NCLEX-PN
NCLEX PN Exam Practice Test with NGN Questions
Extract:
The nurse is caring for a 6-year-old client accompanied by the parents.
History and Physical
Body System
Findings
General
Client is brought to the emergency department due to
shortness of breath; medical history includes cystic fibrosis
and many previous hospital admissions for pneumonia; in the
3rd percentile for height and weight
Neurological
Alert and oriented to person, place, and time; no neurologic
deficits
Pulmonary
Vital signs: RR 30, SpO, 87% on room air; moderate
subcostal retractions; bilateral wheezing and coarse crackles
throughout lung fields with fine inspiratory crackles at left lung
base; paroxysmal coughing that produces thick, yellow,
blood-tinged sputum; parents report that the client has begun
to become "winded" after showering and other activities Cardiovascular
Vital signs: T 101.7 F (38.7 C), P 130, BP 94/58; skin warm
and dry; peripheral pulses palpable 2+; capillary refill 3
econds; mild finger clubbing noted
Gastrointestinal
Abdomen soft with normoactive bowel sounds; parent states,
"Swallowing the enzyme capsules is very difficult for my child,
and I have noticed an increase in greasy, bulky stools"
Question 1 of 5
The nurse should prioritize interventions for Select...
Correct Answer: D
Rationale: Impaired airway clearance is a priority in cystic fibrosis exacerbations due to thick mucus causing respiratory distress and infection risk.
Extract:
The nurse is caring for a 40-year-old client.
History Admission:
The client is brought to the psychiatric emergency department by ambulance after being observed walking in the street and shouting at vehicles. The client states that aliens are trying to attack him and that he is now on a mission to find and kill them. The clients mother says that last year he believed that he was being watched by an unidentified government agency and subsequently broke up with his girlfriend, quit his job, and disconnected his phone. The mother has noticed that he no longer seems to care about activities that used to interest him, and last month she discovered that he had moved into the family garden shed with his dog.
On examination, the client is malodorous and disheveled and laughs for no apparent reason. He appears anxious, avoids eye contact, and shows little emotion. His answers are very brief, and he asks if the interview is being secretly recorded. The client's speech is difficult to follow, and he repeatedly says in a monotone voice, "I said I'll find them." He later becomes angry and refuses to sit in a chair for the interview. I'll find them." He later becomes angry and refuses to sit in a chair for the interview.
Question 2 of 5
For each finding, click to specify whether the finding indicates that the client's status has improved or not improved.
| Finding | Improved | Not Improved |
|---|---|---|
| Client is seen talking alone in the hallway | ||
| Client is seen playing board games with peers | ||
| Client asks the technician for hygiene supplies | ||
| Client states, 'The voices are a part of my illness.' | ||
| Client refuses to take medication from a new nurse | ||
| Client is willing to eat food that is prepackaged only |
Correct Answer: B,C,D
Rationale: Social interaction , hygiene requests , and insight into illness show improvement. Talking alone , medication refusal , and food paranoia indicate ongoing symptoms.
Extract:
Question 3 of 5
Click to highlight below the findings indicating that the client is improving.
| Abdominal dressing removed. Wound is clean, dry, and intact with no bleeding or foul-smelling drainage. |
| Fundus is firm, midline, and at the umbilicus. Urine output was $500 \mathrm{~mL}$ over the past 4 hours. |
| Client states that she is too tired and sore to ambulate in room with nursing assistance. |
| Client states that she cannot properly latch the newborn during breastfeeding. |
| Tolerating oral labetalol; systolic BP has been 110-130 mm Hg and diastolic BP has been 70-80 mm Hg over the past 12 hours. |
| Client reports no headaches and remains free of seizures. |
Correct Answer: A,B,E,F
Rationale: Clean wound , normal fundus and urine output , stable blood pressure , and absence of headaches/seizures indicate improvement.
Extract:
The nurse is caring for a 68-year-old client who is brought to the emergency department due to confusion.
History and Physical Body System Findings
General- Client's adult child reports the confusion started this morning, following 3 days of fever and productive cough; medical history includes small bowel resection 10 days ago, chronic heart failure, and coronary artery disease
Neurological- Client is drowsy and oriented to person only, but intermittently agitated Integumentary- Small abdominal surgical incision is present over lower left quadrant, edges are well approximated, and no redness or drainage is noted
Pulmonary- Vital signs are RR 24 and SpO 90% on room air; labored breathing is observed, and crackles and diminished breath sounds are auscultated over right lower chest; client is expectorating yellow sputum; history includes smoking a pack of cigarettes daily for the past 40 years
Cardiovascular- Vital signs are T 102.9 F (39.4 C), P 110, and BP 110/70; S1 and S2 are heard on auscultation; bilateral lower extremity edema is 1+; ECG shows sinus tachycardia
Gastrointestinal- Normoactive bowel sounds are auscultated; client's last bowel movement was 1 day ago
Genitourinary- Client voided concentrated yellow urine
Question 4 of 5
Which action should the nurse take?
Correct Answer: B
Rationale: Pneumothorax requires chest tube insertion to re-expand the lung.
Extract:
The nurse is caring for a 68-year-old client in the emergency department.
History Physical Vital Signs
Admission: The client comes to the emergency department with progressively worsening back pain that began 3 weeks ago. The pain has become significantly worse over the past 12 hours. Pain level is rated as 8 on a scale of 0-10. The client was recently diagnosed with prostate cancer and has had a poor response to treatment. This morning, the client had trouble walking and reports decreased sensation in the feet. The client also reports mild nausea, difficulty urinating, decreased urinary sensation, and no bowel movement in the past 3 days
Question 5 of 5
For each finding below, click to specify if the finding is consistent with the disease process of spinal cord compression or syndrome of inappropriate antidiuretic hormone.
| Finding | Spinal Cord Compression | Syndrome of Inappropriate Antidiuretic Hormone |
|---|---|---|
| Back pain | ||
| Confusion | ||
| Constipation | ||
| Urinary retention | ||
| Numbness in lower extremities |
Correct Answer: A,B,C,D,E
Rationale: Back pain , constipation , urinary retention , and numbness are typical of spinal cord compression. Confusion is associated with SIADH.