NCLEX PN Practice Test with NGN
Question 1 of 5.
Extract:The nurse in the emergency department is caring for a 62-year-old client. Progress Notes Emergency Department 0900: The client is brought to the emergency department by a family member after being found confused and lethargic. On arrival, the client is obtunded and does not respond to verbal stimuli. Medical history includes major depressive disorder and chronic neck and back pain after a motor vehicle collision 2 years ago. The family member states that the client takes multiple medications but does not know which kind. The client was divorced a few months ago. Physical examination shows 1-mm pupils, shallow breathing, and reduced bowel sounds. Fingerstick blood glucose is 78 mg/dL (4.3 mmol/L). ECG reveals normal sinus rhythm. Breath alcohol test is negative. Vital signs: T 98.1 F (36.7 C), P 62, RR 8, BP 80/40, SpO2 94% on room air. 1800: The client is awake, alert, and oriented to person, place, time, and situation. The client is experiencing severe withdrawal symptoms and is admitted for supervised detoxification. Laboratory Results Urine Drug Screen On admission Cocaine- Negative Opioids- Positive Amphetamines- Negative Marijuana- Positive Phencyclidine-Negative Benzodiazepines- Negative Barbiturates- Negative Laboratory Test and Reference Range Cocaine- Negative Opioids- Negative Amphetamines- Negative Marijuana- Negative Phencyclidine- Negative Benzodiazepines- Negative Barbiturates- Negative
The nurse has reviewed the information from the Progress Notes and Laboratory Results. For each potential intervention, click to specify if the intervention is expected or unexpected for the care of the client.
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Explanation: B: Expected - Depression history increases suicide risk during withdrawal. C: Expected - Antidiarrheals and antiemetics manage withdrawal symptoms like nausea. D: Expected - Standardized scales (e.g., COWS) assess opioid withdrawal severity. A: Unexpected - Seizures are more associated with alcohol or benzodiazepine withdrawal, not opioids.
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.
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