NCLEX-PN
NCLEX PN Practice Test with NGN Questions
Extract:
The nurse is caring for a 58-year-old client on a medical-surgical unit.
History and Physical
General
The client is vomiting bright red blood; medical history includes alcohol use disorder, liver cirrhosis, and hypertension; the client was admitted a year ago for alcohol-induced acute pancreatitis
Neurological
The client is oriented to person and place; the pupils are equal, round, and reactive to light and accommodation
Eye, Ear, Nose, and Throat (EENT)
Yellow scleras are noted
Pulmonary
Vital signs are RR 18, SpO 94% on room air
Cardiovascular
Vital signs are T 99 F (37.2 C), P 102, BP 90/40; S1 and S2 are heard on auscultation; peripheral pulses are 2+ in all extremities; 1+ edema is noted at the bilateral lower extremities
Gastrointestinal
The abdomen is distended and nontender to palpation; the flanks are dull to percussion; bowel sounds are hypoactive; distended veins are present around the umbilicus
Genitourinary
Client is voiding amber-colored urine
Question 1 of 5
Complete the following sentence by choosing from the lists of options. The nurse should prioritize interventions for ___ due to the risk of ___.
Correct Answer: B,E
Rationale: The client is vomiting bright red blood and has low BP (90/40) and elevated pulse (102), indicating hypovolemia (E) from bleeding esophageal varices (
B), which is confirmed later. Prioritizing interventions for esophageal varices addresses the bleeding source, and hypovolemia addresses the life-threatening volume loss.
Question 2 of 5
The health care provider confirms that the client is experiencing bleeding from esophageal varices secondary to complications from liver cirrhosis. For each potential prescription, specify if the prescription is anticipated or unanticipated for the care of this client.
| Potential Prescription | Anticipated | Unanticipated |
|---|---|---|
| Maintain NPO status | ||
| Start octreotide infusion | ||
| Administer IV fluid bolus | ||
| Transfuse packed RBCs | ||
| Gather supplies for paracentesis | ||
| Prepare client for esophagogastroduodenoscopy |
Correct Answer: A: Anticipated, B: Anticipated, C: Anticipated, D: Anticipated, E: Unanticipated, F: Anticipated
Rationale:
A) Anticipated: NPO prevents aspiration and supports esophageal varices management.
B) Anticipated: Octreotide reduces portal pressure to control variceal bleeding.
C) Anticipated: IV fluids address hypovolemia (BP 90/40).
D) Anticipated: PRBCs treat blood loss from variceal bleeding. E) Unanticipated: Paracentesis is for ascites, not urgent here. F) Anticipated: EGD is standard to visualize and treat varices.
Extract:
The nurse is caring for a 25-year-old female client.
History and Physical
Body System
General
Client reports jitteriness, anxiety, and palpitations for the past 2 months. Fine hand tremor is noted. Client reports insomnia for approximately 1 week.
Integumentary
Client is diaphoretic.
Eye, Ear, Nose, andThroat (EENT)
Exophthalmos is noted. Goiter is present.
Gastrointestinal
Client reports 10 lb (4.5 kg) weight loss over the past month. Bowel sounds are normoactive. Client reports diarrhea for the past few days.
Reproductive
Last menstrual period was 3 months ago.
Vital Signs
T 99.2 F (37.3 C)
P 164
RR 22
BP 156/92
Question 3 of 5
Which clinical finding is most concerning at this time?
Correct Answer: C
Rationale: Tachycardia (pulse 164) is most concerning as it may indicate severe hyperthyroidism or other cardiovascular issues requiring immediate intervention.
Extract:
The nurse is caring for a client at a women’s health clinic.
History & Physical
Labor and delivery unit
0800:
A 28-year-old nulliparous female comes to the clinic for confirmation of suspected pregnancy due to amenorrhea and a positive home pregnancy test. The client's current exercise regimen includes indoor cycling and outdoor running. The client reports nausea, vomiting, and breast tenderness. She has a 28-day menstrual cycle, and her last menstrual period was March 10- 17. The health care provider notes a bluish-purple vaginal mucosa and cervix during pelvic examination and confirms a 12-week intrauterine pregnancy by sonography. A fetal heart rate of 155/min is detected with handheld Doppler.
Question 4 of 5
Which of the following laboratory tests should the nurse anticipate during the first prenatal visit? Select all that apply.
Correct Answer: C,D,E
Rationale: First prenatal visit tests include maternal blood type and screen, STI screen, and urinalysis. Glucose tolerance and Group B Streptococcus tests are performed later in pregnancy.
Extract:
The nurse in the emergency department is caring for a 62-year-old client.
Progress Notes
Emergency Department
0900: The client is brought to the emergency department by a family member after being found confused and lethargic. On arrival, the client is obtunded and does not respond to verbal stimuli.
Medical history includes major depressive disorder and chronic neck and back pain after a motor vehicle collision 2 years ago. The family member states that the client takes multiple medications but does not know which kind. The client was divorced a few months ago.
Physical examination shows 1-mm pupils, shallow breathing, and reduced bowel sounds. Fingerstick blood glucose is 78 mg/dL (4.3 mmol/L). ECG reveals normal sinus rhythm. Breath alcohol test is negative.
Vital signs: T 98.1 F (36.7 C), P 62, RR 8, BP 80/40, SpO, 94% on room air.
1800:
The client is awake, alert, and oriented to person, place, time, and situation. The client is experiencing severe withdrawal symptoms and is admitted for supervised detoxification.
Laboratory Results
Urine Drug Screen
On admission
Cocaine- Negative
Opioids- Positive
Amphetamines- Negative
Marijuana- Positive
Phencyclidine-Negative
Benzodiazepines- Negative
Barbiturates- Negative
Laboratory Test and Reference Range
Cocaine- Negative
Opioids- Negative
Amphetamines- Negative
Marijuana- Negative
Phencyclidine- Negative
Benzodiazepines- Negative
Barbiturates- Negative
Question 5 of 5
The nurse is helping the client prepare for discharge after 3 days of inpatient detoxification. Which of the following actions should the nurse take? Select all that apply.
Correct Answer: A,B,C,D,E
Rationale: All are appropriate: A: Identifying maladaptive behaviors supports recovery. B: Support groups aid long-term sobriety. C: Naloxone training prevents overdose deaths. D: Referrals ensure continued care. E: Education on medications (e.g., methadone) ensures adherence.