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Practice Test 4 - NCLEX Pn

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

  1. According to Piaget's theory of cognitive development, which behavior demonstrates that an infant has developed object permanence?
  2. Which intervention should the nurse include in the client's plan of care to promote wound healing?
  3. The practical nurse (PN) aspirates fluid from a newly placed nasogastric tube to confirm placement. Which pH value would indicate the tube is likely in the correct position in the stomach?
  4. Acute care setting: A 63-year-old client with type 2 diabetes is receiving tube feedings via PEG. The client becomes lethargic and confused; bedside glucose reads "HI"; vital signs are HR 116, BP 146/90, RR 24; mucous membranes are dry; urine output decreased. History includes recent steroid therapy for COPD exacerbation; tube feeding rate was increased 4 hours ago. Using SBAR to call the provider, which detail is MOST important to include in the Situation part of SBAR?
  5. A 73-year-old client with dementia is in a long-term care facility and wanders into other residents' rooms. Staff have attempted structured activities, placing familiar items in the client's room, and redirecting, but wandering continues. Which action should the nurse take to ensure the client's safety while minimizing restraint use?
  6. The practical nurse (PN) is preparing to perform postmortem care for a client whose family is present and wishes to participate. Which action by the PN demonstrates respect and provides comfort to the family?
  7. A 55-year-old client is 8 hours post-op after a bowel resection. The client has increasing abdominal pain and a rigid abdomen; vital signs show HR 122/min and BP 88/54 mm Hg. Hemoglobin has dropped from 12.4 g/dL pre-op to 8.1 g/dL. Which finding indicates the need for immediate intervention?
  8. Based on the current clinical data, which nursing hypothesis is the priority?
  9. A 70-year-old postoperative client is taking Morphine immediate-release 15 mg by mouth every 4 hours as needed for pain. The client has a history of chronic obstructive pulmonary disease and reports constipation and drowsiness, stating, "I'm taking it every 4 hours on the dot even if my pain is mild." The LPN/VN is reinforcing safe use. Which statement by the client indicates a need for further teaching?
  10. An 81-year-old client in long-term care is immobile and receiving a bowel regimen. History: hemorrhoids. Assessment: stool is black and tarry; client reports dizziness when sitting up; VS: T 98.4°F (36.9°C), HR 112, RR 18, BP 96/58. Which finding should the nurse REPORT immediately in a client with bowel management needs?
  11. A client throws a lunch tray on the floor and yells, "This food is not fit for a dog!" What is the PN's most immediate response?
  12. The nurse prepares to set the infusion pump. At what rate, in mL/hr, should the pump be set?
  13. A 6-year-old child, recently adopted from a country with no available immunization records, is brought to the clinic. What is the most appropriate plan for the PN to anticipate?
  14. A 33-year-old client with gastroenteritis has had vomiting and diarrhea for 2 days and reports muscle cramps. Vital signs: HR 104/min, BP 98/60 mm Hg, RR 18/min, T 98.9°F (37.2°C). Labs: potassium 2.9 mEq/L, sodium 140 mEq/L. What intervention should be implemented IMMEDIATELY for this client?
  15. In a Head Start classroom, an LPN/VN observes a 4-year-old (preschool age) whose family recently welcomed a new baby. The child sometimes regresses to "baby talk" at home but is talkative at school. What developmental ability should the nurse expect in a 4-year-old child?
  16. A client at 28 weeks gestation is planning a long car trip. The PN reinforces travel safety instructions. Which client statement indicates a need for further teaching?
  17. A 38-year-old client in outpatient care states, "I stopped drinking 10 days ago, but I'm worried I'll relapse." The client has stable vital signs, is not in acute withdrawal, and asks for ongoing support. Which community resource should the nurse recommend to the client first?
  18. An LPN/VN is preparing a 64-year-old client for discharge after a left knee replacement. Data: ambulates 60 feet with a walker and contact guard assist; pain 5/10 with movement; blood pressure 138/82 mm Hg; client has throw rugs at home and a low toilet seat. What information is MOST important to share with the physical therapist regarding the client's mobility plan?
  19. A 74-year-old client with end-stage heart failure is in the hospital and has a do-not-resuscitate order. The family asks, "What will you do if his heart stops?" The client is drowsy but responsive and appears calm. The nurse should include which information when discussing palliative care options?
  20. An elderly client with Alzheimer's disease becomes increasingly restless and agitated each evening. Which action should the PN implement to help manage this behavior?

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