300-Item NLE Practice Exam
Situation – Richard has a nursing diagnosis of ineffective airway clearance related to excessive
secretions and is at risk for infection because of retained secretions. Part of Nurse Mario’s nursing
care plan is to loosen and remove excessive secretions in the airway.
1. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the
lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs
when Mario does percussion would be:
A. Client lying on his back then flat on his abdomen on Trendelenburg position
B. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his
back and on his abdomen
C. Client lying flat on his back and then flat on his abdomen
D. Client lying on his right then left side on Trendelenburg position
2. When documenting outcome of Richard’s treatment Mario should include the following in his
recording EXCEPT:
A. Color, amount and consistency of sputum
B. Character of breath sounds and respiratory rate before and after procedure
C. Amount of fluid intake of client before and after the procedure
D. Significant changes in vital signs
3. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario
would focus on the following EXCEPT:
A. Amount of food and fluid taken during the last meal before treatment
B. Respiratory rate, breath sounds and location of congestion
C. Teaching the client’s relatives to perform the procedure
D. Doctor’s order regarding position restrictions and client’s tolerance for lying flat
4. Mario prepares Richard for postural drainage and percussion. Which of the following is a special
consideration when doing the procedure?
A. Respiratory rate of 16 to 20 per minute
B. Client can tolerate sitting and lying positions
C. Client has no signs of infection
D. Time of last food and fluid intake of the client
5. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference
between the procedures is:
A. Percussion uses only one hand while vibration uses both hands
B. Percussion delivers cushioned blows to the chest with cupped palms while vibration gently
shakes secretion loose on the exhalation cycle
C. In both percussion and vibration the hands are on top of each other and hand action is in tune
with client’s breath rhythm
D. Percussion slaps the chest to loosen secretions while vibration shakes the secretions along
with the inhalation of air
Situation – A 61 year old man, Mr. Regalado, is admitted to the private ward for observation after
complaints of severe chest pain. You are assigned to take care of the client.
6. When doing an initial assessment, the best way for you to identify the client’s priority problem is
to:
A. Interview the client for chief complaints and other symptoms
B. Talk to the relatives to gather data about history of illness
C. Do auscultation to check for chest congestion
D. Do a physical examination while asking the client relevant questions
, A. bargaining
B. denial
C. anger
D. acceptance
8. Which of the following ethical principles refers to the duty to do good?
A. Beneficence
B. Fidelity
C. Veracity
D. Nonmaleficence
9. During which step of the nursing process does the nurse analyze data related to the patient's
health status?
A. Assessment
B. Implementation
C. Diagnosis
D. Evaluation
10. The basic difference between nursing diagnoses and collaborative problems is that
A. nurses manage collaborative problems using physician-prescribed interventions.
B. collaborative problems can be managed by independent nursing interventions.
C. nursing diagnoses incorporate physician-prescribed interventions.
D. nursing diagnoses incorporate physiologic complications that nurses monitor to detect change
in status.
Situation – Mrs. Seva, 52 years old, asks you about possible problems regarding her elimination now
that she is in the menopausal stage.
11. Instruction on health promotion regarding urinary elimination is important. Which would you
include?
A. Hold urine as long as she can before emptying the bladder to strengthen her sphincter muscles
B. If burning sensation is experienced while voiding, drink pineapple juice
C. After urination, wipe from anal area up towards the pubis
D. Tell client to empty the bladder at each voiding
12. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what physical
changes predispose her to constipation?
A. inhibition of the parasympathetic reflex
B. weakness of sphincter muscles of anus
C. loss of tone of the smooth muscles of the colon
D. decreased ability to absorb fluids in the lower intestines
13. The nurse understands that one of these factors contributes to constipation:
A. excessive exercise
B. high fiber diet
C. no regular time for defecation daily
D. prolonged use of laxatives
14. You will do nasopharyngeal suctioning on Mr. Abad. Your guide for the length of insertion of the
tubing for an adult would be:
A. tip of the nose to the base of the neck
B. the distance from the tip of the nose to the middle of the neck
C. the distance from the tip of the nose to the tip of the ear lobe
D. eight to ten inches
Situation– Mr. Dizon, 84 years old, brought to the Emergency Room for complaint of hypertension,
, A. Take the blood pressure reading on both arms for comparison
B. Listen to and identify the phases of Korotkoff’s sound
C. Pump the cuff to around 50 mmHg above the point where the pulse is obliterated
D. Observe procedures for infection control
16. A pulse oximeter is attached to Mr. Dizon’s finger to:
A. Determine if the client’s hemoglobin level is low and if he needs blood transfusion
B. Check level of client’s tissue perfusion
C. Measure the efficacy of the client’s anti-hypertensive medications
D. Detect oxygen saturation of arterial blood before symptoms of hypoxemia develops
17. In which type of shock does the patient experiences a mismatch of blood flow to the cells?
A. Distributive C. Hypovolemic
B. Cardiogenic D. Septic
18. The preferred route of administration of medication in the most acute care situations is which of
the following routes?
A. Intravenous C. Subcutaneous
B. Epidural D. Intramuscular
19. After a few hours in the Emergency Room, Mr. Dizon is admitted to the ward with an order of
hourly monitoring of blood pressure. The nurse finds that the cuff is too narrow and this will cause
the blood pressure reading to be:
A. inconsistent
B. low systolic and high diastolic
C. higher than what the reading should be
D. lower than what the reading should be
20. Through the client’s health history, you gather that Mr. Dizon smokes and drinks coffee. When
taking the blood pressure of a client who recently smoked or drank coffee, how long should the
nurse wait before taking the client’s blood pressure for accurate reading?
A. 15 minutes
B. 30 minutes
C. 1 hour
D. 5 minutes
21. While the client has pulse oximeter on his fingertip, you notice that the sunlight is shining on the
area where the oximeter is. Your action will be to:
A. Set and turn on the alarm of the oximeter
B. Do nothing since there is no identified problem
C. Cover the fingertip sensor with a towel or bedsheet
D. Change the location of the sensor every four hours
22. When taking blood pressure reading the cuff should be:
A. deflated fully then immediately start second reading for same client
B. deflated quickly after inflating up to 180 mmHg
C. large enough to wrap around upper arm of the adult client 1 cm above brachial artery
D. inflated to 30 mmHg above the estimated systolic BP based on palpation of radial or brachial
artery
23. To ensure client safety before starting blood transfusions the following are needed before the
procedure can be done EXCEPT:
A. take baseline vital signs
B. blood should be warmed to room temperature for 30 minutes before blood transfusions is
administered
C. have two nurses verify client identification, blood type, unit number and expiration date of blood
D. get consent signed for blood transfusion
, C. 1 tbsp of salt/day with some patis and toyo
D. 1 tsp of salt/day but no patis and toyo
25. Which of the following methods is the best method for determining nasogastric tube placement in
the stomach?
A. X-ray
B. Observation of gastric aspirate
C. Testing of pH of gastric aspirate
D. Placement of external end of tube under water
26. Which of the following is the most important risk factor for development of Chronic Obstructive
Pulmonary Disease?
A. Cigarette smoking
B. Occupational exposure
C. Air pollution
D. Genetic abnormalities
27. When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and
gently rotating the catheter 360 degrees for which of the following time periods?
A. 10-15 seconds C. 20-25 seconds
B. 30-35 seconds D. 0-5 seconds
28. The nurse auscultates the apex beat at which of the following anatomical locations?
A. Fifth intercostal space, midclavicular line
B. Mid-sternum
C. 2” to the left of the lower end of the sternum
D. 1” to the left of the xiphoid process
29. Which of the following terms describes the amount of blood ejected per heartbeat?
A. Stroke volume
B. Cardiac output
C. Ejection fraction
D. Afterload
30. You are to apply a transdermal patch of nitoglycerin to your client. The following are important
guidelines to observe EXCEPT:
A. Apply to hairless clean area of the skin not subject to much wrinkling
B. Patches may be applied to distal part of the extremities like forearm
C. Change application and site regularly to prevent irritation of the skin
D. Wear gloves to avoid any medication on your hand
31. The GAUGE size in ET tubes determines:
A. The external circumference of the tube
B. The internal diameter of the tube
C. The length of the tube
D. The tube’s volumetric capacity
32. The nurse is correct in performing suctioning when she applies the suction intermittently during:
A. Insertion of the suction catheter
B. Withdrawing of the suction catheter
C. both insertion and withdrawing of the suction catheter
D. When the suction catheter tip reaches the bifurcation of the trachea
33. The purpose of the cuff in Tracheostomy tube is to:
A. Separate the upper and lower airway
B. Separate trachea from the esophagus
Situation – Richard has a nursing diagnosis of ineffective airway clearance related to excessive
secretions and is at risk for infection because of retained secretions. Part of Nurse Mario’s nursing
care plan is to loosen and remove excessive secretions in the airway.
1. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the
lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs
when Mario does percussion would be:
A. Client lying on his back then flat on his abdomen on Trendelenburg position
B. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his
back and on his abdomen
C. Client lying flat on his back and then flat on his abdomen
D. Client lying on his right then left side on Trendelenburg position
2. When documenting outcome of Richard’s treatment Mario should include the following in his
recording EXCEPT:
A. Color, amount and consistency of sputum
B. Character of breath sounds and respiratory rate before and after procedure
C. Amount of fluid intake of client before and after the procedure
D. Significant changes in vital signs
3. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario
would focus on the following EXCEPT:
A. Amount of food and fluid taken during the last meal before treatment
B. Respiratory rate, breath sounds and location of congestion
C. Teaching the client’s relatives to perform the procedure
D. Doctor’s order regarding position restrictions and client’s tolerance for lying flat
4. Mario prepares Richard for postural drainage and percussion. Which of the following is a special
consideration when doing the procedure?
A. Respiratory rate of 16 to 20 per minute
B. Client can tolerate sitting and lying positions
C. Client has no signs of infection
D. Time of last food and fluid intake of the client
5. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference
between the procedures is:
A. Percussion uses only one hand while vibration uses both hands
B. Percussion delivers cushioned blows to the chest with cupped palms while vibration gently
shakes secretion loose on the exhalation cycle
C. In both percussion and vibration the hands are on top of each other and hand action is in tune
with client’s breath rhythm
D. Percussion slaps the chest to loosen secretions while vibration shakes the secretions along
with the inhalation of air
Situation – A 61 year old man, Mr. Regalado, is admitted to the private ward for observation after
complaints of severe chest pain. You are assigned to take care of the client.
6. When doing an initial assessment, the best way for you to identify the client’s priority problem is
to:
A. Interview the client for chief complaints and other symptoms
B. Talk to the relatives to gather data about history of illness
C. Do auscultation to check for chest congestion
D. Do a physical examination while asking the client relevant questions
, A. bargaining
B. denial
C. anger
D. acceptance
8. Which of the following ethical principles refers to the duty to do good?
A. Beneficence
B. Fidelity
C. Veracity
D. Nonmaleficence
9. During which step of the nursing process does the nurse analyze data related to the patient's
health status?
A. Assessment
B. Implementation
C. Diagnosis
D. Evaluation
10. The basic difference between nursing diagnoses and collaborative problems is that
A. nurses manage collaborative problems using physician-prescribed interventions.
B. collaborative problems can be managed by independent nursing interventions.
C. nursing diagnoses incorporate physician-prescribed interventions.
D. nursing diagnoses incorporate physiologic complications that nurses monitor to detect change
in status.
Situation – Mrs. Seva, 52 years old, asks you about possible problems regarding her elimination now
that she is in the menopausal stage.
11. Instruction on health promotion regarding urinary elimination is important. Which would you
include?
A. Hold urine as long as she can before emptying the bladder to strengthen her sphincter muscles
B. If burning sensation is experienced while voiding, drink pineapple juice
C. After urination, wipe from anal area up towards the pubis
D. Tell client to empty the bladder at each voiding
12. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what physical
changes predispose her to constipation?
A. inhibition of the parasympathetic reflex
B. weakness of sphincter muscles of anus
C. loss of tone of the smooth muscles of the colon
D. decreased ability to absorb fluids in the lower intestines
13. The nurse understands that one of these factors contributes to constipation:
A. excessive exercise
B. high fiber diet
C. no regular time for defecation daily
D. prolonged use of laxatives
14. You will do nasopharyngeal suctioning on Mr. Abad. Your guide for the length of insertion of the
tubing for an adult would be:
A. tip of the nose to the base of the neck
B. the distance from the tip of the nose to the middle of the neck
C. the distance from the tip of the nose to the tip of the ear lobe
D. eight to ten inches
Situation– Mr. Dizon, 84 years old, brought to the Emergency Room for complaint of hypertension,
, A. Take the blood pressure reading on both arms for comparison
B. Listen to and identify the phases of Korotkoff’s sound
C. Pump the cuff to around 50 mmHg above the point where the pulse is obliterated
D. Observe procedures for infection control
16. A pulse oximeter is attached to Mr. Dizon’s finger to:
A. Determine if the client’s hemoglobin level is low and if he needs blood transfusion
B. Check level of client’s tissue perfusion
C. Measure the efficacy of the client’s anti-hypertensive medications
D. Detect oxygen saturation of arterial blood before symptoms of hypoxemia develops
17. In which type of shock does the patient experiences a mismatch of blood flow to the cells?
A. Distributive C. Hypovolemic
B. Cardiogenic D. Septic
18. The preferred route of administration of medication in the most acute care situations is which of
the following routes?
A. Intravenous C. Subcutaneous
B. Epidural D. Intramuscular
19. After a few hours in the Emergency Room, Mr. Dizon is admitted to the ward with an order of
hourly monitoring of blood pressure. The nurse finds that the cuff is too narrow and this will cause
the blood pressure reading to be:
A. inconsistent
B. low systolic and high diastolic
C. higher than what the reading should be
D. lower than what the reading should be
20. Through the client’s health history, you gather that Mr. Dizon smokes and drinks coffee. When
taking the blood pressure of a client who recently smoked or drank coffee, how long should the
nurse wait before taking the client’s blood pressure for accurate reading?
A. 15 minutes
B. 30 minutes
C. 1 hour
D. 5 minutes
21. While the client has pulse oximeter on his fingertip, you notice that the sunlight is shining on the
area where the oximeter is. Your action will be to:
A. Set and turn on the alarm of the oximeter
B. Do nothing since there is no identified problem
C. Cover the fingertip sensor with a towel or bedsheet
D. Change the location of the sensor every four hours
22. When taking blood pressure reading the cuff should be:
A. deflated fully then immediately start second reading for same client
B. deflated quickly after inflating up to 180 mmHg
C. large enough to wrap around upper arm of the adult client 1 cm above brachial artery
D. inflated to 30 mmHg above the estimated systolic BP based on palpation of radial or brachial
artery
23. To ensure client safety before starting blood transfusions the following are needed before the
procedure can be done EXCEPT:
A. take baseline vital signs
B. blood should be warmed to room temperature for 30 minutes before blood transfusions is
administered
C. have two nurses verify client identification, blood type, unit number and expiration date of blood
D. get consent signed for blood transfusion
, C. 1 tbsp of salt/day with some patis and toyo
D. 1 tsp of salt/day but no patis and toyo
25. Which of the following methods is the best method for determining nasogastric tube placement in
the stomach?
A. X-ray
B. Observation of gastric aspirate
C. Testing of pH of gastric aspirate
D. Placement of external end of tube under water
26. Which of the following is the most important risk factor for development of Chronic Obstructive
Pulmonary Disease?
A. Cigarette smoking
B. Occupational exposure
C. Air pollution
D. Genetic abnormalities
27. When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and
gently rotating the catheter 360 degrees for which of the following time periods?
A. 10-15 seconds C. 20-25 seconds
B. 30-35 seconds D. 0-5 seconds
28. The nurse auscultates the apex beat at which of the following anatomical locations?
A. Fifth intercostal space, midclavicular line
B. Mid-sternum
C. 2” to the left of the lower end of the sternum
D. 1” to the left of the xiphoid process
29. Which of the following terms describes the amount of blood ejected per heartbeat?
A. Stroke volume
B. Cardiac output
C. Ejection fraction
D. Afterload
30. You are to apply a transdermal patch of nitoglycerin to your client. The following are important
guidelines to observe EXCEPT:
A. Apply to hairless clean area of the skin not subject to much wrinkling
B. Patches may be applied to distal part of the extremities like forearm
C. Change application and site regularly to prevent irritation of the skin
D. Wear gloves to avoid any medication on your hand
31. The GAUGE size in ET tubes determines:
A. The external circumference of the tube
B. The internal diameter of the tube
C. The length of the tube
D. The tube’s volumetric capacity
32. The nurse is correct in performing suctioning when she applies the suction intermittently during:
A. Insertion of the suction catheter
B. Withdrawing of the suction catheter
C. both insertion and withdrawing of the suction catheter
D. When the suction catheter tip reaches the bifurcation of the trachea
33. The purpose of the cuff in Tracheostomy tube is to:
A. Separate the upper and lower airway
B. Separate trachea from the esophagus
