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Exam (elaborations)

RN Comprehensive Online Practice Exam (2019 B) Updated for 2024–2025 with NGN — 150 Q&A

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This document appears to be a nursing practice exam modeled after ATI or NCLEX-based comprehensive assessments. It includes: Clinical prioritization questions (e.g., which postoperative client to assess first) Highlighted correct answers Rationales explaining clinical reasoning (e.g., paralytic ileus signs) Assessment categories for ADHD vs. intellectual disability Pediatric nursing scenarios Multiple Q&A sections (150 questions total) Its purpose is to help RN candidates prepare for the Next-Generation NCLEX (NGN) by practicing clinical judgment, prioritization, and assessment interpretation

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Uploaded on
November 18, 2025
Number of pages
78
Written in
2025/2026
Type
Exam (elaborations)
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Questions & answers

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@PROFNOVIEK




RN Comprehensive Online Practice 2019 B
with NGN-with 100% verified solutions-2024-
2025
With 150 Q&A


A nurse has just received change-of-shift report on four clients. Which of the
following clients should the nurse assess first?

A client who is postoperative with abdominal distention and no bowel sounds

A client who has diabetes mellitus and a blood glucose level of 105 mg/dL

A client who has heart failure and 2+ pitting edema

A client who is receiving maintenance IV fluids and needs a new IV catheter
A client who is postoperative with abdominal distention and no bowel sounds

Using the acute vs. chronic approach to client care, the nurse should first assess the
client who is postoperative with abdominal distention and no bowel sounds because
these manifestations are indications of a paralytic ileus.
For each assessment finding, click to specify if the finding is consistent with attention
deficit hyperactivity disorder (ADHD) or intellectual disability (ID). Each finding may
support more than 1 disease process.

Assessment Findings
Intellectual impairment
Interrupting others
Impaired language skills
Hyperreactivity to sensory input
Losing necessary things

A nurse is caring for a school-age child.

Nurses' Notes
First visit:
A child is brought to the clinic accompanied by guardians. The guardians have

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received feedback from the child's teacher that the child has become disinterested in
schoolwork and has difficulty paying attention during class. The child often loses
their school supplies.
The guardians report that the child demonstrates these behaviors at home as well.
The child refuses to participate in household chores, keeps their room untidy, does
not clean up when told to, and is generally careless and disinterested.
On assessing, the child is found to be talkative, restless, and easily distracted.

2 weeks later:
The child's guardians report that the child seems to be doing better at school. The
child is improving at paying attention during class and completing assignments on
time.

Vital Signs
First visit:
Blood pressure 94/56 mm Hg
Heart rate 90/min
Respiratory rate 24/min
Temperature 37.2° C (99° F)
SaO2 99% on room air

2 weeks later:
Blood pressure 98/60 mm Hg
Heart rate 88/min
Respiratory rate 22/min
Temperature 37° C (98.6° F)
SaO2 99% on room air

Provider Prescriptions
Atomoxetine 10 mg PO daily with breakfast for 5 days, then increase dose to 18 mg
PO daily with breakfast
ADHD
Hyperreactivity to sensory input
Losing necessary things
Interrupting others
Intellectual impairment

ID
Intellectual impairment
Hyperreactivity to sensory input

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When analyzing cues, the nurse should identify that manifestations of ADHD include
losing necessary things, interrupting others, intellectual impairment, and hyper
reactivity to sensory input.

In ADHD, the client often loses necessary things in daily life, such as pencils, erasers,
and books. The client often interrupts others and has difficulty waiting for their turn
in conversation.

The client might have an intellectual impairment, which can lead to poor academic
performance and difficulties with socialization. The client might exhibit
hyperreactivity or hyporeactivity to stimuli.
A charge nurse is providing an educational session about infection control for a group
of staff nurses. Which of the following statements by one of the staff nurses
indicates an understanding of isolation precautions?

"Droplet precautions should be initiated for a client who tests positive for measles."

"A client who requires airborne precautions should be placed in a negative-pressure
airflow room."

"Airborne precautions should be initiated for a client who has Clostridium difficile."

"A client who is immunocompromised should be placed in a negative-pressure
airflow room."
A client who requires airborne precautions should be placed in a negative-pressure
airflow room."

Airborne precautions require a negative-pressure airflow room that has at least six to
12 air exchanges each hour using a HEPA filtration system.
A nurse is admitting a client who has pneumonia. The nurse should initiate which of
the following isolation precautions for the client?

Droplet

Airborne

Contact

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Protective environment
Droplet

The nurse should initiate droplet precautions for this client by placing the client in a
private room and wearing a surgical mask when caring for the client. Pneumonia is
transmitted by droplet particles.
A nurse in a community center is providing an educational session to a group of
clients about ovarian cancer. Which of the following manifestations of ovarian cancer
should the nurse include in the teaching?

Diarrhea

Urinary retention

Purulent discharge

Abdominal bloating
Abdominal bloating

The nurse should include the presence of abdominal bloating as an early
manifestation of ovarian cancer. Other manifestations include an increase in
abdominal girth, pelvic or abdominal pain, early satiety, and urinary frequency or
urgency.
A nurse is reviewing the ABG values of a client. The client has a pH of 7.2, PaCO2 of
60 mm Hg, and HCO3- of 25 mEq/L. The nurse should identify that the client has
which of the following acid-base imbalances?

Respiratory alkalosis

Metabolic alkalosis

Respiratory acidosis

Metabolic acidosis
Respiratory acidosis

A client who has respiratory acidosis will have a decreased pH below the expected
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