NCLEX-PN
NCLEX PN Practice Test with NGN Questions
Extract:
Question 1 of 5
The nurse is assisting with a staff in-service regarding safe handling of controlled substances. For each behavior or finding, click to specify whether the behavior/finding is concerning or not concerning for possible drug diversion.
Correct Answer: A,C,D,E
Rationale: A: Excessive wasting of controlled substances is concerning as it may indicate diversion for personal use or distribution. C: Inventory discrepancies suggest possible theft or misuse. D: Frequently volunteering to administer medications may provide opportunities for diversion. E: Requesting another nurse's password is a security breach and highly concerning for diversion.
Extract:
The nurse is evaluating the client's use of hearing aids. Nurses' Notes
The client reports keeping hearing aids in a box in the bedside table when asleep. The client demonstrates pulling the top of the ear down and back to insert the hearing aid. When the device makes a whistling sound, the client reports turning the volume up. Every few days, when the aids are dirty, the client washes them gently with a wet washcloth. Before taking a break from the hearing aids over the weekend, the client removes the battery
Question 2 of 5
Select 3 findings that require follow-up.
Correct Answer: C,D,E
Rationale: Turning up the volume for whistling (feedback) may indicate improper fit. Washing hearing aids with water can damage them. Removing batteries for storage is correct, but follow-up ensures proper technique.
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 3 of 5
Which of the following laboratory tests should the nurse anticipate during the first prenatal visit? Select all that apply.
Correct Answer: C,D,E
Rationale: First prenatal visit tests include maternal blood type and screen, STI screen, and urinalysis. Glucose tolerance and Group B Streptococcus tests are performed later in pregnancy.
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 4 of 5
For each potential intervention, click to specify if the intervention is indicated or not indicated for the care of the client.
| Potential Intervention | Indicated | Not Indicated |
|---|---|---|
| Wash the injury with soap and water | ||
| Screen the client for hepatitis C virus | ||
| Squeeze tissue to let the wound bleed | ||
| Anticipate initiating antiretrovirals for the nurse | ||
| Anticipate initiating oral antibiotics for the nurse | ||
| Replace the cap on the needle prior to disposal |
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:
The nurse in the emergency department is caring for a 62-year-old client.
History and Physical
Neurological
The client is alert and oriented to time, place, person, and situation; the client reports sudden-onset right-sided facial drooping, speech is slurred; positive right-sided arm drift is seen
Eye, Ear, Nose, and Throat (EENT)
Bilateral pupils are equal, round, and reactive to light and accommodation
Pulmonary
Vital signs: RR 16, SpO, 95% on room air, lung sounds are clear bilaterally
Cardiovascular
Vital signs: T 99 F (37.2 C), P 86, BP 166/90; S1 and S2 are heard on auscultation; no murmurs are noted; the client has a history of hypertension
Musculoskeletal
Right-sided lower extremity weakness is seen
Endocrine
The client has diabetes mellitus
Psychosocial
The client reports drinking one glass of wine each evening with dinner, no tobacco use, and a history of major depression; the client takes sertraline.
Laboratory Results
During Admission
Blood Chemistry.
Glucose: 72 mg/dL (4.0 mmol/L)
Sodium: 133 mEq/L (133 mEq/L)
Chloride: 101 mEq/L (101 mmol/L)
Potassium: 3.7 mEq/L (3.7 mmol/L)
Laboratory Test and Reference Range
Blood Chemistry.
Glucose 74-106 mg/dL (4.1-5.9 mmol/L)
Sodium 136-145 mEq/L (136-145 mmol/L)
Chloride 98-106 mEq/L(98-106 mmol/L)
Potassium 3.5-5.0 mEq/L (3.5-5.0 mmol/L
Diagnostic Results
Admission
CT scan of the head without contrast
1830:
No areas of hemorrhage are noted
Nurses’ notes
Intensive Care Unit
2100:
Tissue plasminogen activator infusion is complete.
2330:
The client suddenly has become combative and confused and is disoriented to person, place, and time. The client vomited once forcefully. Neurologic assessment shows confusion and right-sided weakness.
Vital signs: T 100 F (37.8 C), P 105, RR 18, BP 188/94, SpO2 96% on room air.
Question 5 of 5
The nurse has reviewed the information from the Nurses' Notes. Which of the following is the priority action?
Correct Answer: C
Rationale: The client's sudden change in mental status (combative, confused, disoriented) and vomiting after tissue plasminogen activator (tP
A) infusion suggest a possible intracranial hemorrhage, a known complication of tPA. A repeat CT scan is the priority to assess for this life-threatening condition.