Exit HESI PN
The Practical Nurse (PN) is assigned to care for four children which should be assessed first
18 month old who has cystic fibrosis is wheezing
The practical nurse (PN) is obtaining fetal heart rates on four antepartum client in their third trimester of pregnancy what fetal heart rate should be reported to the registered nurse?
180 (NORMAL 110-160)
Risk to devolve breast cancer
32 year old whos mother had brest cancer
The practical nurse (PN) is working in a cancer detention mobile clinic. Four individuals come for screening with a complaint of hoarseness a danger sign for cancer of the larynx which client has the highest risk of development of cancer of the larynx that the PN should refer to healthcare provider
A older male who drinks a 6 pack of beer nightly and smokes heavily
The practical nurse (PN) is planning evening shift rounds for a group of postoperative client who all had surgery earlier that day which client should the PN check first
A preschooler who had an emergency appendectomy for appendicitis
the chest xray for a client who is admitted for pneumonia shows pleural effusion what should the PN expect to hear when auscultating the upper lobe?
A rubbing pleural sound
The practical nurse is reinforcing teaching to a group of evacuees in a mass casualty center after a natural flooding disaster which information should the PN include in the review?
• Drink only boiled water or bottled oral rehydration solution • Clean hands using soap clean water or waterless antibacterial solutions • Wash all fruits and vegetables thoroughly in running tap water
The practical nurse (PN) who is working on a skilled nursing unit delegates the 2 hour turning schedule a group of bedridden clients to a UA[P to minimize lower back injury which strategies should the PN implant while moving the client in bed
• Encourage the client to help • Maintain a broad base of support
A client diagnosed with cdiff which action should the practical nurse (Pn) implement to prevent the spread of the organism?
• Hand washing • Don non sterile gloves when performing direct care
An older client with metastatic breast cancer is experiencing shortness of breath as a result of a bilateral pneumonia the client has a living will and the family is requesting hospice care which information should the practical nurse (PN) reinforce with the client and family regarding hospice?
• Instructions for care should be included in the clients living will • Care can be provided in home where client resides • Care focuses on comfort dignity and emotion support
Influenza precautions
• Mask • Gloves • Private room
What do you do before giving medication
• Pain scare • Effectiveness of pain • Last given
The practical nurse (PN) administers an antibiotic to a client with respiration tract infection to evaluate the medication lab values
• White blood count • Sputum culture and sensitivity
A male client tells the practical nurse (PN) that the pill he has been taking at home is different color and size then the one the PN is trying to give him now how should the nurse respond
Explain that the pharmacy often substitutes generic for more expensive brands
When gathering data about a client with dark skin tones which site should the practical nurse (PN) observe
Finger and toe nails
A female client with bipolar disorder reports to the practical nurse (PN) that he has not taken his prescribed medication divalproex sodium of what parameter is most important for the PN to obtain
Frame of mind
While the practical nurse (PN) and unlicensed assistive personal (UAP) are turning a client with an abdominal incision the incision eviscerates which task is best for the PN to assign the UAP
Gather supplies
A male client with tuberculosis returns to the clinic for daily antibiotic injections for a UTI the clients been taking antitubercular medication 10 weeks and states ringing in his ears which medication should the nurse report
Gentamycin 160mg IM daily
The home health practical nurse (PN) visit a young male client with AIDS who has Kaposi sarcoma and peripheral neuropathies his—who provides care for the client states that their son sleeps most of the time the PN observes the client is semi-conscience with stable vitals--- and cries out in pain when turned or moved a fentanyl patch is in place and skin lesions are closed and dried which interventions should the PN implement
Give a complete bed bath to further assess the client
Based on the computer documentation the electronic medical record (EMR) which action should the practical nurse (PN) implement cclicic on each chart tab for addition information
Give rubella vaccine subcutaneously
Vitamin k diet
Green leafy vegetables
The parents of a child with acute glomerulonephritis are describing to the practical nurse (PN) that originally motivated them to seek medical care which signs is the child most likely exhibiting
Hematuria
The practical nurse (PN) is providing care for a client who is NPO after small bowel resection the client NG tube is connected to intermittent suction the client reports dizziness and tingling in digits which assessment finding should the PN report to the healthcare proiver
Hypoactive bowel sounds on assessment
Which statement by an older adult female client who lost her spouse 2 years ago should indicate to the Practical Nurse (PN) that the client may need treatment counseling
I realized that life must go on but sometimes I wonder why
the practice nurse (PN ) is caring for a client with fractured metatarsals after slamming a hand in the car door after administering the prescribed hydrocodone/acetaminophen for pain which intervention should the PN include in the client care?
Implement ongoing assessments for signs of shortness or slowed breathing
The practical nurse (PN) ask the UAP for feedback about assigned client instead the UAP walks away from the PN ignoring the question what action is best for the PN to take
In a private setting ask the other nurses for feedback about UAP behaviors
The practical nurse (PN) plans to reinforce the proper use of a cane to an older client who is recovering from a stoke when providing information to the client how to correctly use assistive devices where should the PN reinforce with the client to place the cane
Ineffective side
The practical nurse (PN) is caring for a client whose urine drug screen is positive for cocaine which behavior should the PN document with cocaine withdrawal
Intense cravings
A married woman comes to the clinic for her annual well woman physical examination during the interview with the with the practical nurse (PN) observes a yellow bruise to the lower eye and purple bruising on the clients upper arm which should the nurse ask?
Is anyone hurting you
Which interventions should thr practical nurse (PN) reinforce for a client with pruritis?
Keep finger nails trimmed short
The Glasgow scale is being used to monitor a client who experienced a traumatic brain injury what primary assessment should the PN evaluate
Level of consciousness
Which foot care instruction is most important for the practical nurse (PN) to reinforce for a patient newly diagnose with type 2 diabetes
Make sure the shoe size fits, minimizing rubbing and blisters
The practical nurse determines that a client who is one day postpartum has a moderate amount of lochia and rubra and the uterus is firm diverted and three finger breaths above umbilicus what should be the first initial action
Massage the uterus to decrease atony
A client is receiving an epidural anesthesia during labor which observation is the most important adverse effect that the practical nurse (PN) should assess for following the administration of the epidural
Maternal hypotension
A client with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500mg by mouth twice a daily which action should the practical nurse (PN) take?
Monitor the client for a rash and hives
A client receives ondansetron prior to chemotherapy treatment how should the practical nurse evaluate the effectiveness of the medication
Monitor the client for nausea or vomiting following the treatment
The practical nurse (PN) overhears the female client with crushing syndrome tell her family in a very loud and anger voice to leave her room and not come back the response by the PN is based on recognizing which common manifestations of the syndrome
Mood adherence
A male preop client who already signed the informed consent for a surgical procedure the client tells the PN that he is really frightened and unsure about undergoing the surgery which priority action should you take?
Notify the charge nurse of the clients concerns
The practical nurse (PN) views the midline episiotomy of a client who repots pain in her stiches whar action should the action should the PN take first?
Observe suture line for separation and hematoma formation
The birth weight of an infant delivered by a woman with gestational diabetes is 10.1 pounds the infant is jittery and has a heel stick glucose level of 40 30 minuets after birth based on this information which interventions should the PN implement first
Offer nipple feedings of 10% dextrose
The practical nurse (PN) is assisting with the plan of care for a client with osteochondrosis who is not experiencing increased discomfort in breathing the client receives a prescription for tramadol what interventions should the PN include in the client plan of care
On going assessment for signs of shallow or slowed breathing
The Practical nurse (PN) is caring for a client with obstructive sleep apnea the PN should recognize the client is at greater risk for the development of what complication
Peptic ulcer disease
The practical nurse (PN) is caring for a client who is receiving intravenous fluids via a gravity infusion to confirm that the client is receiving the correct amount of fluid volume what part of iv delivery system should the PN monitor
Picture with hand dot picture on arm
A child reviving chemotherapy develops a cough that productive of yellow tinged sputum after determine that the client is afebrile which priority action for the practice nurse (PN) to take?
Provide oral hygiene
During the morning rounds a client who is admitted with obsessive compulsives disorder in the dayroom repeatable is washing on top of the same table witch intervention should the PN implement when approaching
Provide time for the behaviors then guide the client to other actives
The practical nurse (PN) determines that a clients pupils constrict as they change focus from a far object to a near object how should the PN document this finding
Pupils reactive to accommodation
A client with hypertension complains of a persistent dry cough the practical nurse (PN) should tell the client that this is a common side effect with what medication
Quinapril
Which finding for a client with an arteriovenous fistula (AV fistula) should the practical nurse report to the health care provider
Radial pulse distal to AVF is absent and ulnar pulse is present
The patents of a child with pre diabetic report to thr practical nurse (PN) that the child wants to join the soccer team what is the best action for the PN to implement
Reassure the patents that increased physical activity reduces risk for diabetes
The practical nurse (PN) administers a anticonvulsant that causes photosensitivity which action should the PN take after admitting the medication?
Remind the client to protect skin rom sunlight
An older female client adult who has been admitted to long term facility yesterday is confused about what day of the week it is her history does not include that she was confused prior to admission what action should the practical nurse (PN) take?
Remind the client what day of the week it is
While assisting the RN with the admission of a toddler which intervention should the practical nurse (PN) implement to make the experience lease stressful for the client
Remove child's clothing down to the diaper
A home health practical nurse (PN) visits and older client living with offspring who exhibits fear unkempt and has lost a lot of weight which action should the PN take
Report suspected abuse to supervisor and protective services
A client who had orthopedic surgery 2 days ago complains of difficulty sleeping which initial intervention is best foe the practical nurse (PN) to implement
Reposition the client and provide a back rub
A client who is primigravida at herm to the prenatal clinal and tells the practical nurse (PN) that she is having contractions every 5 minutes the PN monitors the clint for an hour using external fetal monitor and determines that the clients contractions are 7 to 15 minutes apart lasting to 20 to 30 seconds with mild intensity by palpitation which actin should the PN take?
Send the client home
Clients blind how to communicate
Stand in front
An older client tells the home health care practical nurse (PN) about experiencing ------- whats most important for the PN to obtain
Standing blood pressure
A practical nurse (Pn) is at the nurses station describing her social life sexual activities and alcohol drinking in a boisterous voice that might be heard by the client and visitors
Suggest going to the nurses lounge to discuss these topics
A new protocol for fall prevention is being implemented on the medical unit during safety rounds the practical nurse (PN) identifies that the UAP had omitted a vital component of the protocol after implementing the missing component which action should the nurse take?
Supervise the UAP after reviewing the protocol
The practical nurse (PN) and unlicensed assistive personal (UAP) enters a clients room and finds the client lying on the bed the PN determines that the client is unresponsive which action should the PN give the UAP first
obtain emergency help
The healthcare provider Gives a pregnant woman a prescription for one prenatal vitamin with iron daily and tells her that she needs to increase iron rich foods in her diet because her hemoglobin is 8.2 gramsldi when a list of iron list foods is given to the client the client tells the practical nurse she's a vegetarian and does not eat bleeds what instructions should the PN give?
• Add lenhl and black beans • Increase green leafy vegetables in the diet • Oatmeal is a good choice for breakfast
At the beginning of a shift in which order of priority should the practical nurse assess their 4 patients
• An older adult with dizziness whose o2 is 86% • An older adult woman who's vomiting who's potassium is 2.8 • A young adult with a history of asthma who's arterial pit is 7.48 • An adult client with an ulcer who's hemoglobin's is 9.8
The practical nurse (PN) is documenting the insertion of a urinary catheter for a female client with urinary retention which information should PN include during the electronic documentation of a procedure
• Appearance of urine obtained • Size of urinary catheter • Amount of urine obtained
Prior to administering pain medication to an older adult post operative client what information should the practical nurse (PN) obtain
• Clients pain rating 1-10 scale • Time of last administration of pain medication • Effectives of last pain8 medication administration
A 2 day old infant with hydrocephalus returns from surgery following placement of a ventriculoperitoneal shunt which nursing interventions should the practical nurse (PN) implement during postoperative care
• Document strict I & O • Measure head circumference • Monitor body temp
A 2 day old infant with hydrocephalus returns from surgery following placement of a ventriculoperitoneal shunt which nursing intervention should the practical nurse (PN) implement during postoperative care
• Document strict intake and out take • Measure head circumference • Monitor body temperature every 4 hours
The practical nurse (PN) learns that the client whos receiving chemotherapy has developed stomatitis which information should the PN obtain from the client during focused assessment
Ability to swallow
A client is admitted with a hemothorax following a motor vehicle collision and surgeon inserts a chest tube that is attached to a chest drainage system with suction at 20cm water pressure. The practical nurse (PN) fluid level is at 15cm which action should be implemented to ensure effectiveness suctioning of the chest drainage system?
Additional sterile water should be added to the suction chamber to the 20 ml level
When preparing to change a clients sterile dressing the practical Nurse (Pn) opens a package of gauze pads as seen in the picture which action should the PN take next? (picture question)
Apply a new pair of sterile gloves
A client who is a gravida 1 para 0 is transferred to the recovery room following a normal vaginal delivery of a healthy newborn the practical nurse (PN) observes that the client is shaking uncontrollably and states she's cold
Apply light warm blanket and assure her that this is normal following delivery
The parents with a one year old child with the diagnosis of hypospadias informed the practical nurse (PN) that they plan to delay corrective surgery to see if the child will outgrow the problem which information should the PN provide to these parents
Ask the patents to explain what they understand about the child's diagnosis
The practical nurse (PN) is assigned to care for a client who had an endoscopic procedure in which a local anesthetic was sprayed on their throat which priority action should the PN include in this care of plan?
Assess the gag reflexes
The practical nurse (PN) is assessing an older client with left sided heart failure what intervention is most important for the PN to implement
Auscultate all the lung fields
A female client with immune thrombocytopenic purpura is transported to a long term facility for physical therapy rehabilitation to prevent injury the most important for the practical nurse (PN) to implement?
Ensure the client has minimum clutter in the room
Which location should the practical nurse palpate to determine if a client submandibular lymph node are enlarged?
Beneath the lower jaw
An older client who had a colon resection 8 days ago is straining at stool the practical nurse (PN) observes from the client klound followed by appearance of bowel on the skin which complication has occurred?
Evisceration
The spouse of a hospitalized client asks the practical nurse (PN) for acetaminophen for a tension headache which action would you take?
Explain that medication can only be provided to client
Patient feels dizzy standing up
Check bp
The practical nurse is caring for a client with influenza who requires droplet precautions which action should the PN take after entering the room to provide care?
Close the door to the client's room
The practical nurse (PN) observes a newly hired UAP who's counting client radial pulse as seen in the picture which action should the PN take?
Demonstrate the correct pulse side to the UAP
The practical nurse (PN) and the unlicensed asstive personnel (UAP) are providing care for a client who exhibits signs of neglect syndrome following a stoke affecting the right hemisphere which client should the PN implement
Demonstrate to the UAP how to approach the client from the left side
Which interventions is within the scope of practice for a practical nurse (PN)
Demonstrating deep breathing and coughing to be a post operative client
The practical nurse (PN) accompanies a healthcare provider when the client receives the diagnosis of stage 5 metastatic cancer the client's wife immediately responds "you must have made a mistake we want to get a second option" the PN should consider which stage of the grieving process in order to respond best to the wife's comments?
Denial
While administering prescription medication to an older adult resident in a extended care facility the practical nurse notice that the client is having difficulty hearing what action is most important for the PN to take?
Determine if client has had difficulty hearing in the past
When preforming of focused gastrointestinal system assessment thr practical nurse (PN) ask the male client when his last bowel movement occurred the client answers three days ago which action should the PN implement first
Determine the clients usual bowel patterns
When obtaining a capillary blood sample for glucose measure which intervention should the practical nurse (PN) implement
Determine what finger was used previously
In caring for a client with buck traction the practical nurse (PN) observes thar the prescribed amount of weight are hanging freely and traction is on pully which action should the PN implement next
Document the back traction is being maintained
The practical nurse (PN) plans to distraction technique while client undergoes a brief painful procedure which action should the PN implement during the procedure
Encourage the client to reminisce about a favorite past family event
The practical nurse (PN) explains to a client how to clean a sputum and client indicates understanding the procedure after the PN leaves the room the client obtain the sputum and notifies the PN when the PN arrives to collect the sputum it appears as seen in the picture. What action should the PN take?
The PN should teach the client how to obtain a sputum specimen and the client does not correctly collect the specimen the PN should assist the client is obtaining another specimen cough directly into a sterile cup
A client who is being care for in her home has a lab serum sodium level of 125 to determine the cause of this level which information should the PN request from the client
The amount of salt used in meal preparation
The practical nurse (PN) ia changing the abdominal dressing of a male client who was discharged home following a colon resection which information should the PN report to the health care provider
The client reports the wound care is painful and would like a prescription for an analgesic
The practical nurse is caring for a client with coronary artery disease who is admitted intermitted chest pain the admissions lobotomy results indicated elevated tropine 1 and creatine phosphoicinase myoglobulin isoenzymes levels what should the PN consider the most significant risk is for this client on the second day of admissions?
The labs results indicate myocadiac damage and the client is at risk for cardiac dysrhythmias
A full term 24 hour old infant in the nursery regulates and suddenly turns cyanotic which immediate interventions should the practical nurse (PN) take?
Turn the infant to the right side
In administering nystatin suspension to the gums of an infant with candida infection which approach should the practical nurse (PN) use
Use a gloved finger to suspension over the infected area
The Practical Nurse (PN) is preforming a focused assessment for a male client with schizophrenia who is admitted to an acute care inpatient facility which behavior should the PN document as symptoms of schizophrenia?
Voices telling the client to hurt himself
Diabetes patient's
Wash feet dry good
A client with schizophrenia reports auditing hallucinations when admitted to the hospital what questions is most important for the practical nurse (PN) to include in the assessment
What is the voices altering
What standard of care is acceptable in a nursing malpractice case
What would a responsible prudent nurse have done under similar circumstances
The practical nurse (PN) is auscultating a clients lungs sounds which description should the PN use to document this sounds (listen to the audio)
Wheezing
The practical nurse (PN) is caring for a client receiving a prescription for paroxetine who suddenly exhibits restlessness tachycardia fever and elevated blood pressure which action should the PN implement first
Withhold the next dose contact the health care provider
