4/3/25, 6:17 NGN Case Study |
PM
NGN CASE STUDY EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED
Assessment findings:
Cardiac – Patient 1 Cardiovascular: Sinus tachycardia with occasional
premature ventricular contractions (PVCs). No
Client was brought to the emergency murmur noted
department by his son with reports of Respiratory: Tachypnea, inspiratory crackles
difficulty breathing and inability to walk auscultated throughout bilateral lung
short distances without becoming fields, dyspnea with mild exertion,
extremely short of breath. Client is a orthopnea,
72- year-old African American man nonproductive chronic cough
with a history of obesity, hypertension, Gastrointestinal: Positive bowel sounds
coronary artery disease, and diabetes Genitourinary: Clear yellow urine, urinary
mellitus. frequency, and nocturia
Client reports fatigue related to difficulty Peripheral: +4 pitting edema in bilateral lower
sleeping at night as a result of a extremities
nonproductive cough that is unresolved Vital signs:
with cough drops. Temperature: 98.6°F (37°C)Heart rate: 120
Client reports a weight gain of 10 beats/minRespiratory rate: 26 breaths/minBlood
pounds in the past week, despite his pressure: 152/90 mm HgPulse oximetry reading
decreased of 93%
appetite.
The son reports that his father has Imaging Studies
been unable to care for himself as a Electrocardiogram (ECG) reveals ventricular
result of the fatigue and increasing hypertrophy
shortness of Chest x-ray reveals cardiomegaly
breath. He states “he has not showered in Echocardiogram results pending
over a week.”
1/17
,4/3/25, 6:17 NGN Case Study |
PM
2/17
, 4/3/25, 6:17 NGN Case Study |
PM
Potential Conditions
HF
The nurse is preparing a plan of care for
the client. Based on the information
Anticipated Meds
provided, choose the potential condition
furosemide
with anticipated medication and side
nitroglycerin
effect from the list of options provided.
SEs to monitor
Potential Conditions
hypokalemia
gastroparesis
hypotension
acute renal
failure HF
Rationale:
hypothyroidism
Heart failure is a chronic condition when the heart does not effectively work as a
pump. This condition is evident by tachycardia, orthopnea, fatigue, edema, fluid
Anticipated Meds
overload, and elevated BNP levels. Furosemide is a loop diuretic prescribed to
finasteride
treat heart failure. It is potassium wasting so the nurse should monitor for
furosemide
hypokalemia. Nitroglycerin is a vasodilator prescribed to decrease the volume of
docusate sodium
blood return to the heart. Because it causes a decrease in blood pressure,
nitroglycerin
the
levothyroxine
nurse should monitor for hypotension. Gastroparesis is a complication caused by
decreased stimulation and peristalsis in the stomach. Acute renal failure is a
SEs to monitor
temporary decrease in renal function that causes elevated serum waste
hypokalemia
products. Hypothyroidism is a decrease in the thyroid hormone production
hypoglycemia
causing weight gain and muscle weakness. Levothyroxine is a medication that
stomatitis
can treat
hypotension
hypothyroidism. Finasteride is a medication given to decrease an enlarged
nausea
prostate, not treat heart failure. Docusate sodium is a stool softener prescribed
for constipation, not for heart failure. Stomatitis are sores in the mouth often
caused by chemotherapy treatment, not heart failure. Nausea is not a common
side effect of either furosemide of nitroglycerin.
Cardiac – Patient 2 He reports sleeping on two pillows and waking at night one to two times
per week, gasping with difficulty breathing and having to get up during the
A 64-year-old male client has arrived for night to urinate. He has noticed increased irritability and anxiety. Client reports
an appointment at the outpatient clinic joint and back pain in the evenings. He has increasing shortness of breath
because of difficulty breathing and a rash. when he walks more than 30 feet and is concerned about a red scaly rash on
his left lower leg.
History:
Hypertension His body mass index (BMI) is 32 kg/m2. He works as the manager in a retail
Hypothyroidism clothing store. He is divorced and has two adult children and a grandchild who
Depression lives in another state. He lives in an apartment on the second floor.
Erectile dysfunction
Chronic back pain Current vital signs:
Hyperlipidemia Temperature: 99.3° F (37.3° C)
Anterior wall myocardial infarction (MI) at Heart rate: (HR) 118 beats/min
age 44. Up until the MI, he smoked two Blood pressure (BP): 142/90 mm Hg
packs of cigarettes per day for 25 years. Respiratory rate (RR): 30 breaths/min
After the MI, he completed a cardiac Oxygen saturation: 92% on room air
rehabilitation program. His only current
physical activity is walking around at
work.
3/17
PM
NGN CASE STUDY EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED
Assessment findings:
Cardiac – Patient 1 Cardiovascular: Sinus tachycardia with occasional
premature ventricular contractions (PVCs). No
Client was brought to the emergency murmur noted
department by his son with reports of Respiratory: Tachypnea, inspiratory crackles
difficulty breathing and inability to walk auscultated throughout bilateral lung
short distances without becoming fields, dyspnea with mild exertion,
extremely short of breath. Client is a orthopnea,
72- year-old African American man nonproductive chronic cough
with a history of obesity, hypertension, Gastrointestinal: Positive bowel sounds
coronary artery disease, and diabetes Genitourinary: Clear yellow urine, urinary
mellitus. frequency, and nocturia
Client reports fatigue related to difficulty Peripheral: +4 pitting edema in bilateral lower
sleeping at night as a result of a extremities
nonproductive cough that is unresolved Vital signs:
with cough drops. Temperature: 98.6°F (37°C)Heart rate: 120
Client reports a weight gain of 10 beats/minRespiratory rate: 26 breaths/minBlood
pounds in the past week, despite his pressure: 152/90 mm HgPulse oximetry reading
decreased of 93%
appetite.
The son reports that his father has Imaging Studies
been unable to care for himself as a Electrocardiogram (ECG) reveals ventricular
result of the fatigue and increasing hypertrophy
shortness of Chest x-ray reveals cardiomegaly
breath. He states “he has not showered in Echocardiogram results pending
over a week.”
1/17
,4/3/25, 6:17 NGN Case Study |
PM
2/17
, 4/3/25, 6:17 NGN Case Study |
PM
Potential Conditions
HF
The nurse is preparing a plan of care for
the client. Based on the information
Anticipated Meds
provided, choose the potential condition
furosemide
with anticipated medication and side
nitroglycerin
effect from the list of options provided.
SEs to monitor
Potential Conditions
hypokalemia
gastroparesis
hypotension
acute renal
failure HF
Rationale:
hypothyroidism
Heart failure is a chronic condition when the heart does not effectively work as a
pump. This condition is evident by tachycardia, orthopnea, fatigue, edema, fluid
Anticipated Meds
overload, and elevated BNP levels. Furosemide is a loop diuretic prescribed to
finasteride
treat heart failure. It is potassium wasting so the nurse should monitor for
furosemide
hypokalemia. Nitroglycerin is a vasodilator prescribed to decrease the volume of
docusate sodium
blood return to the heart. Because it causes a decrease in blood pressure,
nitroglycerin
the
levothyroxine
nurse should monitor for hypotension. Gastroparesis is a complication caused by
decreased stimulation and peristalsis in the stomach. Acute renal failure is a
SEs to monitor
temporary decrease in renal function that causes elevated serum waste
hypokalemia
products. Hypothyroidism is a decrease in the thyroid hormone production
hypoglycemia
causing weight gain and muscle weakness. Levothyroxine is a medication that
stomatitis
can treat
hypotension
hypothyroidism. Finasteride is a medication given to decrease an enlarged
nausea
prostate, not treat heart failure. Docusate sodium is a stool softener prescribed
for constipation, not for heart failure. Stomatitis are sores in the mouth often
caused by chemotherapy treatment, not heart failure. Nausea is not a common
side effect of either furosemide of nitroglycerin.
Cardiac – Patient 2 He reports sleeping on two pillows and waking at night one to two times
per week, gasping with difficulty breathing and having to get up during the
A 64-year-old male client has arrived for night to urinate. He has noticed increased irritability and anxiety. Client reports
an appointment at the outpatient clinic joint and back pain in the evenings. He has increasing shortness of breath
because of difficulty breathing and a rash. when he walks more than 30 feet and is concerned about a red scaly rash on
his left lower leg.
History:
Hypertension His body mass index (BMI) is 32 kg/m2. He works as the manager in a retail
Hypothyroidism clothing store. He is divorced and has two adult children and a grandchild who
Depression lives in another state. He lives in an apartment on the second floor.
Erectile dysfunction
Chronic back pain Current vital signs:
Hyperlipidemia Temperature: 99.3° F (37.3° C)
Anterior wall myocardial infarction (MI) at Heart rate: (HR) 118 beats/min
age 44. Up until the MI, he smoked two Blood pressure (BP): 142/90 mm Hg
packs of cigarettes per day for 25 years. Respiratory rate (RR): 30 breaths/min
After the MI, he completed a cardiac Oxygen saturation: 92% on room air
rehabilitation program. His only current
physical activity is walking around at
work.
3/17
