NCLEX PN Practice Test with NGN
Question 1 of 5.
Extract:The nurse is caring for an 8-year-old client who was brought to the emergency department after becoming short of breath at school. History and Physical General Well-nourished child; currently sitting in the tripod position; patches of dry, scaly, reddened skin are present in the creases of bilateral elbows and behind both knees; client reports that these areas itch Neurological Alert and oriented to person, place, and time Eye, Ear, Nose, andThroat (EENT) Pupils equal, round, and reactive to light and accommodation; client reports no nasal congestion Pulmonary Vital signs: RR 34, SpO 92% on room air, airway patent, intercostal retractions noted during inspiration; expiratory wheezes auscultated bilaterally; dry, spasmodic cough is noted; no stridor; difficulty speaking in complete sentences Cardiovascular Vital signs: T 98.8 F (37.1 C), P 110, BP 94/60; S1 and S2 heard on auscultation; nom murmurs noted; peripheral pulses 2+; capillary refill 3 seconds; no edema Gastrointestinal Abdomen soft; bowel sounds normal Psychosocial Client appears anxious and is crying, client speaks in short phrases, stating, "left my medicine at a friend's house" and "feels like I can't breathe"; client cannot remember the name of the prescribed home medication; client's parents were notified and are en route to hospital Progress Notes 0910: Client's parents were spoken to over the phone. Last evening, the client spent the night at a friend's housewhere some family members smoke cigarettes and have a pet cat that lives in the home. Medical history: No accidents or injuries were reported, vaccinations are up to date, mild persistent asthma was diagnosed at age 7, and client has atopic dermatitis. Allergies: No known allergies. Family history: Client is an only child. Parents report having no known medical conditions. Paternal grandfather died of chronic obstructive pulmonary disease, and maternal grandmother has heart disease. Social history: Client lives with parents; they do not smoke cigarettes. There are no pets in the client's home. Current medications: Beclomethasone inhaler 2 puffs twice a day, albuterol (salbutamol) inhaler 2 puffs every 4 hours as needed for quick relief of symptoms.
The nurse receives the following prescriptions. Which 3 actions should the nurse prioritize?
A. Administer albuterol (salbutamol) with ipratropium bromide via nebulizer
B. Administer initial dose of PO prednisone once
C. Initiate maintenance IV fluids
D. Initiate NPO status except oral medication
E. Titrate oxygen to achieve an oxygen saturation of >95%
Explanation: A: Nebulized albuterol and ipratropium are first-line treatments for acute asthma exacerbation to relieve bronchospasm. B: Prednisone reduces inflammation and prevents worsening. E: Titrating oxygen to >95% corrects hypoxia, a critical concern with SpO2 at 92%.
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.