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
Which of the following parent statements indicate a correct understanding? Select all that apply.
Correct Answer: B,C,D,E,F
Rationale: Exercise , flu vaccine , daily breathing exercises , vitamin supplementation , and sprinkling pancre-lipase are correct. A low-fat diet is incorrect; a high-calorie, high-fat diet is needed for cystic fibrosis.
Extract:
The newborn nurse is attending births in the labor and delivery unit.
Nurses' Notes
Labor and Delivery Unit
0000: A 39-year-old client, gravida 4 para 3, at 38 weeks gestation arrives at the labor and delivery unit reporting contractions every 2-3 min. During this pregnancy, the client was diagnosed with gestational diabetes mellitus and prescribed insulin, but she reports not taking the insulin. The client reports cigarette smoking (3-5 cigarettes/day) but denies alcohol or recreational drug use. The client received treatment for bacterial vaginosis during the second trimester. The client has gained 55 lb (25 kg) during the pregnancy. Group B Streptococcus result is negative.
Question 2 of 5
Click to highlight below the 3 findings that should concern the nurse.
| The client was diagnosed with gestational diabetes mellitus and prescribed insulin, but she reports not taking the insulin. |
| The client reports cigarette smoking (3-5 cigarettes/day) but denies alcohol or recreational drug use. |
| The client received treatment for bacterial vaginosis during the second trimester. |
| The client has gained 55 lb (25 kg) during the pregnancy. Group B Streptococcus result is negative. |
Correct Answer: A,B,D
Rationale: Non-compliance with insulin , smoking , and excessive weight gain increase neonatal risks.
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 3 of 5
For each potential intervention, click to specify if the intervention is expected or unexpected for the care of the client.
| Potential Intervention | Expected | Unexpected |
|---|---|---|
| Administer antipyretics | ||
| Administer IV antibiotics | ||
| Implement strict bed rest | ||
| Implement NPO restrictions | ||
| Implement airborne precautions | ||
| Prepare client for bedside thoracentesis | ||
| Administer oxygen to maintain SpO2 ≥ 95% |
Correct Answer: A,B,G
Rationale: Antipyretics , antibiotics , oxygen are expected for pneumonia. Bed rest , NPO , isolation , and thoracentesis are not routine.
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 4 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.
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 5 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.