RN Concept-Based Assessment Level 4 Online
Practice A with NGN | Exam Questions With
Correct Answers 100% Verified
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.
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 effect 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.
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 they have
had burning, itching, thick, cottage cheese-like vaginal discharge. The client also reports
night sweats and a recent unintentional weight loss of approximately 10 lb over 3
months.
Past medical history: Hypertension, rheumatoid arthritisSocial history: The client reports
drinking three glasses wine per day, reports IV heroin use, and uses a nicotine vape
pen. The client reports "a few" sexual partners and "sometimes" uses condoms.Family:
Client's sister has type 2 diabetes mellitus, and brother is HIV+.
Physical Exam:
General: no acute distress, flushed
Respiratory: breath sounds clear bilaterally
Cardiovascular: S1, S2 no murmur
Extremities: diffuse lymphadenopathy
Practice A with NGN | Exam Questions With
Correct Answers 100% Verified
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.
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 effect 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.
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 they have
had burning, itching, thick, cottage cheese-like vaginal discharge. The client also reports
night sweats and a recent unintentional weight loss of approximately 10 lb over 3
months.
Past medical history: Hypertension, rheumatoid arthritisSocial history: The client reports
drinking three glasses wine per day, reports IV heroin use, and uses a nicotine vape
pen. The client reports "a few" sexual partners and "sometimes" uses condoms.Family:
Client's sister has type 2 diabetes mellitus, and brother is HIV+.
Physical Exam:
General: no acute distress, flushed
Respiratory: breath sounds clear bilaterally
Cardiovascular: S1, S2 no murmur
Extremities: diffuse lymphadenopathy
