NCLEX-PN
NCLEX PN Exam Practice Test with NGN Questions
Extract:
The nurse is caring for a 55-year-old client in the clinic.
History and Physical
Body System
Findings: General - The client reports cramping pain in the left calf that has worsened over the past year. The pain is precipitated by walking and is partially relieved with rest. The client reports difficulty walking more than 3 blocks. Height: 72 in (182.9 cm), weight: 250 lb (113.4 kg), BMI: 33.9 kg/m?
Pulmonary- Vital signs are RR 16, SpO, 97% on room air. Client reports smoking 1 pack of cigarettes daily for the past 35 years. Breath sounds are mildly decreased throughout with mild prolonged expiration. Client has a history of chronic obstructive pulmonary disease.
Cardiovascular- Vital signs are T 98.8 F (37.1 C), P 82, BP 146/82. S1 and S2 heard on auscultation. The left lower extremity (LLE) is cooler to touch than the right and appears shiny with sparse hair. LLE pulses: femoral 2+, popliteal 1+, posterior tibia 1+, dorsalis pedis audible with Doppler. LLE capillary refill >3 sec. Client has a history of hypertension.
Gastrointestinal- Client is obese. No tenderness, guarding, masses, bruits, or hepatosplenomegaly.
Question 1 of 5
For each potential finding below, click to specify if the finding is consistent with the disease process of chronic venous insufficiency or peripheral artery disease.
Correct Answer: A, B,C,D,E
Rationale: Edema and pain relief with elevation are typical of venous insufficiency. Hair loss , weak pulses , and cool skin indicate arterial insufficiency.
Question 2 of 5
For each potential finding below, click to specify if the finding is consistent with the disease process of chronic venous insufficiency or peripheral artery disease.
| Potential Finding | Chronic Venous Insufficiency | Peripheral Artery Disease |
|---|---|---|
| Peripheral edema | ||
| Decreased leg hair | ||
| Decreased peripheral pulses | ||
| Skin temperature cool to touch | ||
| Pain improves with leg elevation |
Correct Answer: A, B,C,D,E
Rationale: Edema and pain relief with elevation are typical of venous insufficiency. Hair loss , weak pulses , and cool skin indicate arterial insufficiency.
Extract:
The nurse is caring for a 43-year-old client.
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
Question 3 of 5
Which finding is the most concerning to the nurse at this time?
Correct Answer: B
Rationale: Difficulty swallowing indicates bulbar involvement in Guillain-Barré syndrome, risking aspiration and requiring urgent intervention.
Extract:
The nurse is caring for a 40-year-old client.
History Admission:
The client is brought to the psychiatric emergency department by ambulance after being observed walking in the street and shouting at vehicles. The client states that aliens are trying to attack him and that he is now on a mission to find and kill them. The clients mother says that last year he believed that he was being watched by an unidentified government agency and subsequently broke up with his girlfriend, quit his job, and disconnected his phone. The mother has noticed that he no longer seems to care about activities that used to interest him, and last month she discovered that he had moved into the family garden shed with his dog.
On examination, the client is malodorous and disheveled and laughs for no apparent reason. He appears anxious, avoids eye contact, and shows little emotion. His answers are very brief, and he asks if the interview is being secretly recorded. The client's speech is difficult to follow, and he repeatedly says in a monotone voice, "I said I'll find them." He later becomes angry and refuses to sit in a chair for the interview. I'll find them." He later becomes angry and refuses to sit in a chair for the interview.
Question 4 of 5
For each finding, click to specify whether the finding indicates that the client's status has improved or not improved.
| Finding | Improved | Not Improved |
|---|---|---|
| Client is seen talking alone in the hallway | ||
| Client is seen playing board games with peers | ||
| Client asks the technician for hygiene supplies | ||
| Client states, 'The voices are a part of my illness.' | ||
| Client refuses to take medication from a new nurse | ||
| Client is willing to eat food that is prepackaged only |
Correct Answer: B,C,D
Rationale: Social interaction , hygiene requests , and insight into illness show improvement. Talking alone , medication refusal , and food paranoia indicate ongoing symptoms.
Extract:
The nurse is caring for a 63-year-old client.
Progress Notes
Emergency department
1 week ago: The client is admitted to the hospital with dyspnea, orthopnea, and bilateral leg swelling. The client has hypertension, heart failure, and chronic kidney disease. Medications include furosemide, hydrochlorothiazide, lisinopril, and metoprolol.
Clinic visit
Today: The client was recently discharged from the hospital after treatment for acute heart failure. Symptoms improved after treatment with diuretics. Today, the client reports new-onset muffled hearing and difficulty understanding speech. Examination shows bilateral hearing loss.
Question 5 of 5
Which medication should the nurse clarify with the health care provider?
Correct Answer: A
Rationale: Furosemide is associated with ototoxicity, which may cause hearing loss, requiring clarification.