RN COMP PRACTICE 2023 A QUESTIONS
WITH ACTUAL SOLUTIONS.
NGN: What assessment findings are consistent with Crohn's disease, ulcerative
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colitis, or peritonitis?
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Temperature (100F) cc
Weight (-9.7 lbs) cc cc
Albumin level (2.4) cc cc
WBC (14) cc
Bowel pattern (freq. loose stools)
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Abdominal pain location (RLQ) cc cc cc
Heart rate (105) - ANSWER:Temperature: Crohn's, UC & peritonitis.
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-Elevation can occur with all three due to inflammation and infection.
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Weight: Crohn's & UC. cc cc cc cc
-Unintended weight loss can occur due to malabsorption in the GI tract.
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Bowel pattern: Crohn's.
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-If the patient reported there was blood in the stool, it would be UC. Crohn's
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doesn't cause tarry stools.
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WBC: Crohn's, UC & peritonitis.
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-Elevation can occur due to inflammation and infection.
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Heart rate: peritonitis.
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-Tachycardia can occur due to inflammation, infection, and dehydration.
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Albumin level: Crohn's & UC.
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-Because of the malabsorption in the GI tract, the body isn't receiving enough
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protein.
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Abdominal pain location: Crohn's. cc cc cc cc
-Because it is in the RLQ, it is more consistent with Crohn's. With patients that
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have peritonitis, they experience generalized abd. pain that radiates to the shoulder
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and back.
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NGN: What assessment findings can indicate a transfusion reaction in a patient
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receiving blood?
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,Urine output (150mL of clear, yellow)
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Skin (pale, cool and dry)
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Anxiety
Vital signs (within normal range)
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Headache
Back pain - ANSWER:Back pain, headache & anxiety.
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Hemolytic reaction S/S: back pain, headache, anxiety, fever, chills, chest pain,
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tachycardia, dyspnea, hypotension.
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NGN: Patient arrives with palpitations, difficulty breathing, and reports feeling faint.
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Reports constipation and joint pain for x2 days. In childhood, patient experienced
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physical abuse, and emotionally detached parents. Reports nervousness and only
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leaving home when necessary.
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PMH: freq. hospital visits due to headaches and GI distress.
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Bowtie: - ANSWER:Condition: somatic symptom disorder
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-due to physical inactivity & joint pain
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Interventions: Monitor physical manifestations & assess for presence of 2nd gains
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from their illness
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-disorder is characterized by the presence of other real manifestations like
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dizziness, nausea, back pain, and joint pain.
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Monitor: Vital signs & pain. cc cc cc cc
NGN: What actions should the nurse take when her pedi patient is exhibiting
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symptoms of an allergic reaction?
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Administer 0.9% NS IV cc cc cc
Administer epi IM cc cc
Monitor urine output q2hrscc cc cc
DC supplemental oxygen
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Monitor vital signs frequently
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DC IV medication - ANSWER:Administer 0.9% NS IV
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Administer epi IM cc cc
Monitor vital signs frequently
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DC IV medication
cc cc
-Nurse should DC the Rocephin and give IV NS to help restore fluids because fluid
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shifts can occur quickly during a reaction. Administering epi IM is the first line of
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therapy for anaphylactic reactions because it constricts blood vessels and dilates
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bronchioles. Monitoring vital sings frequently will allow the nurse to monitor for
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signs of shock.
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,NGN: What 5 actions should the nurse plan to take with a patient experiencing
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hallucinations, following alcohol withdrawal?
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Administer thiamine cc
Maintain a low-stimulation environment
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Administer chlordiazepoxide cc
Initiate seizure precautions
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Perform a CIWA-Ar cc cc
Administer disulfiram - ANSWER:Administer thiamine
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Maintain a low-stimulation environment
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Administer chlordiazepoxide cc
Initiate seizure precautions
cc cc
Perform a CIWA-Ar cc cc
-Nurse should plan interventions that keep the patient safe and treat the physical
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manifestations of withdrawal. Use the CIWA-Ar to determine the severity of the
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withdrawal. Withdrawal seizures can occur 12-24hrs after cessation of alcohol use,
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therefore initiate seizure precautions to prevent injury. Administer chlordiazepoxide
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(a benzodiazepine) and place patient in a low-stim environment to decrease
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agitation and the risk for seizures. Administering thiamine can prevent Wernicke
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syndrome.
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NGN: A post-op patient is experiencing right lower extremity pain and itching,
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following an emergent appy. Reports right lower extremity pain that has been
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intermittent for x2 months.
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Assessment: Bilat lower extremities warm to touch, pedal pulses 2+ bilat. Spider
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veins noted. Distended veins noted on right lower extremity. Vital signs are within
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normal limits.
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Bowtie: - ANSWER:Condition: Varicose veins.
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-due to edema & pruritis
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Interventions: Elevate extremity & apply compression stockings
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-to promote venous return & circulation
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Monitor: Pruritis & edema cc cc cc
NGN: Which assessment findings require an immediate follow-up in a schizophrenic
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patient?
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Hyperactive bowel sounds x4 cc cc cc
Last HCP appointment was 6 months ago
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Client AO x2 cc cc
Agitated
Speech disorganized cc
, Involuntary tongue movement and foot tremor cc cc cc cc cc
Increase in urination and one episode of incontinence
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Family c/o increased agitation and delusions - ANSWER:Involuntary tongue
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movement and foot tremor
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Frequent urination and incontinence cc cc cc
Increase in agitation cc cc
-Patient is experiencing tardive dyskinesia
cc cc cc cc
A home health nurse is evaluation a school-age child who has cystic fibrosis. The
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nurse should initiate a request for a high-frequency chest compression vest in
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response to which of the following parent statements?
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A. "My child doesn't like to sit still for nebulizer treatments."
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B. "I think that my child has been running a fever over the last couple of days."
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C. "My child only has a small amount of mucus after percussion therapy."
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D. "I am concerned about my child's future participation in team sports." -
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ANSWER:C. "My child has only a small amount of mucus after percussion
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therapy."
cc
-The nurse should recommend a high-frequency vest for a child who has
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inadequate results from other airway clearance therapy techniques. Older children
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often require other techniques in addition to percussion and postural drainage to
cc cc cc cc cc cc cc cc cc cc cc cc
achieve adequate mucus expectoration.
cc cc cc cc
-The nurse should teach the parent techniques for administration for nebulizer
cc cc cc cc cc cc cc cc cc cc
treatments to the child.
cc cc cc cc cc
-The nurse should follow-up on reports of fever, as this could indicate a pulmonary
cc cc cc cc cc cc cc cc cc cc cc cc cc
infection.
cc
-The nurse should discuss participation in sports activities in relation to the child's
cc cc cc cc cc cc cc cc cc cc cc cc
current physical and pulmonary health.
cc cc cc cc cc
NGN: A patient who is x2 post-op, following a surgical repair of a left hip fracture,
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is c/o of intermittent abdominal pain. Rates 5/10 on left side of abdomen. Pain
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began after eating dinner. Last bowel movement was 5 days prior. Reports usual
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pattern is x1 daily.
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Assessment: Abdomen distended, dull to percussion, firm and non-tender on
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palpation. Hypoactive bowel sounds x4. Vital signs are within normal limits.
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Bowtie: - ANSWER:Condition: Intestinal obstruction
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-bowel sounds hypoactive x4, last BM was 5 days prior, intermittent to constant
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pain.
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WITH ACTUAL SOLUTIONS.
NGN: What assessment findings are consistent with Crohn's disease, ulcerative
cc cc cc cc cc cc cc cc cc
colitis, or peritonitis?
cc cc cc
Temperature (100F) cc
Weight (-9.7 lbs) cc cc
Albumin level (2.4) cc cc
WBC (14) cc
Bowel pattern (freq. loose stools)
cc cc cc cc
Abdominal pain location (RLQ) cc cc cc
Heart rate (105) - ANSWER:Temperature: Crohn's, UC & peritonitis.
cc cc cc cc cc cc cc cc cc
-Elevation can occur with all three due to inflammation and infection.
cc cc cc cc cc cc cc cc cc cc cc
Weight: Crohn's & UC. cc cc cc cc
-Unintended weight loss can occur due to malabsorption in the GI tract.
cc cc cc cc cc cc cc cc cc cc cc cc
Bowel pattern: Crohn's.
cc cc
-If the patient reported there was blood in the stool, it would be UC. Crohn's
cc cc cc cc cc cc cc cc cc cc cc cc cc cc
doesn't cause tarry stools.
cc cc cc cc cc
WBC: Crohn's, UC & peritonitis.
cc cc cc cc
-Elevation can occur due to inflammation and infection.
cc cc cc cc cc cc cc cc
Heart rate: peritonitis.
cc cc cc
-Tachycardia can occur due to inflammation, infection, and dehydration.
cc cc cc cc cc cc cc cc cc
Albumin level: Crohn's & UC.
cc cc cc cc cc
-Because of the malabsorption in the GI tract, the body isn't receiving enough
cc cc cc cc cc cc cc cc cc cc cc cc
protein.
cc cc
Abdominal pain location: Crohn's. cc cc cc cc
-Because it is in the RLQ, it is more consistent with Crohn's. With patients that
cc cc cc cc cc cc cc cc cc cc cc cc cc cc
have peritonitis, they experience generalized abd. pain that radiates to the shoulder
cc cc cc cc cc cc cc cc cc cc cc cc
and back.
cc cc
NGN: What assessment findings can indicate a transfusion reaction in a patient
cc cc cc cc cc cc cc cc cc cc cc
receiving blood?
cc cc
,Urine output (150mL of clear, yellow)
cc cc cc cc cc
Skin (pale, cool and dry)
cc cc cc cc
Anxiety
Vital signs (within normal range)
cc cc cc cc
Headache
Back pain - ANSWER:Back pain, headache & anxiety.
cc cc cc cc cc cc cc cc
Hemolytic reaction S/S: back pain, headache, anxiety, fever, chills, chest pain,
cc cc cc cc cc cc cc cc cc cc
tachycardia, dyspnea, hypotension.
cc cc cc
NGN: Patient arrives with palpitations, difficulty breathing, and reports feeling faint.
cc cc cc cc cc cc cc cc cc cc
Reports constipation and joint pain for x2 days. In childhood, patient experienced
cc cc cc cc cc cc cc cc cc cc cc cc
physical abuse, and emotionally detached parents. Reports nervousness and only
cc cc cc cc cc cc cc cc cc cc
leaving home when necessary.
cc cc cc cc cc
PMH: freq. hospital visits due to headaches and GI distress.
cc cc cc cc cc cc cc cc cc cc
Bowtie: - ANSWER:Condition: somatic symptom disorder
cc cc cc cc cc cc
-due to physical inactivity & joint pain
cc cc cc cc cc cc
Interventions: Monitor physical manifestations & assess for presence of 2nd gains
cc cc cc cc cc cc cc cc cc cc
from their illness
cc cc cc
-disorder is characterized by the presence of other real manifestations like
cc cc cc cc cc cc cc cc cc cc
dizziness, nausea, back pain, and joint pain.
cc cc cc cc cc cc cc cc
Monitor: Vital signs & pain. cc cc cc cc
NGN: What actions should the nurse take when her pedi patient is exhibiting
cc cc cc cc cc cc cc cc cc cc cc cc
symptoms of an allergic reaction?
cc cc cc cc cc
Administer 0.9% NS IV cc cc cc
Administer epi IM cc cc
Monitor urine output q2hrscc cc cc
DC supplemental oxygen
cc cc
Monitor vital signs frequently
cc cc cc
DC IV medication - ANSWER:Administer 0.9% NS IV
cc cc cc cc cc cc cc
Administer epi IM cc cc
Monitor vital signs frequently
cc cc cc
DC IV medication
cc cc
-Nurse should DC the Rocephin and give IV NS to help restore fluids because fluid
cc cc cc cc cc cc cc cc cc cc cc cc cc cc
shifts can occur quickly during a reaction. Administering epi IM is the first line of
cc cc cc cc cc cc cc cc cc cc cc cc cc cc cc
therapy for anaphylactic reactions because it constricts blood vessels and dilates
cc cc cc cc cc cc cc cc cc cc cc
bronchioles. Monitoring vital sings frequently will allow the nurse to monitor for
cc cc cc cc cc cc cc cc cc cc cc cc
signs of shock.
cc cc cc
,NGN: What 5 actions should the nurse plan to take with a patient experiencing
cc cc cc cc cc cc cc cc cc cc cc cc cc
hallucinations, following alcohol withdrawal?
cc cc cc cc
Administer thiamine cc
Maintain a low-stimulation environment
cc cc cc cc
Administer chlordiazepoxide cc
Initiate seizure precautions
cc cc
Perform a CIWA-Ar cc cc
Administer disulfiram - ANSWER:Administer thiamine
cc cc cc cc
Maintain a low-stimulation environment
cc cc cc cc
Administer chlordiazepoxide cc
Initiate seizure precautions
cc cc
Perform a CIWA-Ar cc cc
-Nurse should plan interventions that keep the patient safe and treat the physical
cc cc cc cc cc cc cc cc cc cc cc cc
manifestations of withdrawal. Use the CIWA-Ar to determine the severity of the
cc cc cc cc cc cc cc cc cc cc cc cc
withdrawal. Withdrawal seizures can occur 12-24hrs after cessation of alcohol use,
cc cc cc cc cc cc cc cc cc cc cc
therefore initiate seizure precautions to prevent injury. Administer chlordiazepoxide
cc cc cc cc cc cc cc cc cc
(a benzodiazepine) and place patient in a low-stim environment to decrease
cc cc cc cc cc cc cc cc cc cc cc
agitation and the risk for seizures. Administering thiamine can prevent Wernicke
cc cc cc cc cc cc cc cc cc cc cc
syndrome.
cc
NGN: A post-op patient is experiencing right lower extremity pain and itching,
cc cc cc cc cc cc cc cc cc cc cc
following an emergent appy. Reports right lower extremity pain that has been
cc cc cc cc cc cc cc cc cc cc cc cc
intermittent for x2 months.
cc cc cc cc cc
Assessment: Bilat lower extremities warm to touch, pedal pulses 2+ bilat. Spider
cc cc cc cc cc cc cc cc cc cc cc
veins noted. Distended veins noted on right lower extremity. Vital signs are within
cc cc cc cc cc cc cc cc cc cc cc cc cc
normal limits.
cc cc cc
Bowtie: - ANSWER:Condition: Varicose veins.
cc cc cc cc
-due to edema & pruritis
cc cc cc cc cc
Interventions: Elevate extremity & apply compression stockings
cc cc cc cc cc cc
-to promote venous return & circulation
cc cc cc cc cc
Monitor: Pruritis & edema cc cc cc
NGN: Which assessment findings require an immediate follow-up in a schizophrenic
cc cc cc cc cc cc cc cc cc cc
patient?
cc
Hyperactive bowel sounds x4 cc cc cc
Last HCP appointment was 6 months ago
cc cc cc cc cc cc
Client AO x2 cc cc
Agitated
Speech disorganized cc
, Involuntary tongue movement and foot tremor cc cc cc cc cc
Increase in urination and one episode of incontinence
cc cc cc cc cc cc cc
Family c/o increased agitation and delusions - ANSWER:Involuntary tongue
cc cc cc cc cc cc cc cc
movement and foot tremor
cc cc cc cc
Frequent urination and incontinence cc cc cc
Increase in agitation cc cc
-Patient is experiencing tardive dyskinesia
cc cc cc cc
A home health nurse is evaluation a school-age child who has cystic fibrosis. The
cc cc cc cc cc cc cc cc cc cc cc cc cc
nurse should initiate a request for a high-frequency chest compression vest in
cc cc cc cc cc cc cc cc cc cc cc cc
response to which of the following parent statements?
cc cc cc cc cc cc cc cc
A. "My child doesn't like to sit still for nebulizer treatments."
cc cc cc cc cc cc cc cc cc cc
B. "I think that my child has been running a fever over the last couple of days."
cc cc cc cc cc cc cc cc cc cc cc cc cc cc cc cc
C. "My child only has a small amount of mucus after percussion therapy."
cc cc cc cc cc cc cc cc cc cc cc cc
D. "I am concerned about my child's future participation in team sports." -
cc cc cc cc cc cc cc cc cc cc cc cc
ANSWER:C. "My child has only a small amount of mucus after percussion
cc cc cc cc cc cc cc cc cc cc cc cc
therapy."
cc
-The nurse should recommend a high-frequency vest for a child who has
cc cc cc cc cc cc cc cc cc cc cc
inadequate results from other airway clearance therapy techniques. Older children
cc cc cc cc cc cc cc cc cc cc
often require other techniques in addition to percussion and postural drainage to
cc cc cc cc cc cc cc cc cc cc cc cc
achieve adequate mucus expectoration.
cc cc cc cc
-The nurse should teach the parent techniques for administration for nebulizer
cc cc cc cc cc cc cc cc cc cc
treatments to the child.
cc cc cc cc cc
-The nurse should follow-up on reports of fever, as this could indicate a pulmonary
cc cc cc cc cc cc cc cc cc cc cc cc cc
infection.
cc
-The nurse should discuss participation in sports activities in relation to the child's
cc cc cc cc cc cc cc cc cc cc cc cc
current physical and pulmonary health.
cc cc cc cc cc
NGN: A patient who is x2 post-op, following a surgical repair of a left hip fracture,
cc cc cc cc cc cc cc cc cc cc cc cc cc cc cc
is c/o of intermittent abdominal pain. Rates 5/10 on left side of abdomen. Pain
cc cc cc cc cc cc cc cc cc cc cc cc cc cc
began after eating dinner. Last bowel movement was 5 days prior. Reports usual
cc cc cc cc cc cc cc cc cc cc cc cc cc
pattern is x1 daily.
cc cc cc cc cc
Assessment: Abdomen distended, dull to percussion, firm and non-tender on
cc cc cc cc cc cc cc cc cc
palpation. Hypoactive bowel sounds x4. Vital signs are within normal limits.
cc cc cc cc cc cc cc cc cc cc cc cc
Bowtie: - ANSWER:Condition: Intestinal obstruction
cc cc cc cc
-bowel sounds hypoactive x4, last BM was 5 days prior, intermittent to constant
cc cc cc cc cc cc cc cc cc cc cc cc
pain.
cc cc
