1
NCLEX NGN RN EXAM
NCLEX NGN RN EXAM 2 (WITH ALL
QUESTIONS FORMART) NEW ACTUAL
EXAM ALL 150 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH DETAILED
RATIONALES|ALREADY GRADED A+
The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease
about dietary measures to implement during exacerbation episodes. Which statement made
by the client indicates a need for further instruction?
A. "I should increase the fiber in my diet."
B. "I will need to avoid caffeinated beverages."
, 2
NCLEX NGN RN EXAM
C. "I'm going to learn some stress reduction techniques."
D. "I can have exacerbations and remissions with Crohn's disease."
A
Rationale:
Crohn's disease is an inflammatory disease that can occur anywhere in the gastrointestinal
tract but most often affects the terminal ileum and leads to thickening and scarring, a
narrowed lumen, fistulas, ulcerations, and abscesses. It is characterized by exacerbations
and remissions. If stress increases the symptoms of the disease, the client is taught stress
management techniques and may require additional counseling. The client is taught to avoid
gastrointestinal stimulants containing caffeine and to follow a high-calorie and high-protein
diet. A low-fiber diet may be prescribed, especially during periods of exacerbation.
The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that
there is documentation of the presence of asterixis. How should the nurse assess for its
presence?
A. Dorsiflex the client's foot.
B. Measure the abdominal girth.
C. Ask the client to extend the arms.
D. Instruct the client to lean forward.
C
Rationale:
Asterixis is irregular flapping movements of the fingers and wrists when the hands and arms
are outstretched, with the palms down, wrists bent up, and fingers spread. Asterixis is the
most common and reliable sign that hepatic encephalopathy is developing. Options 1, 2, and
4 are incorrect.
, 3
NCLEX NGN RN EXAM
The nurse is reviewing the laboratory results for a client with cirrhosis and notes that the
ammonia level is 85 mcg/dL (51 mcmol/L). Which dietary selection does the nurse suggest to
the client?
A. Roast pork
B. Cheese omelet
C. Pasta with sauce
D. Tuna fish sandwich
C
Rationale:
Cirrhosis is a chronic, progressive disease of the liver characterized by diffuse degeneration
and destruction of hepatocytes. The serum ammonia level assesses the ability of the liver to
deaminate protein byproducts. Normal reference interval is 10 to 80 mcg/dL (6 to 47
mcmol/L). Most of the ammonia in the body is found in the gastrointestinal tract. Protein
provided by the diet is transported to the liver by the portal vein. The liver breaks down
protein, which results in the formation of ammonia. Foods high in protein should be avoided
since the client's ammonia level is elevated above the normal range; therefore, pasta with
sauce would be the best selection.
The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To
determine whether the problem is currently active, the nurse should assess the client for
which manifestation of duodenal ulcer?
A. Weight loss
B. Nausea and vomiting
C. Pain relieved by food intake
D. Pain radiating down the right arm
C
Rationale:
, 4
NCLEX NGN RN EXAM
A frequent symptom of duodenal ulcer is pain that is relieved by food intake. These clients
generally describe the pain as a burning, heavy, sharp, or "hungry" pain that often localizes
in the midepigastric area. The client with duodenal ulcer usually does not experience weight
loss or nausea and vomiting. These symptoms are more typical in the client with a gastric
ulcer.
A client with hiatal hernia chronically experiences heartburn following meals. The nurse
should plan to teach the client to avoid which action because it is contraindicated with a
hiatal hernia?
A. Lying recumbent following meals
B. Consuming small, frequent, bland meals
C. Taking H2-receptor antagonist medication
D. Raising the head of the bed on 6-inch (15 cm) blocks
A
Rationale:
Hiatal hernia is caused by a protrusion of a portion of the stomach above the diaphragm
where the esophagus usually is positioned. The client usually experiences pain from reflux
caused by ingestion of irritating foods, lying flat following meals or at night, and eating large
or fatty meals. Relief is obtained with the intake of small, frequent, and bland meals; use of
H2-receptor antagonists and antacids; and elevation of the thorax following meals and
during sleep
The nurse is providing care for a client with a recent transverse colostomy. Which
observation requires immediate notification of the primary health care provider?
A. Stoma is beefy red and shiny
B. Purple discoloration of the stoma
C. Skin excoriation around the stoma
D. Semiformed stool noted in the ostomy pouch
B
NCLEX NGN RN EXAM
NCLEX NGN RN EXAM 2 (WITH ALL
QUESTIONS FORMART) NEW ACTUAL
EXAM ALL 150 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH DETAILED
RATIONALES|ALREADY GRADED A+
The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease
about dietary measures to implement during exacerbation episodes. Which statement made
by the client indicates a need for further instruction?
A. "I should increase the fiber in my diet."
B. "I will need to avoid caffeinated beverages."
, 2
NCLEX NGN RN EXAM
C. "I'm going to learn some stress reduction techniques."
D. "I can have exacerbations and remissions with Crohn's disease."
A
Rationale:
Crohn's disease is an inflammatory disease that can occur anywhere in the gastrointestinal
tract but most often affects the terminal ileum and leads to thickening and scarring, a
narrowed lumen, fistulas, ulcerations, and abscesses. It is characterized by exacerbations
and remissions. If stress increases the symptoms of the disease, the client is taught stress
management techniques and may require additional counseling. The client is taught to avoid
gastrointestinal stimulants containing caffeine and to follow a high-calorie and high-protein
diet. A low-fiber diet may be prescribed, especially during periods of exacerbation.
The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that
there is documentation of the presence of asterixis. How should the nurse assess for its
presence?
A. Dorsiflex the client's foot.
B. Measure the abdominal girth.
C. Ask the client to extend the arms.
D. Instruct the client to lean forward.
C
Rationale:
Asterixis is irregular flapping movements of the fingers and wrists when the hands and arms
are outstretched, with the palms down, wrists bent up, and fingers spread. Asterixis is the
most common and reliable sign that hepatic encephalopathy is developing. Options 1, 2, and
4 are incorrect.
, 3
NCLEX NGN RN EXAM
The nurse is reviewing the laboratory results for a client with cirrhosis and notes that the
ammonia level is 85 mcg/dL (51 mcmol/L). Which dietary selection does the nurse suggest to
the client?
A. Roast pork
B. Cheese omelet
C. Pasta with sauce
D. Tuna fish sandwich
C
Rationale:
Cirrhosis is a chronic, progressive disease of the liver characterized by diffuse degeneration
and destruction of hepatocytes. The serum ammonia level assesses the ability of the liver to
deaminate protein byproducts. Normal reference interval is 10 to 80 mcg/dL (6 to 47
mcmol/L). Most of the ammonia in the body is found in the gastrointestinal tract. Protein
provided by the diet is transported to the liver by the portal vein. The liver breaks down
protein, which results in the formation of ammonia. Foods high in protein should be avoided
since the client's ammonia level is elevated above the normal range; therefore, pasta with
sauce would be the best selection.
The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To
determine whether the problem is currently active, the nurse should assess the client for
which manifestation of duodenal ulcer?
A. Weight loss
B. Nausea and vomiting
C. Pain relieved by food intake
D. Pain radiating down the right arm
C
Rationale:
, 4
NCLEX NGN RN EXAM
A frequent symptom of duodenal ulcer is pain that is relieved by food intake. These clients
generally describe the pain as a burning, heavy, sharp, or "hungry" pain that often localizes
in the midepigastric area. The client with duodenal ulcer usually does not experience weight
loss or nausea and vomiting. These symptoms are more typical in the client with a gastric
ulcer.
A client with hiatal hernia chronically experiences heartburn following meals. The nurse
should plan to teach the client to avoid which action because it is contraindicated with a
hiatal hernia?
A. Lying recumbent following meals
B. Consuming small, frequent, bland meals
C. Taking H2-receptor antagonist medication
D. Raising the head of the bed on 6-inch (15 cm) blocks
A
Rationale:
Hiatal hernia is caused by a protrusion of a portion of the stomach above the diaphragm
where the esophagus usually is positioned. The client usually experiences pain from reflux
caused by ingestion of irritating foods, lying flat following meals or at night, and eating large
or fatty meals. Relief is obtained with the intake of small, frequent, and bland meals; use of
H2-receptor antagonists and antacids; and elevation of the thorax following meals and
during sleep
The nurse is providing care for a client with a recent transverse colostomy. Which
observation requires immediate notification of the primary health care provider?
A. Stoma is beefy red and shiny
B. Purple discoloration of the stoma
C. Skin excoriation around the stoma
D. Semiformed stool noted in the ostomy pouch
B
