NCLEX-PN
NCLEX PN Exam Practice Test with NGN Questions
Extract:
The nurse is caring for a 21-year-old client.
Nurses' Notes History and Physical Vital Signs
Emergency Department
0800: The client comes to the emergency department due to fear of having a heart attack. The client reports, "I was taking the bus home from work when my chest started feeling really tight. I'm lucky my friend was there and able to help me get to the hospital. What if my friend is not there next time?" The client describes experiencing similar episodes recently at random places and times and worries about when or where the next attack will occur
Question 1 of 5
The nurse recognizes that the client is at highest risk for developing Select..... evidenced by Select......
Correct Answer: B,D
Rationale: Fear of future attacks indicates risk for agoraphobia due to avoidance behavior in panic disorder.
Extract:
The nurse is caring for a 55-year-old client in the clinic.
History and Physical
Body System
Findings: General - The client reports cramping pain in the left calf that has worsened over the past year. The pain is precipitated by walking and is partially relieved with rest. The client reports difficulty walking more than 3 blocks. Height: 72 in (182.9 cm), weight: 250 lb (113.4 kg), BMI: 33.9 kg/m?
Pulmonary- Vital signs are RR 16, SpO, 97% on room air. Client reports smoking 1 pack of cigarettes daily for the past 35 years. Breath sounds are mildly decreased throughout with mild prolonged expiration. Client has a history of chronic obstructive pulmonary disease.
Cardiovascular- Vital signs are T 98.8 F (37.1 C), P 82, BP 146/82. S1 and S2 heard on auscultation. The left lower extremity (LLE) is cooler to touch than the right and appears shiny with sparse hair. LLE pulses: femoral 2+, popliteal 1+, posterior tibia 1+, dorsalis pedis audible with Doppler. LLE capillary refill >3 sec. Client has a history of hypertension.
Gastrointestinal- Client is obese. No tenderness, guarding, masses, bruits, or hepatosplenomegaly.
Question 2 of 5
For each potential prescription, click to specify if prescription is expected or unexpected for the care of the client.
| Potential Prescription | Expected | Unexpected |
|---|---|---|
| Antiplatelet medication | ||
| Lipid-lowering medication | ||
| Antihypertensive medication | ||
| Blood testing for hemoglobin A1c | ||
| Referral for supervised exercise therapy | ||
| Graduated compression stockings to the left lower extremity |
Correct Answer: A,B,C,D,E
Rationale: Antiplatelets , statins , antihypertensives , A1c testing , and exercise therapy are expected for peripheral artery disease. Compression stockings are for venous insufficiency.
Extract:
The nurse is caring for a 75-year-old female client. Nurses' Notes Laboratory Results Diagnostic Results Emergency Department
The client is transferred to the emergency department from a skilled nursing facility for a 3-day history of left lower quadrant abdominal pain rated 8 on a scale of 0-10, loss of appetite, and nausea. Although the client has a history of chronic constipation, she has had 2 or 3 loose stools daily for 1 week. The client reports tenderness on deep palpation of the left lower quadrant. There is an area of blanchable redness on the coccyx. The stool is positive for occult blood.
The client has residual left-sided weakness from an ischemic stroke 2 years ago and ambulates with a walker. The client reports falling several times in the past 6 months; the last fall was 3 weeks ago No ecchymosis or injuries are noted. The client had a hysterectomy and salpingo-oophorectomy for uterine fibroids 20 years ago. Vital signs are T 100 F (37.8 C), P 98, RR 17, BP 126/68, and SpOz 97% on room air.
Medical-Surgical Unit: 4 Days Later
The client continues to experience left lower quadrant pain, decreased appetite, and nausea. Today, she developed chills. Stool frequency has not increased. Severe tenderness is noted in the left lower quadrant, and a mass is palpable. Vital signs are T 101.3 F (38.5 C), P 112, RR 17, BP 110/80, SpO, 97% on room air.
Question 3 of 5
For each potential finding below, click to specify if the finding is consistent with the disease process of acute diverticulitis, gastroenteritis, or irritable bowel syndrome.
| Potential Finding | Acute Diverticulitis | Gastroenteritis | Irritable Bowel Syndrome |
|---|---|---|---|
| Fever | |||
| Loose stools | |||
| Abdominal pain | |||
| Occult blood in the stool | |||
| History of chronic constipation |
Correct Answer: A,B,C,D,E
Rationale: Fever and occult blood are specific to diverticulitis. Loose stools occur in gastroenteritis and IBS, abdominal pain in all, and constipation in diverticulitis and IBS.
Extract:
The nurse is contacting a client at 28 weeks gestation to review laboratory results and schedule a follow-up prenatal visit. Laboratory Results Laboratory Test and Reference Range 12 Weeks Gestation 26 Weeks Gestation 28 Weeks Gestation
WBC (prostent) 5,000-1多份 (5.0-15.0 × 10°/L) 8,900/mm3 (8.9 × 10°/L) 16,500 /mm° (16.5 × 10%/L)
Hemoglobin (pregnant) 11-16 g/dL (110-160 g/L) 13 g/dL (130 g/L) 10.8 g/dL (108 g/L) Hematocrit (pregnant) 33%-47% (0.33-0.47) 39% (0.39) 32% (0.32)
Chlamydia Negative Positive Negative Hemoglobin A1c 4.0%-5.9% 5.1%
1-hour oral glucose challenge test <140 mg/dL (7.8 mmol/L) 175 mg/dL (9.7 mmol/L)
3-hour oral glucose tolerance test Fasting: <110 mg/dL (6.1 mmol/L) 1 hour: <180 mg/dL (10.0 mmol/L) 2 hour: <140 mg/dL (7.8 mmol/L 3 hour: <70-115 mg/dL (<6.4 mmol/L) Fasting: 115 mg/dL (6.4 mmol/L) 1 hour: 205 mg/dL (11.4 mmol/L) 2 hour: 162 mg/dL (9.0 mg/dL) 3 hour: 135 mg/dL (7.5 mg/dL)
Question 4 of 5
The nurse should be most concerned about the client's. and anticipate the client's need for
Correct Answer: D,E
Rationale: Blood glucose levels are critical in gestational diabetes, requiring insulin to manage hyperglycemia.
Extract:
Question 5 of 5
For each event, click to specify whether the event is a sentinel event or a near-miss event.
Correct Answer: A,B,E,F
Rationale: Sentinel events cause harm: fall with fracture , wrong-site procedure , suicide , and anaphylaxis . Near-misses (C,
D) are caught before harm.