NCLEX RN NGN CASE STUDY QUESTIONS
AND ANSWERS COMPLETE SOLUTIONS
◉ Patient 1 info: Answer: Client is a 22-year-old woman brought into
the emergency department (ED) by a friend. Client reports of facial
swelling and pain especially in the mouth area, making it difficult to
talk and swallow. Her eyes, lips, and tongue appear extremely
edematous with erythema. Client is also experiencing pruritis on trunk
area and bilateral lower extremities. Hives noted on abdomen and
bilateral lower legs. Client states she went to her primary doctor a
couple of days ago for signs of a urinary tract infection. She was
prescribed an antibiotic and has taken two doses so far. She does not
remember the name of the medication. Client has a history of
hypothyroidism and takes levothyroxine 100 mcg per day. Client is
alert and oriented with cranial nerves I to XIII intact
◉ Drag one condition and one client finding to complete the sentence.
Answer: The client appears to have [anaphylaxis] based on the client
finding of [angioedema].
◉ Patient 2 info: Answer: A 34-year-old woman with a history of
bipolar disorder and an allergy to tree nuts. The client has experienced
one hypersensitivity reaction as a child. However, as an adult she is
careful to avoid ingestion of tree nuts and thought the sensitivity went
away. She was unaware that the new dish at the restaurant had
crushed cashews in the sauce.
, This evening patient was eating at a local restaurant. After eating
several bites of a new dish, she began to experience itching and
tightness in the back of her throat. Lips became red and edematous.
The client described difficulty breathing and EMS notified.
Emergency services arrived within 6 minutes. The client was hypoxic
but awake on their arrival. The client received oxygen at 8 L per nasal
cannula and 0.3 mg of epinephrine intramuscularly and a bolus of
normal saline intravenously in route to the hospital.
Current assessment reveals stridor with decreased breath sounds,
laryngeal edema, facial swelling, and a decreased level of
consciousness. Currently in sinus tachycardia with heart rate varied
from 120 to 150 beats/min. Current blood pressure is 90/40 mm Hg
after a normal saline fluid bolus in route to the hospital.
◉ Patient 2:
Choose the most likely options for the information missing from the
statements by selecting from the lists of options provided. Answer:
Based on the client's history of previous hypersensitivity reaction, the
nurse identifies [facial edema] and [laryngeal edema] as priority
assessment findings requiring immediate follow-up.
◉ Patient 2:
Which finding indicates that this client has a problem with
oxygenation? Select all that apply. Answer: -Oxygen saturation 86%
on 15L of oxygen
-Blood pressure 90/40 mm Hg
AND ANSWERS COMPLETE SOLUTIONS
◉ Patient 1 info: Answer: Client is a 22-year-old woman brought into
the emergency department (ED) by a friend. Client reports of facial
swelling and pain especially in the mouth area, making it difficult to
talk and swallow. Her eyes, lips, and tongue appear extremely
edematous with erythema. Client is also experiencing pruritis on trunk
area and bilateral lower extremities. Hives noted on abdomen and
bilateral lower legs. Client states she went to her primary doctor a
couple of days ago for signs of a urinary tract infection. She was
prescribed an antibiotic and has taken two doses so far. She does not
remember the name of the medication. Client has a history of
hypothyroidism and takes levothyroxine 100 mcg per day. Client is
alert and oriented with cranial nerves I to XIII intact
◉ Drag one condition and one client finding to complete the sentence.
Answer: The client appears to have [anaphylaxis] based on the client
finding of [angioedema].
◉ Patient 2 info: Answer: A 34-year-old woman with a history of
bipolar disorder and an allergy to tree nuts. The client has experienced
one hypersensitivity reaction as a child. However, as an adult she is
careful to avoid ingestion of tree nuts and thought the sensitivity went
away. She was unaware that the new dish at the restaurant had
crushed cashews in the sauce.
, This evening patient was eating at a local restaurant. After eating
several bites of a new dish, she began to experience itching and
tightness in the back of her throat. Lips became red and edematous.
The client described difficulty breathing and EMS notified.
Emergency services arrived within 6 minutes. The client was hypoxic
but awake on their arrival. The client received oxygen at 8 L per nasal
cannula and 0.3 mg of epinephrine intramuscularly and a bolus of
normal saline intravenously in route to the hospital.
Current assessment reveals stridor with decreased breath sounds,
laryngeal edema, facial swelling, and a decreased level of
consciousness. Currently in sinus tachycardia with heart rate varied
from 120 to 150 beats/min. Current blood pressure is 90/40 mm Hg
after a normal saline fluid bolus in route to the hospital.
◉ Patient 2:
Choose the most likely options for the information missing from the
statements by selecting from the lists of options provided. Answer:
Based on the client's history of previous hypersensitivity reaction, the
nurse identifies [facial edema] and [laryngeal edema] as priority
assessment findings requiring immediate follow-up.
◉ Patient 2:
Which finding indicates that this client has a problem with
oxygenation? Select all that apply. Answer: -Oxygen saturation 86%
on 15L of oxygen
-Blood pressure 90/40 mm Hg
