NCLEX PN Test Questions with NGN

Question 1 of 5.

Extract:The nurse is caring for a 34-year-old female client in the clinic. Nurses' Notes Initial Clinic Visit The client is receiving a tuberculin skin test. The client works at a long-term care facility and has never been vaccinated for tuberculosis. Medical history includes Crohn disease, major depression, and a blood transfusion following a motor vehicle collision 5 years ago. The client takes an immunosuppressant, oral contraceptive pills, and a selective serotonin reuptake inhibitor daily. The client is currently providing housing for a family member who periodically experiences homelessness. The client has a pet dog. Clinic Visit 2 Days Later The client returns to the clinic for inspection of the tuberculin skin test injection site. There is a palpable, raised, hardened area around the injection site that is 16 mm in diameter. The client reports no cough, fever, fatigue, anorexia, weight loss, or nocturnal diaphoresis. Lung sounds are clear throughout all lobes on auscultation. Vital signs are T 98.5 F (36.9 C), P 72, RR 17, BP 118/72, and SpO 98% on room air. Clinic Visit 6 Months Later The client reports fatigue; intermittent fevers; decreased appetite; a 6-Ib (2.7-kg) weight loss; and a productive, chronic cough that began 5 weeks ago. The client has not started the antibiotic regimen for latent tuberculosis. Diagnostic Results Chest x-ray Lungs appear normal. There are no infiltrates, cavitation, or effusions.

The nurse is reinforcing teaching on the plan of care for active tuberculosis. For each of the statements made by the nurse, click to specify if the statement is appropriate or not appropriate to include in the teaching.

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.