RN Comprehensive Practice Exam

RN Comprehensive Practice Exam Next Generation NCLEX (NGN) Format

Total Questions: 60

Domains: Medical-Surgical, Pharmacology, Maternity,

Pediatrics, Mental Health, Leadership 2025

Case Study 1: Heart Failure (Questions 1–5)

Patient Profile:

Mr. Jones, 76 years old, admitted with shortness of breath, 3+ bilateral leg edema, fatigue. History includes hypertension and chronic heart failure (EF 30%).

Vital Signs:

BP 162/90, HR 104, RR 26, SpO₂ 89% on room air

Labs:

BNP 1400 pg/mL, Na 132 mmol/L, K 4.5 mmol/L, Creatinine 1.6 mg/dL

Orders:

Furosemide 40 mg IV BID 1 / 3

Low-sodium diet Oxygen at 2 L/min via nasal cannula

• Matrix/Grid – Select which findings require immediate follow-up

Finding Requires Follow-Up?BNP 1400 pg/mL Yes / No Sodium 132 mmol/L Yes / No SpO₂ 89% Yes / No Bilateral crackles in lungs Yes / No

Correct Answers: All require follow-up

Rationale: Findings indicate worsening heart failure and hypoxia.

• Multiple Response – Select all appropriate nursing interventions
• Elevate legs above heart
• Administer IV furosemide
• Restrict fluid intake
• Withhold potassium supplements
• Apply anti-embolism stockings

Correct Answers: A, B, C, E

Rationale: Appropriate for fluid overload. No indication to withhold potassium.

• / 3

• Dropdown – Based on the lab values, what is the client at risk for?

Select the best answer:

• Seizure activity

• Digoxin toxicity

• Hypernatremia

• Hyperglycemia

Correct Answer: B) Digoxin toxicity

Rationale: Impaired renal function increases risk of digoxin accumulation.

• Cloze – Which dietary instruction is appropriate?

"Because of your condition, we will provide a ______ diet."

Select one:

• High sodium

• Low potassium

• Low sodium
• / 3