Case Study Unit 1

Fill in the blank A client who has a sinus infection is receiving a prescription for amoxicillin/clavulanate potassium (Augmentin) 500 mg PO q8 hours. The available form is 250 mg amoxicillin/125mg clavulanate tablets. How many tablets should the practical nurse administer for each dose? (Enter numeric value only.)

2

A client becomes confused, grabs a pair of scissors, and cuts his IV tubing and indwelling catheter. An emergency security code is called, and two security officers arrive in the client's room. What action should the practical nurse (PN) take next? Ask the security officers what the nurses should do. Assign officers for a coordinated take-down maneuver. Evacuate other staff members away from the area. Distract the client and take away the scissors.

Assign officers for a coordinated take-down maneuver

What information about Reye's syndrome should the practical nurse (PN) reinforce with the parents of a school-aged child? Vaccinate your child before the age of 7 for Reye's syndrome. Keep the child at home for 2 days after the appearance of symptoms. Avoid giving any medication containing aspirin during a viral illness. Do not provide any citrus juices during a bacterial or viral illness.

Avoid giving any medication containing aspirin during a viral illness

Which co-morbidity of a client who is starting thyroid replacement should the practical nurse report to the healthcare provider? Penicillin allergy. Scheduled dental work. History of dysrhythmias. History of peptic ulcer.

history of dysrhythmias

When reviewing the dietary guidelines for a child with nephrotic syndrome, which diet should the practical nurse reinforce with the parents? High protein. Low sodium. Low fat. High carbohydrate.

low sodium

Which finding by the practical nurse indicates that the client's use of ipratropium bromide (Atrovent) inhaler was effective? The sputum culture is negative. Respirations are 16 breaths/minute. Oral temperature is 99.7 F. Bilateral breath sounds are clear

Bilateral breath sounds are clear

Amoxicillin 500 mg PO every 8 hrs is prescribed for a client with an infection. The drug is available in a suspension of 125mg/5 ml. How many ml should the PN administer with each dose? (Enter numerical value only.)

20

Fill in the blank A client who had a small bowel resection two weeks ago is receiving 3/4 strength Ensure feedings 275 ml q4 hours via nasogastric tube. Full strength Ensure is available in a 240 ml can. The practical nurse (PN) should use how many ml of Ensure to prepare the feeding? (Enter numeric value only. Round to nearest whole number if needed.)

206

The practical nurse (PN) is calculating an 8-hour intake for a postoperative client. Based on the client's bedside record, how many ml of intake should the PN enter in the client's electronic record? (Enter numeric value only.) One cup of coffee One 8-ounce glass of iced tea One 6-ounce dish of flavored gelatin One-half cup of chicken broth

780 mL

A 9-month-old infant receives a prescription for digoxin 40 mcg PO daily. Digoxin Oral Solution, USP 50 mcg (0.05 mg) per ml is available. How many ml should the practical nurse administer? (Enter the numerical value only. If rounding is required, round to the nearest tenth.)

0.8

A client with a gastrostomy tube (GT) receives a prescription for Osmolite 1/2 strength enteral formula at 80 ml/hour. To prepare a 4 hour solution, the PN should dilute the full-strength formula with how many ml of water? (Enter numeric value only.)

160

Glipizide (Glucotrol) 10 mg BID is prescribed for a client with type 2 diabetes mellitus. Breakfast is served at 0800, and dinner is served at 1700. Which action should the practical nurse (PN) implement? Administer 30 minutes before a meal BID if capillary glucose is greater than 70 mg/dl. Check the capillary glucose 2 hours postprandial when the drug is given on time. Provide meals at the same scheduled times planned for administration of the drug. Withhold the drug if the client vomits or eats less than 50% of breakfast or lunch.

Administer 30 minutes before a meal BID if capillary glucose is greater than 70 mg/dl

The practical nurse (PN) is assessing a client who has been noncompliant with a prescribed diabetic diet and exercise regimen. This client is using which defense mechanism? Denial. Projection. Dissociation. Displacement.

Denial

A client with myasthenia gravis is admitted in myasthenic crisis. Which priority action should the practical nurse (PN) implement? Determine client's ability to swallow. Evaluate strength when walking to bathroom. Remind client to use the call light for assistance. Perform a fall risk assessment.

Determine client's ability to swallow

A male client with pancreatic cancer who received morphine and midazalom (Versed) during an endoscopic retrograde cholangiopancreatography (ERCP) returns to the unit. His vital signs are pulse 80 beats/minute, 16 breaths/minute, blood pressure 120/80, and pulse oximeter 98%. Which action should the practical nurse (PN) implement? Give naloxone (Narcan) and flumazenil (Ramazicon) per protocol. Arouse the client to give warm oral fluids to sooth a sore throat. Determine client's fingerstick glucose level. Administer a 500-ml intravenous fluid bolus.

Determine client's fingerstick glucose level

Which action should the practical nurse (PN) implement for a client who is recently diagnosed with myasthenia gravis? Give neostigmine bromide (Prostigmin) before meals. Administer prednisone (Deltasone) on an empty stomach. Protect the extremities from trauma. Schedule the client for an eye exam.

Give neostigmine bromide (prostigmin) before meals

The mother calls the clinic and tells the practical nurse (PN) that her child cannot swallow a prescribed tablet that was dispensed by the local pharmacy as a whole tablet. How should the PN respond? "You can crush the tablet and put it in some food." "You should hold the child's nose closed to force her to swallow the tablets." "If a liquid form is available, the pharmacist can call for a prescription change." "If the child can't swallow the tablet, tell the child to chew it."

If a liquid form is ava, the pharmacist can call for a prescription change

The practical nurse (PN) notes an irregular radial pulse for a client who has an implanted pacemaker. What action should the PN do first? Document the finding in the client's record. Measure the apical-radial pulse with another nurse. Ask the client if symptoms of dizziness are present. Report findings to the healthcare provider.

Measure the apical-radial pulse with another nurse

A client who is two days postoperative for a colectomy and temporary colostomy tells the practical nurse (PN) that the drainage bag is full of gas. What action should the PN take? Assess the client for signs of intestinal obstruction. Open the bag's clamp to release the flatus. Administer a PRN dose of simethicone (Mylicon). Change the bag to determine character of output.

Open the bag's clamp to release the flatus

A client who is one-day post-thyroidectomy begins to develop a stridor. Which priority action should the practical nurse implement? Prepare for emergency tracheotomy at the bedside. Insert a large bore needle for IV access. Give the client oxygen per face mask. Assess the client for signs of hypocalcemia.

Prepare for emergency tracheotomy at the bedside

A client with a headache, fever, and stiff neck is admitted with the diagnosis of bacterial meningitis. Which prescription should the practical nurse administer first? Ceftriaxone (Rocephin). Codeine (Brontex). Acetaminophen (Tylenol). Ibuprofen (Advil).

Rpcephin

An adult male presents in the Emergency Center with "tearing" chest pain that has moved into his back. Which finding by the practical nurse in the client's history is relevant to the client's chest pain? Smokes three packs of cigarettes a day. Drinks three cans of beer daily. Has a family history of diabetes. Experienced a bowel obstruction 10 years ago.

Smokes three packs of cigarettes a day

The practical nurse (PN) determines that a female client who is returning to the clinic with urinary urgency, frequency, and burning on urination has been in the clinic several times in the past few months with urinary tract infections (UTIs). The client asks the PN how to prevent these infections from reoccurring. What information should the PN give to this client? (Choose all that apply.) Select all that apply: Take all of the prescribed antibiotic. Void before and after sexual intercourse. Do not drink carbonated drinks. Use vaginal douches and sprays. Wipe from front to back after voiding.

Take all of the prescribed antibiotics Void before and after sexual intercourse Wipe from front to back after voiding

A mother with diabetes expresses her plans to breast feed after delivery. When the newborn develops hypoglycemia 2 hours after admission to the newborn nursery, what action should the practical nurse implement? Take the newborn to the mother to breast feed. Give 10% glucose water per nipple. Obtain a prescription for formula via orogastric tube. Offer formula with high fat content in a bottle.

Take the newborn to the mother to breast feed

Which action by another nurse should the practical nurse (PN) report as a breach of client confidentiality? A client who is in the hallway is told that the charge nurse called the healthcare provider. A color-coded "risk for a fall" wristband is placed on an elderly client. Visitors are told to wear a mask because the client has tuberculosis. The healthcare provider is notified that illegal drugs were found in a client's possession.

Visitor are told to wear a mask because the client has tuberculosis