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
Which clinical finding is most concerning at this time?
Correct Answer: C
Rationale: Tachycardia (pulse 164) is most concerning as it may indicate severe hyperthyroidism or other cardiovascular issues requiring immediate intervention.
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.
Question 2 of 5
Which 3 additional findings or diagnostic results are most important to plan care for this client?
Correct Answer: B, C, E
Rationale: A CT scan (
C) is critical to diagnose stroke type. A standardized stroke assessment (E) evaluates severity and guides treatment. Capillary glucose (
B) ensures hypoglycemia is not contributing to symptoms. Blood alcohol level (
A) is less relevant with minimal alcohol history. EEG (
D) is not urgent for suspected stroke.
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 3 of 5
For each potential prescription, click to specify whether the prescription is anticipated or not anticipated at this time.
| Potential Prescription | Anticipated | Not Anticipated |
|---|---|---|
| Administer propranolol | ||
| Administer methimazole | ||
| Perform a pregnancy test | ||
| Maintain a high-calorie diet | ||
| Offer moisturizing eye drops | ||
| Maintain continuous cardiac monitoring | ||
| Administer thyroid hormone replacement |
Correct Answer: A,B,C,D,E,F
Rationale: A: Propranolol is anticipated to manage tachycardia and palpitations. B: Methimazole is anticipated to treat hyperthyroidism by reducing thyroid hormone production. C: A pregnancy test is anticipated due to the absence of menstruation for 3 months, as pregnancy can affect treatment choices. D: A high-calorie diet is anticipated to address weight loss and increased metabolism. E: Moisturizing eye drops are anticipated for exophthalmos-related eye dryness. F: Continuous cardiac monitoring is anticipated due to the high pulse rate (164). G: Thyroid hormone replacement is not anticipated, as the client has hyperthyroidism, not hypothyroidism.
Extract:
Nurses' Notes
Emergency Department
A newborn is brought to the emergency department due to coughing and difficulty feeding. The client was born at home 6 hours ago via spontaneous vaginal birth. With each attempt to breastfeed, the client coughs, vomits, and "turns blue." The mother did not receive prenatal care. She reports a history of opioid use disorder but reports no opioid use during pregnancy.
Vital signs: T 98.6 F (37 C), P 120, RR 50, and SpO, 95% on room air. Abdominal distension is present. Ballard scoring estimates the client at 37 weeks gestation. Weight and length are consistent with the 25th and 50th percentiles for estimated age, respectively.
1 Hour Later
After attempting a bottle feed with 10 mL of formula, the client has a coughing episode, and there is formula mixed with saliva in the mouth. Coarse breath sounds are noted bilaterally with intercostal retractions. S1 and S2 are present with no murmurs. Neurologic examination shows normal neuromuscular findings.
A nasogastric tube insertion is attempted per prescription by the health care provider, and resistance is met at 10 cm of insertion.
Question 4 of 5
The client has undergone surgical repair of tracheoesophageal fistula with esophageal atresia. The practical nurse is assisting the registered nurse to prepare the family for discharge home. Which of the following parent statements indicate that the teaching has been effective? Select all that apply.
Correct Answer: B,C,E
Rationale: A semi-upright position during feedings reduces reflux, reporting drooling or regurgitation ensures monitoring for complications, and acknowledging the gastrostomy tube's potential continued use shows understanding. A barking cough is not expected, and diluting formula is unsafe.
Extract:
The nurse is caring for a 58-year-old client on a medical-surgical unit.
History and Physical
General
The client is vomiting bright red blood; medical history includes alcohol use disorder, liver cirrhosis, and hypertension; the client was admitted a year ago for alcohol-induced acute pancreatitis
Neurological
The client is oriented to person and place; the pupils are equal, round, and reactive to light and accommodation
Eye, Ear, Nose, and Throat (EENT)
Yellow scleras are noted
Pulmonary
Vital signs are RR 18, SpO 94% on room air
Cardiovascular
Vital signs are T 99 F (37.2 C), P 102, BP 90/40; S1 and S2 are heard on auscultation; peripheral pulses are 2+ in all extremities; 1+ edema is noted at the bilateral lower extremities
Gastrointestinal
The abdomen is distended and nontender to palpation; the flanks are dull to percussion; bowel sounds are hypoactive; distended veins are present around the umbilicus
Genitourinary
Client is voiding amber-colored urine
Nurses’ notes.
Postoperative Day 1
1000:
The client underwent banding of esophageal varices 1 day ago. Today, the client is somnolent and oriented to person only. Speech is slurred. Flapping tremors are present in the clients arms and hands. The abdomen is soft and distended; bowel sounds are present. Dark-colored stool is noted. Amber-colored urine is noted. Vital signs are T 98.2 F (36.8 C), P 85, RR 24, BP 132/76, SpOz 94% on room air.
Question 5 of 5
For each finding, specify if the finding is expected or unexpected for this client.
| Finding | Expected | Unexpected |
|---|---|---|
| Respiratory | ||
| Neurological | ||
| Genitourinary | ||
| Cardiovascular | ||
| Gastrointestinal | ||
| Musculoskeletal |
Correct Answer: A: Expected, B: Expected, C: Expected, D: Expected, E: Expected, F: Unexpected
Rationale:
A) Expected: RR 24 is slightly elevated but consistent with cirrhosis and post-op status.
B) Expected: Somnolence, disorientation, slurred speech, and flapping tremors indicate hepatic encephalopathy, common in cirrhosis.
C) Expected: Amber urine is typical in cirrhosis due to dehydration or bilirubin.
D) Expected: Stabilized vitals (BP 132/76, P 85) are post-treatment improvements. E) Expected: Dark stool is from variceal bleeding or banding, and distended abdomen is from ascites. F) Unexpected: No musculoskeletal issues (e.g., tremors are neurological) are noted.