NGN Highlight Quiz: Can You Spot The Key Findings?

1. Patient has sudden onset severe headache, neck stiffness, and photophobia. Which diagnosis should be highlighted as a priority?

Migraine headache

Tension headache

Possible meningitis requiring urgent evaluation

Caffeine withdrawal

2. A patient receiving vancomycin has serum trough level 25 mcg/mL (goal 15-20). What finding should be highlighted?

Therapeutic level, continue

Subtherapeutic, increase dose

Supratherapeutic with toxicity risk

No clinical significance

3. Patient with diabetes has blood glucose 450 mg/dL, fruity breath odor, and rapid respirations. What condition should be highlighted?

Mild hyperglycemia

Diabetic ketoacidosis requiring urgent treatment

Normal blood glucose variation

Hyperglycemic hyperosmolar state only

4. A patient's INR is 6.2 while on warfarin (therapeutic 2-3) and reports epistaxis. Which action is most critical to highlight?

Continue current warfarin dose

Hold dose and notify provider for reversal consideration

Increase dose to reach therapeutic range

Recheck INR in one week

5. Patient reports calf pain, warmth, and swelling unilaterally. What complication should be highlighted as a priority concern?

Muscle strain

Deep vein thrombosis requiring assessment

Normal post-operative swelling

Cellulitis only

6. Creatinine is 3.2 mg/dL (normal 0.6-1.2) and BUN is 54 mg/dL (normal 7-20). What key finding should be highlighted?

Mild elevation, monitor only

Acute kidney injury requiring intervention

Normal lab variation

Dehydration that will resolve

7. A patient receiving insulin has tremors, diaphoresis, and altered mental status. What emergency condition should be highlighted?

Hyperglycemia

Hypoglycemia requiring immediate glucose

Anxiety response

Normal insulin effect

8. Patient post-stroke has facial droop, arm drift, and slurred speech. Which finding is most critical to highlight for intervention?

Facial droop alone

Speech difficulty only

Acute stroke symptoms requiring time-sensitive treatment

Minor neurological changes

9. Hemoglobin is 7.2 g/dL (normal 12-16). Patient is asymptomatic. What action should be highlighted?

No intervention needed

Severe anemia requiring transfusion consideration

Mild decrease, recheck tomorrow

Increase dietary iron only

10. A patient with COPD has respiratory rate of 32, using accessory muscles, and appears anxious. What is the key finding to highlight?

Anxiety alone

Slight increase in respiratory effort

Respiratory distress requiring intervention

Normal COPD presentation

11. A 68-year-old patient presents with confusion, decreased urine output, and a blood pressure of 88/54 mmHg. Which finding is most critical to highlight?

Confusion and altered mental status

Hypotension and decreased perfusion

Decreased urine output alone

Age of the patient

12. A patient receiving chemotherapy has WBC 2.1 (normal 4.5-11.0), temperature 37.8°C, and reports sore throat. What finding requires immediate action?

Mild fever only

Neutropenia with infection risk

Sore throat is common

Temperature is within acceptable range

13. A patient's oxygen saturation drops from 96% to 88% within one hour. Which response is appropriate?

Continue observation without intervention

Assess respiratory status and notify provider immediately

Increase oxygen only if patient complains

Wait for next scheduled vital sign check

14. Patient on digoxin reports nausea, vomiting, and visual disturbances. What key finding should be highlighted?

Mild gastrointestinal upset

Signs of digoxin toxicity

Expected medication side effects

Need for increased hydration

15. Blood glucose reading is 42 mg/dL in a conscious patient. What action should be highlighted as urgent?

Schedule next meal

Administer fast-acting carbohydrate immediately

Recheck in 30 minutes

Document and monitor

16. A post-operative patient has a temperature of 38.5°C (101.3°F), heart rate 118, and foul-smelling drainage. Which finding is most significant?

Elevated heart rate only

Fever alone

Signs of infection requiring culture and antibiotics

Normal post-operative response

17. Patient reports chest pain (8/10), shortness of breath, and has ST-segment elevation on ECG. What is the priority finding to highlight?

Pain level of 8/10

Shortness of breath

Acute coronary syndrome with ECG changes

Patient's anxiety level

18. A patient receiving heparin has a PT/INR of 8.2 (therapeutic 2-3). Which finding warrants immediate intervention?

Slightly elevated but acceptable

Risk of bleeding complications

Need for dose increase

Normal for this medication

19. Review this lab result: Potassium 6.8 mEq/L (normal 3.5-5.0). What action should be highlighted first?

Continue routine monitoring

Assess for cardiac dysrhythmias immediately

Recheck the lab in 4 hours

Document and notify at next shift change

NGN Highlight Quiz: Can You Spot the Key Findings?