RN Comprehensive Online Practice
2026 B
A nurse is caring for a 5-year-old child
Physical Examination:
1510:
Upon visual inspection, throat is inflamed, tonsils appear pink, reddened and epiglottis
is edematous and cherry red in appearance. Skin appears pale. Stridor noted upon
inspiration with diminished bilateral lung sounds.
Nurse's Notes:
1500
Child accompanied to emergency department by caregiver. Caregiver states child has a
sore throat and reports the child has "pain on swallowing" and denies cough. Child is
agitated and lean - ANSWER-Condition: Epiglottis
Actions: Initiate droplet precautions and request a prescription for IV antibiotics
Monitors: Breath sounds and temperature
The nurse should anticipate initiating droplet precautions and requesting a prescription
for IV antibiotics. The child is most likely experiencing epiglottis because of the clinical
manifestations of a high fever, inflammation and redness of the throat, pale skin, stridor
with inspiration, painful swallowing, no cough, is sitting in tripod position, and drooling.
The nurse should monitor the child's temperature and breath sounds.
A nurse is caring for a client who is on the spinal cord injury (SCI) unit
Nurses' Notes
Day 3, 1700
Client admitted to SCI unit 3 days ago following C7 injury. Skin is cool, pale, and dry to
touch. Respirations easy and unlabored. Lung sounds diminished in lower lobes.
Abdomen soft and nondistended with active bowel sounds. Client passed a small
amount of hard formed stool this AM. Indwelling urinary catheter draining clear yellow
urine. Deep tendon reflexes (DTR) are biceps 1+, triceps 1+, pa - ANSWER-The client
is most likely experiencing manifestations of pneumonia and autonomic dysreflexia.
The nurse should analyze cues from the client's manifestations and determine that the
client is most likely experiencing manifestations of pneumonia and autonomic
dysreflexia. A client who has a cervical SCI is at risk for respiratory complications
because spinal innervation to the respiratory muscles is disrupted. Adventitious breath
sounds in the lower lobes bilaterally and a decrease in oxygen saturation to less than
92% can indicate pneumonia. The client's sudden increase in blood pressure,
bradycardia, flushing of the skin above the area of the injury, headache, and blurred
,vision are manifestations of autonomic dysreflexia, which can be a life-threatening
condition.
A nurse is caring for a client who has abdominal pain
Nurses' Notes
0900
Client reports loss of appetite, weight loss, and fatigue for 1 week. Reports abdominal
pain, 6 on a scale from 0 to 10, for 2 days. Client is a perioperative nurse, returned 1
week ago from a 2-week mission trip to an underdeveloped country
1200
Results of antibody studies obtained. Provider prescription for antiviral medication
pending.
Physical Examination
0930
Lung sounds clear bilaterally. Skin warm to touch and jau - ANSWER-Hepatitis A:
Client's risk from fecal-oral transmission, laboratory results, and physical examination
findings
Hepatitis B: Antiviral treatment, laboratory results, client's risk from bloodborne
transmission, physical examination findings
Hepatitis C: Antiviral treatment, laboratory results, client's risk from bloodborne
transmission, and physical examination findings
When analyzing cues, the nurse should recognize that manifestations of hepatitis A,
hepatitis B, and hepatitis C include jaundice, yellow sclerae, right upper quandrant pain
upon palpation, dark yellow urine, and elevated AST and ALT levels. When analyzing
cues, the nurse should also recognize the client's risk for contracting hepatitis A through
the fecal-oral route during recent travel to an underdeveloped country and the client's
occupational risk as a perioperative nurse for contracting hepatitis B and hepatitis C
through bloodborne transmission. The nurse should recognize that the current standard
of practice for
A nurse is caring for a client on a medical-surgical unit
Vital Signs
0700
Temperature 37.6 C (99.7 F)
Heart rate 100/min
Respiratory rate 22/min
Blood pressure 115/70 mmHg
Oxygen saturation 98% on room air
,Nurses' Notes
1100
Client alert and oriented to person, place, and time. Client had episode of diarrhea,
provided perineal care. Noted 2 cm x 2 cm (0.8 in x 0.8 in) painful edematous area on
sacrum. Client repositioned every 4 hr. - ANSWER-Click to highlight the findings that
require follow up. To deselect a finding, click on the finding again.
- Noted 2 cm x 2 cm (0.8 in x 0.8 in) painful edematous area on sacrum
- Client repositioned every 4 hr
When recognizing cues, the nurse should determine that the client's painful edematous
area on their sacrum and that the client has only been repositioned every 4 hr requires
follow up. The client has manifestations of a pressure injury that need to be addressed.
The client should be repositioned at least every 2 hr to prevent worsening of the
pressure injury and to relieve pressure from the sacral area.
A nurse in an outpatient mental health clinic is caring for a client
Vital Signs
3 months ago
Blood pressure 116/68 mmHg
Heart rate 82/min
Respiratory rate 16/min
Temperature 36.7 C (98.1 F)
SaO2 97% on room air
Today:
Blood pressure 128/76 mmHg
Heart rate 104/min
Respiratory rate 22/min
Temperature 37.4 (99.4 F)
SaO2 97% on room air
Nurses' Notes
3 months ago
Client recently admitted with new diagnosis of schizophrenia. Received inpatient
treatment for 10 days and was discharged 1 week ago. - ANSWER-Select the 3 findings
that require immediate follow up:
- Auditory hallucinations
- Speech
- Restlessness
When recognizing cues, the nurse should identify that the findings of restlessness,
auditory hallucinations, and pressured speech require immediate follow up. These
findings are indications of psychosis. The nurse should notify the provider for additional
evaluation and treatment.
, A nurse is caring for a client who is postoperative following coronary artery bypass
surgery (CABG)
Laboratory Results
0630
Sodium 145 mEq/L (136 to 145 mEq/L)
Potassium 3.2 mEq/L (3.5 to 5 mEq/L)
Chloride 116 mEq/L (98 to 106 mEq/L)
BUN 24 mg/dL (10 to 20 mg/dL)
Magnesium 1.5 mEq/L (1.3 to 2.1 mEq/L)
Total calcium 9 mg/dL (9 to 10.5 mg/dL)
Phosphate 4.6 mg/dL (3 to 4.5 mg/dL)
Glucose 95 mg/dL (74 to 106 mg/dL)
WBC count 9,500/mm3 (5,000 to 10,000/mm3)
I&O
0700
4 hr input 400 mL
4 hr output - ANSWER-The client is at greatest risk for developing dysrhythmias, as
evidenced by electrolyte imbalance.
The nurse should analyze cues to determine the client is at greatest risk for developing
dysrhythmias related to hypokalemia, as evidenced by the laboratory report and the
client's report of muscle cramping. Potassium and magnesium depletion are common
manifestations in clients who are postoperative following CABG. Due to medication or
hemodilation, it is important for the nurse to closely monitor electrolytes.
A nurse is caring for a client who is pregnant in the acute care setting
Nurses' Notes
1400
Client reports a constant low dull backache and painless abdominal tightening for the
past 3 hr. Denies any changes in vaginal discharge. External fetal monitor applied.
1430
Contraction pattern: contractions every 4 to 5 min, lasting 30 to 45 seconds, palpate
mild in intensity
Fetal heart rate: 150/min to 155/min, moderate variability, adequate accelerations
present, no decelerations noted. Provider in - ANSWER-The nurse should first address
the client's respiratory rate, followed by the client's level of consciousness
When prioritizing hypotheses, the nurse should recognize that magnesium sulfate is a
central nervous system depressant that can affect respirations, consciousness, and
reflexes when toxic blood levels occur. Using the airway, breathing, circulation priority
framework, the nurse should plan to first take action to support respirations, followed by
action to increase the client's level of consciousness. The nurse should plan to
2026 B
A nurse is caring for a 5-year-old child
Physical Examination:
1510:
Upon visual inspection, throat is inflamed, tonsils appear pink, reddened and epiglottis
is edematous and cherry red in appearance. Skin appears pale. Stridor noted upon
inspiration with diminished bilateral lung sounds.
Nurse's Notes:
1500
Child accompanied to emergency department by caregiver. Caregiver states child has a
sore throat and reports the child has "pain on swallowing" and denies cough. Child is
agitated and lean - ANSWER-Condition: Epiglottis
Actions: Initiate droplet precautions and request a prescription for IV antibiotics
Monitors: Breath sounds and temperature
The nurse should anticipate initiating droplet precautions and requesting a prescription
for IV antibiotics. The child is most likely experiencing epiglottis because of the clinical
manifestations of a high fever, inflammation and redness of the throat, pale skin, stridor
with inspiration, painful swallowing, no cough, is sitting in tripod position, and drooling.
The nurse should monitor the child's temperature and breath sounds.
A nurse is caring for a client who is on the spinal cord injury (SCI) unit
Nurses' Notes
Day 3, 1700
Client admitted to SCI unit 3 days ago following C7 injury. Skin is cool, pale, and dry to
touch. Respirations easy and unlabored. Lung sounds diminished in lower lobes.
Abdomen soft and nondistended with active bowel sounds. Client passed a small
amount of hard formed stool this AM. Indwelling urinary catheter draining clear yellow
urine. Deep tendon reflexes (DTR) are biceps 1+, triceps 1+, pa - ANSWER-The client
is most likely experiencing manifestations of pneumonia and autonomic dysreflexia.
The nurse should analyze cues from the client's manifestations and determine that the
client is most likely experiencing manifestations of pneumonia and autonomic
dysreflexia. A client who has a cervical SCI is at risk for respiratory complications
because spinal innervation to the respiratory muscles is disrupted. Adventitious breath
sounds in the lower lobes bilaterally and a decrease in oxygen saturation to less than
92% can indicate pneumonia. The client's sudden increase in blood pressure,
bradycardia, flushing of the skin above the area of the injury, headache, and blurred
,vision are manifestations of autonomic dysreflexia, which can be a life-threatening
condition.
A nurse is caring for a client who has abdominal pain
Nurses' Notes
0900
Client reports loss of appetite, weight loss, and fatigue for 1 week. Reports abdominal
pain, 6 on a scale from 0 to 10, for 2 days. Client is a perioperative nurse, returned 1
week ago from a 2-week mission trip to an underdeveloped country
1200
Results of antibody studies obtained. Provider prescription for antiviral medication
pending.
Physical Examination
0930
Lung sounds clear bilaterally. Skin warm to touch and jau - ANSWER-Hepatitis A:
Client's risk from fecal-oral transmission, laboratory results, and physical examination
findings
Hepatitis B: Antiviral treatment, laboratory results, client's risk from bloodborne
transmission, physical examination findings
Hepatitis C: Antiviral treatment, laboratory results, client's risk from bloodborne
transmission, and physical examination findings
When analyzing cues, the nurse should recognize that manifestations of hepatitis A,
hepatitis B, and hepatitis C include jaundice, yellow sclerae, right upper quandrant pain
upon palpation, dark yellow urine, and elevated AST and ALT levels. When analyzing
cues, the nurse should also recognize the client's risk for contracting hepatitis A through
the fecal-oral route during recent travel to an underdeveloped country and the client's
occupational risk as a perioperative nurse for contracting hepatitis B and hepatitis C
through bloodborne transmission. The nurse should recognize that the current standard
of practice for
A nurse is caring for a client on a medical-surgical unit
Vital Signs
0700
Temperature 37.6 C (99.7 F)
Heart rate 100/min
Respiratory rate 22/min
Blood pressure 115/70 mmHg
Oxygen saturation 98% on room air
,Nurses' Notes
1100
Client alert and oriented to person, place, and time. Client had episode of diarrhea,
provided perineal care. Noted 2 cm x 2 cm (0.8 in x 0.8 in) painful edematous area on
sacrum. Client repositioned every 4 hr. - ANSWER-Click to highlight the findings that
require follow up. To deselect a finding, click on the finding again.
- Noted 2 cm x 2 cm (0.8 in x 0.8 in) painful edematous area on sacrum
- Client repositioned every 4 hr
When recognizing cues, the nurse should determine that the client's painful edematous
area on their sacrum and that the client has only been repositioned every 4 hr requires
follow up. The client has manifestations of a pressure injury that need to be addressed.
The client should be repositioned at least every 2 hr to prevent worsening of the
pressure injury and to relieve pressure from the sacral area.
A nurse in an outpatient mental health clinic is caring for a client
Vital Signs
3 months ago
Blood pressure 116/68 mmHg
Heart rate 82/min
Respiratory rate 16/min
Temperature 36.7 C (98.1 F)
SaO2 97% on room air
Today:
Blood pressure 128/76 mmHg
Heart rate 104/min
Respiratory rate 22/min
Temperature 37.4 (99.4 F)
SaO2 97% on room air
Nurses' Notes
3 months ago
Client recently admitted with new diagnosis of schizophrenia. Received inpatient
treatment for 10 days and was discharged 1 week ago. - ANSWER-Select the 3 findings
that require immediate follow up:
- Auditory hallucinations
- Speech
- Restlessness
When recognizing cues, the nurse should identify that the findings of restlessness,
auditory hallucinations, and pressured speech require immediate follow up. These
findings are indications of psychosis. The nurse should notify the provider for additional
evaluation and treatment.
, A nurse is caring for a client who is postoperative following coronary artery bypass
surgery (CABG)
Laboratory Results
0630
Sodium 145 mEq/L (136 to 145 mEq/L)
Potassium 3.2 mEq/L (3.5 to 5 mEq/L)
Chloride 116 mEq/L (98 to 106 mEq/L)
BUN 24 mg/dL (10 to 20 mg/dL)
Magnesium 1.5 mEq/L (1.3 to 2.1 mEq/L)
Total calcium 9 mg/dL (9 to 10.5 mg/dL)
Phosphate 4.6 mg/dL (3 to 4.5 mg/dL)
Glucose 95 mg/dL (74 to 106 mg/dL)
WBC count 9,500/mm3 (5,000 to 10,000/mm3)
I&O
0700
4 hr input 400 mL
4 hr output - ANSWER-The client is at greatest risk for developing dysrhythmias, as
evidenced by electrolyte imbalance.
The nurse should analyze cues to determine the client is at greatest risk for developing
dysrhythmias related to hypokalemia, as evidenced by the laboratory report and the
client's report of muscle cramping. Potassium and magnesium depletion are common
manifestations in clients who are postoperative following CABG. Due to medication or
hemodilation, it is important for the nurse to closely monitor electrolytes.
A nurse is caring for a client who is pregnant in the acute care setting
Nurses' Notes
1400
Client reports a constant low dull backache and painless abdominal tightening for the
past 3 hr. Denies any changes in vaginal discharge. External fetal monitor applied.
1430
Contraction pattern: contractions every 4 to 5 min, lasting 30 to 45 seconds, palpate
mild in intensity
Fetal heart rate: 150/min to 155/min, moderate variability, adequate accelerations
present, no decelerations noted. Provider in - ANSWER-The nurse should first address
the client's respiratory rate, followed by the client's level of consciousness
When prioritizing hypotheses, the nurse should recognize that magnesium sulfate is a
central nervous system depressant that can affect respirations, consciousness, and
reflexes when toxic blood levels occur. Using the airway, breathing, circulation priority
framework, the nurse should plan to first take action to support respirations, followed by
action to increase the client's level of consciousness. The nurse should plan to
