NCLEX-PN
NCLEX PN Practice Test with NGN Questions
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 1 of 5
The nurse is reinforcing client teaching about home precautions following the first dose of RAI. For each nurse statement, click to specify whether the statement is appropriate or not appropriate to include in the teaching.
Correct Answer: A,C,D,E
Rationale: A: Appropriate, as RAI can contaminate utensils, posing a radiation risk to others. B: Not appropriate, as close contact with children should be limited for several days post-RAI to minimize radiation exposure. C: Appropriate, as RAI can affect fertility and fetal health, requiring a delay in pregnancy. D: Appropriate, as washing clothes separately reduces the risk of radiation exposure to others. E: Appropriate, as sleeping separately minimizes radiation exposure to household members.
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.
Nurses' Notes
Inpatient - Mental Health Unit
2100:
Client appears anxious and withdrawn, and states, "I am afraid to sleep at night because I get nightmares about my sibling." The client would not elaborate on the content of the nightmares.
1200:
Client attended the first session of cognitive-behavioral therapy.
1300:
Client was observed yelling at peers in the day room because someone changed the television channel. The client is irritable with poor impulse control.
1700: Client appears to be having a panic attack and was found shaking in the room in tears after waking up from a nightmare. The client reports heart palpitations and appears diaphoretic.
Vital signs: P 112/min, RR 20, BP 155/98.
Question 2 of 5
During the acute phase of a panic attack, the nurse should..... and........
Correct Answer: A,D
Rationale: During a panic attack, staying with the client (
A) provides safety and support, and reassuring them of their safety (
D) helps reduce anxiety. Privacy (
B), discussing triggers (
C), teaching (E), or offering a phone (F) are not appropriate during the acute phase.
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 3 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.
Question 4 of 5
For each potential prescription, click to specify if the prescription is expected or not expected for the care of the client.
| Potential Prescription | Expected | Not Expected |
|---|---|---|
| Restrict fluid intake | ||
| Offer a low-fiber diet | ||
| Use incentive spirometer | ||
| Administer stool softener | ||
| Administer anticoagulant |
Correct Answer: C,D,E
Rationale: Expected prescriptions include using an incentive spirometer (
C) to prevent atelectasis, administering a stool softener (
D) for constipation, and an anticoagulant (E) for DVT prevention. Fluid restriction (
A) and low-fiber diet (
B) are not indicated.
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 5 of 5
For each finding below, click to specify if the finding is consistent with the disease process of myocardial infarction, pneumonia, or pulmonary embolism.
| Finding | Myocardial Infarction | Pneumonia | Pulmonary Embolism |
|---|---|---|---|
| Dyspnea | |||
| Chest pain | |||
| Hypoxemia | |||
| Sinus tachycardia | |||
| Right lower extremity redness and edema |
Correct Answer: A: Myocardial infarction, Pneumonia, Pulmonary embolism; B: Myocardial infarction, Pneumonia, Pulmonary embolism; C: Pneumonia, Pulmonary embolism; D: Myocardial infarction, Pulmonary embolism; E: Pulmonary embolism
Rationale: A: Dyspnea is common in all three due to impaired oxygenation or cardiac output. B: Chest pain occurs in all three, though the nature varies (e.g., pleuritic in pneumonia/PE, crushing in MI). C: Hypoxemia is typical in pneumonia (due to alveolar impairment) and PE (due to ventilation-perfusion mismatch). D: Sinus tachycardia is seen in MI (due to cardiac stress) and PE (due to hypoxia and embolism). E: Right lower extremity redness and edema suggest DVT, which is strongly associated with PE.