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NCLEX NGN Tips & Practice Questions, Answered
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NCLEX NGN Tips & Practice Questions, Answered-How to Recognize Cues - To Recognize Cues, carefully review the client's assessment data like developmental age and history to help determine if findings are relevant or of immediate concern to the nurse. How to Analyze Cues - To Analyze Cues, you ar...

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NCLEX NGN Tips & Practice Questions,
Answered
How to Recognize Cues - To Recognize Cues, carefully review the client's
assessment data like developmental age and history to help determine if findings
are relevant or of immediate concern to the nurse.

How to Analyze Cues - To Analyze Cues, you are not required to make a medical
diagnosis but rather will be expected to connect or link client findings with
selected client conditions or health problems, either actual or potential.

How to Generate Solutions - To Generate Solutions to meet a client's priority
needs, determine the client's desired or expected outcomes first.

Informational: NGN Case Study - The Unfolding Case Study presents the client
over time through several phases of care in the clinical scenario.

The client may initially be evaluated in an ED, acute care hospital, clinic, school,
or urgent care center. As the scenario changes, or "unfolds," new NGN test items
require that the candidate use the information in the current phase of the client's
care to answer each question. Nursing candidates can expect to have three NGN
Case Studies with six questions each. Each of the six questions rep- resents one of
the clinical judgment cognitive skills discussed earlier.

A 42-year-old postpartum client who just gave birth to a third child in 4 years
reports severe "afterbirth pains" of 9/10 on a 0 to 10 pain intensity scale. The client
also reports having problems with getting the baby to latch for breast-
feeding/chest-feeding. The nurse assesses that the client has a boggy uterus and is
saturating a peri-pad every 20 to 30 minutes.

Rank the following items in order of priority:
Difficulty with breast-feeding/chest-feeding due to inability of baby to latch
Severe abdominal pain due to uterine contractions

, Excessive post-partum bleeding due to boggy uterus - 1. Excessive postpartum
bleeding due to boggy uterus
2. Severe abdominal pain due to uterine contractions
3. Difficulty with breast-feeding/chest-feeding due to inability of baby to latch

The priority for this client at this time is to manage excessive postpartum bleeding
because the client could become hypovolemic and develop shock. In this situation,
managing the client's bleeding is more urgent than managing severe pain or breast-
feeding/ chest-feeding difficulty to prevent the risk of a life-threatening
complication.

A 28-year-old client is brought to the ED by friends, who state that the client
became violent this evening in a local bar after a partner "break up." The client
accused the partner of "cheating" and pulled out a knife. The client's friends were
able to stop the client and take the knife before any harm occurred. They state that
they have never seen the client act like this and are worried that something might
be seriously wrong. Currently the client seems agitated and restless, and begins
pacing in the ED demand- ing to "see my partner right now."

Based on the client information provided, what is the nurse's first action?
A. Ask the client's friends to check the client for additional weapons.
B. Reassure the client that the client is safe and secure in the ED.
C. Call Security for assistance.
D. Allow the client to vent own feelings.
E. Administer an anti-anxiety medication.
F. Distract the client and guide the c - D. Allow the client to vent own feelings.

As with any client who is upset, paranoid, angry, or potentially violent, you would
first allow the client to vent feelings, which may help diffuse the situation.
Allowing a client to vent and keeping the client and staff safe are the initial focus
of nursing care when encountering any client with an actual or potential mental
health problem or crisis.

Matrix Multiple Choice Question:

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