NCLEX-PN
NCLEX PN Practice Test with NGN Questions
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 1 of 5
The client's last menstrual period was March 10-17. Unprotected intercourse occurred on March 24. The client's menstrual cycles are regular and occur every 28 days. Based on the Naegele rule, what is the estimated date of birth?
Correct Answer: B
Rationale: Using Naegele's rule (first day of LMP + 1 year - 3 months + 7 days), March 10, 2025 + 1 year = March 10, 2026 - 3 months = December 10, 2025 + 7 days = December 17, 2025.
Question 2 of 5
The nurse has reviewed the information from the Progress Notes. Which of the following statements by the nurse is appropriate? Select all that apply.
Correct Answer: C,D,E
Rationale: Nutrient-dense foods, moderate exercise, and iron-rich foods are appropriate. Avoiding carbohydrates or sodium restriction is not recommended without specific indications.
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
Nurses' Notes
Outpatient Clinic
0930:
Client received radioactive iodine therapy 6 months ago. Client reports absence of heart palpitations and anxiety. No evidence of fine hand tremor.
Client reports weight gain of 10.5 lbs (4.8 kg) within the past 3 months. Client reports feeling more fatigued during the day and requests to speak to the health care provider about feeling depressed.
Question 3 of 5
Following a routine laboratory draw, the nurse suspects that the client is experiencing primary hypothyroidism as evidenced by........... and ........
Correct Answer: A,D
Rationale: Primary hypothyroidism is characterized by increased TSH due to the pituitary gland's attempt to stimulate the thyroid and decreased T3 and T4 levels due to reduced thyroid hormone production.
Extract:
The nurse is caring for a 12-month-old male client.
History and Physical
Body System
General
The client is brought to the emergency department by the parents due to increased leg bruising and left knee swelling for 1 day; the parents report that the client seems more tired and less playful; both parents and the sister are healthy, but a maternal uncle died at age 7 after mild head trauma.
Integumentary
Good hygiene; no abrasions; no burns; bilateral scattered lower extremity bruising
Eye, Ear, Nose, and Throat (EENT)
The parents report that the client's gums have been bleeding when chewing on crackers
Pulmonary
Vital signs: RR 38, SpO 100% on room air, upper respiratory infection 3 weeks ago that completely resolved after 4 days.
Cardiovascular
Vital signs: T 98.7 F (37.1 C), P 136
Musculoskeletal
Left knee redness and swelling with limited range of motion; the client can bear weight on both lower extremities; the parents state the child has recently started learning to walk by holding onto furniture and sometimes falls
Genitourinary
The parents state that urine output has been normal; urine is clear and pale yellow; the penis is uncircumcised
Psychosocial
The client is cooperative during examination; the client appears appropriately dressed for the season and weather; the mother says the child has no interest in toilet-training
Question 4 of 5
Which of the following laboratory tests does the nurse anticipate to help determine the cause of the client's condition? Select all that apply.
Correct Answer: A,D,E
Rationale: A: Anticipated - Testing for clotting factors VIII and IX is essential to diagnose hemophilia, given the symptoms and family history. D: Anticipated - Platelet count helps rule out thrombocytopenia as a cause of bleeding. E: Anticipated - PTT (partial thromboplastin time) assesses the intrinsic clotting pathway, which is prolonged in hemophilia. B, C: Not indicated as they do not directly assess bleeding disorders.
Extract:
The nurse is caring for a client on the medical-surgical unit.
History
Admission
0500: The client is admitted with an abscess and cellulitis of the right leg. The abscess is noted on the lateral aspect of the right calf, with redness, swelling, and warmth extending from the knee to the ankle. The abscess was incised in the emergency department, and a moderate amount of purulent, yellowish-green drainage was noted. The leg was wrapped with gauze, and the client received the first dose of IV antibiotics and opioids for pain control.
The client reports chronic lower back pain and gastrosophageal reflux disease, and he was admitted to the hospital once last year for gastrointestinal bleeding. He is currently prescribed daily pantoprazole but takes it only a few times a week.
Vital signs: T 100.9 F (38.3 C), P 82, RR 14, BP 130/80, SpO, 95% on room air
Progress Notes
Medical-Surgical Unit
2300:
The client reports nausea, headache, and insomnia. The client is trembling, diaphoretic, and restless.
The client states, "I would sleep better if those mice and cats would stop climbing up and down the walls."
The upper portion of the clients dressing is saturated with yellowish-green drainage. The peripheral V was removed by the client, and dried blood is noted at the IV site. The IV catheter is on the floor. The client yelled and pushed the nurse's hands away during inspection of the IV site.
Vital signs: T 99 F (37.2 C), P 102, RR 18, BP 170/96, SpO≥ 95% on room air
Question 5 of 5
The nurse should contact the health care provider and anticipate prescriptions for.....and.....
Correct Answer: B,D
Rationale: B: Thiamine is given to prevent Wernicke encephalopathy in alcohol withdrawal. D: Lorazepam manages withdrawal symptoms and prevents seizures. Naloxone is for opioid overdose, and haloperidol is not first-line for withdrawal.