NCLEX PN Exam Practice Test with NGN
Question 1 of 5.
Extract:The nurse is caring for a 63-year-old client. Progress Notes Emergency department 1 week ago: The client is admitted to the hospital with dyspnea, orthopnea, and bilateral leg swelling. The client has hypertension, heart failure, and chronic kidney disease. Medications include furosemide, hydrochlorothiazide, lisinopril, and metoprolol. Clinic visit Today: The client was recently discharged from the hospital after treatment for acute heart failure. Symptoms improved after treatment with diuretics. Today, the client reports new-onset muffled hearing and difficulty understanding speech. Examination shows bilateral hearing loss.
Which medication should the nurse clarify with the health care provider?
A. Furosemide
B. Hydrochlorothiazide
C. Lisinopril
D. Metoprolol
Explanation: Furosemide is associated with ototoxicity, which may cause hearing loss, requiring clarification.
Question 2 of 5.
Extract:The nurse is caring for a 6-year-old client accompanied by the parents. History and Physical Body System Findings General Client is brought to the emergency department due to shortness of breath; medical history includes cystic fibrosis and many previous hospital admissions for pneumonia; in the 3rd percentile for height and weight Neurological Alert and oriented to person, place, and time; no neurologic deficits Pulmonary Vital signs: RR 30, SpO, 87% on room air; moderate subcostal retractions; bilateral wheezing and coarse crackles throughout lung fields with fine inspiratory crackles at left lung base; paroxysmal coughing that produces thick, yellow, blood-tinged sputum; parents report that the client has begun to become "winded" after showering and other activities Cardiovascular Vital signs: T 101.7 F (38.7 C), P 130, BP 94/58; skin warm and dry; peripheral pulses palpable 2+; capillary refill 3 econds; mild finger clubbing noted Gastrointestinal Abdomen soft with normoactive bowel sounds; parent states, "Swallowing the enzyme capsules is very difficult for my child, and I have noticed an increase in greasy, bulky stools"
Click to highlight below the assessment findings that require immediate follow-up?
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Explanation: Findings A, C, D, and E indicate urgent issues: shortness of breath with a history of cystic fibrosis , low oxygen saturation and respiratory distress , fever and tachycardia , and malabsorption symptoms require immediate intervention.
Question 3 of 5.
Extract:The nurse is caring for a 6-year-old client accompanied by the parents. History and Physical Body System Findings General Client is brought to the emergency department due to shortness of breath; medical history includes cystic fibrosis and many previous hospital admissions for pneumonia; in the 3rd percentile for height and weight Neurological Alert and oriented to person, place, and time; no neurologic deficits Pulmonary Vital signs: RR 30, SpO, 87% on room air; moderate subcostal retractions; bilateral wheezing and coarse crackles throughout lung fields with fine inspiratory crackles at left lung base; paroxysmal coughing that produces thick, yellow, blood-tinged sputum; parents report that the client has begun to become "winded" after showering and other activities Cardiovascular Vital signs: T 101.7 F (38.7 C), P 130, BP 94/58; skin warm and dry; peripheral pulses palpable 2+; capillary refill 3 econds; mild finger clubbing noted Gastrointestinal Abdomen soft with normoactive bowel sounds; parent states, "Swallowing the enzyme capsules is very difficult for my child, and I have noticed an increase in greasy, bulky stools"
Which of the following client findings are consistent with a cystic fibrosis exacerbation? Select all that apply.
A. Blood-tinged sputum
B. Greasy, bulky stools
C. Paroxysmal coughing
D. SpO2 of 87% on room air
E. Temperature of 101.7 F (38.7 C)
Explanation: Cystic fibrosis exacerbations often present with increased respiratory symptoms (A, C, D), fever , and malabsorption issues due to pancreatic insufficiency.
Question 4 of 5.
Extract:The nurse is caring for a 6-year-old client accompanied by the parents. History and Physical Body System Findings General Client is brought to the emergency department due to shortness of breath; medical history includes cystic fibrosis and many previous hospital admissions for pneumonia; in the 3rd percentile for height and weight Neurological Alert and oriented to person, place, and time; no neurologic deficits Pulmonary Vital signs: RR 30, SpO, 87% on room air; moderate subcostal retractions; bilateral wheezing and coarse crackles throughout lung fields with fine inspiratory crackles at left lung base; paroxysmal coughing that produces thick, yellow, blood-tinged sputum; parents report that the client has begun to become "winded" after showering and other activities Cardiovascular Vital signs: T 101.7 F (38.7 C), P 130, BP 94/58; skin warm and dry; peripheral pulses palpable 2+; capillary refill 3 econds; mild finger clubbing noted Gastrointestinal Abdomen soft with normoactive bowel sounds; parent states, "Swallowing the enzyme capsules is very difficult for my child, and I have noticed an increase in greasy, bulky stools"
The nurse should prioritize interventions for Select...
A. Malabsorption of nutrients
B. Alterations in blood glucose
C. Decreased gastrointestinal motility
D. Impaired clearance of airway secretions
Explanation: Impaired airway clearance is a priority in cystic fibrosis exacerbations due to thick mucus causing respiratory distress and infection risk.
Question 5 of 5.
Extract:The nurse is caring for a 6-year-old client accompanied by the parents. History and Physical Body System Findings General Client is brought to the emergency department due to shortness of breath; medical history includes cystic fibrosis and many previous hospital admissions for pneumonia; in the 3rd percentile for height and weight Neurological Alert and oriented to person, place, and time; no neurologic deficits Pulmonary Vital signs: RR 30, SpO, 87% on room air; moderate subcostal retractions; bilateral wheezing and coarse crackles throughout lung fields with fine inspiratory crackles at left lung base; paroxysmal coughing that produces thick, yellow, blood-tinged sputum; parents report that the client has begun to become "winded" after showering and other activities Cardiovascular Vital signs: T 101.7 F (38.7 C), P 130, BP 94/58; skin warm and dry; peripheral pulses palpable 2+; capillary refill 3 econds; mild finger clubbing noted Gastrointestinal Abdomen soft with normoactive bowel sounds; parent states, "Swallowing the enzyme capsules is very difficult for my child, and I have noticed an increase in greasy, bulky stools"
For each potential intervention, click to specify if the intervention is indicated or not indicated for the care of the client.
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Explanation: Antibiotics treat bacterial pneumonia, bronchodilators relieve wheezing, chest physiotherapy aids mucus clearance, and hypertonic saline thins mucus. Airborne isolation is not indicated for bacterial pneumonia.
Related Questions
Which finding is the most concerning to the nurse at this time?