NCLEX PN Test Questions with NGN

Question 1 of 5.

Extract:Nurses' Notes Initial Clinic Visit 1100: The client has experienced enuresis at night for the past 2 weeks and frequently requests to use the bathroom while at school. The client was previously toilet trained with no nighttime bed wetting for 6 months; the client recently relocated to a new home and school where the client lives with parents. The parent reports that the client has recently demonstrated fatigue, irritability, and multiple behavioral outbursts that resemble past temper tantrums. The client frequently reports feeling thirsty. No dysuria or urinary hesitancy is reported. Weight and height were in the 40th percentiles at the previous visit a year ago. Growth charts today show the client's weight in the 20th percentile and height in the 40th percentile. The client appears tired and irritable. Dry mucous membranes are noted with no increased work of breathing. The lungs are clear to auscultation bilaterally. No cardiac murmur is heard.

Select below the 6 findings that require follow-up.

Question 2 of 5.

Extract:History and Physical Body System Findings General The client comes to the emergency department with fatigue, shortness of breath, dry cough, and exertional dyspnea for 1 week; the client is homeless; medical history includes chronic heart failure, uncontrolled hypertension, coronary artery disease, and type 2 diabetes mellitus Pulmonary Vital signs: RR 22, SpO, 88% on room air, the client is dyspneic but can speak in full sentences; lung auscultation reveals decreased breath sounds at the lung bases and bilateral crackles; the client reports smoking 1 pack of cigarettes per day for 35 years; the client was hospitalized for pneumonia 6 months ago Cardiovascular Vital signs: T 99 F (37.2 C), P 90, BP 170/100; continuous cardiac monitor shows sinus rhythm with occasional premature ventricular contractions; S1, S2, and S3 are heard on auscultation; bilateral lower extremity pitting edema is noted

Select below the 5 findings that are most concerning.

Question 3 of 5.

Extract:Nurses' Notes Outpatient Clinic Initial visit The child recently started attending a new preschool and hit a teacher during lunch. The parent says, "My child has never been aggressive before but has always been particular about food." The client was born at full term without complications and has no significant medical history. The child started babbling at age 6 months, and the parent reports that the first words were spoken around age 12 months. The client then became quiet and "obsessed" with stacking blocks and organizing toys by color. The child can kick a ball, draw a circle, pedal a tricycle, and now says two-word phrases. Vitals signs are normal, and the client is tracking adequately on growth curves. During the evaluation, the child sits in the corner of the room playing with blocks. The client does not follow the parents gaze when the parent points to toys in the office. The child begins screaming and rocking back and forth when the health care provider comes near. Laboratory Results Laboratory Test and Reference Range 1030 Glucose (random) 71-200 mg/dL (3.9-11.1 mmol/L) 110 mg/dL (6.1 mmol/L) Sodium 136-145 mEq/L (136-145 mmol/L)| 133 mEq/L (133 mmol/L)| Potassium 3.5-5.0 mEq/L (3.5-5.0 mmol/L) 4.5 mEq/L (4.5 mmol/L) B-type natriuretic peptide <100 pg/mL (<100 ng/L) 640 pg/mL (640 ng/L) Diagnostic Results Chest X-ray 1030:Mild cardiomegaly Echocardiogram 1100:Mild left ventricular hypertrophy with left ventricular ejection fraction of 30%

The nurse suspects the client is experiencing acute decompensated heart failure. Which of the following findings are consistent with this condition? Select all that apply.

Question 4 of 5.

Extract:Nurses' Notes Outpatient Clinic Initial visit The child recently started attending a new preschool and hit a teacher during lunch. The parent says, "My child has never been aggressive before but has always been particular about food." The client was born at full term without complications and has no significant medical history. The child started babbling at age 6 months, and the parent reports that the first words were spoken around age 12 months. The client then became quiet and "obsessed" with stacking blocks and organizing toys by color. The child can kick a ball, draw a circle, pedal a tricycle, and now says two-word phrases. Vitals signs are normal, and the client is tracking adequately on growth curves. During the evaluation, the child sits in the corner of the room playing with blocks. The client does not follow the parents gaze when the parent points to toys in the office. The child begins screaming and rocking back and forth when the health care provider comes near. Laboratory Results Laboratory Test and Reference Range 1030 Glucose (random) 71-200 mg/dL (3.9-11.1 mmol/L) 110 mg/dL (6.1 mmol/L) Sodium 136-145 mEq/L (136-145 mmol/L)| 133 mEq/L (133 mmol/L)| Potassium 3.5-5.0 mEq/L (3.5-5.0 mmol/L) 4.5 mEq/L (4.5 mmol/L) B-type natriuretic peptide <100 pg/mL (<100 ng/L) 640 pg/mL (640 ng/L) Diagnostic Results Chest X-ray 1030:Mild cardiomegaly Echocardiogram 1100:Mild left ventricular hypertrophy with left ventricular ejection fraction of 30%

Drag words from the choices below to fill in the blanks. The nurse should prioritize interventions for acute decompensated heart failure to reduce the risk of the client developing-----------------------and ------------------

Question 5 of 5.

Extract:Nurses' Notes Outpatient Clinic Initial visit The child recently started attending a new preschool and hit a teacher during lunch. The parent says, "My child has never been aggressive before but has always been particular about food." The client was born at full term without complications and has no significant medical history. The child started babbling at age 6 months, and the parent reports that the first words were spoken around age 12 months. The client then became quiet and "obsessed" with stacking blocks and organizing toys by color. The child can kick a ball, draw a circle, pedal a tricycle, and now says two-word phrases. Vitals signs are normal, and the client is tracking adequately on growth curves. During the evaluation, the child sits in the corner of the room playing with blocks. The client does not follow the parents gaze when the parent points to toys in the office. The child begins screaming and rocking back and forth when the health care provider comes near. Laboratory Results Laboratory Test and Reference Range 1030 Glucose (random) 71-200 mg/dL (3.9-11.1 mmol/L) 110 mg/dL (6.1 mmol/L) Sodium 136-145 mEq/L (136-145 mmol/L)| 133 mEq/L (133 mmol/L)| Potassium 3.5-5.0 mEq/L (3.5-5.0 mmol/L) 4.5 mEq/L (4.5 mmol/L) B-type natriuretic peptide <100 pg/mL (<100 ng/L) 640 pg/mL (640 ng/L) Diagnostic Results Chest X-ray 1030:Mild cardiomegaly Echocardiogram 1100:Mild left ventricular hypertrophy with left ventricular ejection fraction of 30%

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