NCLEX-PN
NCLEX PN Practice Test with NGN Questions
Extract:
The nurse is caring for a 66-year-old client in the emergency department.
Nurses' Notes
Emergency Department
1930:
The client is admitted for cellulitis of the right arm due to V drug use. The client was diagnosed with HIV 25 years ago and is taking antiretroviral therapy but reports frequently skipping doses. This is the client's third admission to the hospital within the past 6 months for complications due to IV drug use.
2015:
While assisting with an IV catheter placement, the nurse accidentally sustains a needlestick injury.
Question 1 of 5
For each potential intervention, click to specify if the intervention is indicated or not indicated for the care of the client.
Correct Answer: A,B,C,D
Rationale: A: Indicated - Washing with soap and water is a standard first step to clean a needlestick injury and reduce infection risk. B: Indicated - Screening the client for hepatitis C is necessary due to the risk of bloodborne pathogen transmission, especially given the client's IV drug use history. C: Indicated - Allowing the wound to bleed can help flush out potential contaminants. D: Indicated - Post-exposure prophylaxis with antiretrovirals may be needed due to the client's HIV status and non-compliance with therapy. E: Not indicated - Antibiotics are not routinely given for needlestick injuries unless infection is evident. F: Not indicated - Recapping needles increases the risk of injury and is against safety protocols.
Extract:
Nurses' Notes
0930:
The client reports shortness of breath and left-sided chest pain for 2 days. The client fractured the right femoral neck a month ago after a fall and decided against operative management. Since then, the client has been wheelchair dependent and takes acetaminophen for fracture pain management. The client was placed on continuous cardiac monitoring.
History and physical
Body System
Neurological
The client is awake, alert, and oriented to person, place, time, and situation; the client appears anxious
Pulmonary
Vital signs are RR 22, SpOz 89% on room air; bilateral breath sounds are clear; pain increases with inhalation; the client reports shortness of breath for the past 2 days; the client smoked 1 pack of cigarettes per day for 10 years.
Cardiovascular
Vital signs are T 99.8 F (37.7 C), P 110, BP 110/60; S1 and S2 are present; there are no murmurs, redness and edema of the right lower extremity are noted; sinus tachycardia is seen on the monitor, chest pain is reported as 7 on a scale of 0-10
Musculoskeletal
The client has osteoporosis, is wheelchair dependent, and is unable to bear weight on the right leg
Question 2 of 5
Select the findings that require immediate follow-up.
Correct Answer: B,C,D
Rationale: B: SpO2 of 89% indicates hypoxemia, requiring immediate oxygen supplementation. C: Tachycardia (P 110) and low BP (110/60) suggest cardiovascular instability, needing urgent evaluation. D: Severe chest pain (7/10) warrants immediate investigation for potential cardiac or pulmonary issues. A: Anxiety is noted but not immediately life-threatening. E: Musculoskeletal issues are chronic and do not require immediate follow-up.
Question 3 of 5
Based on the client's history and physical examination findings, which disease process is the most likely cause of this client's current condition?
Correct Answer: D
Rationale: The client's recent immobility (wheelchair dependence post-femoral fracture), right lower extremity redness and edema (suggesting DVT), dyspnea, chest pain, hypoxemia (SpO2 89%), and sinus tachycardia strongly indicate venous thromboembolism, likely a pulmonary embolism secondary to DVT.
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
For each client finding, click to specify if the finding is consistent with presumptive, probable, or positive signs of pregnancy. Note: Each row must have one response option selected
| Client Finding | Presumptive | Probable | Positive |
|---|---|---|---|
| Amenorrhea | |||
| Chadwick sign | |||
| Fetal heart rate | |||
| Nausea/vomiting | |||
| Breast tenderness | |||
| Home pregnancy test | |||
| Fetus visible on ultrasound |
Correct Answer: A: Presumptive, B: Probable, C: Positive, D: Presumptive, E: Presumptive, F: Probable, G: Positive
Rationale: Presumptive signs are subjective and may have other causes (e.g., amenorrhea, nausea/vomiting, breast tenderness). Probable signs are objective but not definitive (e.g., Chadwick sign, positive home pregnancy test). Positive signs confirm pregnancy (e.g., fetal heart rate, fetus visible on ultrasound).
Extract:
The nurse is caring for a 52-year-old client on the orthopedic unit.
Nurses' Notes
Postoperative Day 1
0900:
The client's left leg was placed in balanced suspension skeletal traction for a fractured femur 12 hours ago. The client is positioned supine in the center of the bed with the foot of the bed elevated 15 degrees. Traction ropes are free of frays, centered in the pulleys, and moving freely with attached weights resting on the bed frame.
Serous drainage noted around the pin sites. Left foot slightly cool to the touch with posterior tibial and dorsalis pedis pulses palpable at 2+ and capillary refill <2 seconds in the toes. Client has normal sensation and movement of the left toes. Client rates left leg pain as 8 on a scale of 0-10.
Vital signs are T 100.4 F (38 C), P 110, RR 18, and BP 132/68. Weight is 173 lb (78.5 kg).
Question 5 of 5
Select the 2 findings that require immediate follow-up.
Correct Answer: G,E
Rationale: Serous drainage (G) and a slightly cool foot (E) require immediate follow-up due to potential infection or compromised circulation.