NGN NCLEX PN ACTUAL EXAM WITH NGN /PN NCLEX ACTUAL
EXAM (NEXT GENERATION) COMPLETE 200 QUESTIONS AND
CORRECT DETAILED ANSWERS
A client is shifted to the recovery unit after amputation of the left leg. Which of the
following is the priority nursing action in the immediate postoperative period?
A. Monitor Vital Signs
B. Assess the proximal pulse at the amputated part
C. Keep a surgical tourniquet t the bedside
D. Administer IV fluids - ANSWER: C. Keep a surgical tourniquet t the bedside
Rationale: Hemorrhage is the most concerning primary immediate complication of
amputation. Therefore, a surgical tourniquet is kept at the bedside in case of acute
bleeding.
The practical nurse knows that human papillomavirus infection (HPV) can lead to:
A. Cervical cancer
B. Infertility
C. Pelvic inflammatory disease (PID)
D. Rectal cancer - ANSWER: A. Cervical cancer
Rationale: HPV can lead to cervical cancer due to changes of the cervix from the
genital warts. There is no known connection between HPV and infertility, PID, or
rectal cancer.
The nurse is to apply an Ace wrap to the client's right lower leg. Which action should
the nurse take to ensure that the dressing is not too tight:
A. Remove it every hour and reapply
B. Check the pedal pulses
C. Obtain a Doppler study to determine circulation
D. Allow the wrap to remain in place for a minimum of 24 hours - ANSWER: B. Check
the pedal pulses
Rationale: To ensure that the Ace wrap is not too tight, the nurse should check the
pulse, color, and temperature of the extremity.
A doctor is preparing to remove a chest tube from a client. Before removing the
tube, the nurse should instruct the client to:
A. Breathe normally
B. Hold breathe and bear down
C. Take a deep breath
D. Cough on demand - ANSWER: B. Hold breathe and bear down
Rationale: The client should be asked to hold breathe and bear down which
prevents changes in pressure until an occlusive dressing is applied.
A client admitted to the floor 3 days ago after a bowel resection suddenly develops
chest pain and shortness of breath. Assessment of the client reveals rales, BP
160/40, and severe tachycardia. The nurse's first action should be to:
,A. Apply 02 at 2L/minute via mask
B. Begin CPR
C. Place the client in high Flower's position
D. Administer a prescribed sedative - ANSWER: C. Place the client in high Flower's
position
Rationale: The client during the post-operative period with a widening pulse
pressure, SOB, and rales may have a pulmonary emboli. To facilitate breathing, he
should be placed in high Flowler's position. Oxygen would the be applied.
The nurse is caring for a pt. with a urinary catheter. The nurse should do which of the
following to prevent a urinary tract infection? (select all that apply)
A. Provide perineal care each day and after each bowel movement
B. Change the catheter every day
C. Encourage the pt. to drink fluids
D. Ask the physician to prescribe prophylactic antibiotics
E. Assess the pt. every shift for signs of infection - ANSWER: A. Provide perineal care
each day and after each bowel movement
C. Encourage the pt. to drink fluids
E. Assess the pt. every shift for signs of infection
The nurse is caring for a pt. with Raynaud's phenomenon. The nurse should
emphasize that the pt. can reduce symptoms of this disease by:
A. Increase coffee to three cups each day
B. Keeping the house at 68 degrees F.
C. Wearing gloves when handling frozen foods
D. Running cold water over her hands during an episode - ANSWER: C. Wearing
gloves when handling frozen foods
Rationale: Raynaud's phenomenon is characterized by vasospasm caused by
extreme changes in temperature. Wearing gloves when handing cold caused by
extreme changes in temperature. Wearing gloves when handing cold foods can
help prevent the problem. This phenomenon is exacerbated by caffeine so the pt.
should not increase caffeine intake. A house temperature of 68 degrees F is likely
to increase vasospasm. During a vasospastic incident, the pt. can run warm water
over her hands.
A woman in labor has been pushing for one hour and is not making progress. Which
of the following conditions could be hindering the descent of the fetus in the second
stage of labor?
A. A full bladder
B. A paracervical block administered during the first stage of labor
C. Mother lying in a side-lying position
D. Fetus in left occiput anterior position - ANSWER: A. A full bladder
During a one-to-one conversation with a nurse, a client says, "I'm worried about my
medication.'' The nurse replies, "Tell me more about that." The nurse's response is
an example of:
A. Focusing
,B. Clarifying
C. Reflecting
D. Refocusing - ANSWER: A. Focusing
You are caring for a child with cerebral palsy. You notice that the child's movements
are very stiff, and it is very difficult for him to move his joints. What types of cerebral
palsy does this child exhibit?
A. Spastic cerebral palsy
B. Ataxic cerebral palsy
C. Athetoid cerebral palsy
D. Coritcate cerebral palsy - ANSWER: A. Spastic cerebral palsy
Rationale: Spastic cerebral palsy causes stiffness and movement difficulties. Athetoid
cerebral palsy leads to involuntary and uncontrolled movements. Ataxic cerebral
palsy causes a disturbed sense of balance and depth perception.
The nurse is caring for a patient with multiple sclerosis. Which of the following
symptoms is NOT indicative of the disease?
A. Muscle weakness
B. Trouble with coordination and balance
C. Thinking and memory problems
D. Hearing Loss - ANSWER: D. Hearing Loss
Rationale: Hearing Loss. Common symptoms of MS include fatigue, weakness,
spasticity, balance problems, bladder and bowel problems, numbness,
thinking/memoray problems, vision loss, tremors and depression.
A patient is diagnosed with acute pancreatitis. Which of the following is the best
choice for pain control?
A. Morphine
B. Ibuprofen
C. Fentanyl
D. Demerol - ANSWER: D. Demerol
Rationale: Pain in acute pancreatitis is caused by irritation and edema of the
inflamed pancreas as well as spasm due to obstruction of the pancreatic ducts.
Demerol is the drug of choice because it is less likely to cause spasm of the Sphincter
of Oddi unlike Morphine which is spasmogenic.
A patient has recently been diagnosed with a peptic ulcer. Upon reviewing lab data,
the nurse notices that the patient's Helicobacter pylori titer is elevated. Which of the
following would indicate the best understanding of the data?
A. Treatment will be to continue to assess and monitor Helicobacter pylori titers
B. Treatment involves educating the patient to avoid solid foods
C. Treatment will consist of Ranitidine and Antibiotics
D. Treatment will involve surgical intervention - ANSWER: C. Treatment will consist
of Ranitidine and Antibiotics
Rationale: One of the causes of peptic ulcer is H. Pylori infection. It releases toxin
that destroys the gastric and duodenal mucosa which decreases the gastric
epithelium's resistance to acid digestion. Giving antibiotics will control the infection
, and Ranitidine, which is a histamine-2 blocker, will reduce acid secretion that can
lead to an ulcer.
A client with congestive heart failure is being discharged home on a diet restricting
sodium to 2000 milligrams per day. The client demonstrates adequate knowledge of
the discharge instructions by avoiding which of the following foods?
A. Plain nuts
B. Canned sardines
C. Spinach
D. Whole milk - ANSWER: B. Canned sardines
Rationale: Canned sardines have the highest sodium content.
A symptom that a client is developing a complication of heart failure is:
A.Increased weight gain
B. Development of ascites
C. Restless and confusion
D. Increased liver enzymes - ANSWER: D. Increased liver enzymes
Rationale: All of the symptoms mentioned are found in heart failure; however
increased liver enzymes indicate congestion in the heart has reached the liver.
A patient presents with complaints of generally not feeling well for 2 weeks, fatigue
and occasional dizziness. The patient is placed on a cardiac monitor which shows a
regular ventricular rate of 33 and more P waves than QRS complexes that do not
seem to be associated. The patient is most likely experiencing:
A. 1st degree heart block
B. Sinus bradycardia
C. 3rd degree heart block
D. Junctional rhythm - ANSWER: C. 3rd degree heart block
Rationale: In 3rd degree heart block there are more P waves than QRS complexes
and there is no association between the P waves (atrial contraction) and QRS
complexes (ventricular contraction).
Which situation necessitates the use of restraints on a client?
A. Insufficient staffing on the unit
B. The client is confused and combative
C. Family request to make sure client is safe
D. Medical evaluation and written provider orders - ANSWER: D. Medical evaluation
and written provider orders
Rationale: A medical evaluation and written healthcare provider orders that are
timed and dated as per agency policy is required for the use of restraints.
A client experiences an episode of pulmonary edema because the nurse forgot to
administer the morning dose of furosemide (Lasix). Which legal element can the
nurse be charged with?
A. Assault
B. Slander
C. Negligence
EXAM (NEXT GENERATION) COMPLETE 200 QUESTIONS AND
CORRECT DETAILED ANSWERS
A client is shifted to the recovery unit after amputation of the left leg. Which of the
following is the priority nursing action in the immediate postoperative period?
A. Monitor Vital Signs
B. Assess the proximal pulse at the amputated part
C. Keep a surgical tourniquet t the bedside
D. Administer IV fluids - ANSWER: C. Keep a surgical tourniquet t the bedside
Rationale: Hemorrhage is the most concerning primary immediate complication of
amputation. Therefore, a surgical tourniquet is kept at the bedside in case of acute
bleeding.
The practical nurse knows that human papillomavirus infection (HPV) can lead to:
A. Cervical cancer
B. Infertility
C. Pelvic inflammatory disease (PID)
D. Rectal cancer - ANSWER: A. Cervical cancer
Rationale: HPV can lead to cervical cancer due to changes of the cervix from the
genital warts. There is no known connection between HPV and infertility, PID, or
rectal cancer.
The nurse is to apply an Ace wrap to the client's right lower leg. Which action should
the nurse take to ensure that the dressing is not too tight:
A. Remove it every hour and reapply
B. Check the pedal pulses
C. Obtain a Doppler study to determine circulation
D. Allow the wrap to remain in place for a minimum of 24 hours - ANSWER: B. Check
the pedal pulses
Rationale: To ensure that the Ace wrap is not too tight, the nurse should check the
pulse, color, and temperature of the extremity.
A doctor is preparing to remove a chest tube from a client. Before removing the
tube, the nurse should instruct the client to:
A. Breathe normally
B. Hold breathe and bear down
C. Take a deep breath
D. Cough on demand - ANSWER: B. Hold breathe and bear down
Rationale: The client should be asked to hold breathe and bear down which
prevents changes in pressure until an occlusive dressing is applied.
A client admitted to the floor 3 days ago after a bowel resection suddenly develops
chest pain and shortness of breath. Assessment of the client reveals rales, BP
160/40, and severe tachycardia. The nurse's first action should be to:
,A. Apply 02 at 2L/minute via mask
B. Begin CPR
C. Place the client in high Flower's position
D. Administer a prescribed sedative - ANSWER: C. Place the client in high Flower's
position
Rationale: The client during the post-operative period with a widening pulse
pressure, SOB, and rales may have a pulmonary emboli. To facilitate breathing, he
should be placed in high Flowler's position. Oxygen would the be applied.
The nurse is caring for a pt. with a urinary catheter. The nurse should do which of the
following to prevent a urinary tract infection? (select all that apply)
A. Provide perineal care each day and after each bowel movement
B. Change the catheter every day
C. Encourage the pt. to drink fluids
D. Ask the physician to prescribe prophylactic antibiotics
E. Assess the pt. every shift for signs of infection - ANSWER: A. Provide perineal care
each day and after each bowel movement
C. Encourage the pt. to drink fluids
E. Assess the pt. every shift for signs of infection
The nurse is caring for a pt. with Raynaud's phenomenon. The nurse should
emphasize that the pt. can reduce symptoms of this disease by:
A. Increase coffee to three cups each day
B. Keeping the house at 68 degrees F.
C. Wearing gloves when handling frozen foods
D. Running cold water over her hands during an episode - ANSWER: C. Wearing
gloves when handling frozen foods
Rationale: Raynaud's phenomenon is characterized by vasospasm caused by
extreme changes in temperature. Wearing gloves when handing cold caused by
extreme changes in temperature. Wearing gloves when handing cold foods can
help prevent the problem. This phenomenon is exacerbated by caffeine so the pt.
should not increase caffeine intake. A house temperature of 68 degrees F is likely
to increase vasospasm. During a vasospastic incident, the pt. can run warm water
over her hands.
A woman in labor has been pushing for one hour and is not making progress. Which
of the following conditions could be hindering the descent of the fetus in the second
stage of labor?
A. A full bladder
B. A paracervical block administered during the first stage of labor
C. Mother lying in a side-lying position
D. Fetus in left occiput anterior position - ANSWER: A. A full bladder
During a one-to-one conversation with a nurse, a client says, "I'm worried about my
medication.'' The nurse replies, "Tell me more about that." The nurse's response is
an example of:
A. Focusing
,B. Clarifying
C. Reflecting
D. Refocusing - ANSWER: A. Focusing
You are caring for a child with cerebral palsy. You notice that the child's movements
are very stiff, and it is very difficult for him to move his joints. What types of cerebral
palsy does this child exhibit?
A. Spastic cerebral palsy
B. Ataxic cerebral palsy
C. Athetoid cerebral palsy
D. Coritcate cerebral palsy - ANSWER: A. Spastic cerebral palsy
Rationale: Spastic cerebral palsy causes stiffness and movement difficulties. Athetoid
cerebral palsy leads to involuntary and uncontrolled movements. Ataxic cerebral
palsy causes a disturbed sense of balance and depth perception.
The nurse is caring for a patient with multiple sclerosis. Which of the following
symptoms is NOT indicative of the disease?
A. Muscle weakness
B. Trouble with coordination and balance
C. Thinking and memory problems
D. Hearing Loss - ANSWER: D. Hearing Loss
Rationale: Hearing Loss. Common symptoms of MS include fatigue, weakness,
spasticity, balance problems, bladder and bowel problems, numbness,
thinking/memoray problems, vision loss, tremors and depression.
A patient is diagnosed with acute pancreatitis. Which of the following is the best
choice for pain control?
A. Morphine
B. Ibuprofen
C. Fentanyl
D. Demerol - ANSWER: D. Demerol
Rationale: Pain in acute pancreatitis is caused by irritation and edema of the
inflamed pancreas as well as spasm due to obstruction of the pancreatic ducts.
Demerol is the drug of choice because it is less likely to cause spasm of the Sphincter
of Oddi unlike Morphine which is spasmogenic.
A patient has recently been diagnosed with a peptic ulcer. Upon reviewing lab data,
the nurse notices that the patient's Helicobacter pylori titer is elevated. Which of the
following would indicate the best understanding of the data?
A. Treatment will be to continue to assess and monitor Helicobacter pylori titers
B. Treatment involves educating the patient to avoid solid foods
C. Treatment will consist of Ranitidine and Antibiotics
D. Treatment will involve surgical intervention - ANSWER: C. Treatment will consist
of Ranitidine and Antibiotics
Rationale: One of the causes of peptic ulcer is H. Pylori infection. It releases toxin
that destroys the gastric and duodenal mucosa which decreases the gastric
epithelium's resistance to acid digestion. Giving antibiotics will control the infection
, and Ranitidine, which is a histamine-2 blocker, will reduce acid secretion that can
lead to an ulcer.
A client with congestive heart failure is being discharged home on a diet restricting
sodium to 2000 milligrams per day. The client demonstrates adequate knowledge of
the discharge instructions by avoiding which of the following foods?
A. Plain nuts
B. Canned sardines
C. Spinach
D. Whole milk - ANSWER: B. Canned sardines
Rationale: Canned sardines have the highest sodium content.
A symptom that a client is developing a complication of heart failure is:
A.Increased weight gain
B. Development of ascites
C. Restless and confusion
D. Increased liver enzymes - ANSWER: D. Increased liver enzymes
Rationale: All of the symptoms mentioned are found in heart failure; however
increased liver enzymes indicate congestion in the heart has reached the liver.
A patient presents with complaints of generally not feeling well for 2 weeks, fatigue
and occasional dizziness. The patient is placed on a cardiac monitor which shows a
regular ventricular rate of 33 and more P waves than QRS complexes that do not
seem to be associated. The patient is most likely experiencing:
A. 1st degree heart block
B. Sinus bradycardia
C. 3rd degree heart block
D. Junctional rhythm - ANSWER: C. 3rd degree heart block
Rationale: In 3rd degree heart block there are more P waves than QRS complexes
and there is no association between the P waves (atrial contraction) and QRS
complexes (ventricular contraction).
Which situation necessitates the use of restraints on a client?
A. Insufficient staffing on the unit
B. The client is confused and combative
C. Family request to make sure client is safe
D. Medical evaluation and written provider orders - ANSWER: D. Medical evaluation
and written provider orders
Rationale: A medical evaluation and written healthcare provider orders that are
timed and dated as per agency policy is required for the use of restraints.
A client experiences an episode of pulmonary edema because the nurse forgot to
administer the morning dose of furosemide (Lasix). Which legal element can the
nurse be charged with?
A. Assault
B. Slander
C. Negligence
