RN CONCEPT – BASED
ASSESSMENT LEVEL 4 ONLINE
PRACTICE A WITH NGN
QUESTIONS AND CORRECT
SOLUTIONS 2026/2027 .
, 1. Nurses' NotesToday: Client is a 48-year-old male who presents with slurred speech and paresthesia in hands.
Heart rate is regular, S1, S2, S3 present. Shortness of breath was reported at rest, with fine crackles throughout
all lung fields. Abdomen is soft, nontender, bowel sounds present. 2+ pitting edema is in feet bilaterally. Client
voided 25 mL dark amber urine, with bladder nondistended. The client reports they had a CT scan with contrast
yesterday to evaluate a lung nodule and have been "feeling bad ever since." They report trouble lying flat.Client
has a 10-year history of hypertension. Myocardial infarction occurred 4 years ago with stent placed ✔✔ correct
answer Potential Condition:
Acute kidney injury
Actions to Take:
Administer IV dextrose 50% with insulin & provide client education. + Prepare to administer IV dextrose 50% with insulin
Parameters to monitor:
Urine output + serum potassium level.
Upon recognizing and analyzing the client cues of shortness of breath, elevated potassium level, increased blood urea nitrogen and creatinine, along with the audible S3, crackles in
all lung fields, 3+ pitting edema, and small amount (25 mL) of dark, amber urine, the nurse's priority hypothesis is that the client is likely experiencing acute kidney injury as an
adverse ettect of the CT scan with contrast dye. The nurse should generate solutions and address the acute kidney injury. Therefore, the nurse should administer IV dextrose 50%
with insulin and provide client education. The nurse should administer IV dextrose 50% of insulin to decrease the potassium level, which can prevent dysrhythmias. The nurse
should educate the client about the condition so that the client can understand the cause of the acute kidney injury. To evaluate the client's response to these interventions, the
nurse should monitor the serum potassium level and urine output.
2. A nurse is caring for a client in the emergency department.
Exhibit 1
History and Physical
1000: The client states, "I have a terrible yeast infection." The client reports
ASSESSMENT LEVEL 4 ONLINE
PRACTICE A WITH NGN
QUESTIONS AND CORRECT
SOLUTIONS 2026/2027 .
, 1. Nurses' NotesToday: Client is a 48-year-old male who presents with slurred speech and paresthesia in hands.
Heart rate is regular, S1, S2, S3 present. Shortness of breath was reported at rest, with fine crackles throughout
all lung fields. Abdomen is soft, nontender, bowel sounds present. 2+ pitting edema is in feet bilaterally. Client
voided 25 mL dark amber urine, with bladder nondistended. The client reports they had a CT scan with contrast
yesterday to evaluate a lung nodule and have been "feeling bad ever since." They report trouble lying flat.Client
has a 10-year history of hypertension. Myocardial infarction occurred 4 years ago with stent placed ✔✔ correct
answer Potential Condition:
Acute kidney injury
Actions to Take:
Administer IV dextrose 50% with insulin & provide client education. + Prepare to administer IV dextrose 50% with insulin
Parameters to monitor:
Urine output + serum potassium level.
Upon recognizing and analyzing the client cues of shortness of breath, elevated potassium level, increased blood urea nitrogen and creatinine, along with the audible S3, crackles in
all lung fields, 3+ pitting edema, and small amount (25 mL) of dark, amber urine, the nurse's priority hypothesis is that the client is likely experiencing acute kidney injury as an
adverse ettect of the CT scan with contrast dye. The nurse should generate solutions and address the acute kidney injury. Therefore, the nurse should administer IV dextrose 50%
with insulin and provide client education. The nurse should administer IV dextrose 50% of insulin to decrease the potassium level, which can prevent dysrhythmias. The nurse
should educate the client about the condition so that the client can understand the cause of the acute kidney injury. To evaluate the client's response to these interventions, the
nurse should monitor the serum potassium level and urine output.
2. A nurse is caring for a client in the emergency department.
Exhibit 1
History and Physical
1000: The client states, "I have a terrible yeast infection." The client reports
