NCLEX-PN
NCLEX PN Practice Test with NGN Questions
Extract:
The nurse is caring for a 6-hour-old newborn.
Nurses' Notes
Emergency Department
A newborn is brought to the emergency department due to coughing and difficulty feeding. The client was born at home 6 hours ago via spontaneous vaginal birth. With each attempt to breastfeed, the client coughs, vomits, and "turns blue." The mother did not receive prenatal care. She reports a history of opioid use disorder but reports no opioid use during pregnancy.
Vital signs: T 98.6 F (37 C), P 120, RR 50, and SpOz 95% on room air. Abdominal distension is present. Ballard scoring estimates the client at 37 weeks gestation. Weight and length are consistent with the 25th and 50th percentiles for estimated age, respectively.
Question 1 of 5
Select 2 findings that require immediate feedback?
Correct Answer: C,E
Rationale: Coughing, vomiting, and cyanosis during feeding indicate potential airway or gastrointestinal issues, such as tracheoesophageal fistula. The elevated respiratory rate (RR 50) suggests respiratory distress, requiring immediate attention.
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 2 of 5
For each finding below, click to specify if the finding is consistent with the disease process of hyperthyroidism or hypothyroidism. Each finding may support more than one disease process. Note: Each column must have at least one response option selected.
| Finding | Hyperthyroidism | Hypothyroidism |
|---|---|---|
| Weight gain | ||
| Tachycardia | ||
| Constipation | ||
| Exophthalmos | ||
| Heat intolerance | ||
| Fine hand tremor |
Correct Answer: A: Hypothyroidism, B: Hyperthyroidism, C: Hypothyroidism, D: Hyperthyroidism, E: Hyperthyroidism, F: Hyperthyroidism
Rationale: Hyperthyroidism is characterized by increased metabolic rate, leading to tachycardia, exophthalmos, heat intolerance, and fine hand tremor. Hypothyroidism, with a decreased metabolic rate, is associated with weight gain and constipation.
Extract:
Question 3 of 5
The home health nurse is caring for a 45-year-old client who is prescribed peritoneal dialysis for end-stage renal disease. For each of the actions performed by the client, click to specify whether the action is appropriate or not appropriate when performing peritoneal dialysis.
| Client Actions | Appropriate | Not Appropriate |
|---|---|---|
| Microwaves the dialysate bag prior to infusion | ||
| Sits at a 20-degree angle during the exchange | ||
| Wears a face mask when accessing the catheter | ||
| Places the drainage bag below the abdomen during the drainage phase | ||
| States, 'I will notify my health care provider if the dialysate outflow is cloudy' | ||
| Changes positions to facilitate drainage if the output volume is less than the input volume |
Correct Answer: C,D,E,F
Rationale: A: Not appropriate, as microwaving can unevenly heat the dialysate, risking burns or degradation. B: Not appropriate, as a higher angle (e.g., 45 degrees) or upright position is preferred to facilitate drainage. C: Appropriate, as wearing a face mask reduces infection risk. D: Appropriate, as placing the drainage bag below the abdomen uses gravity to facilitate outflow. E: Appropriate, as cloudy outflow may indicate peritonitis, requiring prompt reporting. F: Appropriate, as changing positions can help resolve drainage issues.
Extract:
The nurse in an inpatient mental health unit is caring for a 43-year-old client.
History
Admission:
The client comes to the inpatient psychiatric facility for an evaluation. The client is having distressing nightmares, flashbacks, and feelings of being "on edge" since a severe motor vehicle collision 6 months ago that resulted in the death of the client's sibling. The client blames self for the sibling's death and verbalizes feelings of guilt. The client reports an inability to sleep well and being quick to anger, both of which led to job loss and the client seeking help. The client reports a loss of interest in previously enjoyed activities, such as working out and interacting with friends. The client has started smoking cigarettes daily since the collision and typically consumes ≥4 alcoholic beverages per day. Mental status examination reveals an irritable, guarded, and easily distracted mood. The client's appearance is well- kept, and grooming and hygiene are appropriate. The client’s speech is hyperverbal yet coherent, and thought process is organized. The client admits to feelings of hopelessness after the death of the sibling. The client reports occasionally seeing "shadows" but no visual hallucinations. The client has no homicidal ideations or history of violence toward others.
Vital signs: P 78, RR 17, BP 132/78.
Question 4 of 5
The nurse should prioritize interventions for due to the risk of
Correct Answer: C
Rationale: The client's consumption of ≥4 alcoholic beverages per day indicates a risk of alcohol withdrawal, which can be life-threatening and requires prioritized intervention.
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
Which statement by the client is the most concerning?
Correct Answer: A
Rationale: Pain and tightness in the calf (
A) is concerning for deep venous thrombosis, a potentially life-threatening complication requiring immediate attention.