NCSBN TEST BANK EXAM LATEST 2023

LATEST UPDATE 2023 NCSBN TEST BANK EXAM QUESTIONS & ANSWERS (100% VERIFIED) NCSBN TEST BANK EXAM-2023 1.A client has been hospitalized after an automobile accident. A full leg cast was applied in theemergency room. themost important reason for thenurse to elevate thecasted leg is to A) Promote theclient's comfort B) Rthe dryingdrying time C) Decrease irritation to theskin D) Improve venous return D: Improve venous return. Elevating theleg both improves venous return and reduces swelling. Client comfort will be improvedas well. 2. The nurse is reviewing with a client how to collect a clean catch urine specimen. What is theappropriate sequence to teach theclient? A) Clean themeatus, begin voiding, then catch urine stream B) Void a little, clean themeatus, then collect specimen C) Clean themeatus, then urinate into container D) Void continuously and catch some of theurine A: Clean themeatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires cleardirections. Instructing theclient to carefully clean themeatus, then void naturally with a steady stream prevents surface bacteriafrom contaminating theurine specimen. As starting and stopping flow can be difficult, once theclient begins voiding it’s best tojust slip thecontainer into thestream. Other responses do not reflect correct technique 3. Following change-of-shift report on an orthopedic unit, which client should thenurse see first? A) 16 year-old who had an open reduction of a fractured wrist 10 hours ago B) 20 year-old in skeletal traction for 2 weeks since a motor cycle accident C) 72 year-old recovering from surgery after a hip replacement 2 hours ago D)75 year-old who is in skin traction prior to planned hip pinning surgery. C: Look for theclient who has themost imminent risks and acute vulnerability. theclient who returned from surgery 2 hoursago is at risk for life threatening hemorrhage and should be seen first. the16 year- old should be seen next because it is still thefirst post-op day. the75 year-old is potentially vulnerable to age-related physical and cognitive consequences in skin tractionshould be seen next. theclient who can safely be seen last is the20 year-old who is 2 weeks post-injury. 4. A client with Guillain Barre is in a nonresponsive state, yet vital signs are stable and breathing is independent. What should thenurse document to most accurately describe theclient's condition? A) Comatose, breathing unlabored B) Glascow Coma Scale 8, respirations regular C) Appears to be sleeping, vital signs stable D) Glascow Coma Scale 13, no ventilator required B: Glascow Coma Scale 8, respirations regular. theGlascow Coma Scale provides a standard reference for assessing ormonitoring level of consciousness. Any score less than 13 indicates a neurological impairment. Using theterm comatose providestoo much room for interpretation and is not very precise. 5. When caring for a client receiving warfarin sodium (Coumadin), which lab test would thenurse monitor to determine therapeuticresponse to thedrug? A) Bleeding time B) Coagulation time C) Prothrombin time D)Partial thromboplastin time C: Prothrombin time. Coumadin is ordered daily, based on theclient''s prothrombin time (PT). This test evaluates theadequacyof theextrinsic system and common pathway in theclotting cascade; Coumadin affects theVitamin K dependent clotting factors. 6. A client with moderate persistent asthma is admitted for a minor surgical procedure. On admission thepeak flow meter is measuredat 480 liters/minute. Post-operatively theclient is complaining of chest tightness. thepeak flow has dropped to 200 liters/minute.What should thenurse do first? A) Notify both thesurgeon and provider B) Administer theprn dose of albuterol C) Apply oxygen at 2 liters per nasal cannula D) Repeat thepeak flow reading in 30 minutes B: Administer theprn dose of albuterol. Peak flow monitoring during exacerbations of asthma is recommended for clients withmoderate-to-severe persistent asthma to determine theseverity of theexacerbation and to guide thetreatment. A peak flowreading of less than 50% of theclient''s baseline reading is a medical alert condition and a short-acting beta-agonist must be takenimmediately. 7.A client had 20 mg of Lasix (furosemide) PO at 10 AM. Which would be essential for thenurse to include at thechange of shiftreport? A) theclient lost 2 pounds in 24 hours 1 B) theclient’s potassium level is 4 mEq/liter. C) theclient’s urine output was 1500 cc in 5 hours D) theclient is to receive another dose of Lasix at 10 PM C: theclient’s urine output was 1500 cc in 5 hours. Although all of these may be correct information to include in report, theessential piece would be theurine output. 8.A client has been tentatively diagnosed with Graves' disease (hyperthyroidism). Which of these findings noted on theinitial nursing assessment requires quick intervention by thenurse? A) a report of 10 pounds weight loss in thelast month B) a comment by theclient "I just can't sit still." C) the appearance of eyeballs that appear to "pop" out of theclient's eye sockets D) a report of thesudden onset of irritability in thepast 2 weeks C: theappearance of eyeballs that appear to "pop" out of theclient''s eye sockets. Exophthalmos or protruding eyeballs is adistinctive characteristic of Graves'' Disease. It can result in corneal abrasions with severe eye pain or damage when theeyelid is unable to blink down over theprotruding eyeball. Eye drops or ointment may be needed. 9. The nurse has performed theinitial assessments of 4 clients admitted with an acute episode of asthma. Which assessmentfinding would cause thenurse to call theprovider immediately? A) prolonged inspiration with each breath B) expiratory wheezes that are suddenly absent in 1 lobe C) expectoration of large amounts of purulent mucous D) appearance of theuse of abdominal muscles for breathing B: expiratory wheezes that are suddenly absent in 1 lobe. Acute asthma is characterized by expiratory wheezes caused byobstruction of theairways. Wheezes are a high pitched musical sounds produced by air moving through narrowed airways.Clients often associate wheezes with thefeeling of tightness in thechest. However, sudden cessation of wheezing is an ominousor bad sign that indicates an emergency -- thesmall airways are now collapsed. 10. During theinitial home visit, a nurse is discussing thecare of a client newly diagnosed with Alzheimer's disease with familymembers. Which of these interventions would be most helpful at this time? A) leave a book about relaxation techniques B) write out a daily exercise routine for them to assist theclient to do C) list actions to improve theclient's daily nutritional intake D) suggest communication strategies D: suggest communication strategies. Alzheimer''s disease, a progressive chronic illness, greatly challenges caregivers. thenursecan be of greatest assistance in helping thefamily to use communication strategies to enhance their ability to relate to theclient.By use of select verbal and nonverbal communication strategies thefamily can best support theclient’s strengths and cope withany aberrant behavior. 11. An 80 year-old client admitted with a diagnosis of possible cerebral vascular accident has had a blood pressure from 160/100 to180/110 over thepast 2 hours. thenurse has also noted increased lethargy. Which assessment finding should thenurse reportimmediately to theprovider? A) Slurred speech B) Incontinence C) Muscle weakness D) Rapid pulse A: Slurred speech. Changes in speech patterns and level of conscious can be indicators of continued intracranial bleeding orextension of thestroke. Further diagnostic testing may be indicated. 12.A school-aged child has had a long leg (hip to ankle) synthetic cast applied 4 hours ago. Which statement from theparentindicates that teaching has been inadequate? A) "I will keep thecast uncovered for thenext day to prevent burning of theskin." B) "I can apply an ice pack over thearea to relieve itching inside thecast." C) "The cast should be propped on at least 2 pillows when my child is lying down." D) "I think I remember that my child should not stand until after 72 hours." D: "I think I remember that my child should not stand until after 72 hours.". Synthetic casts will typically set up in 30 minutesand dry in a few hours. Thus, theclient may stand within theinitial 24 hours. With plaster casts, theset up and drying time,especially in a long leg cast whichisthickerthananarmcast,cantake up to 72 hours. Both types of castsgiveoffalotofheawhendryinganditis preferable to keep thecast uncovered for thefirst 24 hours. Clients may complain of a chill from thewetcast and therefore can simply be covered lightly with a sheet or blanket. Applying ice is a safe method of relieving theitching. 13.Which blood serum finding in a client with diabetic ketoacidosis alerts thenurse that immediate action is required? A) pH below 7.3 B) Potassium of 5.0 C) HCT of 60 D) Pa O2 of 79%2 C: HCT of 60. This high hematocrit is indicative of severe dehydration which requires priority attention in diabetic ketoacidosis.Without sufficient hydration, all systems of thebody are at risk for hypoxia from a lack of or sluggish circulation. In theabsenceof insulin, which facilitates thetransport of glucose into thecell, thebody breaks down fats and proteins to supply energyketones, a by-product of fat metabolism. These accumulate causing metabolic acidosis (pH 7.3), which would be thesecondconcern for this client. thepotassium and PaO2 levels are near normal. 14.The nurse is preparing a client with a deep vein thrombosis (DVT) for a Venous Doppler evaluation. Which of thefollowingwould be necessary for preparing theclient for this test? A) Client should be NPO after midnight B) Client should receive a sedative medication prior to thetest C) Discontinue anti-coagulant therapy prior to thetest D) No special preparation is necessary D: No special preparation is necessary. This is a non-invasive procedure and does not require preparation other than clienteducation. 15.A client is admitted with infective endocarditis (IE). Which finding would alert thenurse to a complication of this condition? A) dyspnea B)heart murmur C) macular rash D) HemorrhageB: heart murmur. Large, soft, rapidly developing vegetations attach to theheart valves. They have a tendency to break off,causing emboli and leaving ulcerations onthevalveleaflets. theseemboli produce findings ofcardiacmurmurfever,anorexia,mala is eandneurologic sequelae of emboli. Furthermore, thevegetations may travel to various organs such as spleen, kidney,coronary artery, brain and lungs, and obstruct blood flow. 16.The nurse explains an autograft to a client scheduled for excision of a skin tumor. thenurse knows theclient understands the procedure when theclient says, "I will receive tissue from A) a tissue bank." B) a pig." C) my thigh." D)synthetic skin." C: my thigh.". Autografts are done with tissue transplanted from theclient''s own skin. 17.A client is admitted to theemergency room following an acute asthma attack. Which of thefollowing assessments would beexpected by thenurse? A)Diffuse expiratory wheezing B) Loose, productive cough C) No relief from inhalant D)Fever and chills A: Diffuse expiratory wheezing. In asthma, theairways are narrowed, creating difficulty getting air in. A wheezing sound results. 18.A client has been admitted with a fractured femur and has been placed in skeletal traction. Which of thefollowing nursinginterventions should receive priority? A) Maintaining proper body alignment B)Frequent neurovascular assessments of theaffected leg C) Inspection of pin sites for evidence of drainage or inflammation D)Applying an over-bed trapeze to assist theclient with movement in bed B: Frequent neurovascular assessments of theaffected leg. themost important activity for thenurse is to assess neurovascularstatus. Compartment syndrome is a serious complication of fractures. Prompt recognition of this neurovascular problem and earlyintervention may prevent permanent limb damage. 19.The nurse is assigned to care for a client who had a myocardial infarction (MI) 2 days ago. theclient has many questions aboutthis condition. What area is a priority for thenurse to discuss at this time? A)Daily needs and concerns B) The overview cardiac rehabilitation C) Medication and diet guideline D)Activity and rest guidelines A: Daily needs and concerns. At 2 days post-MI, theclient’s education should be focused on theimmediate needs and concernsfor theday. 20.A 3 year-old child is brought to theclinic by his grandmother to be seen for "scratching his bottom and wetting thebed at night."Based on these complaints, thenurse would initially assess for which problem? A) allergies B) scabies C) regression D)pinworms D: pinworms. Signs of pinworm infection include intense perianal itching, poor sleep patterns, general irritability, restlessness,bed-wetting, distractibility and short attention span. Scabies is an itchy skin condition caused by a tiny, eight-legged burrowingmite called Sarcoptes scabiei . thepresence of themite leads to intense itching in thearea of its burrows. 21.The nurse is caring for a newborn with tracheoesophageal fistula. Which nursing diagnosis is a priority? A) Risk for dehydration B)Ineffective airway clearance C) Altered nutrition D)Risk for injury B: Ineffective airway clearance. themost common form of TEF is one in which theproximal esophageal segment terminates in ablind pouch and thedistal segment is connected to thetrachea or primary bronchus by a short fistula at or near thebifurcation.Thus, a priority is maintaining an open airway, preventing aspiration. Other nursing diagnoses are then addressed. 22.The nurse is developing a meal plan that would provide themaximum possible amount of iron for a child with anemia. Which dinner menu would be best? A) Fish sticks, french fries, banana, cookies, milk B) Ground beef patty, lima beans, wheat roll, raisins, milk C) Chicken nuggets, macaroni, peas, cantaloupe, milk D)Peanut butter and jelly sandwich, apple slices, milk B: Ground beef patty, lima beans, wheat roll, raisins, milk. Iron rich foods include red meat, fish, egg yolks, green leafy vegetables, legumes, whole grains, and dried fruits such as raisins. This dinner is thebest choice: It is high in iron and is appropriate for a toddler. 23.The nurse admitting a 5 month-old who vomited 9 times in thepast 6 hours should observe for signs of which overall imbalance? A) Metabolic acidosis B) Metabolic alkalosis C) Some increase in theserum hemoglobin D) A little decrease in theserum potassium B: Metabolic alkalosis. Vomiting causes loss of acid from thestomach. Prolonged vomiting can result in excess loss of acid and lead to metabolic alkalosis. Findings include irritability, increased activity, hyperactive reflexes, muscle twitching and elevated pulse. Options C and D are correct answers but not thebest answers since they are too general. 24.A two year-old child is brought to theprovider's office with a chief complaint of mild diarrhea for two days. Nutritional counseling by thenurse should include which statement? A) Place thechild on clear liquids and gelatin for 24 hours B) Continue with theregular diet and include oral rehydration fluids C) Give bananas, apples, rice and toast as tolerated D)Place NPO for 24 hours, then rehydrate with milk and water B: Continue with theregular diet and include oral rehydration fluids. Current recommendations for mild to moderate diarrhea are to maintain a normal diet with fluids to rehydrate. 25.The nurse is teaching parents about theappropriate diet for a 4 month-old infant with gastroenteritis and mild dehydration. In addition to oral rehydration fluids, thediet should include A) formula or breast milk B) broth and tea C) rice cereal and apple juice D)gelatin and ginger ale A: formula or breast milk. theusual diet for a young infant should be followed. 26.A child is injured on theschool playground and appears to have a fractured leg. thefirst action theschool nurse should take is A) call for emergency transport to thehospital B) immobilize thelimb and joints above and below theinjury C) assess thechild and theextent of theinjury D)apply cold compresses to theinjured area C: assess thechild and theextent of theinjury. When applying thenursing process, assessment is thefirst step in providing care. The "5 Ps" of vascular impairment can be used as a guide (pain, pulse, pallor, paresthesia, paralysis). 27.The mother of a 3 month-old infant tells thenurse that she wants to change from formula to whole milk and add cereal and meats to thediet. What should be emphasized as thenurse teaches about infant nutrition? A) Solid foods should be introduced at 3-4 months B) Whole milk is difficult for a young infant to digest C) Fluoridated tap water should be used to dilute milk D)Supplemental apple juice can be used between feedings B: Whole milk is difficult for a young infant to digest. Cow''s milk is not given to infants younger than 1 year because thetough, hard curd is difficult to digest. In addition, it contains little iron and creates a high renal solute load. 4 28.The nurse is preparing a handout on infant feeding to be distributed to families visiting theclinic. Which notation should be included in theteaching materials? A) Solid foods are introduced one at a time beginning with cereal B) Finely ground meat should be started early to provide iron C) Egg white is added early to increase protein intake D)Solid foods should be mixed with formula in a bottle A: Solid foods are introduced one at a time beginning with cereal. Solid foods should be added one at a time between 4-6 months. If theinfant is able to tolerate thefood, another may be added in a week. Iron fortified cereal is therecommended first food. 29.The nurse planning care for a 12 year-old child with sickle cell disease in a vaso-occlusive crisis of theelbow should include which one of thefollowing as a priority? A) Limit fluids B) Client controlled analgesia C) Cold compresses to elbow D)Passive range of motion exercise B: Client controlled analgesia. Management of a sickle cell crisis is directed towards supportive and symptomatic treatment. The priority of care is pain relief. In a 12 year-old child, client controlled analgesia promotes maximum comfort. 30.The nurse is performing a physical assessment on a toddler. Which of thefollowing actions should be thefirst? A) Perform traumatic procedures B) Use minimal physical contact C) Proceed from head to toe D)Explain theexam in detail B: Use minimal physical contact. thenurse should approach thetoddler slowly and use minimal physical contact initially so as to gain thetoddler''s cooperation. Be flexible in thesequence of theexam, and give only brief simple explanations just prior to the action. 31.What finding signifies that children have attained thestage of concrete operations ( Piaget)? A) Explores theenvironment with theuse of sight and movement B) Thinks in mental images or word pictures C) Makes themoral judgment that "stealing is wrong" D)Reasons that homework is time-consuming yet necessary C: Makes themoral judgment that "stealing is wrong". thestage of concrete operations is depicted by logical thinking and moral judgments. 32.The mother of a child with a neural tube defect asks thenurse what she can do to decrease thechances of having another baby with a neural tube defect. What is thebest response by thenurse? A) "Folic acid should be taken before and after conception." B) "Multivitamin supplements are recommended during pregnancy." C) "A well balanced diet promotes normal fetal development." D)"Increased dietary iron improves thehealth of mother and fetus." A: "Folic acid should be taken before and after conception.". theAmerican Academy of Pediatrics recommends that all childbearing women increase folic acid from dietary sources and/or supplements. There is evidence that increased amounts of folic acid prevents neural tube defects. 33.The provider orders Lanoxin (digoxin) 0.125 mg PO and furosemide 40 mg every day. Which of these foods would thenurse reinforce for theclient to eat at least daily? A) Spaghetti B) Watermelon C) Chicken D)Tomatoes B: Watermelon. Watermelon is high in potassium and will replace potassium lost by thediuretic. theother foods are not high in potassium. 34.While teaching thefamily of a child who will take phenytoin (Dilantin) regularly for seizure control, it is most important for the nurse to teach them about which of thefollowing actions? A) Maintain good oral hygiene and dental care B) Omit medication if thechild is seizure free C) Administer acetaminophen to promote sleep D)Serve a diet that is high in iron A: Maintain good oral hygiene and dental care. Swollen and tender gums occur often with use of phenytoin. Good oral hygiene and regular visits to thedentist should be emphasized. 35.The nurse is offering safety instructions to a parent with a four month-old infant and a four year-old child. Which statement by the parent indicates understanding of appropriate precautions to take with thechildren? 5 A) "I strap theinfant car seat on thefront seat to face backwards." B) "I place my infant in themiddle of theliving room floor on a blanket to play with my four year-old while I make supper in thekitchen." C) "My sleeping baby lies so cute in thecrib with thelittle buttocks stuck up in theair while thefour year-old naps on the sofa." D) "I have thefour year-old hold and help feed thefour month-old a bottle in thekitchen while I make supper." D: theinfant seat is to be placed on therear seat. Small children and infants are not to be left unsupervised. 36.The nurse admits a 7 year-old to theemergency room after a leg injury. thex-rays show a femur fracture near theepiphysis. The parents ask what will be theoutcome of this injury. theappropriate response by thenurse should be which of these statements? A) "The injury is expected to heal quickly because of thin periosteum." B) "In some instances theresult is a retarded bone growth." C) "Bone growth is stimulated in theaffected leg." D)"This type of injury shows more rapid union than that of younger children." B: "In some instances theresult is a retarded bone growth.". An epiphyseal (growth) plate fracture in a 7 year-old often results in retarded bone growth. theleg often will be different in length than theuninjured leg. 37.The parents of a 4 year-old hospitalized child tell thenurse, “We are leaving now and will be back at 6 PM.” A few hours later the child asks thenurse when theparents will come again. What is thebest response by thenurse? A) "They will be back right after supper." B) "In about 2 hours, you will see them." C) "After you play awhile, they will be here." D)"When theclock hands are on 6 and 12 ." A: "They will be back right after supper." Time is not completely understood by a 4 year-old. Preschoolers interpret time with their own frame of reference. Thus, it is best to explain time in relationship to a known, common event. 38.The nurse is giving instructions to theparents of a child with cystic fibrosis. thenurse would emphasize that pancreatic enzymes should be taken A) once each day B) 3 times daily after meals C) with each meal or snack D)each time carbohydrates are eaten C: Pancreatic enzymes should be taken with each meal and every snack to allow for digestion of all foods that are eaten. 39.A nurse is providing a parenting class to individuals living in a community of older homes. In discussing formula preparation, which of thefollowing is most important to prevent lead poisoning? A) Use ready-to-feed commercial infant formula B) Boil thetap water for 10 minutes prior to preparing theformula C) Let tap water run for 2 minutes before adding to concentrate D)Buy bottled water labeled "lead free" to mix theformula C: Let tap water run for 2 minutes before adding to concentrate. Use of lead-contaminated water to prepare formula is a major source of poisoning in infants. Drinking water may be contaminated by lead from old lead pipes or lead solder used in sealing water pipes. Letting tap water run for several minutes will diminish thelead contamination. 40.Which of thefollowing manifestations observed by theschool nurse confirms thepresence of pediculosis capitis in students? A) Scratching thehead more than usual B) Flakes evident on a student's shoulders C) Oval pattern occipital hair loss D)Whitish oval specks sticking to thehair D: Whitish oval specks sticking to thehair. Diagnosis of pediculosis capitis is made by observation of thewhite eggs (nits) firmly attached to thehair shafts. Treatment can include application of a medicated shampoo with lindane for children over 2 years of age, and meticulous combing and removal of all nits.