RN Comp Practice 2024 Questions with Answers Latest Update
NGN: What assessment findings are consistent with Cohn’s disease, ulcerative colitis, or
peritonitis?
Temperature (100F)
Weight (-9.7 lbs.)
Albumin level (2.4)
WBC (14)
Bowel pattern (freq. loose stools)
Abdominal pain location (RLQ)
Heart rate (105) - correct answers Temperature: Cohn’s, UC & peritonitis.
-Elevation can occur with all three due to inflammation and infection.
Weight: Cohn’s & UC.
-Unintended weight loss can occur due to malabsorption in the GI tract.
Bowel pattern: Cohn’s.
-If the patient reported there was blood in the stool, it would be UC. Cohn’s doesn't cause
tarry stools.
WBC: Cohn’s, UC & peritonitis.
-Elevation can occur due to inflammation and infection.
Heart rate: peritonitis.
-Tachycardia can occur due to inflammation, infection, and dehydration.
Albumin level: Cohn’s & UC.
-Because of the malabsorption in the GI tract, the body isn't receiving enough protein.
Abdominal pain location: Cohn’s.
-Because it is in the RLQ, it is more consistent with Cohn’s. With patients that have
peritonitis, they experience generalized bad. pain that radiates to the shoulder and back.
NGN: What assessment findings can indicate a transfusion reaction in a patient receiving
blood?
Urine output (150mL of clear, yellow)
Skin (pale, cool and dry)
Anxiety
Vital signs (within normal range)
Headache
Back pain - correct answers Back pain, headache & anxiety.
,Hemolytic reaction S/S: back pain, headache, anxiety, fever, chills, chest pain, tachycardia,
dyspnea, and hypotension.
NGN: Patient arrives with palpitations, difficulty breathing, and reports feeling faint.
Reports constipation and joint pain for x2 days. In childhood, patient experienced physical
abuse, and emotionally detached parents. Reports nervousness and only leaving home
when necessary.
PMH: freq. hospital visits due to headaches and GI distress.
Bowtie: - correct answers Condition: somatic symptom disorder
-due to physical inactivity & joint pain
Interventions: Monitor physical manifestations & assess for presence of 2nd gains from
their illness
-disorder is characterized by the presence of other real manifestations like dizziness,
nausea, back pain, and joint pain.
Monitor: Vital signs & pain.
NGN: What actions should the nurse take when her Pedi patient is exhibiting symptoms of
an allergic reaction?
Administer 0.9% NS IV
Administer epic IM
Monitor urine output q2hrs
DC supplemental oxygen
Monitor vital signs frequently
DC IV medication - correct answers Administer 0.9% NS IV
Administer epic IM
Monitor vital signs frequently
DC IV medication
-Nurse should DC the Rocephin and give IV NS to help restore fluids because fluid shifts can
occur quickly during a reaction. Administering epic IM is the first line of therapy for
anaphylactic reactions because it constricts blood vessels and dilates bronchioles.
Monitoring vital sings frequently will allow the nurse to monitor for signs of shock.
NGN: What 5 actions should the nurse plan to take with a patient experiencing
hallucinations, following alcohol withdrawal?
Administer thiamine
Maintain a low-stimulation environment
Administer chlordiazepoxide
Initiate seizure precautions
Perform a CIWA-AR
,Administer disulfiram - correct answers Administer thiamine
Maintain a low-stimulation environment
Administer chlordiazepoxide
Initiate seizure precautions
Perform a CIWA-AR
-Nurse should plan interventions that keep the patient safe and treat the physical
manifestations of withdrawal. Use the CIWA-AR to determine the severity of the
withdrawal. Withdrawal seizures can occur 12-24hrs after cessation of alcohol use;
therefore initiate seizure precautions to prevent injury. Administer chlordiazepoxide (a
benzodiazepine) and place patient in a low-stem environment to decrease agitation and the
risk for seizures. Administering thiamine can prevent Wernicke syndrome.
NGN: A post-op patient is experiencing right lower extremity pain and itching, following an
emergent apply. Reports right lower extremity pain that has been intermittent for x2
months.
Assessment: Billet lower extremities warm to touch, pedal pulses 2+ billet. Spider veins
noted. Distended veins noted on right lower extremity. Vital signs are within normal limits.
Bowtie: - correct answers Condition: Varicose veins.
-due to edema & pruritus
Interventions: Elevate extremity & apply compression stockings
-to promote venous return & circulation
Monitor: Pruritus & edema
NGN: Which assessment findings require an immediate follow-up in a schizophrenic
patient?
Hyperactive bowel sounds x4
Last HCP appointment was 6 months ago
Client AO x2
Agitated
Speech disorganized
Involuntary tongue movement and foot tremor
Increase in urination and one episode of incontinence
Family c/o increased agitation and delusions - correct answers Involuntary tongue
movement and foot tremor
Frequent urination and incontinence
Increase in agitation
-Patient is experiencing tardive dyskinesia
, A home health nurse is evaluation a school-age child who has cystic fibrosis. The nurse
should initiate a request for a high-frequency chest compression vest in response to which
of the following parent statements?
A. "My child doesn't like to sit still for nebulizer treatments."
B. "I think that my child has been running a fever over the last couple of days."
C. "My child only has a small amount of mucus after percussion therapy."
D. "I am concerned about my child's future participation in team sports." - correct answers
C. "My child has only a small amount of mucus after percussion therapy."
-The nurse should recommend a high-frequency vest for a child who has inadequate results
from other airway clearance therapy techniques. Older children often require other
techniques in addition to percussion and postural drainage to achieve adequate mucus
expectoration.
-The nurse should teach the parent techniques for administration for nebulizer treatments
to the child.
-The nurse should follow-up on reports of fever, as this could indicate a pulmonary
infection.
-The nurse should discuss participation in sports activities in relation to the child's current
physical and pulmonary health.
NGN: A patient, who is x2 post-op, following a surgical repair of a left hip fracture, is c/o of
intermittent abdominal pain. Rates 5/10 on left side of abdomen. Pain began after eating
dinner. Last bowel movement was 5 days prior. Reports usual pattern is x1 daily.
Assessment: Abdomen distended, dull to percussion, firm and non-tender on palpation.
Hypoactive bowel sounds x4. Vital signs are within normal limits.
Bowtie: - correct answers Condition: Intestinal obstruction
-bowel sounds hypoactive x4, last BM was 5 days prior, intermittent to constant pain.
Interventions: Assist patient in semi-Fowler & prepare to administer IV fluids.
-to relieve the pressure from the distention and reduce risk of developing fluid/electrolyte
imbalance.
Monitor: Bowel sounds & urine output.
A nurse is caring for a patient who has a new prescription for clonidine. The nurse should
inform the patient that which of the following findings is an adverse effect of this
medication?
A. Diarrhea
B. Dry mouth
NGN: What assessment findings are consistent with Cohn’s disease, ulcerative colitis, or
peritonitis?
Temperature (100F)
Weight (-9.7 lbs.)
Albumin level (2.4)
WBC (14)
Bowel pattern (freq. loose stools)
Abdominal pain location (RLQ)
Heart rate (105) - correct answers Temperature: Cohn’s, UC & peritonitis.
-Elevation can occur with all three due to inflammation and infection.
Weight: Cohn’s & UC.
-Unintended weight loss can occur due to malabsorption in the GI tract.
Bowel pattern: Cohn’s.
-If the patient reported there was blood in the stool, it would be UC. Cohn’s doesn't cause
tarry stools.
WBC: Cohn’s, UC & peritonitis.
-Elevation can occur due to inflammation and infection.
Heart rate: peritonitis.
-Tachycardia can occur due to inflammation, infection, and dehydration.
Albumin level: Cohn’s & UC.
-Because of the malabsorption in the GI tract, the body isn't receiving enough protein.
Abdominal pain location: Cohn’s.
-Because it is in the RLQ, it is more consistent with Cohn’s. With patients that have
peritonitis, they experience generalized bad. pain that radiates to the shoulder and back.
NGN: What assessment findings can indicate a transfusion reaction in a patient receiving
blood?
Urine output (150mL of clear, yellow)
Skin (pale, cool and dry)
Anxiety
Vital signs (within normal range)
Headache
Back pain - correct answers Back pain, headache & anxiety.
,Hemolytic reaction S/S: back pain, headache, anxiety, fever, chills, chest pain, tachycardia,
dyspnea, and hypotension.
NGN: Patient arrives with palpitations, difficulty breathing, and reports feeling faint.
Reports constipation and joint pain for x2 days. In childhood, patient experienced physical
abuse, and emotionally detached parents. Reports nervousness and only leaving home
when necessary.
PMH: freq. hospital visits due to headaches and GI distress.
Bowtie: - correct answers Condition: somatic symptom disorder
-due to physical inactivity & joint pain
Interventions: Monitor physical manifestations & assess for presence of 2nd gains from
their illness
-disorder is characterized by the presence of other real manifestations like dizziness,
nausea, back pain, and joint pain.
Monitor: Vital signs & pain.
NGN: What actions should the nurse take when her Pedi patient is exhibiting symptoms of
an allergic reaction?
Administer 0.9% NS IV
Administer epic IM
Monitor urine output q2hrs
DC supplemental oxygen
Monitor vital signs frequently
DC IV medication - correct answers Administer 0.9% NS IV
Administer epic IM
Monitor vital signs frequently
DC IV medication
-Nurse should DC the Rocephin and give IV NS to help restore fluids because fluid shifts can
occur quickly during a reaction. Administering epic IM is the first line of therapy for
anaphylactic reactions because it constricts blood vessels and dilates bronchioles.
Monitoring vital sings frequently will allow the nurse to monitor for signs of shock.
NGN: What 5 actions should the nurse plan to take with a patient experiencing
hallucinations, following alcohol withdrawal?
Administer thiamine
Maintain a low-stimulation environment
Administer chlordiazepoxide
Initiate seizure precautions
Perform a CIWA-AR
,Administer disulfiram - correct answers Administer thiamine
Maintain a low-stimulation environment
Administer chlordiazepoxide
Initiate seizure precautions
Perform a CIWA-AR
-Nurse should plan interventions that keep the patient safe and treat the physical
manifestations of withdrawal. Use the CIWA-AR to determine the severity of the
withdrawal. Withdrawal seizures can occur 12-24hrs after cessation of alcohol use;
therefore initiate seizure precautions to prevent injury. Administer chlordiazepoxide (a
benzodiazepine) and place patient in a low-stem environment to decrease agitation and the
risk for seizures. Administering thiamine can prevent Wernicke syndrome.
NGN: A post-op patient is experiencing right lower extremity pain and itching, following an
emergent apply. Reports right lower extremity pain that has been intermittent for x2
months.
Assessment: Billet lower extremities warm to touch, pedal pulses 2+ billet. Spider veins
noted. Distended veins noted on right lower extremity. Vital signs are within normal limits.
Bowtie: - correct answers Condition: Varicose veins.
-due to edema & pruritus
Interventions: Elevate extremity & apply compression stockings
-to promote venous return & circulation
Monitor: Pruritus & edema
NGN: Which assessment findings require an immediate follow-up in a schizophrenic
patient?
Hyperactive bowel sounds x4
Last HCP appointment was 6 months ago
Client AO x2
Agitated
Speech disorganized
Involuntary tongue movement and foot tremor
Increase in urination and one episode of incontinence
Family c/o increased agitation and delusions - correct answers Involuntary tongue
movement and foot tremor
Frequent urination and incontinence
Increase in agitation
-Patient is experiencing tardive dyskinesia
, A home health nurse is evaluation a school-age child who has cystic fibrosis. The nurse
should initiate a request for a high-frequency chest compression vest in response to which
of the following parent statements?
A. "My child doesn't like to sit still for nebulizer treatments."
B. "I think that my child has been running a fever over the last couple of days."
C. "My child only has a small amount of mucus after percussion therapy."
D. "I am concerned about my child's future participation in team sports." - correct answers
C. "My child has only a small amount of mucus after percussion therapy."
-The nurse should recommend a high-frequency vest for a child who has inadequate results
from other airway clearance therapy techniques. Older children often require other
techniques in addition to percussion and postural drainage to achieve adequate mucus
expectoration.
-The nurse should teach the parent techniques for administration for nebulizer treatments
to the child.
-The nurse should follow-up on reports of fever, as this could indicate a pulmonary
infection.
-The nurse should discuss participation in sports activities in relation to the child's current
physical and pulmonary health.
NGN: A patient, who is x2 post-op, following a surgical repair of a left hip fracture, is c/o of
intermittent abdominal pain. Rates 5/10 on left side of abdomen. Pain began after eating
dinner. Last bowel movement was 5 days prior. Reports usual pattern is x1 daily.
Assessment: Abdomen distended, dull to percussion, firm and non-tender on palpation.
Hypoactive bowel sounds x4. Vital signs are within normal limits.
Bowtie: - correct answers Condition: Intestinal obstruction
-bowel sounds hypoactive x4, last BM was 5 days prior, intermittent to constant pain.
Interventions: Assist patient in semi-Fowler & prepare to administer IV fluids.
-to relieve the pressure from the distention and reduce risk of developing fluid/electrolyte
imbalance.
Monitor: Bowel sounds & urine output.
A nurse is caring for a patient who has a new prescription for clonidine. The nurse should
inform the patient that which of the following findings is an adverse effect of this
medication?
A. Diarrhea
B. Dry mouth
