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 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.
Question 2 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.
Extract:
The nurse is caring for an 82-year-old client in the emergency department.
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
Diagnostic Results
CT pulmonary angiography
1030: Pulmonary embolism is confirmed
Lower extremity doppler ultrasound
1100: Deep venous thrombosis is noted in the right lower extremity.
Question 3 of 5
Which of the following statements by the nurse indicate a correct understanding of heparin therapy? Select all that apply.
Correct Answer: A,B,C,D,E
Rationale: A: Correct, as recent surgery or hemorrhagic stroke are contraindications due to bleeding risk. B: Correct, as heparin is typically administered via IV infusion pump for precise dosing. C: Correct, as high-risk medications like heparin often require dual verification. D: Correct, as significant platelet decrease may indicate heparin-induced thrombocytopenia, requiring discontinuation. E: Correct, as baseline CBC and coagulation panels are needed before starting heparin. F: Incorrect, as heparin dosing is adjusted based on aPTT, not PT/INR, which is used for warfarin.
Extract:
The nurse in the surgical unit is caring for a 57-year-old client who underwent an abdominal hysterectomy.
Progress Notes
1 Day Postoperative
0800:
The client underwent total abdominal hysterectomy with bilateral oophorectomy and tumor debulking 1 day ago for treatment of ovarian cancer. She has had four episodes of vomiting with bilious emesis over the past 12 hours, which have continued despite V antiemetic administration. The client has been receiving V broad-spectrum antibiotics since the procedure. The skin is warm. A low transverse abdominal incision is present; staples are clean and dry. Chest expansion is symmetric; respirations are unlabored: diminished breath sounds are auscultated in bilateral lower lobes. Radial pulses 2+ bilaterally, capillary refill <3 seconds in all four extremities; no peripheral edema is noted. The client reports frequent hot flashes occurring roughly every hour, starting last night. The abdomen is markedly distended and tender to palpation. Bowel sounds are absent in all four quadrants; the client reports no flatus. Urine is clear yellow with moderate output. The client reports incontinence with coughing or during episodes of vomiting.
Question 4 of 5
For each finding below, click to specify if the finding is consistent with the disease process of postoperative ileus or small bowel obstruction.
| Finding | Postoperative Ileus | Small Bowel Obstruction |
|---|---|---|
| Vomiting | ||
| Abdominal pain | ||
| Abdominal distension | ||
| Hypoactive bowel sounds |
Correct Answer: A,B,C,D
Rationale: A: Consistent with both - Vomiting occurs in both postoperative ileus and small bowel obstruction due to impaired gut motility or blockage. B: Consistent with both - Abdominal pain is common in both conditions due to distension or obstruction. C: Consistent with both - Abdominal distension results from gas/fluid accumulation in both. D: Consistent with both - Hypoactive bowel sounds reflect reduced peristalsis in ileus or obstruction.
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
The nurse recognizes that improperly maintained skeletal traction may lead to........ and.....
Correct Answer: C,D
Rationale: Improperly maintained traction can cause increased pain (
C) and bone malunion (
D) due to misalignment or inadequate stabilization.