NCLEX PN Practice Test with NGN

Question 1 of 5.

Extract:The nurse in the surgical unit is caring for a 57-year-old client who underwent an abdominal hysterectomy. Progress Notes 1 Day Postoperative 0800: The client underwent total abdominal hysterectomy with bilateral oophorectomy and tumor debulking 1 day ago for treatment of ovarian cancer. She has had four episodes of vomiting with bilious emesis over the past 12 hours, which have continued despite V antiemetic administration. The client has been receiving V broad-spectrum antibiotics since the procedure. The skin is warm. A low transverse abdominal incision is present; staples are clean and dry. Chest expansion is symmetric; respirations are unlabored: diminished breath sounds are auscultated in bilateral lower lobes. Radial pulses 2+ bilaterally, capillary refill <3 seconds in all four extremities; no peripheral edema is noted. The client reports frequent hot flashes occurring roughly every hour, starting last night. The abdomen is markedly distended and tender to palpation. Bowel sounds are absent in all four quadrants; the client reports no flatus. Urine is clear yellow with moderate output. The client reports incontinence with coughing or during episodes of vomiting. Prescriptions 0820: • 5% dextrose and 0.45% sodium chloride at 75 m/hr continuous • 50% dextrose 25 mg IV push as needed for blood glucose <70 mg/dL (3.9 mmol/L) • Ketorolac 15 mg IV push every 6 hours as needed for severe pain • Ondansetron 8 mg PO every 8 hours as needed for nausea • Pantoprazole 40 mg PO daily • Potassium chloride 40 mEq/100 mL IVPB once • Sips of clear liquids, advance diet as tolerated Laboratory Results Laboratory Test and Reference Range: 1 day postoperative WBC count: 5000-10.000/mm3 (5-10 x 10%L): 12,000/mm3 (12 x 10°/L) Urea nitrogen (BUN) 10-20 mg/dL (3.6-7.1 mmol/L): 24 mg/dL (8.6 mmol/L) Creatinine Male: 0.6-1.2 mg/dL(53-106 umol/L): 1.6 mg/dL (141.4 pmol/L) Female: 0.5-1.1 mg/dL (44-97 umol/L): Potassium 3.5-5.0 mEq/L (3.5--5.0 mmol/L): 3.3 mEq/L (3.3 mmol/L) Sodium 135-145 mEq/L (135-145 mmol/L): 137 mEq/L (137 mmol/L) Blood glucose level 74-106 mg/dL (4.1-5.9 mmol/L): 75 mg/dL (4.2 mmol/L) Nurses' Notes 0900: Continuous IV fluids and potassium chloride infusion initiated; opioids discontinued per health care provider prescription. Ondansetron administered once for nausea. Assisted client to ambulate in hallway once; client currently sitting up in chair. 2100: No emesis since 0800. Client has ambulated two more times and has remained out of bed. Ketorolac administered for abdominal pain rated as 7 on a scale of 0-10. Tolerating small sips of clear liquids. Bowel sounds absent. Surgical Unit: 1 Day Postoperative 0700: Client reports no nausea. Client ambulated 50 ft (15 m) this morning. After ambulation, client reports one small, loose bowel movement. Pain remains at 7 on a scale of 0-10. Tolerating clear liquids. Bowel sounds hypoactive.

The nurse has reviewed the information from the Laboratory Results and Nurses' Notes. Which of the following findings indicate that the client condition is improving following treatment of postoperative ileus? Select all that apply.

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

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?

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.

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.