1|Page
NURS 493 NGN Practice 1 – Study
Guide SP 2025
📘 Course: Nursing 493 – Next Generation NCLEX (NGN) Practice
📅 Exam: Spring 2025 – Practice Review
📑 Document Contents
This study guide provides a comprehensive review of high-yield clinical
scenarios and critical thinking exercises to prepare for NGN-style nursing
exams. Topics covered include:
• Cardiac Care: Pericarditis, dysrhythmias, digitalis toxicity,
hypokalemia, management of pediatric cardiac patients
• Hematology & Oncology: Acute leukemia, bleeding risks, infection
prevention, laboratory interpretation
• Maternal-Child Health: Postpartum hemorrhage, hydramnios,
gestational diabetes, labor and delivery complications
• Emergency & Critical Care: Chest pain assessment, vital signs
interpretation, rapid response interventions, medication administration
• Diagnostic & Monitoring Parameters: Laboratory values, fetal heart
monitoring, vital signs trends, pulsus paradoxus, ECG interpretation
🔑 Keywords:
NURS 493 NGN practice questions, NGN exam review 2024, nursing case
scenarios, maternal-child health, cardiac care, hematology nursing, critical care
nursing, high-yield nursing study guide, clinical judgment exercises
✨ Use this guide to review clinical scenarios, reinforce critical thinking, and
ensure readiness for the NGN practice and final examinations.
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A nurse is caring for a 45-year-old client in the emergency department.
Nurses' Notes
Admitted to the emergency accompanied by partner. Alert and oriented x3.
Skin warm and dry, no discoloration noted. Client reports substernal chest
pain that radiates to the left shoulder and neck. Rates pain as 8 on a scale of
0 to 10. Pain increases with aspiration and when lying down. Client reports
decreased pain when sitting upright and leaning forward. Heart sounds
regular with a pericardial friction rub auscultated left lower sternal border.
Lungs clear to auscultation with occasional non-productive cough. No
peripheral edema noted.
Vital Signs
Temperature 38.3° C (101° F)
Heart rate 100/min
Respiration rate 20/min
BP 128/82 mm Hg
Oxygen saturation 98% on room air
Actions to Take
- obtain an echocardiogram
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- obtain a prescription for an NSAID such as ibuprofen
Potential Condition
- pericarditis
Parameters to Monitor
- pain level
- pulsus paradoxus
The nurse should obtain an echocardiogram and obtain a prescription for an
NSAID such as ibuprofen because the client is most likely experiencing
pericarditis due a respiratory infection.
The nurse should monitor the client's pain as well as for pulsus paradoxus (a
systolic blood pressure increase of > 10 mm Hg during inspiration) which is a
manifestation of cardiac tamponade and is a medical emergency.
A nurse is reviewing the medical record of a client who has acute leukemia.
Diagnostic Results
Month Three:
WBC count 15,500/mm3 (5,000 to 10,000/mm3)
RBC count 4.0 million/mm3 (4.2 to 5.4 million/mm3)
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Hemoglobin 11 g/dL (12 to 16 g/dL)
Hematocrit 33% (37% to 47%)
Platelet count 100,000/mm3 (150,000 to 400,000/mm3)
PT 13.5 seconds (11 to 12.5 seconds)
INR 2.2 seconds (0.8 to 1.1 seconds)
PTT 85 seconds (60 to 70 seconds)
Sodium 137 mEq/L (136 to 145 mEq/L)
Potassium 4.5 mEq/L (3.5 to 5 mEq/L)
Glucose 98 mg/dL (74 to 106 mg/dL)
BUN 15 mg/dL (10 to 20 mg/dL)
Creatinine 0.8 mg/dL (0.5 to 1 mg/dL)
Calcium 9.5 mg/dL (9 to 10.5 mg/dL)
Vitamin D 65 ng/dL (25 to 80 ng/dL)
Drag words from the choices below to fill in each blank in the following
sentence.
Bleeding and infection are correct.
NURS 493 NGN Practice 1 – Study
Guide SP 2025
📘 Course: Nursing 493 – Next Generation NCLEX (NGN) Practice
📅 Exam: Spring 2025 – Practice Review
📑 Document Contents
This study guide provides a comprehensive review of high-yield clinical
scenarios and critical thinking exercises to prepare for NGN-style nursing
exams. Topics covered include:
• Cardiac Care: Pericarditis, dysrhythmias, digitalis toxicity,
hypokalemia, management of pediatric cardiac patients
• Hematology & Oncology: Acute leukemia, bleeding risks, infection
prevention, laboratory interpretation
• Maternal-Child Health: Postpartum hemorrhage, hydramnios,
gestational diabetes, labor and delivery complications
• Emergency & Critical Care: Chest pain assessment, vital signs
interpretation, rapid response interventions, medication administration
• Diagnostic & Monitoring Parameters: Laboratory values, fetal heart
monitoring, vital signs trends, pulsus paradoxus, ECG interpretation
🔑 Keywords:
NURS 493 NGN practice questions, NGN exam review 2024, nursing case
scenarios, maternal-child health, cardiac care, hematology nursing, critical care
nursing, high-yield nursing study guide, clinical judgment exercises
✨ Use this guide to review clinical scenarios, reinforce critical thinking, and
ensure readiness for the NGN practice and final examinations.
,2|Page
A nurse is caring for a 45-year-old client in the emergency department.
Nurses' Notes
Admitted to the emergency accompanied by partner. Alert and oriented x3.
Skin warm and dry, no discoloration noted. Client reports substernal chest
pain that radiates to the left shoulder and neck. Rates pain as 8 on a scale of
0 to 10. Pain increases with aspiration and when lying down. Client reports
decreased pain when sitting upright and leaning forward. Heart sounds
regular with a pericardial friction rub auscultated left lower sternal border.
Lungs clear to auscultation with occasional non-productive cough. No
peripheral edema noted.
Vital Signs
Temperature 38.3° C (101° F)
Heart rate 100/min
Respiration rate 20/min
BP 128/82 mm Hg
Oxygen saturation 98% on room air
Actions to Take
- obtain an echocardiogram
,3|Page
- obtain a prescription for an NSAID such as ibuprofen
Potential Condition
- pericarditis
Parameters to Monitor
- pain level
- pulsus paradoxus
The nurse should obtain an echocardiogram and obtain a prescription for an
NSAID such as ibuprofen because the client is most likely experiencing
pericarditis due a respiratory infection.
The nurse should monitor the client's pain as well as for pulsus paradoxus (a
systolic blood pressure increase of > 10 mm Hg during inspiration) which is a
manifestation of cardiac tamponade and is a medical emergency.
A nurse is reviewing the medical record of a client who has acute leukemia.
Diagnostic Results
Month Three:
WBC count 15,500/mm3 (5,000 to 10,000/mm3)
RBC count 4.0 million/mm3 (4.2 to 5.4 million/mm3)
, 4|Page
Hemoglobin 11 g/dL (12 to 16 g/dL)
Hematocrit 33% (37% to 47%)
Platelet count 100,000/mm3 (150,000 to 400,000/mm3)
PT 13.5 seconds (11 to 12.5 seconds)
INR 2.2 seconds (0.8 to 1.1 seconds)
PTT 85 seconds (60 to 70 seconds)
Sodium 137 mEq/L (136 to 145 mEq/L)
Potassium 4.5 mEq/L (3.5 to 5 mEq/L)
Glucose 98 mg/dL (74 to 106 mg/dL)
BUN 15 mg/dL (10 to 20 mg/dL)
Creatinine 0.8 mg/dL (0.5 to 1 mg/dL)
Calcium 9.5 mg/dL (9 to 10.5 mg/dL)
Vitamin D 65 ng/dL (25 to 80 ng/dL)
Drag words from the choices below to fill in each blank in the following
sentence.
Bleeding and infection are correct.
