NCSBN NCLEX RN EXAM 1 TEST BANK With Questions
And Answers Actual Exam New Complete V erified
Questions And Correct Detailed Answers With
Rationales | Already Graded A+
A patient is admitted to the medical-surgical unit with methicillin-resistant staphylococcus aureus
(MRSA) of a wound. The nurse initiates contact precautions, which includes use of which of the
following?
a. Clean gown and gloves
b. N-95 respirator
c. Biohazard bin placed in the room
d. Negative airflow room - Correct Answer-a. Clean gown and gloves
Contact isolation requires all people entering the room to follow standard precautions in addition to
wearing a clean (not sterile) gown and gloves. Other diseases that require contact precautions include
the following: norovirus, rotavirus, and Clostridium difficile. Additionally, patients with draining wounds,
uncontrolled secretions, pressure ulcers, generalized rash, and ostomy bags/tubes also warrant contact
precautions.
A patient in the medical-surgical unit tells the nurse they haven't had a bowel movement in two days.
What is the first intervention the nurse should implement?
a. Review the patient's medical record to determine normal bowel pattern
b. Offer prune juice with every meal
c. Call the healthcare provider to request an order for stool softener
d. Increase the patient's oral fluid intake - Correct Answer-a. Review the patient's medical record to
determine normal bowel pattern
Bowel patterns can vary greatly in adults: three BMs weekly up to three BMs daily is considered within
normal range. Several factors can influence normal bowel patterns, including surgery, stress, and opioid
medications. The nurse should review the medical record to determine the patient's normal bowel
patterns prior to hospitalization.
Page 1 of 208
,A 40-year-old patient in the clinic tells the nurse they have frequent constipation. The patient has taken
steps to remedy the constipation but would like to prevent it with a bowel-training program. Which of
the following is of greatest concern to the nurse?
a. The patient does not eat any fruits and vegetables
b. The patient drinks 2 liters of water daily
c. The patient exercises 3 to 4 days per week
d. The patient's home recently tested positive for lead - Correct Answer-d. The patient's home recently
tested positive for lead
Lead poisoning can cause constipation. This is the greatest concern for the nurse at this time. The
patient will need their blood to be tested for lead, and other people living in the home will need to be
assessed as well.
A patient appears anxious about an upcoming procedure. Which of the following responses by the nurse
will reduce this patient's anxiety?
a. "Don't worry. It will be fine."
b. "Read this pamphlet about the procedure and let me know if you have questions."
c. "I will turn on some music for you."
d. "Would you like to talk about what's bothering you?" - Correct Answer-d. "Would you like to talk
about what's bothering you?"
Anxiety is common before medical procedures. The patient may feel helpless, isolated, or insecure.
Encouraging the patient to talk about their feelings can reduce anxiety and helps the nurse be
supportive by developing goals with the patient for some sense of control. This is the response that
displays therapeutic communication.
A patient is admitted to the cardiac unit after myocardial infarction (MI). The patient tells the nurse they
don't want their spouse to know what happened. What is the best response by the nurse?
a. "I have to tell your spouse what happened."
b. "I will need you to fill out paperwork preventing anyone from telling your spouse."
c. "Why don't you want me to tell your spouse?"
Page 2 of 208
,d. "Is there someone else you would like listed as an appropriate person with whom we can discuss your
care?" - Correct Answer-d. "Is there someone else you would like listed as an appropriate person with
whom we can discuss your care?"
Patients have the right to decide what information regarding their condition is shared with whom. It is
the responsibility of the nurse to obtain this information from the patient and document it in the
medical record so others following in care will know as well. Clarifying the patient statement and
determining who the patient wants involved is the best response.
The nurse is caring for a 72-year-old patient who has a history of a left-sided stroke. The patient uses a
cane while walking. Which is the best way for the nurse to assess the strength of their lower
extremities?
a. Have the patient push with their feet against the nurse's hands
b. Observe the patient walking in the hall
c. Notify the physical therapy department and request an assessment
d. Assist the patient to the bathroom - Correct Answer-d. Assist the patient to the bathroom
Patients who have experienced a stroke often have residual weakness on the affected side and use
assistive devices to help with mobility. Using the cane and assisting the patient to the bathroom is the
best way for the nurse to assess the patient's lower extremity strength. The nurse can assist the patient
to the bathroom, and therefore, eliminate the risk for a fall.
A nurse is working with a community group promoting healthy aging. What recommendation is best to
help prevent osteoarthritis (OA)?
a. Avoid contact sports.
b. Get plenty of calcium.
c. Lose weight if needed.
d. Engage in weight-bearing exercise. - Correct Answer-c. Lose weight if needed.
Obesity can lead to OA, and if the client is overweight, losing weight can help prevent OA or reduce
symptoms once it occurs. Arthritis can be caused by contact sports, but this is less common than
obesity. Calcium and weight-bearing exercise are both important for osteoporosis.
A nurse in the family clinic is teaching a client newly diagnosed with osteoarthritis (OA) about drugs used
to treat the disease. For which medication does the nurse plan primary teaching?
Page 3 of 208
, a. Acetaminophen (Tylenol)
b. Cyclobenzaprine hydrochloride (Flexeril)
c. Hyaluronate (Hyalgan)
d. Ibuprofen (Motrin) - Correct Answer-a. Acetaminophen (Tylenol)
All of the drugs are appropriate to treat OA. However, the first-line drug is acetaminophen.
Cyclobenzaprine is a muscle relaxant given to treat muscle spasms. Hyaluronate is a synthetic joint fluid
implant. Ibuprofen is a nonsteroidal anti-inflammatory drug.
The clinic nurse assesses a client with diabetes during a checkup. The client also has osteoarthritis (OA).
The nurse notes the clients blood glucose readings have been elevated. What question by the nurse is
most appropriate?
a. Are you compliant with following the diabetic diet?
b. Have you been taking glucosamine supplements?
c. How much exercise do you really get each week?
d. You're still taking your diabetic medication, right? - Correct Answer-b. Have you been taking
glucosamine supplements?
All of the topics are appropriate for a client whose blood glucose readings have been higher than usual.
However, since this client also has OA, and glucosamine can increase blood glucose levels, the nurse
should ask about its use. The other questions all have an element of nontherapeutic communication in
them. Compliant is a word associated with negative images, and the client may deny being
noncompliant. Asking how much exercise the client really gets is accusatory. Asking if the client takes his
or her medications right? is patronizing.
The nurse working in the orthopedic clinic knows that a client with which factor has an absolute
contraindication for having a total joint replacement?
a. Needs multiple dental fillings
b. Over age 85
c. Severe osteoporosis
d. Urinary tract infection - Correct Answer-c. Severe osteoporosis
Page 4 of 208
And Answers Actual Exam New Complete V erified
Questions And Correct Detailed Answers With
Rationales | Already Graded A+
A patient is admitted to the medical-surgical unit with methicillin-resistant staphylococcus aureus
(MRSA) of a wound. The nurse initiates contact precautions, which includes use of which of the
following?
a. Clean gown and gloves
b. N-95 respirator
c. Biohazard bin placed in the room
d. Negative airflow room - Correct Answer-a. Clean gown and gloves
Contact isolation requires all people entering the room to follow standard precautions in addition to
wearing a clean (not sterile) gown and gloves. Other diseases that require contact precautions include
the following: norovirus, rotavirus, and Clostridium difficile. Additionally, patients with draining wounds,
uncontrolled secretions, pressure ulcers, generalized rash, and ostomy bags/tubes also warrant contact
precautions.
A patient in the medical-surgical unit tells the nurse they haven't had a bowel movement in two days.
What is the first intervention the nurse should implement?
a. Review the patient's medical record to determine normal bowel pattern
b. Offer prune juice with every meal
c. Call the healthcare provider to request an order for stool softener
d. Increase the patient's oral fluid intake - Correct Answer-a. Review the patient's medical record to
determine normal bowel pattern
Bowel patterns can vary greatly in adults: three BMs weekly up to three BMs daily is considered within
normal range. Several factors can influence normal bowel patterns, including surgery, stress, and opioid
medications. The nurse should review the medical record to determine the patient's normal bowel
patterns prior to hospitalization.
Page 1 of 208
,A 40-year-old patient in the clinic tells the nurse they have frequent constipation. The patient has taken
steps to remedy the constipation but would like to prevent it with a bowel-training program. Which of
the following is of greatest concern to the nurse?
a. The patient does not eat any fruits and vegetables
b. The patient drinks 2 liters of water daily
c. The patient exercises 3 to 4 days per week
d. The patient's home recently tested positive for lead - Correct Answer-d. The patient's home recently
tested positive for lead
Lead poisoning can cause constipation. This is the greatest concern for the nurse at this time. The
patient will need their blood to be tested for lead, and other people living in the home will need to be
assessed as well.
A patient appears anxious about an upcoming procedure. Which of the following responses by the nurse
will reduce this patient's anxiety?
a. "Don't worry. It will be fine."
b. "Read this pamphlet about the procedure and let me know if you have questions."
c. "I will turn on some music for you."
d. "Would you like to talk about what's bothering you?" - Correct Answer-d. "Would you like to talk
about what's bothering you?"
Anxiety is common before medical procedures. The patient may feel helpless, isolated, or insecure.
Encouraging the patient to talk about their feelings can reduce anxiety and helps the nurse be
supportive by developing goals with the patient for some sense of control. This is the response that
displays therapeutic communication.
A patient is admitted to the cardiac unit after myocardial infarction (MI). The patient tells the nurse they
don't want their spouse to know what happened. What is the best response by the nurse?
a. "I have to tell your spouse what happened."
b. "I will need you to fill out paperwork preventing anyone from telling your spouse."
c. "Why don't you want me to tell your spouse?"
Page 2 of 208
,d. "Is there someone else you would like listed as an appropriate person with whom we can discuss your
care?" - Correct Answer-d. "Is there someone else you would like listed as an appropriate person with
whom we can discuss your care?"
Patients have the right to decide what information regarding their condition is shared with whom. It is
the responsibility of the nurse to obtain this information from the patient and document it in the
medical record so others following in care will know as well. Clarifying the patient statement and
determining who the patient wants involved is the best response.
The nurse is caring for a 72-year-old patient who has a history of a left-sided stroke. The patient uses a
cane while walking. Which is the best way for the nurse to assess the strength of their lower
extremities?
a. Have the patient push with their feet against the nurse's hands
b. Observe the patient walking in the hall
c. Notify the physical therapy department and request an assessment
d. Assist the patient to the bathroom - Correct Answer-d. Assist the patient to the bathroom
Patients who have experienced a stroke often have residual weakness on the affected side and use
assistive devices to help with mobility. Using the cane and assisting the patient to the bathroom is the
best way for the nurse to assess the patient's lower extremity strength. The nurse can assist the patient
to the bathroom, and therefore, eliminate the risk for a fall.
A nurse is working with a community group promoting healthy aging. What recommendation is best to
help prevent osteoarthritis (OA)?
a. Avoid contact sports.
b. Get plenty of calcium.
c. Lose weight if needed.
d. Engage in weight-bearing exercise. - Correct Answer-c. Lose weight if needed.
Obesity can lead to OA, and if the client is overweight, losing weight can help prevent OA or reduce
symptoms once it occurs. Arthritis can be caused by contact sports, but this is less common than
obesity. Calcium and weight-bearing exercise are both important for osteoporosis.
A nurse in the family clinic is teaching a client newly diagnosed with osteoarthritis (OA) about drugs used
to treat the disease. For which medication does the nurse plan primary teaching?
Page 3 of 208
, a. Acetaminophen (Tylenol)
b. Cyclobenzaprine hydrochloride (Flexeril)
c. Hyaluronate (Hyalgan)
d. Ibuprofen (Motrin) - Correct Answer-a. Acetaminophen (Tylenol)
All of the drugs are appropriate to treat OA. However, the first-line drug is acetaminophen.
Cyclobenzaprine is a muscle relaxant given to treat muscle spasms. Hyaluronate is a synthetic joint fluid
implant. Ibuprofen is a nonsteroidal anti-inflammatory drug.
The clinic nurse assesses a client with diabetes during a checkup. The client also has osteoarthritis (OA).
The nurse notes the clients blood glucose readings have been elevated. What question by the nurse is
most appropriate?
a. Are you compliant with following the diabetic diet?
b. Have you been taking glucosamine supplements?
c. How much exercise do you really get each week?
d. You're still taking your diabetic medication, right? - Correct Answer-b. Have you been taking
glucosamine supplements?
All of the topics are appropriate for a client whose blood glucose readings have been higher than usual.
However, since this client also has OA, and glucosamine can increase blood glucose levels, the nurse
should ask about its use. The other questions all have an element of nontherapeutic communication in
them. Compliant is a word associated with negative images, and the client may deny being
noncompliant. Asking how much exercise the client really gets is accusatory. Asking if the client takes his
or her medications right? is patronizing.
The nurse working in the orthopedic clinic knows that a client with which factor has an absolute
contraindication for having a total joint replacement?
a. Needs multiple dental fillings
b. Over age 85
c. Severe osteoporosis
d. Urinary tract infection - Correct Answer-c. Severe osteoporosis
Page 4 of 208
