PROCTORED EXAM WITH NGN 100
EXPECTED QUESTION AND ANSWERS.
A nurse is teaching a client who has ovarian cancer about skin care
following radiation treatment. Which of the following instructions
should the nurse include?
A. Pat the skin on the radiation site to dry it.
B. Apply over-the-counter moisturizer to the radiation site.
C. Cover the radiation site loosely with a gauze wrap before dressing.
D. Use a soft washcloth to clean the area around the radiation site.
Correct Answer: A. Pat the skin on the radiation site to dry it.
Rationale
The skin at the radiation site should be dried thoroughly using patting
motions to prevent irritation and breakdown. Applying over-the-counter
moisturizers should be avoided unless prescribed by the provider, as they
may contain irritating ingredients. The radiation site should not be covered
with gauze wrap; loose cotton clothing is recommended to avoid friction.
A soft washcloth is acceptable, but patting dry is the key instruction.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
A nurse is caring for a client who has diabetes insipidus. Which of the
following medications should the nurse plan to administer?
A. Desmopressin
B. Regular insulin
C. Furosemide
D. Lithium carbonate
Correct Answer: A. Desmopressin.
Rationale
Diabetes insipidus is characterized by decreased antidiuretic hormone
(ADH), leading to excessive urination and thirst. Desmopressin is a
,synthetic ADH analog that replaces the deficient hormone and reduces
urine output. Regular insulin is used for diabetes mellitus, furosemide is a
diuretic, and lithium carbonate can actually cause diabetes insipidus.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
A nurse is admitting a client who has arthritic pain and reports taking
ibuprofen several times daily for 3 years. Which of the following tests
should the nurse monitor?
A. Fasting blood glucose
B. Stool for occult blood
C. Urine for white blood cells
D. Serum calcium
Correct Answer: B. Stool for occult blood.
Rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can
cause gastrointestinal bleeding. The nurse should monitor for occult blood
in the stool, which may indicate GI bleeding. Fasting blood glucose, urine
WBCs, and serum calcium are not directly related to long-term ibuprofen
use.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
A nurse in the emergency department is assessing a client. Which of
the following actions should the nurse take first? (Click on the
"Exhibit" button for additional information about the client. There
are three tabs that contain separate categories of data.)
A. Obtain a sputum sample for culture.
B. Prepare the client for a chest x-ray.
C. Initiate airborne precautions.
D. Administer ondansetron.
Correct Answer: C. Initiate airborne precautions.
,Rationale
The priority is to implement airborne precautions based on the client's
presenting symptoms, which likely include manifestations of tuberculosis
or another airborne infection. Airborne precautions protect both the client
and others from transmission. Sputum culture, chest x-ray, and antiemetics
are important but secondary to infection control.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
A nurse is contacting the provider for a client who has cancer and is
experiencing breakthrough pain. Which of the following prescriptions
should the nurse anticipate?
A. Transmucosal fentanyl
B. Intramuscular meperidine
C. Oral acetaminophen
D. Intravenous dexamethasone
Correct Answer: A. Transmucosal fentanyl.
Rationale
Transmucosal fentanyl is a rapid-onset opioid used for breakthrough pain
in cancer patients. Meperidine is not recommended for chronic pain due to
neurotoxicity. Acetaminophen is not strong enough for breakthrough pain.
Dexamethasone is a corticosteroid used for inflammation, not acute pain.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
A nurse is admitting a client who reports chest pain and has been
placed on a telemetry monitor. Which of the following should the
nurse analyze to determine whether the client is experiencing a
myocardial infarction?
A. PR interval
B. QRS duration
C. T wave
D. ST segment
, Correct Answer: D. ST segment.
Rationale
ST segment elevation indicates myocardial infarction, while ST segment
depression indicates ischemia. PR interval reflects AV conduction, QRS
duration reflects ventricular depolarization, and T wave changes may
indicate ischemia but are not as specific as ST segment changes.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
A nurse is assessing a client who is 12 hours postoperative following a
colon resection. Which of the following findings should the nurse
report to the surgeon?
A. Heart rate 90/min
B. Absent bowel sounds
C. Hemoglobin 8.2 g/dL
D. Gastric pH of 3.0
Correct Answer: C. Hemoglobin 8.2 g/dL.
Rationale
A hemoglobin of 8.2 g/dL is below the normal range (12-16 g/dL for
females, 13-18 g/dL for males) and may indicate postoperative
hemorrhage. Heart rate 90/min is within normal limits. Absent bowel
sounds are expected after major bowel surgery. Gastric pH of 3.0 is
normal.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
A nurse is caring for a client who is receiving a blood transfusion. The
nurse observes that the client has bounding peripheral pulses,
hypertension, and distended jugular veins. The nurse should
anticipate administering which of the following prescribed
medications?
A. Diphenhydramine
B. Acetaminophen