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QUESTION 1 (Single Choice, NGN Clinical Judgment)
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An adult woman with a history of inferior myocardial infarction (MI), esophageal reflux, and type 1
diabetes mellitus is admitted to the telemetry unit for sudden onset of dizziness with palpitations and
a burning sensation in her chest. Which intervention should the nurse implement first?
A. Evaluate the telemetry cardiac rhythm
B. Administer an oral antacid
C. Assess blood glucose level
D. Review the client’s last meal choices
CORRECT ANSWER: A. Evaluate the telemetry cardiac rhythm
EXPERT-VERIFIED RATIONALE:
• Priority Setting: Use of the ABCs (Airway, Breathing, Circulation) and the immediate concern for a
possible dysrhythmia in a patient with a past MI.
• Dizziness and palpitations strongly suggest a cardiac etiology. Given her prior inferior MI,
identifying any new arrhythmia or ischemic change on telemetry is critical.
• Although the burning sensation in the chest could indicate reflux and checking her blood glucose is
important (because she is diabetic), the immediate risk of a life-threatening dysrhythmia takes
priority.
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QUESTION 2 (Select All That Apply, NGN Style)
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When conducting diet teaching for a client who was diagnosed with a myocardial infarction, which
snack foods should the nurse encourage the client to eat? (Select all that apply.)
A. Chicken bouillon soup and toast
B. Fresh vegetables with mayonnaise dip
C. Fresh turkey slices and berries
D. Raw unsalted almonds and apples
E. Soda crackers and peanut butter
CORRECT ANSWERS:
,C. Fresh turkey slices and berries
D. Raw unsalted almonds and apples
EXPERT-VERIFIED RATIONALE:
• Post-MI clients should focus on low-fat, low-sodium, and heart-healthy diets.
• Fresh turkey (minimally processed, lean protein) with fruit (berries) fits a heart-healthy pattern.
• Raw, unsalted almonds (healthy fats) with apples (fiber) also align well with diet recommendations.
• Chicken bouillon soup may be high in sodium; mayonnaise dip adds saturated fat. Peanut butter plus
crackers can be acceptable in moderation, but it may contain higher sodium and fats.
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QUESTION 3 (Single Choice)
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A male client who is experiencing musculoskeletal pain is discharged with instructions to take
ibuprofen by mouth twice daily (BID). After receiving discharge teaching, the client states he plans to
take the medication at breakfast and dinner. How should the nurse respond?
A. Review the need to limit intake of leafy, green vegetables such as spinach
B. Confirm that the client has an effective plan for when to take the medication
C. Explain the need to take the medication before meals to increase absorption
D. Remind the client to increase fluid intake while taking the medication
CORRECT ANSWER: B. Confirm that the client has an effective plan for when to take the
medication
EXPERT-VERIFIED RATIONALE:
• Ibuprofen is often prescribed to be taken with food to minimize gastritis or GI discomfort.
• The client’s plan to take ibuprofen with breakfast and dinner is appropriate and consistent with
many instructions for NSAIDs.
• While increasing fluids and limiting certain foods may be relevant, the focus is that the client has a
safe, practical schedule.
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QUESTION 4 (Single Choice, NGN Clinical Judgment/Case Scenario)
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,A client at 28 weeks’ gestation is admitted to the obstetrical unit following involvement in a motor
vehicle collision. After stabilizing the client, the nurse obtains a fetal monitor reading. What action
should the nurse take if fetal tachycardia is assessed on the monitor?
A. Recount the heart rate manually to confirm a monitor malfunction
B. Contact the health care provider after initiating oxygen by face mask
C. Explain that there is no indication the fetal heart rate is due to trauma
D. Evaluate the presence of preterm labor by performing a vaginal examination
CORRECT ANSWER: B. Contact the health care provider after initiating oxygen by face mask
EXPERT-VERIFIED RATIONALE:
• Fetal tachycardia is often a sign of fetal distress/hypoxia.
• Priority is to administer supplemental oxygen to improve fetal oxygenation.
• The next step is to notify the provider for potential interventions.
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QUESTION 5 (Single Choice)
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Four hours after the nurse administers interferon alpha subcutaneously, the client develops headache,
muscle aches, and fever of 101.8°F (38.8°C). What action should the nurse implement?
A. Administer the prescribed PRN dose of acetaminophen for these side effects
B. Explain that an antihistamine may be needed for this allergic reaction
C. Document these findings as an idiosyncratic response to the medication
D. Observe the site where the medication was injected for a local reaction
CORRECT ANSWER: A. Administer the prescribed PRN dose of acetaminophen for these side effects
EXPERT-VERIFIED RATIONALE:
• Flu-like symptoms (fever, headache, muscle aches) are common side effects of interferon alpha.
• Administering acetaminophen helps alleviate these symptoms.
• These symptoms are not necessarily indicative of an allergic reaction.
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QUESTION 6 (Single Choice, NGN Case-Based)
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, The nurse is caring for a client with a suspected diagnosis of osteomyelitis. Which diagnostic test
should the nurse prepare the client to expect the health care provider to prescribe?
A. Radiographs
B. Radionuclide bone scan
C. C-reactive protein (CRP) test
D. Erythrocyte sedimentation rate (ESR)
CORRECT ANSWER: B. Radionuclide bone scan
EXPERT-VERIFIED RATIONALE:
• While X-rays, CRP, and ESR can be used to support the diagnosis, a radionuclide bone scan is highly
sensitive in detecting early osteomyelitis.
• Bone scans can identify areas of high bone metabolism and are often done before changes are visible
on X-ray.
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QUESTION 7 (Single Choice, Psychosocial)
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When the nurse attempts to teach self-administration of insulin to a client newly diagnosed with
type 1 diabetes mellitus, the client shouts for the nurse to leave the room. What action should the
nurse take?
A. Leave the client’s room and return later in the day
B. Explain that insulin is a life-saving drug for the client
C. Encourage the client to implement relaxation techniques
D. Refer the client to a social worker for support therapy
CORRECT ANSWER: A. Leave the client’s room and return later in the day
EXPERT-VERIFIED RATIONALE:
• The client’s response may indicate anger, denial, or feeling overwhelmed.
• It is therapeutic to respect the client’s space, allow time, and attempt teaching later.
• Pressuring the client in the moment could worsen resistance or anxiety.
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QUESTION 8 (Single Choice)
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QUESTION 1 (Single Choice, NGN Clinical Judgment)
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An adult woman with a history of inferior myocardial infarction (MI), esophageal reflux, and type 1
diabetes mellitus is admitted to the telemetry unit for sudden onset of dizziness with palpitations and
a burning sensation in her chest. Which intervention should the nurse implement first?
A. Evaluate the telemetry cardiac rhythm
B. Administer an oral antacid
C. Assess blood glucose level
D. Review the client’s last meal choices
CORRECT ANSWER: A. Evaluate the telemetry cardiac rhythm
EXPERT-VERIFIED RATIONALE:
• Priority Setting: Use of the ABCs (Airway, Breathing, Circulation) and the immediate concern for a
possible dysrhythmia in a patient with a past MI.
• Dizziness and palpitations strongly suggest a cardiac etiology. Given her prior inferior MI,
identifying any new arrhythmia or ischemic change on telemetry is critical.
• Although the burning sensation in the chest could indicate reflux and checking her blood glucose is
important (because she is diabetic), the immediate risk of a life-threatening dysrhythmia takes
priority.
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QUESTION 2 (Select All That Apply, NGN Style)
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When conducting diet teaching for a client who was diagnosed with a myocardial infarction, which
snack foods should the nurse encourage the client to eat? (Select all that apply.)
A. Chicken bouillon soup and toast
B. Fresh vegetables with mayonnaise dip
C. Fresh turkey slices and berries
D. Raw unsalted almonds and apples
E. Soda crackers and peanut butter
CORRECT ANSWERS:
,C. Fresh turkey slices and berries
D. Raw unsalted almonds and apples
EXPERT-VERIFIED RATIONALE:
• Post-MI clients should focus on low-fat, low-sodium, and heart-healthy diets.
• Fresh turkey (minimally processed, lean protein) with fruit (berries) fits a heart-healthy pattern.
• Raw, unsalted almonds (healthy fats) with apples (fiber) also align well with diet recommendations.
• Chicken bouillon soup may be high in sodium; mayonnaise dip adds saturated fat. Peanut butter plus
crackers can be acceptable in moderation, but it may contain higher sodium and fats.
──────────────────────────────────────────
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QUESTION 3 (Single Choice)
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A male client who is experiencing musculoskeletal pain is discharged with instructions to take
ibuprofen by mouth twice daily (BID). After receiving discharge teaching, the client states he plans to
take the medication at breakfast and dinner. How should the nurse respond?
A. Review the need to limit intake of leafy, green vegetables such as spinach
B. Confirm that the client has an effective plan for when to take the medication
C. Explain the need to take the medication before meals to increase absorption
D. Remind the client to increase fluid intake while taking the medication
CORRECT ANSWER: B. Confirm that the client has an effective plan for when to take the
medication
EXPERT-VERIFIED RATIONALE:
• Ibuprofen is often prescribed to be taken with food to minimize gastritis or GI discomfort.
• The client’s plan to take ibuprofen with breakfast and dinner is appropriate and consistent with
many instructions for NSAIDs.
• While increasing fluids and limiting certain foods may be relevant, the focus is that the client has a
safe, practical schedule.
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QUESTION 4 (Single Choice, NGN Clinical Judgment/Case Scenario)
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,A client at 28 weeks’ gestation is admitted to the obstetrical unit following involvement in a motor
vehicle collision. After stabilizing the client, the nurse obtains a fetal monitor reading. What action
should the nurse take if fetal tachycardia is assessed on the monitor?
A. Recount the heart rate manually to confirm a monitor malfunction
B. Contact the health care provider after initiating oxygen by face mask
C. Explain that there is no indication the fetal heart rate is due to trauma
D. Evaluate the presence of preterm labor by performing a vaginal examination
CORRECT ANSWER: B. Contact the health care provider after initiating oxygen by face mask
EXPERT-VERIFIED RATIONALE:
• Fetal tachycardia is often a sign of fetal distress/hypoxia.
• Priority is to administer supplemental oxygen to improve fetal oxygenation.
• The next step is to notify the provider for potential interventions.
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QUESTION 5 (Single Choice)
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Four hours after the nurse administers interferon alpha subcutaneously, the client develops headache,
muscle aches, and fever of 101.8°F (38.8°C). What action should the nurse implement?
A. Administer the prescribed PRN dose of acetaminophen for these side effects
B. Explain that an antihistamine may be needed for this allergic reaction
C. Document these findings as an idiosyncratic response to the medication
D. Observe the site where the medication was injected for a local reaction
CORRECT ANSWER: A. Administer the prescribed PRN dose of acetaminophen for these side effects
EXPERT-VERIFIED RATIONALE:
• Flu-like symptoms (fever, headache, muscle aches) are common side effects of interferon alpha.
• Administering acetaminophen helps alleviate these symptoms.
• These symptoms are not necessarily indicative of an allergic reaction.
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QUESTION 6 (Single Choice, NGN Case-Based)
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, The nurse is caring for a client with a suspected diagnosis of osteomyelitis. Which diagnostic test
should the nurse prepare the client to expect the health care provider to prescribe?
A. Radiographs
B. Radionuclide bone scan
C. C-reactive protein (CRP) test
D. Erythrocyte sedimentation rate (ESR)
CORRECT ANSWER: B. Radionuclide bone scan
EXPERT-VERIFIED RATIONALE:
• While X-rays, CRP, and ESR can be used to support the diagnosis, a radionuclide bone scan is highly
sensitive in detecting early osteomyelitis.
• Bone scans can identify areas of high bone metabolism and are often done before changes are visible
on X-ray.
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QUESTION 7 (Single Choice, Psychosocial)
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When the nurse attempts to teach self-administration of insulin to a client newly diagnosed with
type 1 diabetes mellitus, the client shouts for the nurse to leave the room. What action should the
nurse take?
A. Leave the client’s room and return later in the day
B. Explain that insulin is a life-saving drug for the client
C. Encourage the client to implement relaxation techniques
D. Refer the client to a social worker for support therapy
CORRECT ANSWER: A. Leave the client’s room and return later in the day
EXPERT-VERIFIED RATIONALE:
• The client’s response may indicate anger, denial, or feeling overwhelmed.
• It is therapeutic to respect the client’s space, allow time, and attempt teaching later.
• Pressuring the client in the moment could worsen resistance or anxiety.
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QUESTION 8 (Single Choice)
