NCLEX-PN
NCLEX PN Practice Test with NGN Questions
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 1 of 5
The nurse is planning care with the registered nurse. For each potential intervention, click to specify if the intervention is anticipated or unanticipated for the care of the client.
Correct Answer: A,C,D,F
Rationale: A: Anticipated - Keeping the room well lit reduces confusion and hallucinations in alcohol withdrawal. B: Unanticipated - NPO status is not indicated unless specific conditions (e.g., surgery) apply. C: Anticipated - IV fluids support hydration during withdrawal. D: Anticipated - Padding prevents injury during potential seizures. E: Unanticipated - News may increase agitation. F: Anticipated - Standardized tools (e.g., CIWA-Ar) assess withdrawal severity.
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 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:
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
Question 3 of 5
Based on the client's history and physical examination findings, which disease process is the most likely cause of this client's current condition?
Correct Answer: D
Rationale: The client's recent immobility (wheelchair dependence post-femoral fracture), right lower extremity redness and edema (suggesting DVT), dyspnea, chest pain, hypoxemia (SpO2 89%), and sinus tachycardia strongly indicate venous thromboembolism, likely a pulmonary embolism secondary to DVT.
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 4 of 5
The client is most likely experiencing.......... and requires intervention to prevent............
Correct Answer: B,F
Rationale: The client's symptoms (tachycardia, weight loss, exophthalmos, etc.) indicate hyperthyroidism, and intervention is needed to prevent acute thyrotoxicosis, a life-threatening complication.
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 5 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.