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Practice Test 5 - NCLEX Pn

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

  1. A 70-year-old client is receiving 0.9% sodium chloride through a peripheral intravenous catheter in the left forearm. History includes chronic kidney disease stage 3. The client reports burning at the site; the nurse notes a red, warm, tender streak along the vein. Vital signs: T 99.1°F (37.3°C), HR 92/min, BP 136/80 mm Hg, RR 16/min, SpO2 97% on room air; potassium 4.6 mEq/L (normal 3.5–5.0). What complication is the client MOST at risk for?
  2. A 9-month-old infant received the first dose of MMR vaccine 2 weeks ago while traveling internationally. The mother brings the infant to the clinic today requesting the second dose. What is the PN's most appropriate action?
  3. A 58-year-old client with type 2 diabetes takes insulin glargine nightly and insulin lispro with meals. Before lunch, the client is diaphoretic and confused; vital signs: heart rate 112/min, blood pressure 138/82 mm Hg, respiratory rate 18/min. Point-of-care glucose is 46 mg/dL (low; normal fasting 70–99 mg/dL). The nurse should notify the RN when the client exhibits which sign?
  4. A 72-year-old client with type 2 diabetes and chronic kidney disease is admitted for dehydration. During the shift, the LPN/VN receives a new provider order and must document intake and output in the electronic health record (EHR) so the interdisciplinary team can view updates. How should the nurse ensure data privacy when using the EHR?
  5. A 49-year-old client is using a PCA pump with hydromorphone after hernia repair. Assessment: the pump alarm indicates "dose limit reached"; vital signs: heart rate 92/min, blood pressure 138/84 mmHg, respiratory rate 18/min, oxygen saturation 98% on room air; pain rating 9/10; client is alert and requesting more medication. Which finding indicates a problem with the PCA pump?
  6. A 9-week-old infant (born at 40 weeks, uncomplicated) is at a clinic visit; the parent is hesitant about vaccines due to fear of autism. The infant weighs 5.6 kg, breastfeeds every 3–4 hours, and has vital signs: temperature 36.8°C, heart rate 132/min, respiratory rate 30/min. How should the nurse educate parents about this infant care practice?
  7. In home care, a 69-year-old client with chronic bronchitis is prescribed oxygen at 2 L/min via nasal cannula. During teaching, which instruction is the PRIORITY safety precaution for the nurse to emphasize regarding oxygen equipment use?
  8. The nurse recognizes that the client's drop in blood pressure and increased heart rate most likely indicates:
  9. An 82-year-old client in a long-term care facility with moderate dementia has new bruises on the inner upper arms and a small tear on the forearm; the client has become withdrawn and refuses to attend usual group activities. The unlicensed assistive personnel states, "He keeps bumping into things," but the pattern is inconsistent with the client's usual gait and the client flinches when staff approach. Which observation requires IMMEDIATE reporting to the RN?
  10. The nurse should program the infusion pump to deliver how many mL/hr?
  11. The nurse should regulate the manual IV infusion to deliver how many drops per minute (gtt/min)?
  12. The nurse recognizes that because the client is pulseless and unresponsive, the most likely underlying problem is:
  13. The LPN/VN is assisting at a pediatric immunization clinic. A 12-month-old child is due for MMR, varicella, hepatitis A, and PCV vaccines at today's visit. Which statement best reflects current guidance on administering multiple vaccines at one visit?
  14. A 67-year-old client with COPD reports increased shortness of breath and has been using the rescue inhaler more often today. Assessment: temperature 37.0°C (98.6°F), heart rate 108/min, respiratory rate 30/min, blood pressure 150/84 mm Hg, oxygen saturation 85% on room air; client has pursed-lip breathing and is unable to lie flat. Which data indicates an acute change that requires IMMEDIATE action?
  15. A client receiving palliative care reports persistent nausea. After administering a prescribed antiemetic, which additional action should the practical nurse (PN) take to promote comfort?
  16. During a one-on-one interaction, a client asks the PN for their home phone number. Which response by the PN is most appropriate?
  17. The nurse is preparing to administer an IM immunization to an adult client who is obese. Which needle length is most appropriate for a ventrogluteal injection?
  18. A bus collision has created a mass casualty incident. The LPN/VN is providing first aid at the scene; a 28-year-old client with no known history has heavy bleeding from a lower leg laceration, is pale and anxious, and has vital signs: heart rate 132/min, respiratory rate 28/min, blood pressure 88/54 mm Hg. Which action should the LPN/VN take FIRST in this scenario?
  19. In an outpatient clinic, a 58-year-old client started metformin 500 mg twice daily 1 week ago and reports diarrhea 4–5 times/day with mild dizziness; vital signs are blood pressure 94/58 mm Hg, heart rate 102/min, and the client reports drinking "very little" today. The LPN/VN needs to update the physician and collaborate with the pharmacist about side effects. Which detail should the nurse report to the physician about the client's medication response?
  20. The practical nurse (PN) is caring for a client on the palliative care unit who is experiencing spiritual distress. The PN should initiate a referral by collaborating with which member of the interdisciplinary team?

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