NCLEX NGN Tips Practice Questions,

NCLEX NGN Tips & Practice Questions, Answered How to Recognize Cues - To Recognize Cues, carefully review the client's assessment data like developmental age and history to help determine if findings are relevant or of immediate concern to the nurse.

How to Analyze Cues - To Analyze Cues, you are not required to make a medical diagnosis but rather will be expected to connect or link client findings with selected client conditions or health problems, either actual or potential.

How to Generate Solutions - To Generate Solutions to meet a client's priority needs, determine the client's desired or expected outcomes first.

Informational: NGN Case Study - The Unfolding Case Study presents the client

over time through several phases of care in the clinical scenario.

The client may initially be evaluated in an ED, acute care hospital, clinic, school, or urgent care center. As the scenario changes, or "unfolds," new NGN test items require that the candidate use the information in the current phase of the client's care to answer each question. Nursing candidates can expect to have three NGN Case Studies with six questions each. Each of the six questions rep- resents one of the clinical judgment cognitive skills discussed earlier.

A 42-year-old postpartum client who just gave birth to a third child in 4 years reports severe "afterbirth pains" of 9/10 on a 0 to 10 pain intensity scale. The client also reports having problems with getting the baby to latch for breast- feeding/chest-feeding. The nurse assesses that the client has a boggy uterus and is saturating a peri-pad every 20 to 30 minutes.

Rank the following items in order of priority:

Difficulty with breast-feeding/chest-feeding due to inability of baby to latch Severe abdominal pain due to uterine contractions

Excessive post-partum bleeding due to boggy uterus - 1. Excessive postpartum bleeding due to boggy uterus

• Severe abdominal pain due to uterine contractions
• Difficulty with breast-feeding/chest-feeding due to inability of baby to latch

The priority for this client at this time is to manage excessive postpartum bleeding because the client could become hypovolemic and develop shock. In this situation, managing the client's bleeding is more urgent than managing severe pain or breast- feeding/ chest-feeding difficulty to prevent the risk of a life-threatening complication.

A 28-year-old client is brought to the ED by friends, who state that the client became violent this evening in a local bar after a partner "break up." The client accused the partner of "cheating" and pulled out a knife. The client's friends were able to stop the client and take the knife before any harm occurred. They state that they have never seen the client act like this and are worried that something might be seriously wrong. Currently the client seems agitated and restless, and begins pacing in the ED demand- ing to "see my partner right now."

Based on the client information provided, what is the nurse's first action?

• Ask the client's friends to check the client for additional weapons.
• Reassure the client that the client is safe and secure in the ED.
• Call Security for assistance.
• Allow the client to vent own feelings.
• Administer an anti-anxiety medication.
• Distract the client and guide the c - D. Allow the client to vent own feelings.

As with any client who is upset, paranoid, angry, or potentially violent, you would first allow the client to vent feelings, which may help diffuse the situation.Allowing a client to vent and keeping the client and staff safe are the initial focus of nursing care when encountering any client with an actual or potential mental health problem or crisis.

Matrix Multiple Choice Question:

The nurse provides health teaching for a 70-year-old client who had a TKA 3 days ago and is preparing to go home with a daughter.

For each client statement, specify (with an U or N/U) whether the statement indicates understanding or no understanding of the teaching provided.

"I'll call my surgeon if my incision gets red or has drainage." "I can stop taking my blood thinner when I get home." "I'll have physical therapy for about a week." "I'm allowed to bear weight on my right leg." "I can probably drive in a few months." - "I'll call my surgeon if my incision gets red or has drainage." U "I can stop taking my blood thinner when I get home." N/U "I'll have physical therapy for about a week." N/U "I'm allowed to bear weight on my right leg." U "I can probably drive in a few months. U

Multiple Response Select All That Apply An 81-year-old client was admitted to an acute care unit from an assisted-living facility with a low-grade fever and acute confusion. The client's daughter tells the admitting nurse that the client's mother had a stroke 2 years ago that resulted in left hemiparesis and urinary incontinence, and the client has been in the assisted- living facility for the past 5 months. The client has a long history of DM type 2, which has been well controlled. Until this morning, the client's daughter had not been allowed to visit the facility due to the COVID-19 pandemic. During the visit today, the daughter noted that her mother was lethargic, confused, and unable to ambulate with a walker. POC testing in the ED indicated the presence of multiple bacteria in the client's urine and FSBG of 331 mg/dL (18.4 mmol/L). The client's BP is currently 96/48 mm Hg.

The nurse reviews the client assessme - A. Urosepsis

• Delirium
• Dehydration
• Hyperglycemic hyperosmolar syndrome

Rationale: The client's assessment findings indicate that the client likely has a UTI (as evidenced by multiple bacteria in the urine). Fever, acute confusion, and a low BP suggest that the client is dehydrated and may have urosepsis. Acute confusion is also known as delirium, a common assessment finding in older clients who have a UTI. Because the client has type 2 diabetes, the client also is likely experiencing a diabetic complication called hyperglycemic hyperosmolar syndrome. The client's elevated blood glucose and dehydration are consistent with a hyperosmolar state. A low blood pressure is also consistent with dehydration.

Multiple Response Select N The nurse assesses a 53-year-old client whose partner brought the client to the ED with report of acute onset dyspnea and back pain that started about an hour ago.The client's medical history includes DM type 2, obesity, hypertension,

hypercholesteremia, and asthma. The client's admission vital signs include:

Temperature = 98.8°F (37.1°C) HR = 78 BPM and irregular RR = 26 bpm and slightly labored BP=148/90mmHg SpO2 = 95% (on RA)

The nurse reviews the client's assessment data. Select 4 client findings that are relevant and of immediate concern to the nurse.A.Dyspnea

• Back pain
• Temperature
• History of obesity
• History of diabetes
• Tachypnea
• History of asthma
• Elevated BP - A.Dyspnea
• Back pain
• Tachypnea
• Elevated BP