NCLEX PN Practice Test with NGN
Question 1 of 5.
Extract:The nurse is caring for a client on the medical-surgical unit. History Admission 0500: The client is admitted with an abscess and cellulitis of the right leg. The abscess is noted on the lateral aspect of the right calf, with redness, swelling, and warmth extending from the knee to the ankle. The abscess was incised in the emergency department, and a moderate amount of purulent, yellowish-green drainage was noted. The leg was wrapped with gauze, and the client received the first dose of IV antibiotics and opioids for pain control. The client reports chronic lower back pain and gastrosophageal reflux disease, and he was admitted to the hospital once last year for gastrointestinal bleeding. He is currently prescribed daily pantoprazole but takes it only a few times a week. Vital signs: T 100.9 F (38.3 C), P 82, RR 14, BP 130/80, SpO, 95% on room air Progress Notes Medical-Surgical Unit 2300: The client reports nausea, headache, and insomnia. The client is trembling, diaphoretic, and restless. The client states, "I would sleep better if those mice and cats would stop climbing up and down the walls." The upper portion of the clients dressing is saturated with yellowish-green drainage. The peripheral V was removed by the client, and dried blood is noted at the IV site. The IV catheter is on the floor. The client yelled and pushed the nurse's hands away during inspection of the IV site. Vital signs: T 99 F (37.2 C), P 102, RR 18, BP 170/96, SpO≥ 95% on room air
Select client findings that require immediate follow-up.
A. The client reports nausea, headache, and insomnia.
B. The client is trembling, diaphoretic, and restless.
C. The client states, 'I would sleep better if those mice and cats would stop climbing up and down the walls.'
D. The upper portion of the client's dressing is saturated with yellowish-green drainage.
E. The peripheral IV was removed by the client, and dried blood is noted at the IV site.
F. The IV catheter is on the floor. The client yelled and pushed the nurse's hands away during inspection of the IV site.
G. Vital signs: T 99 F (37.2 C), P 102, RR 18, BP 170/96, SpO2 95% on room air
Explanation: Trembling, diaphoresis, restlessness, hallucinations, saturated dressing, removed IV, aggressive behavior, and elevated pulse and blood pressure indicate potential withdrawal, infection, or sepsis, requiring urgent attention.
Question 2 of 5.
Extract:The nurse is caring for a client at a women's health clinic. History & Physical Labor and delivery unit 0800: A 28-year-old nulliparous female comes to the clinic for confirmation of suspected pregnancy due to amenorrhea and a positive home pregnancy test. The client's current exercise regimen includes indoor cycling and outdoor running. The client reports nausea, vomiting, and breast tenderness. She has a 28-day menstrual cycle, and her last menstrual period was March 10- 17. The health care provider notes a bluish-purple vaginal mucosa and cervix during pelvic examination and confirms a 12-week intrauterine pregnancy by sonography. A fetal heart rate of 155/min is detected with handheld Doppler.
For each client finding, click to specify if the finding is consistent with presumptive, probable, or positive signs of pregnancy. Note: Each row must have one response option selected
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Explanation: Presumptive signs are subjective and may have other causes (e.g., amenorrhea, nausea/vomiting, breast tenderness). Probable signs are objective but not definitive (e.g., Chadwick sign, positive home pregnancy test). Positive signs confirm pregnancy (e.g., fetal heart rate, fetus visible on ultrasound).
Question 3 of 5.
Extract:The nurse is caring for a client at a women's health clinic. History & Physical Labor and delivery unit 0800: A 28-year-old nulliparous female comes to the clinic for confirmation of suspected pregnancy due to amenorrhea and a positive home pregnancy test. The client's current exercise regimen includes indoor cycling and outdoor running. The client reports nausea, vomiting, and breast tenderness. She has a 28-day menstrual cycle, and her last menstrual period was March 10- 17. The health care provider notes a bluish-purple vaginal mucosa and cervix during pelvic examination and confirms a 12-week intrauterine pregnancy by sonography. A fetal heart rate of 155/min is detected with handheld Doppler.
The client's last menstrual period was March 10-17. Unprotected intercourse occurred on March 24. The client's menstrual cycles are regular and occur every 28 days. Based on the Naegele rule, what is the estimated date of birth?
A. 3-Dec
B. 17-Dec
C. 24-Dec
D. 31-Dec
Explanation: Using Naegele's rule (first day of LMP + 1 year - 3 months + 7 days), March 10, 2025 + 1 year = March 10, 2026 - 3 months = December 10, 2025 + 7 days = December 17, 2025.
Question 4 of 5.
Extract:The nurse is caring for a client at a women's health clinic. History & Physical Labor and delivery unit 0800: A 28-year-old nulliparous female comes to the clinic for confirmation of suspected pregnancy due to amenorrhea and a positive home pregnancy test. The client's current exercise regimen includes indoor cycling and outdoor running. The client reports nausea, vomiting, and breast tenderness. She has a 28-day menstrual cycle, and her last menstrual period was March 10- 17. The health care provider notes a bluish-purple vaginal mucosa and cervix during pelvic examination and confirms a 12-week intrauterine pregnancy by sonography. A fetal heart rate of 155/min is detected with handheld Doppler.
Which of the following topics should the nurse reinforce during the initial prenatal visit? Select all that apply.
A. Commitment to pain management preferences during labor
B. Expected discomforts of pregnancy
C. Foods to avoid
D. Herbal supplements and over-the-counter medications to avoid
E. Method of delivery
F. Symptoms of potential pregnancy complications
Explanation: The initial prenatal visit should focus on educating about expected discomforts (e.g., nausea), foods to avoid (e.g., raw fish), medications/supplements to avoid, and symptoms of complications. Pain management and delivery method are discussed later.
Question 5 of 5.
Extract:The nurse is caring for a client at a women's health clinic. History & Physical Labor and delivery unit 0800: A 28-year-old nulliparous female comes to the clinic for confirmation of suspected pregnancy due to amenorrhea and a positive home pregnancy test. The client's current exercise regimen includes indoor cycling and outdoor running. The client reports nausea, vomiting, and breast tenderness. She has a 28-day menstrual cycle, and her last menstrual period was March 10- 17. The health care provider notes a bluish-purple vaginal mucosa and cervix during pelvic examination and confirms a 12-week intrauterine pregnancy by sonography. A fetal heart rate of 155/min is detected with handheld Doppler.
Which of the following laboratory tests should the nurse anticipate during the first prenatal visit? Select all that apply.
A. 1-hour glucose tolerance test
B. Group B Streptococcus rectovaginal culture
C. Maternal blood type and screen
D. Sexually transmitted infection screen
E. Urinalysis
Explanation: First prenatal visit tests include maternal blood type and screen, STI screen, and urinalysis. Glucose tolerance and Group B Streptococcus tests are performed later in pregnancy.