Practice Test 3 - NCLEX Pn

20 questions. Answer them in any order, then submit to see your score and every explanation.

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1. A 45-year-old client receiving intravenous antibiotics reports sudden itching and throat tightness; within minutes the LPN notes wheezing, stridor, facial swelling, hives, blood pressure 78/40 mm Hg, heart rate 132/min, and oxygen saturation 86%. What is the nurse's FIRST action in this emergency?
2. A 55-year-old client is 6 hours post-operative from a total laryngectomy with a new tracheostomy on a medical-surgical unit. Vital signs: temperature 37.1°C (98.8°F), heart rate 96/min, respiratory rate 22/min, blood pressure 138/82 mm Hg, oxygen saturation 93% on humidified tracheostomy collar. The client has thick secretions. What is the PRIORITY nursing action for this client?
3. A 24-year-old client arrives at a community mental health center walk-in clinic after losing their job yesterday and reports they "can't breathe" and "feel like I'm dying." The client is pacing, shaking, speaking rapidly, and repeatedly looking toward the exit; history includes occasional panic episodes during school exams but no prior hospitalizations. Which intervention should the nurse implement IMMEDIATELY to support the client in crisis?
4. A 77-year-old long-term care resident with obesity and limited mobility is prescribed sequential compression devices (SCDs) when in bed. The nurse finds the SCD pump turned on, but the sleeves are loosely wrapped and sliding down; the resident has 1+ edema and calf circumferences are equal at 35 cm bilaterally. Which action is MOST important for ensuring the effectiveness of the compression device?
5. The nurse recognizes that because the client is now unstable, which task is no longer appropriate to delegate to a UAP?
6. A 6-year-old child with asthma lives with grandparents in a home where family members smoke indoors. The nurse observes a strong smoke odor, a cat that sleeps in the child's bedroom, and stuffed animals covering the bed; the caregiver reports the child wakes up coughing at night. What is the PRIORITY safety concern for this client?
7. A client with liver failure is ordered to receive fresh frozen plasma (FFP). The LPN/VN understands that FFP is most likely ordered for which therapeutic purpose in this client?
8. A 57-year-old client is newly prescribed Lisinopril 10 mg by mouth daily for hypertension. The client has a history of mild chronic kidney disease and reports dizziness when standing up, saying, "I might just stop taking it." The LPN/VN is reinforcing medication teaching about expected effects and safety. Which side effect should the nurse emphasize when reinforcing medication education?
9. A 50-year-old client is admitted for alcohol withdrawal and asks the nurse not to tell their employer, who is calling the unit, that the client is hospitalized. The caller says they are the client's supervisor and need to know the diagnosis to arrange coverage. Facility policy prohibits confirming a patient's presence without authorization. Which action should the nurse take to maintain client confidentiality?
10. An older adult client with delirium is agitated, pulling at an IV line, and unable to rest. Which action should the practical nurse (PN) prioritize to provide comfort and safety?
11. A 9-month-old infant is being evaluated for failure to thrive. Birth history is unremarkable; current weight is 6.3 kg (below the 3rd percentile), and the caregiver reports the infant drinks diluted formula because it is 'too strong' otherwise; intake record shows approximately 14 oz/day of diluted formula and little solid food. The infant has sunken fontanel, dry mucous membranes, and only 2 wet diapers today. What intervention should the nurse implement to address the client's dehydration?
12. Based on the pink, frothy sputum and coarse crackles, which nursing hypothesis is the priority?
13. Based on the assessment of bladder distension and lack of output, which nursing hypothesis is the priority?
14. A 58-year-old client with chronic low back pain identifies as Native American and says he uses smudging with sage at home for spiritual healing and comfort. He is hospitalized for an acute exacerbation and asks if he can perform a brief smudging ritual. What should the nurse do to accommodate the client's spiritual needs?
15. A 66-year-old client is newly prescribed Hydrochlorothiazide 25 mg by mouth each morning for hypertension. The client has a history of gout and reports dizziness when standing, saying, "I stopped taking it because it makes me pee too much." The LPN/VN is reinforcing medication education. What information should the nurse reinforce about this medication?
16. A client is experiencing a panic attack and reports shortness of breath, dizziness, and a feeling of impending doom. Which instruction by the PN is most helpful?
17. Which statement should the nurse include?
18. Which fluid should the nurse obtain to fill the water seal chamber?
19. Which action should the nurse take to support the client's health goals?
20. A 39-year-old client newly started on hemodialysis says, "I hate being tied to this machine. I'm thinking about skipping treatments." Assessment: anxious, pacing; vital signs stable. The client asks if missing one session matters. Which nursing action is MOST important for the LPN to take?

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