NCLEX-PN
NCLEX PN Practice Test with NGN Questions
Extract:
The nurse is caring for an 8-year-old client who was brought to the emergency department after
becoming short of breath at school.
History and Physical
General
Well-nourished child; currently sitting in the tripod position; patches of dry, scaly, reddened skin are present in the creases of bilateral elbows and behind both knees; client reports that these areas itch
Neurological
Alert and oriented to person, place, and time
Eye, Ear, Nose, andThroat (EENT)
Pupils equal, round, and reactive to light and accommodation; client reports no nasal congestion
Pulmonary
Vital signs: RR 34, SpO 92% on room air, airway patent, intercostal retractions noted during inspiration; expiratory wheezes auscultated bilaterally; dry, spasmodic cough is noted; no stridor; difficulty speaking in complete sentences
Cardiovascular
Vital signs: T 98.8 F (37.1 C), P 110, BP 94/60; S1 and S2 heard on auscultation; nom murmurs noted; peripheral pulses 2+; capillary refill 3 seconds; no edema
Gastrointestinal
Abdomen soft; bowel sounds normal
Psychosocial
Client appears anxious and is crying, client speaks in short phrases, stating, "left my medicine at a friend's house" and "feels like I can't breathe"; client cannot remember the name of the prescribed home medication; client's parents were notified and are en route to hospital
Progress Notes
0910:
Client's parents were spoken to over the phone. Last evening, the client spent the night at a friend's housewhere some family members smoke cigarettes and have a pet cat that lives in the home.
Medical history:
No accidents or injuries were reported, vaccinations are up to date, mild persistent asthma was diagnosed at age 7, and client has atopic dermatitis.
Allergies: No known allergies.
Family history:
Client is an only child. Parents report having no known medical conditions. Paternal grandfather died of chronic obstructive pulmonary disease, and maternal grandmother has heart disease.
Social history:
Client lives with parents; they do not smoke cigarettes. There are no pets in the client's home.
Current medications:
Beclomethasone inhaler 2 puffs twice a day, albuterol (salbutamol) inhaler 2 puffs
every 4 hours as needed for quick relief of symptoms.
Question 1 of 5
Which of the following interventions should the nurse anticipate?
Correct Answer: A,B,C,E
Rationale: A: Oral prednisone reduces airway inflammation in asthma exacerbations. B: Nebulized albuterol and ipratropium relieve bronchospasm. C: Semi-Fowler position aids breathing by reducing diaphragm pressure. E: Continuous pulse oximetry monitors oxygenation status.
Extract:
The practical nurse is assisting the registered nurse with the care of a 58-year-old client in the emergency department.
Nurses' Notes
Initial Clinic Visit
The client monitors blood pressure (BP) at home and reports that it has been elevated for the past month. BP is 157/92 mm Hg. Physical examination is normal. The client is prescribed a thiazide diuretic for hypertension.
Emergency Department 4 Weeks Later
The client reports muscle weakness and severe cramping in the lower extremities with increased lethargy over the past 3 days. BP is 123/75 mm Hg. Physical examination findings include 1+ deep tendon reflexes bilaterally.
Question 2 of 5
The nurse recognizes that the client is most likely experiencing.......... and, without prompt intervention, is at risk for...........
Correct Answer: A,F
Rationale: The client is most likely experiencing hypokalemia and, without prompt intervention, is at risk for cardiac dysrhythmias. Thiazide diuretics can cause potassium loss, leading to muscle weakness, cramping, and lethargy. Low potassium levels can disrupt cardiac electrical activity, risking dysrhythmias.
Extract:
The nurse in the emergency department is caring for a 62-year-old client.
Progress Notes
Emergency Department
0900: The client is brought to the emergency department by a family member after being found confused and lethargic. On arrival, the client is obtunded and does not respond to verbal stimuli.
Medical history includes major depressive disorder and chronic neck and back pain after a motor vehicle collision 2 years ago. The family member states that the client takes multiple medications but does not know which kind. The client was divorced a few months ago.
Physical examination shows 1-mm pupils, shallow breathing, and reduced bowel sounds. Fingerstick blood glucose is 78 mg/dL (4.3 mmol/L). ECG reveals normal sinus rhythm. Breath alcohol test is negative.
Vital signs: T 98.1 F (36.7 C), P 62, RR 8, BP 80/40, SpO, 94% on room air.
1800:
The client is awake, alert, and oriented to person, place, time, and situation. The client is experiencing severe withdrawal symptoms and is admitted for supervised detoxification.
Laboratory Results
Urine Drug Screen
On admission
Cocaine- Negative
Opioids- Positive
Amphetamines- Negative
Marijuana- Positive
Phencyclidine-Negative
Benzodiazepines- Negative
Barbiturates- Negative
Laboratory Test and Reference Range
Cocaine- Negative
Opioids- Negative
Amphetamines- Negative
Marijuana- Negative
Phencyclidine- Negative
Benzodiazepines- Negative
Barbiturates- Negative
Question 3 of 5
The nurse is helping the client prepare for discharge after 3 days of inpatient detoxification. Which of the following actions should the nurse take? Select all that apply.
Correct Answer: A,B,C,D,E
Rationale: All are appropriate: A: Identifying maladaptive behaviors supports recovery. B: Support groups aid long-term sobriety. C: Naloxone training prevents overdose deaths. D: Referrals ensure continued care. E: Education on medications (e.g., methadone) ensures adherence.
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 4 of 5
Select the findings that require immediate follow-up.
Correct Answer: B,C,D
Rationale: B: SpO2 of 89% indicates hypoxemia, requiring immediate oxygen supplementation. C: Tachycardia (P 110) and low BP (110/60) suggest cardiovascular instability, needing urgent evaluation. D: Severe chest pain (7/10) warrants immediate investigation for potential cardiac or pulmonary issues. A: Anxiety is noted but not immediately life-threatening. E: Musculoskeletal issues are chronic and do not require immediate follow-up.
Extract:
Question 5 of 5
The home health nurse is caring for a 45-year-old client who is prescribed peritoneal dialysis for end-stage renal disease. For each of the actions performed by the client, click to specify whether the action is appropriate or not appropriate when performing peritoneal dialysis.
Client Actions | Appropriate | Not Appropriate |
---|---|---|
Microwaves the dialysate bag prior to infusion | ||
Sits at a 20-degree angle during the exchange | ||
Wears a face mask when accessing the catheter | ||
Places the drainage bag below the abdomen during the drainage phase | ||
States, 'I will notify my health care provider if the dialysate outflow is cloudy' | ||
Changes positions to facilitate drainage if the output volume is less than the input volume |
Correct Answer: C,D,E,F
Rationale: A: Not appropriate, as microwaving can unevenly heat the dialysate, risking burns or degradation. B: Not appropriate, as a higher angle (e.g., 45 degrees) or upright position is preferred to facilitate drainage. C: Appropriate, as wearing a face mask reduces infection risk. D: Appropriate, as placing the drainage bag below the abdomen uses gravity to facilitate outflow. E: Appropriate, as cloudy outflow may indicate peritonitis, requiring prompt reporting. F: Appropriate, as changing positions can help resolve drainage issues.