NCLEX-RN NGN Strategy Practice Questions (20 Flashcards)

The 3lb weight gain and crackles are the most critical cues indicating fluid volume overload. In NGN, Recognizing Cues requires filtering noise (gout) from urgent clinical findings. Weight gain >2lbs/day is a red flag for worsening HF. Strategy: Look for cues that deviate from the patient's baseline and indicate acute physiological instability. Distinguish between chronic conditions and acute exacerbations.

These are classic cues for Autonomic Dysreflexia. The nurse must recognize the trigger cues: bladder distention (kinked catheter), fecal impaction, or tight clothing. Strategy: When presented with a cluster of autonomic symptoms (high BP, low HR, headache), look for source cues. NCSBN focuses on the nurse's ability to find the root cause of acute physiological changes in high-risk patients.

The interaction between Warfarin and Sulfa drugs significantly increases the INR and bleeding risk. The nurse should recognize cues like easy bruising, hematuria, or gingival bleeding. Strategy: Recognize cues that indicate drug-drug interactions. On NCLEX, whenever a patient is on an anticoagulant, any new medication must be scrutinized for potentiation or inhibition of the drug's effect.

B is the priority. Per current 2024-2026 guidelines, fluid resuscitation (30 mL/kg) for hypotension or high lactate is the first-line solution to restore perfusion. Antibiotics (A) are critical but follow fluid initiation in the bundle for shock. Strategy: Follow the 1-hour bundle for sepsis; address circulation (perfusion) first in distributive shock.

C. In DKA, the priority is volume resuscitation to restore organ perfusion and dilute glucose. While insulin (B) is needed, it is started after or concurrent with initial fluid boluses to avoid vascular collapse. Strategy: Fluids first in DKA/HHS prevents circulatory collapse. Always address volume before shifting electrolytes or glucose too rapidly.