NCLEX-PN
NCLEX PN Exam Practice Test with NGN Questions
Extract:
The nurse is caring for a 68-year-old client in the emergency department.
History Physical Vital Signs
Admission: The client comes to the emergency department with progressively worsening back pain that began 3 weeks ago. The pain has become significantly worse over the past 12 hours. Pain level is rated as 8 on a scale of 0-10. The client was recently diagnosed with prostate cancer and has had a poor response to treatment. This morning, the client had trouble walking and reports decreased sensation in the feet. The client also reports mild nausea, difficulty urinating, decreased urinary sensation, and no bowel movement in the past 3 days
Question 1 of 5
For each finding, click to specify whether the finding indicates that the client's condition has improved or not improved.
Correct Answer: A,B,E
Rationale: Improved strength , normal reflexes , and sensation indicate recovery. Constipation , pain , and residual urine suggest ongoing issues.
Extract:
Nurses' Notes
Vital Signs
Emergency Department
0800:
A 43-year-old client comes to the emergency department due to lower
back pain and bilateral leg weakness. The client reports that the
weakness began 3 days ago in the feet and has gradually worsened.
The client sought treatment today after becoming "so weak that I fell
while walking" and noticing new hand weakness and difficulty
swallowing. Back pain radiates down both legs and is rated as 5 on a
scale of 0-10. The client recently recovered from an illness with flu-like
symptoms. The client reports a history of hypertension and takes no
medications. Assessment of the lower extremities reveals muscle
strength of 2/5 and decreased sensation to pinprick. Achilles tendon
and patellar reflexes are decreased.
1000:
The client reports difficulty raising the arms and inability to squeeze the
fingers. The client reports chest tightness and difficulty breathing.
Question 2 of 5
For each intervention, click to specify if the intervention is appropriate or inappropriate for the care of the client.
| Intervention | Appropriate | Inappropriate |
|---|---|---|
| Ensure bedside suction is set up | ||
| Place a bag valve mask at the bedside | ||
| Ensure intubation equipment is available | ||
| Reposition the client in the bed every 2 hours | ||
| Place the client on continuous cardiac monitoring | ||
| Apply a sequential compression device to the legs | ||
| Mark the appropriate surgical site for a tracheotomy |
Correct Answer: A,B,C,D,E,F
Rationale: Suction , bag valve mask , intubation equipment , repositioning , cardiac monitoring , and compression devices prepare for GBS complications. Tracheotomy marking is premature.
Extract:
The nurse is caring for a 21-year-old client.
Nurses' Notes History and Physical Vital Signs
Emergency Department
0800: The client comes to the emergency department due to fear of having a heart attack. The client reports, "I was taking the bus home from work when my chest started feeling really tight. I'm lucky my friend was there and able to help me get to the hospital. What if my friend is not there next time?" The client describes experiencing similar episodes recently at random places and times and worries about when or where the next attack will occur
Question 3 of 5
For each finding below, click to specify if the finding is consistent with the disease process of hyperthyroidism, myocardial infarction, or panic disorder.
| Finding | Hyperthyroidism | Myocardial Infarction | Panic Disorder |
|---|---|---|---|
| Diaphoresis | |||
| Trembling hands | |||
| Heart palpitations | |||
| Shortness of breath |
Correct Answer: A,B,C,D
Rationale: Diaphoresis , palpitations , and shortness of breath occur in all three. Trembling hands are specific to hyperthyroidism and panic disorder.
Extract:
The nurse is caring for a 75-year-old female client. Nurses' Notes Laboratory Results Diagnostic Results Emergency Department
The client is transferred to the emergency department from a skilled nursing facility for a 3-day history of left lower quadrant abdominal pain rated 8 on a scale of 0-10, loss of appetite, and nausea. Although the client has a history of chronic constipation, she has had 2 or 3 loose stools daily for 1 week. The client reports tenderness on deep palpation of the left lower quadrant. There is an area of blanchable redness on the coccyx. The stool is positive for occult blood.
The client has residual left-sided weakness from an ischemic stroke 2 years ago and ambulates with a walker. The client reports falling several times in the past 6 months; the last fall was 3 weeks ago No ecchymosis or injuries are noted. The client had a hysterectomy and salpingo-oophorectomy for uterine fibroids 20 years ago. Vital signs are T 100 F (37.8 C), P 98, RR 17, BP 126/68, and SpOz 97% on room air.
Medical-Surgical Unit: 4 Days Later
The client continues to experience left lower quadrant pain, decreased appetite, and nausea. Today, she developed chills. Stool frequency has not increased. Severe tenderness is noted in the left lower quadrant, and a mass is palpable. Vital signs are T 101.3 F (38.5 C), P 112, RR 17, BP 110/80, SpO, 97% on room air.
Question 4 of 5
For each potential intervention, click to specify the intervention is expected or not expected for the care of the client at this time.
| Potential Intervention | Indicated | Not Indicated |
|---|---|---|
| Keep NPO | ||
| Maintain IV fluids | ||
| Administer antibiotics | ||
| Apply heating pad to abdomen | ||
| Verify consent for abdominal surgery |
Correct Answer: A,B,C
Rationale: NPO status , IV fluids , and antibiotics are expected for acute diverticulitis. Heating pads worsen inflammation, and surgery is not immediate.
Extract:
The nurse is caring for a 23-year-old client. Nurses' Notes Vital Signs Medication Administration Record
Inpatient Unit Admission:
The client was found alone in a public park shouting at people who were not present. The client told the staff, "There's nothing wrong with me. It's just the effects of the microchip that was implanted in my head." The client is not oriented to place or time. Day 7: The client has developed confusion, fever, and diaphoresis. Speech is slurred Muscular rigidity is observed in all extremities. Deep tendon reflexes are 2+; no clonus is noted
Question 5 of 5
The nurse recognizes that the client is most likely experiencing which is a complication of
Correct Answer: C,F
Rationale: Neuroleptic malignant syndrome is a complication of antipsychotics like olanzapine , presenting with fever, rigidity, and confusion.