and observe the chest wall rising and falling.
B: Auscultate stomach gurgling when ventilating the patient, and observe no rise or fall of the chest wall.
C: Auscultate breath sounds only on the right, and observe rise and fall of the chest wall on the right.
D: Auscultate stomach gurgling when ventilating the patient, and observe chest rise only on the left side of the chest.

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