NCLEX Practice Test: Video 2 Answers (25 Questions) — Questions and Answers

Question 1: The primary purpose for using a CPM machine for the client with a total knee repair is to help:

Prevent contractures
Alleviate lactic acid production in the leg muscles
Decrease the pain associated with early ambulation
Promote flexion of the artificial joint (Correct answer)

Correct answer: Promote flexion of the artificial joint

A Continuous Passive Motion (CPM) machine is used after total knee repair to gently and continuously move the knee joint. Its primary purpose is to prevent stiffness and scar tissue formation, thereby promoting and maintaining the range of motion, particularly flexion, of the artificial joint. This helps in early rehabilitation and improves long-term joint function.

Question 2: Which of the following conditions is most likely related to the development of renal calculi?

Disc disease
Fractured femur
Pancreatitis
Gout (Correct answer)

Correct answer: Gout

Gout is a metabolic disorder characterized by elevated levels of uric acid in the blood. High uric acid concentrations can lead to the formation of uric acid crystals, which can precipitate in the kidneys and form renal calculi (kidney stones). Therefore, gout is a significant risk factor for developing uric acid kidney stones.

Question 3: The nurse is admitting a client with a suspected duodenal ulcer. The client will most likely report that his abdominal discomfort lessens when he:

Sits upright after eating
Eats a meal (Correct answer)
Rests in recumbent position
Skips a meal

Correct answer: Eats a meal

Duodenal ulcer pain is typically described as burning or gnawing, occurring 2-3 hours after a meal or waking the patient at night. The pain is characteristically relieved by eating food, which buffers stomach acid, or by taking antacids. This temporary relief distinguishes it from gastric ulcer pain, which often worsens with food.

Question 4: The physician has scheduled a Whipple procedure for a client with pancreatic cancer. The nurse recognizes that the client’s cancer is located in:

The entire pancreas
The tail of the pancreas
The head of the pancreas (Correct answer)
The body of the pancreas

Correct answer: The head of the pancreas

The Whipple procedure, also known as a pancreaticoduodenectomy, is a complex surgical operation primarily performed to remove tumors in the head of the pancreas. This procedure also involves removing parts of the duodenum, gallbladder, and bile duct, making it a major surgery for cancers located specifically in this region.

Question 5: The LPN is reviewing the lab results of an elderly client when she notes a specific gravity of 1.006. The nurse recognizes that:

The client has a normal specific gravity. (Correct answer)
The client has impaired renal function.
The client has mild to moderate dehydration.
The client has diluted urine from fluid overload.

Correct answer: The client has a normal specific gravity.

The normal range for urine specific gravity is typically 1.005 to 1.030. A specific gravity of 1.006 falls within this normal range, indicating that the client's urine concentration is appropriate. This value does not suggest impaired renal function, dehydration, or fluid overload.

Question 6: A nurse is caring for a child with bacterial meningitis. Which assessment finding requires immediate intervention?

Kernig's sign present
Temperature of 38.5°C (101.3°F)
Petechial rash spreading rapidly with purpura (Correct answer)
Mild headache and photophobia

Correct answer: Petechial rash spreading rapidly with purpura

A rapidly spreading petechial/purpuric rash in bacterial meningitis indicates meningococcemia — disseminated meningococcal infection with septicemia and potential DIC. This is immediately life-threatening.

Question 7: An infant is at the 4-month well-child visit. Which vaccine is NOT recommended at this visit according to the standard immunization schedule?

IPV (inactivated poliovirus)
MMR (measles, mumps, rubella) (Correct answer)
DTaP (diphtheria, tetanus, acellular pertussis)
Hib (Haemophilus influenzae type b)

Correct answer: MMR (measles, mumps, rubella)

MMR is not given until 12–15 months of age (and again at 4–6 years). At 4 months, the scheduled vaccines include DTaP, IPV, Hib, PCV13, and rotavirus.

Question 8: Which assessment finding in a newborn at 24 hours of life requires the nurse to immediately notify the provider?

Epstein pearls on the hard palate
Jaundice (yellow discoloration) visible at 24 hours of life (Correct answer)
Cephalhematoma from vacuum extraction
Milia on the nose and cheeks

Correct answer: Jaundice (yellow discoloration) visible at 24 hours of life

Jaundice appearing within the first 24 hours of life is pathologic (not physiologic) and requires immediate evaluation. It suggests hemolytic disease (ABO or Rh incompatibility) requiring urgent bilirubin measurement.

Question 9: The nurse is performing a developmental assessment on a 4-month-old infant. Which finding would be cause for concern?

Cannot walk with support
No social smile in response to caregiver (Correct answer)
Cannot hold a rattle
Does not yet pull to stand

Correct answer: No social smile in response to caregiver

Social smiling (responsive smile to a caregiver's face) normally develops by 6–8 weeks. Absence of a social smile by 4 months is a developmental red flag requiring further evaluation.

Question 10: A parent asks when their infant should receive the first dose of the hepatitis B vaccine. The nurse should respond:

Only if the mother tests positive for hepatitis B
At 2 months of age at the first well-baby visit
Within 24 hours of birth (Correct answer)
At 6 months when the immune system matures

Correct answer: Within 24 hours of birth

The CDC recommends the first dose of hepatitis B vaccine within 24 hours of birth for all newborns. This is especially important if the mother's hepatitis B status is unknown or positive.

Question 11: What is an example of a psychosocial factor that can impact a patient's recovery?

Social support and family involvement (Correct answer)
Complete isolation from family and friends
Chronic denial of the health condition
Lack of adherence to prescribed treatments

Correct answer: Social support and family involvement

Psychosocial factors, such as social support and family involvement, significantly impact a patient's recovery by influencing their mental and emotional well-being. Strong support systems provide emotional comfort, practical assistance, and motivation, which are critical for adherence to treatment plans and overall healing. Conversely, isolation can hinder the recovery process.

Question 12: Which of the following is a common symptom of depression in elderly patients?

Withdrawn behavior, fatigue, and disinterest in socializing (Correct answer)
Increased social interaction and positive outlook
Excessive energy and enthusiasm
Repetitive high-energy activities

Correct answer: Withdrawn behavior, fatigue, and disinterest in socializing

Depression in elderly patients often manifests differently than in younger adults, with less overt sadness. Common symptoms include social withdrawal, persistent fatigue, and a noticeable loss of interest in previously enjoyed activities. Recognizing these subtle signs is crucial for early diagnosis and intervention, as they significantly impact an elderly patient's quality of life.

Question 13: How can nurses support patients facing a terminal diagnosis?

By reassuring patients that they will recover soon
By focusing solely on medical treatments
By providing comfort care and involving family (Correct answer)
By avoiding all discussions about the diagnosis

Correct answer: By providing comfort care and involving family

Nurses support patients with terminal diagnoses by prioritizing comfort care, which includes effective pain management and emotional support. Involving family is crucial for holistic care, as it provides emotional comfort to both the patient and their loved ones. This approach ensures dignity and quality of life during end-of-life care.

Question 14: What is the nurse's role in supporting a patient dealing with grief?

To encourage patients to move on quickly
To provide nonjudgmental listening and emotional support (Correct answer)
To discourage sadness and focus on physical health
To avoid discussing the patient’s loss

Correct answer: To provide nonjudgmental listening and emotional support

When a patient is dealing with grief, the nurse's role is to provide nonjudgmental listening and emotional support. This involves offering a compassionate presence, allowing the patient to express their feelings without interruption or judgment, and validating their experience of loss. Encouraging them to 'move on quickly' or avoiding the topic can invalidate their feelings and hinder the grieving process.

Question 15: Which of the following is a sign of acute emotional distress in a patient?

Improved sleep and appetite
Withdrawn behavior and avoidance of care (Correct answer)
Calm and cooperative demeanor
Increased social interaction and positivity

Correct answer: Withdrawn behavior and avoidance of care

Withdrawn behavior and avoidance of care are common signs of acute emotional distress in a patient. These behaviors indicate that the patient is struggling to cope, may feel overwhelmed, or is experiencing significant psychological discomfort. Recognizing these signs prompts the nurse to provide appropriate psychosocial support and intervention.

Question 16: A patient at 36 weeks gestation presents with painless, bright red vaginal bleeding. What condition does this most likely indicate?

Abruptio placentae
Cervical polyp
Bloody show of impending labor
Placenta previa (Correct answer)

Correct answer: Placenta previa

Painless, bright red vaginal bleeding in the third trimester is the hallmark of placenta previa, where the placenta abnormally implants over the cervical os, creating a risk of hemorrhage.

Question 17: A nurse is caring for a patient diagnosed with preeclampsia who is receiving IV magnesium sulfate. Which finding indicates magnesium toxicity?

Blood pressure of 148/96 mmHg
Urine output of 25 mL/hr and absent deep tendon reflexes (Correct answer)
Headache and visual changes
Fetal heart rate of 145 bpm

Correct answer: Urine output of 25 mL/hr and absent deep tendon reflexes

Absent deep tendon reflexes (DTRs) and oliguria (urine output <30 mL/hr) are signs of magnesium toxicity, indicating the drug level is dangerously elevated and respiratory depression may follow.

Question 18: A nurse assesses a postpartum patient and finds heavy vaginal bleeding with large clots despite a firm uterus. What is the most likely cause?

Bladder distension
Retained placental fragments
Laceration of the cervix or vagina (Correct answer)
Uterine atony

Correct answer: Laceration of the cervix or vagina

Heavy bleeding with a firm, well-contracted uterus suggests the source is a laceration of the birth canal (cervix, vagina, or perineum), not atony. The provider should inspect the birth canal for lacerations.

Question 19: Which position should the nurse avoid placing a postpartum patient who had a spinal anesthetic for cesarean section during the first 8–12 hours?

Left lateral
High Fowler's (head elevated >45°) too soon after spinal (Correct answer)
Flat supine with slight hip roll
Right lateral

Correct answer: High Fowler's (head elevated >45°) too soon after spinal

After spinal anesthesia, keeping the head elevated too early or too high can allow hyperbaric anesthetic solution to spread cephalad, causing high spinal block and respiratory compromise.

Question 20: A laboring patient's external fetal monitor shows variable decelerations. What is the priority nursing intervention?

Administer oxygen at 8–10 L/min via mask
Change maternal position and assess for cord compression (Correct answer)
Notify the provider and prepare for immediate cesarean
Increase IV fluid rate

Correct answer: Change maternal position and assess for cord compression

Variable decelerations are caused by cord compression. Changing maternal position (lateral, knee-chest) relieves cord compression. Repositioning is the first-line nursing intervention.

Question 21: Which antihypertensive class is contraindicated in pregnancy due to risk of fetal renal damage?

Methyldopa
Beta-blockers
ACE inhibitors (Correct answer)
Calcium channel blockers

Correct answer: ACE inhibitors

ACE inhibitors are teratogenic and contraindicated in pregnancy (especially 2nd and 3rd trimesters) due to risk of fetal renal dysplasia, oligohydramnios, and neonatal death.

Question 22: A patient is prescribed metoprolol succinate. Which condition is this medication primarily used to treat?

Atrial fibrillation
Heart failure and hypertension (Correct answer)
Deep vein thrombosis
Pulmonary hypertension

Correct answer: Heart failure and hypertension

Metoprolol succinate is a beta-1 selective blocker used to treat heart failure, hypertension, and angina by reducing heart rate and myocardial oxygen demand.

Question 23: The nurse is caring for a patient receiving IV heparin. Which lab value is used to monitor heparin therapy?

Bleeding time
aPTT (Correct answer)
Platelet count only
PT/INR

Correct answer: aPTT

The aPTT (activated partial thromboplastin time) is used to monitor unfractionated heparin therapy. Therapeutic range is typically 60–100 seconds (1.5–2.5 times normal).

Question 24: Which assessment finding is a priority concern when a patient is receiving IV furosemide (Lasix) for heart failure?

Blood pressure of 130/82 mmHg
Weight loss of 1 lb in 24 hours
Serum potassium of 2.8 mEq/L (Correct answer)
Urine output of 200 mL/hour

Correct answer: Serum potassium of 2.8 mEq/L

Furosemide causes potassium loss (hypokalemia). A potassium of 2.8 mEq/L is below normal (3.5–5.0) and can cause life-threatening cardiac dysrhythmias, requiring immediate intervention.

Question 25: The nurse is administering amlodipine (Norvasc) to a patient. Which food should the nurse advise the patient to avoid?

Grapefruit juice (Correct answer)
Dairy products
Leafy green vegetables
Bananas

Correct answer: Grapefruit juice

Grapefruit juice inhibits CYP3A4 enzymes in the gut, increasing amlodipine blood levels and risk of hypotension and adverse effects.

NCLEX Practice Test: Video 2 Answers (25 Questions)

The primary purpose for using a CPM machine for the client with a total knee repair is to help:

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