Exam 3 Practice Questions

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DISCLAIMER: These questions are from numerous NCLEX sources which will be listed
at the end. There is a good chance that the same style of questions might appear on the
exam but please be mindful that the answer found here may NOT be the exact same
answer found on the exam. Proceed with caution. Good luck and happy studying!

Exam 3 Practice Questions
1. A client with Type 1 diabetes mellitus is admitted to an acute care facility with
diabetic ketoacidosis. To correct this acute diabetic emergency, which measure
should the health care team take first?
a. Initiate fluid replacement therapy
b. Administer insulin
c. Correct diabetic ketoacidosis
d. Determine the cause of diabetic ketoacidosis
2. A client with Addison’s disease comes to the clinic for a follow-up visit. When
assessing this client, the nurse should stay alert for signs and symptoms of:
a. Calcium and phosphorus
b. Chloride and magnesium
c. Sodium and chloride abnormalities
d. Sodium and potassium abnormalities
3. The nurse obtains a fingerstick glucose level of 45 mg/dl from a client newly
diagnosed with diabetes mellitus. The client is alert and oriented, and the client’s
skin is warm and dry. How should the nurse intervene?
a. Give the client 4 oz of milk and a graham cracker with peanut butter
b. Obtain a serum glucose level
c. Obtain a repeat fingerstick glucose level
d. Notify the physician
4. A patient is prescribed levothyroxine (Synthroid) daily. What is the most
important instruction to teach for administration of this drug?
a. Tape the dose and discontinue if mental and emotional problems stabilize
b. Take it at bedtime to avoid the side effects of nausea and flatus
c. Call the doctor immediately at the onset of palpitations or nervousness
d. Decrease the intake of juices and fruits with high potassium and calcium
contents
5. A client with severe head trauma sustained in a car accident is admitted to the
intensive care unit. Thirty-six hours later, the client’s urine output suddenly rises
above 200 mL/hour, leading the nurse to suspect diabetes insipidus. Which
laboratory findings support the nurse’s suspicion of diabetes insipidus?
a. Above-normal urine and serum osmolality levels
b. Below-normal urine and serum osmolality levels
c. Above-normal urine osmolality level, below-normal serum osmolality
level

d. Below-normal urine osmolality level, above-normal serum osmolality
level
6. A new diabetic is learning to administer his insulin. He receives 10U of NPH and
12U of regular insulin each morning. Which of the following statements reflects
understanding of the nurse’s teaching?
a. “When drawing up my insulin, I should draw up the regular insulin first.”
b. “When drawing up my insulin, I should draw up the NPH insulin first.”
c. “It doesn’t matter which insulin I draw up first.”
d. “I cannot mix the insulin, so I will need two shots,”
7. A 60-year-old diabetic is taking glyburide (Diabeta) 1.25 mg daily to treat Type II
diabetes mellitus. Which statement indicates the need for further teaching?
a. “I will keep candy with me just in case my blood sugar drops.”
b. “I will need to stay out of the sun as much as possible.”
c. “I often skip dinner because I don’t feel hungry.”
d. “I always wear my medical identification.”
8. When caring for a client who’s being treated for hyperthyroidism, it’s important
to:
a. Provide extra blankets and clothing to keep the client warm
b. Monitor the client for signs of restlessness, sweating, and excessive weight
loss during thyroid replacement therapy
c. Balance the client’s periods of activity and rest
d. Encourage the client to be active to prevent constipation
9. The nurse is assessing a client with Cushing’s syndrome. Which observation
should the nurse report to the physician immediately?
a. Pitting edema of the legs
b. An irregular apical pulse
c. Dry mucous membranes
d. Frequent urination
10. A client is brought to the emergency department in an unresponsive state, and a
diagnosis of hyperglycemic hyperosmolar state (HHS) is made. The nurse would
immediately prepare to initiate which anticipated health care provider’s
prescription.
a. Endotracheal intubation
b. 100 units of NPH
c. Intravenous infusion of normal saline
d. Intravenous infusion of sodium bicarbonate
11. An external insulin pump is prescribed for a client with diabetes and the client
asks the nurse about the functioning of the pump. The nurse bases the response
on which information about the pump?
a. Is timed to release programmed doses of short-duration or NPH insulin
into the bloodstream at specific intervals
b. Continuously infuses small amounts of NPH insulin into the bloodstream
while regularly monitoring blood glucose levels

c. Is surgically attached to the pancreas and infuses regular insulin into the
pancreas, which in turn releases the insulin into the bloodstream
d. Gives a small continuous dose of short-duration insulin subcutaneously,
and the client can self-administer a bolus with an additional dose from the
pump before each meal
12. A client is admitted to an emergency department, and a diagnosis of myxedema
coma is made. Which action would the nurse prepare to carry out initially?
a. Warm the client
b. Maintain a patent airway
c. Administer thyroid hormone
d. Administer fluid replacement
13. A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes
of hypoglycemia with exercising. Which statement by the client indicates an
adequate understanding of the peak action of NPH insulin and exercise?
a. “The best time for me to exercise is after I eat.”
b. “The best time for me to exercise is after breakfast.”
c. “The best time for me to exercise is mid-to-late afternoon.”
d. “The best time for me to exercise is after my morning snack.”
14. A client is diagnosed with syndrome of inappropriate antidiuretic hormone
secretion (SIADH). Laboratory results reveal serum sodium level 130 mEq/L and
urine specific gravity 1.030. Which nursing intervention would help prevent
complications associated with SIADH?
a. Restricting fluids to 800 mL/day
b. Administering vasopressin as ordered
c. Elevating the client’s head of bed to 90 degrees
d. Restricting sodium intake to 1 gm/day
15. The nurse is caring for a postoperative parathyroidectomy client. Which client
complaint would indicate that a life-threatening complication may be developing,
requiring notification of the health care provider immediately?
a. Laryngeal stridor
b. Abdominal cramps
c. Difficulty in voiding
d. Mild to moderate incisional pain
16. The nurse is providing discharge instructions to a client who has a Cushing’s
syndrome. Which client statement indicates that instructions related to dietary
management are understood?
a. “I will need to limit the amount of protein in my diet.”
b. “I should eat foods that have a lot of potassium in them.”
c. “I am fortunate that I can eat all the salty foods I enjoy.”
d. “I am fortunate that I do not need to follow any special diet.”
17. The nurse is caring for a client who is 2 days postoperative following an
abdominal hysterectomy. The client has a history of diabetes mellitus and has
been receiving regular insulin according to capillary blood glucose testing four
times a day. A carbohydrate-controlled diet has been prescribed but the client has

been complaining of nausea and is not eating. On entering the client’s room, the
nurse finds the client to be confused and diaphoretic. Which action is most
appropriate at this time?
a. Call a code to obtain needed assistance immediately
b. Obtain a capillary blood glucose level and perform a focused assessment
c. Ask the unlicensed assistive personnel (UAP) to stay with the client while
obtaining 15 to 30 g of a carbohydrate snack for the client to eat
d. Stay with the client and ask the UAP to call the health care provider
(HCP) for a prescription for intravenous 50% dextrose
18. In the emergency department during initial assessment of a newly-admitted
patient with diabetes, the nurse discovers all of these findings. Which finding
should be reported to the health care provider immediately?
a. Hammer toe of the left second metatarsophalangeal joint
b. Rapid respiratory rate with deep inspirations
c. Numbness and tingling bilaterally in the feet and hands
d. Decreased sensitivity and swelling of the abdomen
19. A patient with diabetes has hot, dry skin; rapid and deep respirations; and a fruity
odor to his breath. As charge nurse, you observe a newly-graduated RN
performing all the following patient tasks. Which one requires that you intervene
immediately?
a. Checking the patient’s fingerstick glucose level
b. Encouraging the patient to drink orange juice
c. Checking the patient’s order for sliding-scale insulin dosing
d. Assessing the patient’s vital signs every 15 minutes
20. You are preceptor for a senior nursing student who will teach a diabetic patient
about self-care during sick days. For which statement by the student must you
intervene?
a. “When you are sick, be sure to monitor your blood glucose at least every 4
hours.”
b. “Test your urine for ketones whenever your blood glucose level is less
than 240 mg/dL.”
c. “To prevent dehydration, drink 8 ounces of sugar-free liquid every hour
while you are awake.”
d. “Continue to eat your meals and snacks at the usual times.”
21. During the first 24 hours after a client diagnosed with Addisonian crisis, which
intervention should the nurse perform frequently?
a. Weigh the client
b. Test urine for ketones
c. Assess vital signs
d. Administer oral hydrocortisone
22. The nurse is admitting a new client with a diagnosis of myxedema. During the
initial assessment, the nurse is most concerned when the client presents with
which findings?
a. Hypertension and weight loss

b. Heat intolerance and emotional lability
c. Corneal ulcerations and increased appetite
d. Bradycardia and decreased intellectual function
23. A client is scheduled for several tests. Which test should be performed after the
thyroid function tests?
a. Ultrasound of the carotid arteries
b. EEG
c. Chest X-ray
d. Computed tomography scan of the head with contrast
24. A nurse is caring for a client with diabetes insipidus. Which laboratory value is
most important for the nurse to monitor?
a. Glucose
b. Hemoglobin
c. Creatinine
d. Sodium
25. The nurse is admitting a client who is diagnosed with untreated Cushing’s
syndrome. While performing the initial assessment, the nurse can expect to see
which of the following signs and symptoms?
a. Moon face and truncal obesity
b. Weight loss and heat intolerance
c. Changes in skin texture and low body temperature
d. Polyuria and dehydration
26. The nurse administers tamsulosin (Flomax) to a client with benign prostatic
hyperplasia (BPH)? The nurse is aware that which of the following is a priority
assessment?
a. Voiding pattern
b. Size of the prostate
c. Creatinine clearance
d. Serum testosterone level
27. The client with an ileal conduit will be using a resusable appliance at home. The
nurse should teach the client to clean the appliance routinely with which product?
a. Baking soda
b. Soap
c. Hydrogen peroxide
d. Alcohol
28. The client is scheduled for an intravenous pyelogram (IVP) to determine the
location of the renal calculi. Which of the following measures would be most
important for the nurse to include in pretest preparation?
a. Ensuring adequate fluid intake on the day of the test
b. Preparing the client for the possibility of bladder spasms during the test
c. Checking the client’s history for allergy to iodine
d. Determining when the client last had a bowel movement
29. A client is complaining of severe flank and abdominal pain. A flate plate of the
abdomen shows urolithiasis. Which intervention is important?
a. Strain all urine

b. Limit fluid intake
c. Enforce strict bed rest
d. Encourage a high-calcium diet
30. The nurse is providing instruction about skin care at the stoma site for a client
with an ileal conduit. What is the most important information for the nurse to
provide?
a. Change the appliance at bedtime
b. Leave the stoma open to air while changing the appliance
c. Clean the skin around the stoma with mild soap and water and dry it
thoroughly
d. Cut the faceplace or wafer of the appliance no more than 4 mm larger than
the stoma
31. A client has a transurethral prostactectomy for benign prostatic hypertrophy and is
currently being treated with a continuous bladder irrigation. He’s complaining of
an increase in severity of bladder spasms. Which intervention should the nurse do
first?
a. Administer an oral analgesic
b. Stop the irrigation and call the physician
c. Administer a belladonna and opium suppository as ordered by the
physician
d. Check for the presence of clots and make sure the catheter is draining
properly
32. A client has returned from surgery with continuous bladder irrigation. The nurse
is aware that proper maintenance of a continuous bladder irrigation system
includes:
a. Regulating irrigant flow to maintain red urine
b. Regulating irrigant flow to maintain pink urine
c. Maintaining a slow flow rate of irrigant to prevent bladder distension
d. Stopping the irrigation if there’s leakage of large amounts of urine around
the catheter
33. A client is diagnosed with prostate cancer. The physician is most likely to order
which test to monitor the client’s progress?
a. Serum creatinine
b. Complete blood count (CBC)
c. Prostate-specific antigen (PSA)
d. Serum potassium
34. A sterile urine specimen for culture and sensitivity has been ordered for a patient
who has an indwelling urinary catheter. How should the nurse obtain this
specimen?
a. Withdraw several millimeters of urine from the port on the collection
tubing, using a syringe and needle
b. Collect a urine specimen from the collection bag first thing in the morning
or a few hours after the patient receives a diuretic

c. Empty the collection bag, wait 30 minutes, and then collect the contents of
the collection bag
d. Discontinue the indwelling catheter and insert an intermittent catheter to
obtain the sterile specimen
35. The nurse is providing discharge instructions for a client treated for acute
pyelonephritis. What is the most important information for the nurse to include?
a. Avoid taking any dairy products
b. Return for follow-up urine cultures
c. Stop taking the prescribed antibiotics when the symptoms subside
d. Recurrence is unlikely because you’ve been treated with antibiotics
36. A client who will have his last chemotherapy cycle in 11 days becomes
neutropenic. The client understands his condition when he states:
a. “I’ll monitor my temperature frequently and go to the nearest emergency
department if my temperature rises above 100.4°F.”
b. “I’ve found that eating fresh fruit and vegetables reduce the side effects of
chemotherapy and also give me more energy.”
c. “I find that going out for a quiet dinner and a movie relieves the stress and
anxiety of my cancer treatment.”
d. “I love working in my garden; it gives me a lot of inner peace and
tranquility.”
37. A client received chemotherapy 24 hours ago. Which precautions are necessary
when caring for the client?
a. Wear sterile gloves
b. Place incontinence pads in the regular trash container
c. Wear personal protective equipment when handling blood, body fluids,
and feces
d. Provide a urinal or bedpan to decrease the likelihood of soiling linens
38. A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies
the lesion according to the TNM staging system as follows: TIS, N0, M0. What
does this classification mean?
a. No evidence of primary tumor, no abnormal regional lymph nodes, and no
evidence of distant metastasis
b. Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of
distant metastasis
c. Can’t assess tumor or regional lymph nodes and no evidence of metastasis
d. Carcinoma in situ, no demonstrable metastasis of the regional lymph
nodes, and ascending degrees of distant metastasis
39. After cancer chemotherapy, a client experiences nausea and vomiting. The nurse
should assign highest priority to which intervention?
a. Serving small portions of bland food
b. Encouraging rhythmic breathing exercises
c. Administering metoclopramide (Reglan) and dexamethasone (Decadron)
as prescribed

d. Withholding fluids for the first 4 to 6 hours after chemotherapy
administration
40. Which statement by a client undergoing external radiation therapy indicates the
need for further teaching?
a. “I will wash my skin with mild soap and water only.”
b. “I will not use my heating pad during my treatment.”
c. “I will wear protective clothing when outside.”
d. “I will expose my family members to radiation.”

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