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
Which of the following statements by the nurse are appropriate to include in the teaching? Select all that apply
Correct Answer: A,B,C
Rationale: Alprazolam requires avoiding driving , monitoring for suicidal thoughts , and gradual tapering . Alcohol limits are stricter, and sertraline is not for acute attacks.
Extract:
The nurse is caring for a 43-year-old client.
Nurses' Notes Vital Signs
Emergency Department
0800: A 43-year-old client comes to the emergency department due to lower back pain and bilateral leg weakness. The client reports that the weakness began 3 days ago in the feet and has gradually worsened. The client sought treatment today after becoming "so weak that I fell while walking" and noticing new hand weakness and difficulty swallowing. Back pain radiates down both legs and is rated as 5 on a scale of 0-10. The client recently recovered from an illness with flu-like symptoms. The client reports a history of hypertension and takes no medications. Assessment of the lower extremities reveals muscle strength of 2/5 and decreased sensation to pinprick. Achilles tendon and patellar reflexes are decreased
Question 2 of 5
Select the 4 complications the client is most at risk for developing.
| Aspiration pneumonia |
| Pressure injuries |
| Respiratory failure |
| Sepsis |
| Venous thromboembolism |
Correct Answer: A,B,C,E
Rationale: Guillain-Barré syndrome risks include aspiration , pressure injuries , respiratory failure , and thromboembolism due to immobility and respiratory involvement.
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 3 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 12-year-old client.
History and Physical Vital Signs Body System Findings
General- The client has a 2-day history of decreased appetite, nausea, fatigue, and headaches, the client had a "sore throat" 2 weeks ago that resolved without treatment; BMl is in the 65th percentile
Eye, Ears, Nose, and Throat (EENT)- Periorbital edema; no changes in vision
Pulmonary- Lung sounds clear bilaterally; no increased work of breathing; no cough Cardiovascular- S1 and S2 heard on auscultation; no murmur auscultated; 3+ bilateral lower extremity edema is noted
Gastrointestinal- Bowel sounds present, no masses or tenderness felt Musculoskeletal No joint pain or swelling
Genitourinary- Decreased urination; dark, cola-colored urine
Question 4 of 5
For each potential prescription, click to specify if the prescription is anticipated or unanticipated for the care of the client.
| Potential Prescription | Anticipated | Unanticipated |
|---|---|---|
| Obtain daily weights | ||
| Maintain fluid restrictions | ||
| Administer loop diuretics | ||
| Maintain client on strict bed rest | ||
| Administer ibuprofen as needed for headache |
Correct Answer: A,B,C
Rationale: Daily weights , fluid restrictions , and diuretics manage fluid overload. Bed rest is unnecessary, and ibuprofen risks renal damage.
Extract:
The nurse is caring for a 16-year-old client.
History and Physical Laboratory Results
Body System- Findings
General- The client comes to the emergency department with pain in the upper back, both knees, and the lower legs that is rated as 9 on a scale of 0-10; medical history includes sickle cell disease; the client reports attending an outdoor sports camp for the past 4 days; the client appears restless with frequent position changes and facial grimacing
Neurological- The client is alert and oriented to person, place, and time
Pulmonary- Vital signs: RR 24, SpOz 95% on room air, breath sounds are clear bilaterally Cardiovascular- Vital signs: T 98.4 F (36.9 C), P 120, BP 130/78; S1 and S2 are auscultated with no murmurs, continuous cardiac monitor shows sinus tachycardia
Gastrointestinal- The abdomen is soft and nontender with normal bowel sounds; the client vomited 30 mL of clear liquid
Musculoskeletal- The client has multiple, tender, bony points
Genitourinary- The client voided 50 mL of clear, amber-colored urine
Question 5 of 5
Click to highlight below the 2 prescriptions the nurse should implement first.
| Administer morphine |
| Administer hydroxyurea PO |
| Apply moist heat to knees |
| Encourage incentive spirometer |
| Continuous IV fluids |
| Record strict intake and output |
Correct Answer: A,E
Rationale: Morphine and IV fluids are prioritized to relieve pain and improve hydration in a sickle cell crisis.