Question

A nurse is caring for a client in a mental health clinic.

Answer 1

Correct Answers:

Duloxetine
Paroxetine
Escitalopram
Venlafaxine

Rationale :

🔷 Duloxetine Duloxetine is an SNRI (serotonin-norepinephrine reuptake inhibitor) effective in treating generalized anxiety disorder (GAD).

🔷 It helps reduce both psychological symptoms (excessive worry) and physical symptoms (muscle tension).

🔷 FDA-approved for GAD in adults and often well tolerated.

🔷 Paroxetine Paroxetine is an SSRI commonly prescribed for anxiety disorders, including GAD.

🔷 It increases serotonin in the brain, improving mood and reducing anxiety. It is considered a first- line pharmacologic treatment for GAD.

🔷 Escitalopram Escitalopram is another SSRI, effective and FDA-approved for GAD. Known for having a favorable side effect profile compared to some other SSRIs.

🔷 Reduces excessive worry, restlessness, and improves sleep.

🔷 Venlafaxine Venlafaxine is an SNRI effective in treating GAD, especially when symptoms include physical tension and fatigue.

🔷 Often prescribed when SSRIs are not effective or not tolerated. Provides both antidepressant and anti-anxiety benefits.

🔷 Risperidone → An atypical antipsychotic, used for schizophrenia, bipolar, or adjunct in depression not first-line for GAD.

🔷 Memantine → NMDA receptor antagonist, used for Alzheimer’s disease, not anxiety.

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Answer 2

Correct Highlights :

restless, irritable Cardiopulmonary
Oxygen saturation 92% on room air
Temperature 38.3° C (100.9° F)
few petechial lesions noted to the upper chest
oriented to person and place only
Faint crackles bilaterally

Rationale :

👍The client is showing clinical signs consistent with fat embolism syndrome (FES), a serious complication of long bone fractures such as a femur fracture.

👍The findings of restlessness, irritability, and disorientation reflect neurologic changes caused by hypoxemia, as fat globules obstruct cerebral circulation.

👍The drop in oxygen saturation to 92% with new bilateral crackles indicates pulmonary involvement, where emboli and fluid impair alveolar gas exchange.

👍The fever of 38.3 °C (100.9 °F) represents a systemic inflammatory response triggered by fat emboli circulating in the bloodstream.

👍The presence of petechiae on the chest is the classic hallmark sign of FES, caused by dermal capillary occlusion.

👍Together, these symptoms form the classic triad of fat embolism syndrome—hypoxemia, neurologic changes, and petechiae— confirming this as the potential complication of the client’s injury.

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Answer 3

Correct Answers

Blank 1 Correct Option: Crohn’s disease
Blank 2 Correct Option: Educate the client about the purpose of immunosuppressants and Encourage the client to eat foods high in probiotics.
Blank 3 Correct Option: Client’s body weight and Serum albumin

Rationale :

🎗️The client’s chronic diarrhea, weight loss, anemia, low iron, and positive hemoccult indicate a long-standing inflammatory process with malabsorption and blood loss.

🎗️The MRI and colonoscopy findings of cobblestone mucosa, bowel wall thickening, deep ulcerations, and skip lesions are classic hallmarks of 🎗️Crohn’s disease, distinguishing it from other gastrointestinal conditions.

🎗️Because Crohn’s is an autoimmune disorder, management includes immunosuppressant therapy to control inflammation and prevent progression, making patient education about these medications essential.

🎗️Nutritional compromise is common due to poor absorption and intestinal blood loss; therefore, dietary guidance, including the use of probiotics, supports intestinal balance and symptom relief.

🎗️Monitoring the client’s body weight provides a direct measure of nutritional status, while serum albumin reflects protein stores and ongoing disease impact.

🎗️Together, these findings and interventions highlight the importance of both medical management and nutritional monitoring in controlling Crohn’s disease and preventing complications.

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Answer 4

Correct Answers:

Tomatoes

Rationale :

🔷 Tomatoes are acidic and can worsen GERD symptoms by irritating the esophageal lining and lowering the lower esophageal sphincter (LES) tone.

🔷 Acidic and spicy foods (tomatoes, citrus, coffee, chocolate, fatty foods) should be avoided.

🔷 Apples, bananas, and potatoes are generally safe and not strongly acidic.

🔷 Dietary education is central to non-pharmacologic GERD management.

🔷 Patients should also eat smaller meals and avoid lying down after eating.

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Answer 5

Correct Answers:

Pregabalin

Rationale :

🔶 Pregabalin is an anticonvulsant/neuropathic pain agent used to treat diabetic peripheral neuropathy.

🔶 It relieves tingling, burning, and stabbing pain caused by nerve damage.

🔶 Labetalol is an antihypertensive, eplerenone is an aldosterone antagonist, and ondansetron is an antiemetic—none treat neuropathy.

🔶 Pregabalin improves quality of life by reducing chronic pain and discomfort.

🔶 Monitoring includes sedation and dizziness as side effects.

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Answer 6

Correct Answers:

"Stop exercising if your heart rate increases by 20 beats per minute from baseline.”

Rationale :

💠 Post–CABG patients need gradual, safe exercise to improve cardiac conditioning.

💠 A HR rise of more than 20 bpm from baseline signals overexertion and potential ischemia.

💠 They should stop activity if angina occurs—not resume after resting.

💠 Walking should start short and gradually progress, not half a mile twice daily initially.

💠 Sun exposure is not a restriction unless on photosensitizing meds.

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Answer 7

Correct Answers:

Initiate frequent, short periods of exercise throughout the day.

Rationale :

🔷 For clients with hemiplegia, frequent short sessions prevent contractures, improve circulation, and build endurance.

🔷 Once-per-day ROM is inadequate; exercise must be routine and consistent.

🔷 ROM should continue even if mild tightness occurs, with gentle stretching to maintain function.

🔷 Repetitive movements are actually encouraged for neuro-retraining.

🔷 This approach prevents complications such as stiffness, weakness, and skin breakdown.

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Answer 8

Correct Answers:

Cellulitis

Rationale :

🔶 Findings of erythema, edema, tenderness, warmth, and pain indicate cellulitis, a bacterial skin infection.

🔶 Dermatophytosis is fungal (ringworm) and not usually red/swollen.

🔶 Herpes zoster presents with vesicles along a dermatomal pattern, not diffuse swelling.

🔶 Contact dermatitis is allergic, often itchy with rash, not tender with warmth.

🔶 Cellulitis requires prompt antibiotics to prevent systemic spread.

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Answer 9

Correct Answers:

"I will include omega-3 fatty acids in my diet."

Rationale :

💠 Omega-3 fatty acids (from fish, flaxseed, walnuts) reduce triglycerides and improve lipid profile. 💠 Trans fats and saturated fats worsen hyperlipidemia and should be avoided. 💠 Red meat is high in saturated fat and cholesterol, not recommended. 💠 Dietary changes are the first step in managing hyperlipidemia before or with medications. 💠 Lifestyle changes also include exercise and weight control.

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Answer 10

Correct Answers:

"Gestational diabetes increases the risk of your baby having hypoglycemia after birth."

Rationale :

🔷 In gestational diabetes, excess maternal glucose crosses the placenta, stimulating the fetus to produce high insulin.

🔷 After birth, maternal glucose supply stops, but insulin remains high → neonatal hypoglycemia.

🔷 Other risks: macrosomia, birth trauma, respiratory distress—not hemorrhagic disease, low birth weight, or congenital anomalies like cleft lip.

🔷 Neonatal monitoring includes frequent blood glucose checks after delivery.

🔷 Early feeding and IV glucose may be required.

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RN concept based assessment Level 2 with NGN -Retake 1(September 2025)

No.

1 :
A nurse is caring for a client in a mental health clinic.

Answer Options

2 :
A nurse is caring for a client admitted to the trauma medical unit.

Correct Highlights :

3 :
The client presents to the outpatient gastroenterologist's office at the request of the client's primary care provider.

Correct Answers

4 :
A nurse is teaching a client who has gastroesophageal reflux disease about how her diet can help reduce her discomfort. Which of the following foods should the nurse tell the client to avoid?

5 :
A nurse is caring for a client who has diabetes mellitus. The client states, "I have intermittent tingling and burning pain in my feet." The nurse should expect the provider to prescribe which of the following medications?

6 :
A nurse is providing postoperative teaching to a client who had a coronary artery bypass graft due to arteriosclerosis. Which of the following information should the nurse include in the teaching regarding exercise?

7 :
A nurse is planning care for a client who has left-sided hemiplegia. Which of the following actions should the nurse include in the plan?

8 :
A nurse is examining a skin infection on a client's lower left leg. Findings include edema, erythema, tenderness, and the client reports pain. The nurse should identify that these findings indicate which of the following?

9 :
A nurse is providing teaching for a client who has a new diagnosis of hyperlipidemia. Which of the following client statements indicates an understanding of the teaching?

10 :
A nurse is caring for a client who is at 31 weeks of gestation and has gestational diabetes mellitus. The client asks, "Can gestational diabetes affect my baby?" Which of the following responses should the nurse make?

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RN concept based assessment Level 2 with NGN -Retake 1(September 2025)

No.

1 : A nurse is caring for a client in a mental health clinic.

Answer Options

2 : A nurse is caring for a client admitted to the trauma medical unit.

Correct Highlights :

3 : The client presents to the outpatient gastroenterologist's office at the request of the client's primary care provider.

Correct Answers

4 : A nurse is teaching a client who has gastroesophageal reflux disease about how her diet can help reduce her discomfort. Which of the following foods should the nurse tell the client to avoid?

5 : A nurse is caring for a client who has diabetes mellitus. The client states, "I have intermittent tingling and burning pain in my feet." The nurse should expect the provider to prescribe which of the following medications?

6 : A nurse is providing postoperative teaching to a client who had a coronary artery bypass graft due to arteriosclerosis. Which of the following information should the nurse include in the teaching regarding exercise?

7 : A nurse is planning care for a client who has left-sided hemiplegia. Which of the following actions should the nurse include in the plan?

8 : A nurse is examining a skin infection on a client's lower left leg. Findings include edema, erythema, tenderness, and the client reports pain. The nurse should identify that these findings indicate which of the following?

9 : A nurse is providing teaching for a client who has a new diagnosis of hyperlipidemia. Which of the following client statements indicates an understanding of the teaching?

10 : A nurse is caring for a client who is at 31 weeks of gestation and has gestational diabetes mellitus. The client asks, "Can gestational diabetes affect my baby?" Which of the following responses should the nurse make?

1 :
A nurse is caring for a client in a mental health clinic.

2 :
A nurse is caring for a client admitted to the trauma medical unit.

3 :
The client presents to the outpatient gastroenterologist's office at the request of the client's primary care provider.

4 :
A nurse is teaching a client who has gastroesophageal reflux disease about how her diet can help reduce her discomfort. Which of the following foods should the nurse tell the client to avoid?

5 :
A nurse is caring for a client who has diabetes mellitus. The client states, "I have intermittent tingling and burning pain in my feet." The nurse should expect the provider to prescribe which of the following medications?

6 :
A nurse is providing postoperative teaching to a client who had a coronary artery bypass graft due to arteriosclerosis. Which of the following information should the nurse include in the teaching regarding exercise?

7 :
A nurse is planning care for a client who has left-sided hemiplegia. Which of the following actions should the nurse include in the plan?

8 :
A nurse is examining a skin infection on a client's lower left leg. Findings include edema, erythema, tenderness, and the client reports pain. The nurse should identify that these findings indicate which of the following?

9 :
A nurse is providing teaching for a client who has a new diagnosis of hyperlipidemia. Which of the following client statements indicates an understanding of the teaching?

10 :
A nurse is caring for a client who is at 31 weeks of gestation and has gestational diabetes mellitus. The client asks, "Can gestational diabetes affect my baby?" Which of the following responses should the nurse make?