NGN CASE STUDIES EXAM QUESTIONS
WITH 100% CORRECT ANSWERS |
LATEST VERSION 2025/2026.
Patient #1 History and Physical
22-year-old male client arrived at the emergency department (ED) with complaints of
excruciating pain in his back and lower extremities. Client is alert, and oriented to person,
place, and time. Family at the bedside. Client appears to have a grayish cast to his skin tone and
jaundiced mucous membranes. Client rates pain at 10 out of 10 scale without any relief. Client
in tears and grimaces with any movement. Client experiencing shortness of breath, nausea, and
fatigue. He states the pain has overwhelmed him and he can't eat or sleep. No prior medical
history other than a broken femur from a football incident. Client states he recently spent 2
weeks on a study abroad trip in China. - ANS Assessment findings reveal the following:
Cardiovascular: Sinus tachycardia, no murmur noted
Respiratory: Tachypnea, auscultated clear lung fields, dyspnea with mild exertion
Gastrointestinal: Active bowel sounds
Genitourinary: Dark orange-colored urine, episodes of urinary frequency and nocturia, denies
burning or pain when urinating
Peripheral: +1 pitting edema in lower extremities bilaterally
Nurse notes
1515
Client admitted to the intensive care unit (ICU) with sickle cell crisis. RN inserted an 18G
intravenous (IV) line in left arm and started at 150 mL/hr infusion of normal saline. Medicated
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, with morphine 4 mg IV as ordered. Oxygen started at 4 L/minute via nasal cannula. Family at
the bedside.
1600
Client states pain in the lower extremities has decreased to a 5 but the pain is still a 10 in his
back. Repositioned client and notified the health care provider.
1615
Medicated with morphine 4 mg as ordered. Instructed client to call for assistance to use the
bathroom. Client verbalized understanding. Call light within reach.
1645
Client resting quietly. - ANS Nurse notes cont.
2000
Client awake and complaining of chest pain 10/10, cough, and shortness of breath. Assessment
findings reveal the following:
Cardiovascular: Sinus tachycardia, no murmur noted, +2 radial and pedal pulses
Respiratory: Tachypnea, coarse crackles auscultated in bilateral lower lung fields, dyspnea with
mild exertion
Gastrointestinal: Active bowel sounds
Genitourinary: Clear yellow urine, denies burning or pain when urinating
Peripheral: +1 pitting edema in lower extremities bilaterally
Imaging: 1530
Doppler studies: negative for a deep vein thrombosis (DVT)
1630
Chest X-ray: Infiltrates in bilateral lower lung fields
Lab Results
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
WITH 100% CORRECT ANSWERS |
LATEST VERSION 2025/2026.
Patient #1 History and Physical
22-year-old male client arrived at the emergency department (ED) with complaints of
excruciating pain in his back and lower extremities. Client is alert, and oriented to person,
place, and time. Family at the bedside. Client appears to have a grayish cast to his skin tone and
jaundiced mucous membranes. Client rates pain at 10 out of 10 scale without any relief. Client
in tears and grimaces with any movement. Client experiencing shortness of breath, nausea, and
fatigue. He states the pain has overwhelmed him and he can't eat or sleep. No prior medical
history other than a broken femur from a football incident. Client states he recently spent 2
weeks on a study abroad trip in China. - ANS Assessment findings reveal the following:
Cardiovascular: Sinus tachycardia, no murmur noted
Respiratory: Tachypnea, auscultated clear lung fields, dyspnea with mild exertion
Gastrointestinal: Active bowel sounds
Genitourinary: Dark orange-colored urine, episodes of urinary frequency and nocturia, denies
burning or pain when urinating
Peripheral: +1 pitting edema in lower extremities bilaterally
Nurse notes
1515
Client admitted to the intensive care unit (ICU) with sickle cell crisis. RN inserted an 18G
intravenous (IV) line in left arm and started at 150 mL/hr infusion of normal saline. Medicated
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, with morphine 4 mg IV as ordered. Oxygen started at 4 L/minute via nasal cannula. Family at
the bedside.
1600
Client states pain in the lower extremities has decreased to a 5 but the pain is still a 10 in his
back. Repositioned client and notified the health care provider.
1615
Medicated with morphine 4 mg as ordered. Instructed client to call for assistance to use the
bathroom. Client verbalized understanding. Call light within reach.
1645
Client resting quietly. - ANS Nurse notes cont.
2000
Client awake and complaining of chest pain 10/10, cough, and shortness of breath. Assessment
findings reveal the following:
Cardiovascular: Sinus tachycardia, no murmur noted, +2 radial and pedal pulses
Respiratory: Tachypnea, coarse crackles auscultated in bilateral lower lung fields, dyspnea with
mild exertion
Gastrointestinal: Active bowel sounds
Genitourinary: Clear yellow urine, denies burning or pain when urinating
Peripheral: +1 pitting edema in lower extremities bilaterally
Imaging: 1530
Doppler studies: negative for a deep vein thrombosis (DVT)
1630
Chest X-ray: Infiltrates in bilateral lower lung fields
Lab Results
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
