1
NGN CLINICAL SCENARIOS | MENTAL HEALTH,
PHARMACOLOGY & MED-SURG | 2026 CASE-BASED
QUESTIONS WITH EXPLANATIONS.
1)NGN FOCUS: MENTAL HEALTH / SUICIDE ASSESSMENT
SCENARIO:
An adolescent patient with conduct disorder arrives at the emergency
department after threatening suicide to a teacher at school. The caregiver is
gathering additional assessment data.
VITAL SIGNS (for context):
• Temperature 36.9°C (98.4°F), HR 88/min, RR 18/min, BP 108/70 mm Hg
QUESTION:
Which of the following statements should the caregiver include during the
assessment?
A.“Tell me about your siblings?”
B.“Tell me what kind of music
you like?”C.“Tell me how often
you drink alcohol?”D.“Tell me
about your school schedule?”
ANS: C. “Tell me how often you drink alcohol?” EXPLANATION:
• Assessing for substance use, including alcohol, is critical in adolescents
with conduct disorder and suicidal ideation, as substance misuse can
exacerbate mental health issues.
Options A, B, and D can offer general psychosocial
, 2
• information but do not directly address a risk factor (substance use)
that could contribute significantly to suicidal behavior.
1)NGN FOCUS: MEDICAL-
SURGICAL
PRIORITIZATION /
HYPOPARATHYROIDISM
SCENARIO:
A caregiver on an acute medical-surgical unit is
performing shift assessments on multiple patients with
varying diagnoses.
VITAL SIGNS (for context):
• Patient with possible hypoparathyroidism: BP 120/78 mm Hg, HR
76/min, RR 18/min
QUESTION:
Which of the following patients is the highest priority to assess or intervene?
A. A patient who has surgical
hypoparathyroidism and a positive Trousseau’s sign
B. A patient with Clostridium difficile infection and acute diarrhea C.A patient
with acute kidney injury and urine with a low specific gravity
D.A patient who has oral cancer and reports a sore on his gums ANS: A. A patient who
has surgical hypoparathyroidism and a positive Trousseau’s sign
EXPLANATION:
• A positive Trousseau’s sign indicates neuromuscular irritability
related to hypocalcemia, which may progress to life- threatening tetany
or seizures.
• While the other findings warrant follow-up, acute hypocalcemia poses
the greatest immediate risk.
2)NGN FOCUS: PHARMACOLOGY / HEART FAILURE
, 3
SCENARIO:
NGN CLINICAL SCENARIOS | MENTAL HEALTH,
PHARMACOLOGY & MED-SURG | 2026 CASE-BASED
QUESTIONS WITH EXPLANATIONS.
1)NGN FOCUS: MENTAL HEALTH / SUICIDE ASSESSMENT
SCENARIO:
An adolescent patient with conduct disorder arrives at the emergency
department after threatening suicide to a teacher at school. The caregiver is
gathering additional assessment data.
VITAL SIGNS (for context):
• Temperature 36.9°C (98.4°F), HR 88/min, RR 18/min, BP 108/70 mm Hg
QUESTION:
Which of the following statements should the caregiver include during the
assessment?
A.“Tell me about your siblings?”
B.“Tell me what kind of music
you like?”C.“Tell me how often
you drink alcohol?”D.“Tell me
about your school schedule?”
ANS: C. “Tell me how often you drink alcohol?” EXPLANATION:
• Assessing for substance use, including alcohol, is critical in adolescents
with conduct disorder and suicidal ideation, as substance misuse can
exacerbate mental health issues.
Options A, B, and D can offer general psychosocial
, 2
• information but do not directly address a risk factor (substance use)
that could contribute significantly to suicidal behavior.
1)NGN FOCUS: MEDICAL-
SURGICAL
PRIORITIZATION /
HYPOPARATHYROIDISM
SCENARIO:
A caregiver on an acute medical-surgical unit is
performing shift assessments on multiple patients with
varying diagnoses.
VITAL SIGNS (for context):
• Patient with possible hypoparathyroidism: BP 120/78 mm Hg, HR
76/min, RR 18/min
QUESTION:
Which of the following patients is the highest priority to assess or intervene?
A. A patient who has surgical
hypoparathyroidism and a positive Trousseau’s sign
B. A patient with Clostridium difficile infection and acute diarrhea C.A patient
with acute kidney injury and urine with a low specific gravity
D.A patient who has oral cancer and reports a sore on his gums ANS: A. A patient who
has surgical hypoparathyroidism and a positive Trousseau’s sign
EXPLANATION:
• A positive Trousseau’s sign indicates neuromuscular irritability
related to hypocalcemia, which may progress to life- threatening tetany
or seizures.
• While the other findings warrant follow-up, acute hypocalcemia poses
the greatest immediate risk.
2)NGN FOCUS: PHARMACOLOGY / HEART FAILURE
, 3
SCENARIO:
