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NCLEX PN Exam Practice Test with NGN

Home / Nursing & Allied Health Certifications / NCLEX PN

Question 1 of 5.

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.

Click to highlight below the findings that require immediate follow-up.

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Explanation: Calf pain with walking and poor peripheral pulses/cool skin suggest peripheral artery disease, requiring urgent vascular evaluation.

Question 2 of 5.

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"

Click to highlight below the assessment findings that require immediate follow-up?

Description Options
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Explanation: Findings A, C, D, and E indicate urgent issues: shortness of breath with a history of cystic fibrosis , low oxygen saturation and respiratory distress , fever and tachycardia , and malabsorption symptoms require immediate intervention.

Question 3 of 5.

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"

Which of the following client findings are consistent with a cystic fibrosis exacerbation? Select all that apply.

A. Blood-tinged sputum

B. Greasy, bulky stools

C. Paroxysmal coughing

D. SpO2 of 87% on room air

E. Temperature of 101.7 F (38.7 C)

Explanation: Cystic fibrosis exacerbations often present with increased respiratory symptoms (A, C, D), fever , and malabsorption issues due to pancreatic insufficiency.

Question 4 of 5.

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"

The nurse should prioritize interventions for Select...

A. Malabsorption of nutrients

B. Alterations in blood glucose

C. Decreased gastrointestinal motility

D. Impaired clearance of airway secretions

Explanation: Impaired airway clearance is a priority in cystic fibrosis exacerbations due to thick mucus causing respiratory distress and infection risk.

Question 5 of 5.

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"

For each potential intervention, click to specify if the intervention is indicated or not indicated for the care of the client.

Description Options
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Explanation: Antibiotics treat bacterial pneumonia, bronchodilators relieve wheezing, chest physiotherapy aids mucus clearance, and hypertonic saline thins mucus. Airborne isolation is not indicated for bacterial pneumonia.

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