Comprehensive RN Concept-Based Assessment Level 3
Practice B Outline: Next Generation NCLEX (NGN)
Questions, Answers, and Detailed Rationales for Nursing
Exam Prep
1. A nurse is counseling a client who has experienced intimate partner violence.
Which of the following instructions is the priority for the nurse to include in the
teaching?
**Answer:** Develop a safety plan.
**Rationale:** Safety instructions are the highest priority in cases of intimate
partner violence.
2. A nurse in a mental health facility is assessing a client who has a history of
alcohol use disorder. The client states their last drink was 24 hours ago. For
which of the following manifestations of alcohol withdrawal should the nurse
monitor?
**Answer:** Tremors.
**Rationale:** Tremors are a common early sign of alcohol withdrawal.
3. A nurse is teaching a client who has epilepsy and a prescription for valproic
acid. The nurse should instruct the client to report which of the following as an
adverse effect of the medication?
**Answer:** Yellow sclera.
**Rationale:** Yellow sclera indicates potential hepatotoxicity, a serious
adverse effect of valproic acid.
,4. A nurse is obtaining a history for a client who has major depressive disorder.
Which of the following findings should the nurse identify?
- Family history of obsessive compulsive disorder
- Attends weekly religious services
- Schedules monthly appointments with a health care provider
- Recent move across the country to look for work
**Answer:** Recent move across the country to look for work.
**Rationale:** Loss of employment and isolation are risk factors for depression.
5. A nurse is assessing a 2-year-old toddler at a well-child visit. For which of the
following findings should the nurse refer the toddler for an evaluation for ASD?
- Reluctance to make eye contact
- Plays alongside but not with other children
- Speaks using only two- to three-word phrases
- Displays temper tantrums
**Answer:** Reluctance to make eye contact.
**Rationale:** Reluctance to make eye contact is a key indicator of autism
spectrum disorder (ASD) in toddlers.
6. A nurse is caring for a client who is experiencing a postpartum hemorrhage.
Which of the following medications should the nurse plan to administer?
- Methylergonovine
- Magnesium sulfate
- Terbutaline
- Betamethasone
**Answer:** Methylergonovine.
**Rationale:** Causes contraction of the uterine muscle, which decreases
bleeding.
, 7. A nurse at a crisis center is meeting with a client who reports that his
adolescent daughter has been increasingly defiant since the divorce 2 years ago.
The client states, "I'm so stressed that I can't take this anymore." Which of the
following actions should the nurse take first?
- Refer the client and his daughter for family therapy.
- Recommend that the client attend a support group for guardians of
adolescents.
- Identify the client's current coping strategies.
- Teach the client stress-reduction techniques.
**Answer:** Identify the client's current coping strategies.
**Rationale:** Assessing current strategies provides a foundation for additional
support.
8. A nurse is performing a skin assessment for a client who has a history of
melanoma. Which of the following findings should the nurse expect?
- A nodular lesion with ulceration
- An irregularly shaped, colored papule
- A pearly papule with a waxy border
- A dry, scaly macule
**Answer:** An irregularly shaped, colored papule.
**Rationale:** Irregularly shaped with various colors (blue, white, red);
malignant and can occur anywhere on the body.
9. A nurse is reviewing the laboratory results for a client who has HELLP
syndrome. Which of the following lab results should the nurse expect?
- Hct 37%
- BUN 15 mg/dL
- Platelet count 150,000/mm³
Practice B Outline: Next Generation NCLEX (NGN)
Questions, Answers, and Detailed Rationales for Nursing
Exam Prep
1. A nurse is counseling a client who has experienced intimate partner violence.
Which of the following instructions is the priority for the nurse to include in the
teaching?
**Answer:** Develop a safety plan.
**Rationale:** Safety instructions are the highest priority in cases of intimate
partner violence.
2. A nurse in a mental health facility is assessing a client who has a history of
alcohol use disorder. The client states their last drink was 24 hours ago. For
which of the following manifestations of alcohol withdrawal should the nurse
monitor?
**Answer:** Tremors.
**Rationale:** Tremors are a common early sign of alcohol withdrawal.
3. A nurse is teaching a client who has epilepsy and a prescription for valproic
acid. The nurse should instruct the client to report which of the following as an
adverse effect of the medication?
**Answer:** Yellow sclera.
**Rationale:** Yellow sclera indicates potential hepatotoxicity, a serious
adverse effect of valproic acid.
,4. A nurse is obtaining a history for a client who has major depressive disorder.
Which of the following findings should the nurse identify?
- Family history of obsessive compulsive disorder
- Attends weekly religious services
- Schedules monthly appointments with a health care provider
- Recent move across the country to look for work
**Answer:** Recent move across the country to look for work.
**Rationale:** Loss of employment and isolation are risk factors for depression.
5. A nurse is assessing a 2-year-old toddler at a well-child visit. For which of the
following findings should the nurse refer the toddler for an evaluation for ASD?
- Reluctance to make eye contact
- Plays alongside but not with other children
- Speaks using only two- to three-word phrases
- Displays temper tantrums
**Answer:** Reluctance to make eye contact.
**Rationale:** Reluctance to make eye contact is a key indicator of autism
spectrum disorder (ASD) in toddlers.
6. A nurse is caring for a client who is experiencing a postpartum hemorrhage.
Which of the following medications should the nurse plan to administer?
- Methylergonovine
- Magnesium sulfate
- Terbutaline
- Betamethasone
**Answer:** Methylergonovine.
**Rationale:** Causes contraction of the uterine muscle, which decreases
bleeding.
, 7. A nurse at a crisis center is meeting with a client who reports that his
adolescent daughter has been increasingly defiant since the divorce 2 years ago.
The client states, "I'm so stressed that I can't take this anymore." Which of the
following actions should the nurse take first?
- Refer the client and his daughter for family therapy.
- Recommend that the client attend a support group for guardians of
adolescents.
- Identify the client's current coping strategies.
- Teach the client stress-reduction techniques.
**Answer:** Identify the client's current coping strategies.
**Rationale:** Assessing current strategies provides a foundation for additional
support.
8. A nurse is performing a skin assessment for a client who has a history of
melanoma. Which of the following findings should the nurse expect?
- A nodular lesion with ulceration
- An irregularly shaped, colored papule
- A pearly papule with a waxy border
- A dry, scaly macule
**Answer:** An irregularly shaped, colored papule.
**Rationale:** Irregularly shaped with various colors (blue, white, red);
malignant and can occur anywhere on the body.
9. A nurse is reviewing the laboratory results for a client who has HELLP
syndrome. Which of the following lab results should the nurse expect?
- Hct 37%
- BUN 15 mg/dL
- Platelet count 150,000/mm³
