COMPREHENSIVE RN NGN EXAM
REVIEW GUIDE
A nurse is caring for an older adult client who is experiencing chronic anorexia and is
receiving enteral tube feedings. Which of the following laboratory values indicates that
the client needs additional nutrients added to the feeding?
(A) Creatinine 1.1 mg/dL
(B) Albumin 2.8 g/dL
(C) Triglycerides 100 mg/dL
(D) Alkaline phosphatase 118 units/L - ANS>>Albumin 2.8 g/dL
[The expected reference range for albumin is 3.5 to 5 g/dL]
(A creatinine level of 1.1 mg/dL is within the expected reference range of 0.5 to 1.1
mg/dL for a female client, and 0.7 to 1.3 mg/dL for a male client)
(A triglyceride level of 100 mg/dL is within the expected reference range of 35 to 135
mg/dL for a female client, and 40 to 160 mg/dL for a male client)
(An alkaline phosphatase level of 118 units/L is within the expected reference range of
30 to 120 units/L. An elevated alkaline phosphatase level is an indication of liver or
bone disorders, with a decreased level indicating malnutrition)
Burkholderia cepacia lung infection: what type of precautions will be initiated? -
ANS>>Contact isolation precautions
A nurse is preparing a sterile field to perform a sterile dressing change. Which of the
following interventions should the nurse use to maintain surgical aseptic technique?
(A) Hold hands folded below the waist after donning sterile gloves.
(B) Pick up and pour solutions with the palm of the hand covering bottle labels.
(C) Keep sterile items within a 1.3 cm (0.5 in) border of the sterile drape.
(D) Maintain sterile objects within the line of vision. - ANS>>Maintain sterile objects
within the line of vision.
,A nurse is planning care for a client who has rheumatoid arthritis and has moderate to
severe pain in multiple joints. Which of the following actions should the nurse plan to
take?
(A) Perform ADLs for the client to promote rest.
(B) Allow for frequent rest periods throughout the day.
(C) Use heat to reduce joint inflammation.
(D) Develop a daily schedule for acetaminophen up to 6 g/day that covers peak periods
of pain. - ANS>>Allow for frequent rest periods throughout the day.
[The nurse should encourage clients who have rheumatoid arthritis to balance rest with
exercise to maintain muscle strength, joint function, and range of motion]
(The nurse should allow the client to perform their own ADLs to promote the client's joint
mobility and independence)
(The nurse should use ice to reduce joint inflammation and heat to alleviate joint
discomfort)
(The nurse should not administer more than 3 g of acetaminophen to the client each
day to reduce the risk of injury to the client)
A nurse is caring for a client during a follow up visit at a gastrointestinal clinic.
NURSE NOTES:
0600:
Client admitted to the ED with fatigue, shortness of breath, and weakness for the last 2
days. Client states that they have a history of sickle cell disease (SCD). Client is alert
and orientated to person, place, and time. Restless. Client rates generalized pain as a 9
on a scale of 0 to 10. Vital signs taken and blood drawn for laboratory tests. Oxygen 2 L
via nasal cannula applied. Awaiting prescription for pain management.
0615:
Client still rates pain as a 9 on a scale of 0 to 10. Hydromorphone 4 mg IV administered.
Vital Signs
0600:
Temperature 37.8° C (100° F)Heart rate 104/minRespiratory rate 26/minBlood pressure
88/56 mm HgOxygen saturation 90% on 2 L via nasal cannula
Diagnostic Results
0645:
Hematocrit 25% (37% to 52%)Hemoglobin 8.3 g/dL (12 to 16 g/dL)WBC count
18,000/mm3 (5,000 to 10,000/mm3)Reticul - ANS>>[ ] Administer IV fluids: Hydration is
, a priority when caring for a client in sickle cell crisis because it decreases the rate of cell
sickling and can reduce pain. Hypotonic fluids are typically infused at 250 mL/hr for 4 hr.
[ ] Use humidification with oxygen therapy
[ ] Assess peripheral circulation hourly is correct
[ ] assess the client's mouth at least every 8 hr for the presence of sores or lesions and
any other signs of infection
(Using a blood pressure cuff on the client's arm can cause venous occlusion and
increased pain. Alternatives to monitoring blood pressure should be explored when
caring for a client who has sickle cell crisis)
A home health nurse is caring for a group of older adult clients. The nurse should initiate
a referral to the Program of All-Inclusive Care for the Elderly (PACE) for which of the
following clients?
(A) A client whose family requests hospital-based hospice care
(B) A client who requires transfer to a skilled care facility
(C) A client who qualifies for telehealth for pacemaker diagnostics
(D) A client whose caregiver requests adult day care services - ANS>>A client whose
caregiver requests adult day care services
[The nurse should initiate a referral for PACE for this client because PACE provides
adult day care services along with in-home assessments and supportive services]
(A nurse should assist in the coordination of care for a client who requires transfer to a
skilled care facility, which might require a referral for other disciplines such as physical
and occupational therapy)
(The nurse should assist in the facilitation of telehealth for the client to receive home-
based pacemaker diagnostics through the use of electronic communications)
A nurse is caring for a client who had abdominal surgery 24 hr ago. Which of the
following actions is the nurse's priority?
(A) Assess fluid intake every 24 hr.
(B) Ambulate three times a day.
(C) Assist with deep breathing and coughing.
REVIEW GUIDE
A nurse is caring for an older adult client who is experiencing chronic anorexia and is
receiving enteral tube feedings. Which of the following laboratory values indicates that
the client needs additional nutrients added to the feeding?
(A) Creatinine 1.1 mg/dL
(B) Albumin 2.8 g/dL
(C) Triglycerides 100 mg/dL
(D) Alkaline phosphatase 118 units/L - ANS>>Albumin 2.8 g/dL
[The expected reference range for albumin is 3.5 to 5 g/dL]
(A creatinine level of 1.1 mg/dL is within the expected reference range of 0.5 to 1.1
mg/dL for a female client, and 0.7 to 1.3 mg/dL for a male client)
(A triglyceride level of 100 mg/dL is within the expected reference range of 35 to 135
mg/dL for a female client, and 40 to 160 mg/dL for a male client)
(An alkaline phosphatase level of 118 units/L is within the expected reference range of
30 to 120 units/L. An elevated alkaline phosphatase level is an indication of liver or
bone disorders, with a decreased level indicating malnutrition)
Burkholderia cepacia lung infection: what type of precautions will be initiated? -
ANS>>Contact isolation precautions
A nurse is preparing a sterile field to perform a sterile dressing change. Which of the
following interventions should the nurse use to maintain surgical aseptic technique?
(A) Hold hands folded below the waist after donning sterile gloves.
(B) Pick up and pour solutions with the palm of the hand covering bottle labels.
(C) Keep sterile items within a 1.3 cm (0.5 in) border of the sterile drape.
(D) Maintain sterile objects within the line of vision. - ANS>>Maintain sterile objects
within the line of vision.
,A nurse is planning care for a client who has rheumatoid arthritis and has moderate to
severe pain in multiple joints. Which of the following actions should the nurse plan to
take?
(A) Perform ADLs for the client to promote rest.
(B) Allow for frequent rest periods throughout the day.
(C) Use heat to reduce joint inflammation.
(D) Develop a daily schedule for acetaminophen up to 6 g/day that covers peak periods
of pain. - ANS>>Allow for frequent rest periods throughout the day.
[The nurse should encourage clients who have rheumatoid arthritis to balance rest with
exercise to maintain muscle strength, joint function, and range of motion]
(The nurse should allow the client to perform their own ADLs to promote the client's joint
mobility and independence)
(The nurse should use ice to reduce joint inflammation and heat to alleviate joint
discomfort)
(The nurse should not administer more than 3 g of acetaminophen to the client each
day to reduce the risk of injury to the client)
A nurse is caring for a client during a follow up visit at a gastrointestinal clinic.
NURSE NOTES:
0600:
Client admitted to the ED with fatigue, shortness of breath, and weakness for the last 2
days. Client states that they have a history of sickle cell disease (SCD). Client is alert
and orientated to person, place, and time. Restless. Client rates generalized pain as a 9
on a scale of 0 to 10. Vital signs taken and blood drawn for laboratory tests. Oxygen 2 L
via nasal cannula applied. Awaiting prescription for pain management.
0615:
Client still rates pain as a 9 on a scale of 0 to 10. Hydromorphone 4 mg IV administered.
Vital Signs
0600:
Temperature 37.8° C (100° F)Heart rate 104/minRespiratory rate 26/minBlood pressure
88/56 mm HgOxygen saturation 90% on 2 L via nasal cannula
Diagnostic Results
0645:
Hematocrit 25% (37% to 52%)Hemoglobin 8.3 g/dL (12 to 16 g/dL)WBC count
18,000/mm3 (5,000 to 10,000/mm3)Reticul - ANS>>[ ] Administer IV fluids: Hydration is
, a priority when caring for a client in sickle cell crisis because it decreases the rate of cell
sickling and can reduce pain. Hypotonic fluids are typically infused at 250 mL/hr for 4 hr.
[ ] Use humidification with oxygen therapy
[ ] Assess peripheral circulation hourly is correct
[ ] assess the client's mouth at least every 8 hr for the presence of sores or lesions and
any other signs of infection
(Using a blood pressure cuff on the client's arm can cause venous occlusion and
increased pain. Alternatives to monitoring blood pressure should be explored when
caring for a client who has sickle cell crisis)
A home health nurse is caring for a group of older adult clients. The nurse should initiate
a referral to the Program of All-Inclusive Care for the Elderly (PACE) for which of the
following clients?
(A) A client whose family requests hospital-based hospice care
(B) A client who requires transfer to a skilled care facility
(C) A client who qualifies for telehealth for pacemaker diagnostics
(D) A client whose caregiver requests adult day care services - ANS>>A client whose
caregiver requests adult day care services
[The nurse should initiate a referral for PACE for this client because PACE provides
adult day care services along with in-home assessments and supportive services]
(A nurse should assist in the coordination of care for a client who requires transfer to a
skilled care facility, which might require a referral for other disciplines such as physical
and occupational therapy)
(The nurse should assist in the facilitation of telehealth for the client to receive home-
based pacemaker diagnostics through the use of electronic communications)
A nurse is caring for a client who had abdominal surgery 24 hr ago. Which of the
following actions is the nurse's priority?
(A) Assess fluid intake every 24 hr.
(B) Ambulate three times a day.
(C) Assist with deep breathing and coughing.
