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Ncsbn practice Exam Prep Questions And Answers ()
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Ncsbn practice Exam Prep Questions And Answers (202472025)The nurse is reviewing a new prescription for a client with conjunctivitis that reads: Administer
ciprofloxacin solution 1 gtt OD Q4H. Which action should the nurse take next? - ✔✔Contact the
prescriber to clarify and rewrite the order.
Abbreviations, symbols and dose designations can be misinterpreted and lead to medication errors.
"OD" can mean "right eye" (oculus dexter) or "once daily"; it should never be used when
communicating medical information. The abbreviation "Q" should be written out as "every".
Although "gtt" is not on the official "Do Not Use List", it is best to use "drop" instead. Asking
other nurses to interpret an order is a potentially dangerous workaround. The next action the nurse
should take is to call the primary health care provider (HCP) who prescribed the medication and
clarify the order.
The nurse working at a community health clinic is screening clients for risk factors of hypertension.
Which client is at highest risk for developing hypertension? - ✔✔A 65-year-old African American
male.
The incidence of hypertension (HTN) is greater among African Americans than other groups in
the United States. Males have higher rates of HTN than females. Increased age also increases the
risk for developing HTN. Therefore, the client with all of these risk factors is at highest risk for
developing hypertension.
The nurse on an inpatient hospital unit answers a call light and enters a client's room. The client
expresses anger stating they have been waiting for more than 5 minutes for a blanket. Which is the
best response from the nurse? - ✔✔"I see this is frustrating for you. I have a few minutes so let's
talk."
The best response from the nurse acknowledges the client's verbalized needs and encourages an
open conversation. To say "let's talk" and ask a "why" question is not a therapeutic approach
because it does not acknowledge or validate the client's feelings. To apologize and not
acknowledge the client's feelings is inappropriate. It is rude for the nurse to tell a client their request
could wait a few minutes, and this response does not acknowledge the client's verbalized needs.
The nurse is planning care for a 2-year-old hospitalized child. Which issue will produce the most
stress at this age? - ✔✔separation anxiety
,Toddlers experience separation from their parents as a major stressor. Separation anxiety peaks in
the toddler years and will produce the most stress at this age.
The clinic nurse is assisting with medical billing. The nurse uses the Diagnosis Related Group
(DRG) manual for which purpose? - ✔✔To determine reimbursement for a medical diagnosis.
DRGs are the basis of prospective payment plans for reimbursement for Medicare clients. Other
insurance companies often use it as a standard for determining payment. The nurse uses this
manual to determine reimbursement for medical diagnoses.
A woman who is 5 days postpartum and has a history of pregnancy-induced hypertension, calls
the hospital triage nurse hotline to ask for advice. She states, "I have had the worst pounding
headache for the past two days. Since this afternoon, everything I look at appears blurred. Nothing
I have taken helps." What action should the nurse take? - ✔✔Instruct the client to call 911 to be
brought to the nearest emergency room.
The woman is describing symptoms related to pregnancy-induced hypertension (PIH) that appears
to be progressing to preeclampsia/eclampsia. PIH may progress to preeclampsia and eclampsia
prior to, during, or up to 10 days after delivery. This places the woman at risk for seizure activity
which is a medical emergency. The client should call 911 to be brought immediately to the closest
emergency room (ER).
A client is admitted to an ambulatory surgery center and underwent a right inguinal orchiectomy.
Which goal is the priority before the client should be discharged home? - ✔✔The client's
postoperative pain is well-managed.
An orchiectomy is the surgical removal of one or both testicles. It is usually performed to treat
cancer (testicular, prostate, or cancer of the male breast). Due to the location of the incision, pain
management is the priority. Most men will be able to eat regularly when they get home. They
should at least tolerate liquids before discharge. The client should be able to walk without
assistance prior to discharge. Psychological counseling may be needed as part of long-term
aftercare; however, this is not the priority prior to discharge.
,The nurse in an intensive care unit is reviewing the laboratory results for several clients. Which
laboratory result indicates that the client has a partially compensated metabolic acidosis? -
✔✔PaCO2 of 30 mmHg
With metabolic acidosis, the nurse should expect to see a low pH (less than 7.35) and a low HCO3
(less than 22 mEq/L). Compensation means that the body is trying to get the pH back to a normal
range of 7.35 to 7.45. A pure metabolic acidosis will elicit a compensatory response by the lungs
in form of a decrease in PaCO2 (normal range is 35 to 45 mm Hg). Therefore, the PaCO2 level of
30 mm Hg indicates a partially compensated metabolic acidosis. A pH of 7.48 indicates an
alkalosis and the chloride level does not pertain to the acid-base imbalance or compensation.
The nurse is caring for a client with breast cancer who received chemotherapy one week ago.
Which finding is the priority to report to the health care provider? - ✔✔Fever and chills
Chemotherapy causes myelo or bone marrow suppression, resulting in neutropenia, the reduction
in neutrophils (white blood cells) that fight off infections. Neutropenic, i.e., immunocompromised,
clients are at an increased risk for infection, sepsis and septic shock and the nurse has to be extra
vigilant in monitoring for early signs of infection. A fever and chills are indicative of a possible
infection and take priority to be reported to the HCP. The other findings are also important to note
and should be addressed by the nurse after notifying the HCP of the fever and chills.
A nurse is teaching a group of adults about modifiable risk factors for cardiovascular disease.
Which risk factor is most important to include? - ✔✔smoking cessation
Smoking cessation is a priority for clients at risk for cardiac disease. Smoking's effects result in
reduction of cell oxygenation and constriction of the blood vessels. All of the other factors should
be addressed at some point in time, but the priority modifiable cardiac risk factor is smoking.
A child is treated with succimer for lead poisoning. Which of these assessments is the priority? -
✔✔Check the client's complete blood count with differential.
Succimer is used in the management of lead or other heavy metal poisoning. Although it is
generally well-tolerated and has a relatively low toxicity, it may cause neutropenia. Succimer
therapy should be withheld or discontinued if the absolute neutrophil count (ANC) is below
1,200/mm3. The normal range for an ANC is 1.5 to 8.0 (1,500 to 8,000/mm3). Therefore, the
, assessment priority in this scenario is checking the complete blood count (CBC) with differential
which includes an ANC value.
The nurse in the postanesthesia care unit is caring for a client who is recovering from a left lower
lobectomy. The client has a chest tube in place. While repositioning the client during the first post-
op check, the nurse notices 75 mL of a dark red fluid flowing into the collection chamber of the
chest drainage system. What action should the nurse take? - ✔✔Continue to monitor the rate of
the drainage.
Following a lobectomy, it is not unusual for blood to collect in the chest and be released into the
chest drainage system when the client changes positions. This is most common in the immediate,
post-operative phase. The dark color of the blood indicates it is likely old blood and there is not
active bleeding inside of the chest. Sanguineous drainage should be expected within the initial 24
hours post-op, progressing to serosanguineous, and then to a serous type. If the drainage exceeds
approximately 100 mL in one hour, then the nurse should call the surgeon. In this case, the nurse
should continue to monitor the rate of the drainage.
A client is transported to the emergency department after a motor vehicle accident. When assessing
the client 30 minutes after arrival, the nurse notes several physical changes. Which finding requires
immediate attention? - ✔✔tracheal deviation
Tracheal deviation is a sign that a mediastinal shift has occurred, most likely due to a tension
pneumothorax. Air escaping from the injured lung into the pleural cavity causes pressure to build,
collapsing the lung and shifting the mediastinum to the opposite side. This obstructs venous return
to the heart, leading to circulatory instability and may result in cardiac arrest. This is a medical
emergency, requiring emergency placement of a chest tube to remove air from the pleural cavity
relieving the pressure. The other findings are most likely related to the potential pneumothorax.
The nurse is assessing a 4-year-old child who is in skeletal traction 24 hours after surgical repair
of a fractured femur. The child is crying and appears to be having severe pain. The foot on the
affected extremity is pale, cool to touch and the pulse is barely palpable. What action should the
nurse take? - ✔✔Notify the primary health care provider.
The pain and absence of a pulse suggests compartment syndrome. This condition occurs when
there is a buildup of pressure within the muscles. This pressure decreases blood flow and can cause
muscle, tissue, and nerve damage. Compartment syndrome is a medical emergency. Delaying
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