NCLEX PN Exam Practice Test with NGN Related

The nurse is caring for a 68-year-old client in the emergency department.
History Physical Vital Signs
Admission: The client comes to the emergency department with progressively worsening back pain that began 3 weeks ago. The pain has become significantly worse over the past 12 hours. Pain level is rated as 8 on a scale of 0-10. The client was recently diagnosed with prostate cancer and has had a poor response to treatment. This morning, the client had trouble walking and reports decreased sensation in the feet. The client also reports mild nausea, difficulty urinating, decreased urinary sensation, and no bowel movement in the past 3 days

For each potential intervention, click to specify if the intervention is expected or not expected for the care of the client.

• A. Administer corticosteroids
• B. Initiate seizure precautions
• C. Administer an oral stool softener
• D. Perform intermittent urinary catheterization
• E. Perform frequent neuromuscular evaluations
• F. Prepare client for surgical spinal cord decompression

The nurse is caring for a 40-year-old client.
History Admission:
The client is brought to the psychiatric emergency department by ambulance after being observed walking in the street and shouting at vehicles. The client states that aliens are trying to attack him and that he is now on a mission to find and kill them. The clients mother says that last year he believed that he was being watched by an unidentified government agency and subsequently broke up with his girlfriend, quit his job, and disconnected his phone. The mother has noticed that he no longer seems to care about activities that used to interest him, and last month she discovered that he had moved into the family garden shed with his dog.
On examination, the client is malodorous and disheveled and laughs for no apparent reason. He appears anxious, avoids eye contact, and shows little emotion. His answers are very brief, and he asks if the interview is being secretly recorded. The client's speech is difficult to follow, and he repeatedly says in a monotone voice, "I said I'll find them." He later becomes angry and refuses to sit in a chair for the interview. I'll find them." He later becomes angry and refuses to sit in a chair for the interview.

Which action should the nurse perform first?

• A. Administer lorazepam, haloperidol, and diphenhydramine
• B. Direct other clients away from the area
• C. Offer the client distraction activities
• D. Place the client in 4-point restraints
• E. Request additional staff presence

The nurse is caring for a 40-year-old client.
History Admission:
The client is brought to the psychiatric emergency department by ambulance after being observed walking in the street and shouting at vehicles. The client states that aliens are trying to attack him and that he is now on a mission to find and kill them. The clients mother says that last year he believed that he was being watched by an unidentified government agency and subsequently broke up with his girlfriend, quit his job, and disconnected his phone. The mother has noticed that he no longer seems to care about activities that used to interest him, and last month she discovered that he had moved into the family garden shed with his dog.
On examination, the client is malodorous and disheveled and laughs for no apparent reason. He appears anxious, avoids eye contact, and shows little emotion. His answers are very brief, and he asks if the interview is being secretly recorded. The client's speech is difficult to follow, and he repeatedly says in a monotone voice, "I said I'll find them." He later becomes angry and refuses to sit in a chair for the interview. I'll find them." He later becomes angry and refuses to sit in a chair for the interview.

For each finding, click to specify whether the finding indicates that the client's status has improved or not improved.

• A. Client is seen talking alone in the hallway
• B. Client is seen playing board games with peers
• C. Client asks the technician for hygiene supplies
• D. Client states, 'The voices are a part of my illness.'
• E. Client refuses to take medication from a new nurse
• F. Client is willing to eat food that is prepackaged only

The nurse is caring for a 75-year-old female client. Nurses' Notes Laboratory Results Diagnostic Results Emergency Department
The client is transferred to the emergency department from a skilled nursing facility for a 3-day history of left lower quadrant abdominal pain rated 8 on a scale of 0-10, loss of appetite, and nausea. Although the client has a history of chronic constipation, she has had 2 or 3 loose stools daily for 1 week. The client reports tenderness on deep palpation of the left lower quadrant. There is an area of blanchable redness on the coccyx. The stool is positive for occult blood.
The client has residual left-sided weakness from an ischemic stroke 2 years ago and ambulates with a walker. The client reports falling several times in the past 6 months; the last fall was 3 weeks ago No ecchymosis or injuries are noted. The client had a hysterectomy and salpingo-oophorectomy for uterine fibroids 20 years ago. Vital signs are T 100 F (37.8 C), P 98, RR 17, BP 126/68, and SpOz 97% on room air.
Medical-Surgical Unit: 4 Days Later
The client continues to experience left lower quadrant pain, decreased appetite, and nausea. Today, she developed chills. Stool frequency has not increased. Severe tenderness is noted in the left lower quadrant, and a mass is palpable. Vital signs are T 101.3 F (38.5 C), P 112, RR 17, BP 110/80, SpO, 97% on room air.

Complications associated with acute diverticulitis include ........, ........ and ........

• A. Pyelonephritis
• B. Fistula formation
• C. Bowel perforation
• D. Abscess formation
• E. Rupture of the appendix

For each event, click to specify whether the event is a sentinel event or a near-miss event.

• A. A client fall results in a hip fracture
• B. An invasive procedure is performed on the incorrect body site
• C. The nurse identifies an ABO incompatibility while obtaining a blood product
• D. The nurse identifies a miscalculated dose when preparing medications for a client
• E. A client admitted for suicidal ideation dies of suicide in the emergency department
• F. A client has an anaphylactic reaction to a medication that was documented as an allergy