NCLEX-PN
NCLEX PN Practice Test with NGN Questions
Extract:
Question 1 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.
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 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 2 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 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 3 of 5
Which client finding requires immediate follow-up by the nurse?
Correct Answer: A
Rationale: Hopelessness is a critical finding indicating a risk for suicide or severe depression, requiring immediate assessment and intervention in a client with post-traumatic stress symptoms and recent life stressors.
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 4 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.
Extract:
The nurse in the emergency department is caring for a 62-year-old client.
Progress Notes
Emergency Department
0900:
The client is brought to the emergency department by a family member after being found confused and lethargic. On arrival, the client is obtunded and does not respond to verbal stimuli.
Medical history includes major depressive disorder and chronic neck and back pain after a motor vehicle collision 2 years ago. The family member states that the client takes multiple medications but does not know which kind. The client was divorced a few months ago.
Physical examination shows 1-mm pupils, shallow breathing, and reduced bowel sounds. Fingerstick blood glucose is 78 mg/dL (4.3 mmol/L). ECG reveals normal sinus rhythm. Breath alcohol test is negative.
Vital signs: T 98.1 F (36.7 C), P 62, RR 8, BP 80/40, SpO2 94% on room air.
1800:
The client is awake, alert, and oriented to person, place, time, and situation. The client is experiencing severe withdrawal symptoms and is admitted for supervised detoxification.
Laboratory Results
Urine Drug Screen
On admission
Cocaine- Negative
Opioids- Positive
Amphetamines- Negative
Marijuana- Positive
Phencyclidine-Negative
Benzodiazepines- Negative
Barbiturates- Negative
Laboratory Test and Reference Range
Cocaine- Negative
Opioids- Negative
Amphetamines- Negative
Marijuana- Negative
Phencyclidine- Negative
Benzodiazepines- Negative
Barbiturates- Negative
Question 5 of 5
The nurse has reviewed the information from the Progress Notes and Laboratory Results. For each potential intervention, click to specify if the intervention is expected or unexpected for the care of the client.
| Potential Intervention | Expected | Unexpected |
|---|---|---|
| Initiate seizure precautions | ||
| Monitor the client for suicidal ideation | ||
| Administer antidiarrheal and antiemetic medications as needed | ||
| Use a standardized scoring scale to assess for withdrawal symptoms |
Correct Answer: B,C,D
Rationale: B: Expected - Depression history increases suicide risk during withdrawal. C: Expected - Antidiarrheals and antiemetics manage withdrawal symptoms like nausea. D: Expected - Standardized scales (e.g., COWS) assess opioid withdrawal severity. A: Unexpected - Seizures are more associated with alcohol or benzodiazepine withdrawal, not opioids.