Exit hesi

21. The Practical Nurse administers darbepoetin alfa To a client with chronic kidney disease (CKD) which serum laboratory value should the PN monitor to gather the effectiveness of this drug? A. Calcium B. Phosphorus C. Hemoglobin D. White blood cell count

C. Elevated energy level

85. At a community immunization clinic the PN is trying to administer a 1 ml intramuscular injection to a 6 month old. Which action should the PN include in administering the intramuscular injection? (Select all that apply) A. encouraged the parent to hold the child securely B. Use a z-track technique for best absorption C. Inject the needle at 90 degree angle D. Palpate the landmarks for the deltoid muscle E. Locate the vastus lateralis muscle

A,C,E

41. When reinforcing diet teaching for a client who was diagnosed with hypokalemia which foods should the Practical Nurse encourage the client to eat? (select all that apply) A. Orange Juice, oranges, bananas B. Preserved me, apple juice, seeds C. Collard greens, Kale, Turnips D. Soy beans, lima beans, spinach E. White grape juice, clear fat-free broth, consomme

A,C,D

65. The PN is assisting the nurse with the admission physical assessment of a client diagnosed with pneumonia. What symptoms is this client likely to exhibit?( Select all that apply) A. Dyspnea B. Bradycardia C. Lung crackles D. Ankle edema E. Painful cough

A,C,E

28. The healthcare provider prescribes heparin 4,500 units subcutaneously once-daily. The medication is available in a vial that contains Heparin 10,000 units/mL. How many mL should the Practical Nurse administer?

0.45 mL

53. A client is scheduled to receive hydroxyzine 75mg IM postoperatively. The vial contains 50 mg/mL. How many mL should the PN administer?

1.5 mL

75. A client takes one 500 mg calcium tablet twice daily. How many grams of calcium is the client taking daily.

1g

38. The PN is assigning care for a group of clients on the Urology medical unit. Which client care intervention should the PN assign to the unlicensed assistive personnel (UAP)? (select all that apply) A. B. C. D. E. A. Empty bedside drainage unit for a client with an indwelling urinary catheter B. Teach the client with fluid restrictions how to measure urine output C. Irrigate an indwelling urinary catheter for a client with bladder suspension D. Transport a urine culture sample to the laboratory E. Obtain a post void residual volume

A, E

27. The practical nurse is caring for a child who was admitted after experiencing a generalized tonic-clonic seizure. When witnessing the child, they begin to seize again, which action should the PN Implement immediately? (select all that apply) A. Observe the progression of the seizure B. Loosen clothing around the neck C. Pad the side rails with pillows D. Insert tongue blade between the teeth E. Hold the extremities close to the body

A,B,C

15. After administering pantoprazole to a client with gastroesophageal reflux disorder (GERD) which statement by the client indicates to the PN that the medication is producing the desired effect? A. After eating my meal I do not experience any heartburn B. I have great appetite and I'm feeling really hungry C. I should increase the amount of vitamin C in my diet D. While eating I had no difficulty swallowing any of the foods

A. After eating my meal I do not experience any heartburn

6. A client confides to the PN that the client has been substituting herbal supplements for high blood pressure instead of the prescribed medication. How should the PN respond first? A. Ask the client reason for choosing to take herbs instead of prescribed drugs B. Reinforce that the healthcare provider prescribed the medication for a reason C. Have client use own words to describe complications of high blood pressure D. Point out the risk of not taking the herbal medications rather than prescribed

A. Ask the client reason for choosing to take herbs instead of prescribed drugs

14. The practical nurse and unlicensed assistive personnel (UAP) are providing care for a client who exhibits signs of neglect syndrome following a stroke affecting the right hemisphere. which action should the PN implement? A. Demonstrate to the UAP how to approach the client from the clients left side B. Ask the UAP to leave the room and assess the client's body for bruising C. Carefully observe the interaction between the client and family members D. Instruct the UAP to protect the clients left side when transferring to a chair

A. Demonstrate to the UAP how to approach the client from the clients left side

39. A patient on bedrest refuses to wear the prescribed pneumatic compression devices after surgery. Which action should the PN implement in response to the client's refusal? A. Emphasized the importance of active foot flexion B. Check the surgical dressing C. Complete an incident report D. Explain the use of incentive spirometer Q2 hours

A. Emphasized the importance of active foot flexion

82. A new mother who is breastfeeding her newborn for the first time after delivery reports nipple pain when the baby sucks. Based on this client problem, which action should the PN take? A. Ensure that all the areolar tissue of the nipple is in the infant's mouth B. Have the mother reposition the infant from the cradle to the football hold C. Check for engorgement and check the nipples for cracks or lesion D. Applying ice pack to the breast for 10 minutes before each feeding

A. Ensure that all the areolar tissue of the nipple is in the infant's mouth

19. The PN is caring for a client who had a total laryngectomy, left radical neck dissection and tracheostomy. the client is receiving nasogastric tube feedings via an enteral pump. Today the rate of the feeding is increased from 50 mL/hr to 75 mL/hr. What parameter should the PN use to evaluate the client's tolerance to the rate of feeding? A. Gastric residual volumes B. Urinary and stool output C. Daily weight D. Bowel sounds

A. Gastric residual volumes

35. During a clinic visit for a sore throat, a client's basal metabolic panel reveals a serum potassium of 3.0 mEq/L. Which intervention should the practical Nurse recommend to the client based on this finding? A. Increase intake of dried peaches and apricots B. Reduce intake of red meats C. Encourage use of a soft toothbrush D. Force fluid intake of 1500 mL daily

A. Increase intake of dried peaches and apricots

63. The PN notes that an UAP is ambulating a male client who had a stroke and has right sided weakness. The UAP is walking on the clients left side. Which action should the PN take? A. Instruct the UAP to walk on the clients affected side B. Take over the ambulation and counsel the UAP later C. Prove client an assistive device, such as a can or walker D. Tell the UAP to take the client back to his room

A. Instruct the UAP to walk on the clients affected side

17. A male client who has been diagnosed with schizophrenia is withdrawn, isolates himself in the day room, and answers questions with one or two word responses. This morning the PN observes that he is diaphoretic and is pacing the hall. Which intervention is most important for the PN to implement? A. Measure appropriate vital signs B. Provide a drink high in electrolytes C. Observe the client during the shift D. Persuade the client to lay down

A. Measure appropriate vital signs

78. An older male client with Alzheimer's disease is admitted to an extended care facility. Which intervention should the PN include in the client's nursing care? A. Plan to have the same nursing staff provide care for the client whenever possible B. Described activities available to residents and encourage him to choose the ones he prefers C. Encourage the client to remain on the unit for three weeks until he is oriented to his new surroundings D. Introduced the client to the nursing staff and other residents as soon as possible

A. Plan to have the same nursing staff provide care for the client whenever possible

16. During the past 30 days, an elderly client has exhibited a progressively decreasing appetite is spending increasing amounts of the daytime hours in bed and refuses to participate in plant daytime activities. Which action should the PN take? A. Record the findings and Report the symptoms to the charge nurse B. Ask the family members to visit more often to stimulate the client C. Motivate the client by offering favorite foods as a prize D. Withhold any medications that may cause these side effects

A. Record the findings and Report the symptoms to the charge nurse

48. a young adult male tells the Practical Nurse he has decided to change his hours at work so that he has more time to devote to his community. Which stage of Maslow's development is the young adult attempting to achieve? A. Self-actualization B. Intimacy versus isolation C. Altruism D. Purposefulness

A. Self-actualization

9. A 12 year old child is receiving a blood transfusion per infusion pump and begins to complain of "Itching" skin 15 minutes after the unit of blood is started. The child appears flushed. What action should the Practical Nurse take first? A. Stop the transfusion B. Apply lotion to the skin C. Inspect the infusion site D. Obtain the vital signs

A. Stop the transfusion

29. The unlicensed assistive personnel (UAP) is caring for a male resident of a long-term care facility who has an external urinary catheter. which finding should the PN instruct the UAP to report immediately? A. Swollen and discolored penile shaft B. Prepuce extends over head of penis C. Leaking urine around the top of the catheter D. Moist and excoriated perineal skin folds

A. Swollen and discolored penile shaft

13. When providing oral care for a client who is unconscious, the Practical Nurse positions the client laterally and uses a basin to collect secretions. Which intervention is best for the PN to implement? A. Use oral swabs with normal saline B. Support the head with a small pillow C. Provide a yankauer tips for oral suction D. Swab the oral cavity with a washcloth

A. Use oral swabs with normal saline

87. The healthcare provider gives a pregnant woman a prescription for one prenatal vitamin with iron daily and tells her that she needs to increase her iron. Her hemoglobin is 8.2 grams, when a list of iron rich foods is given to the client he tells the practical nurse that she is a vegetarian and does not eat anything that "bleeds". Which instruction should the PN provide? (Select all that apply) A. Take two prenatal vitamins with iron daily B. Increase green leafy vegetables in the diet C. Oatmeal is a good choice for breakfast D. Add lentils and black bean to soups E. Eat red meat just until the anemia is resolved

B,C,D

76. The PN observes a client's initial postoperative dressing and drain as seen in the picture. Which follow-up action should the PN implement? (Select all that apply) A. Clamp the drainage tubing for the next 4 hours B. Document the appearance of the wound is inflamed C. Removed and drainage device and apply a pressure dressing D. Repeat that appearance of the dressing to the charge nurse E. Compress the drainage device before closing the tab

B,D

86. A female Native American client who is receiving chemotherapy places a native artifact, an indian medicine wheel , in her hospital room. The healthcare provider removes the medicine wheel and tells the client, " This type of thing does not belong in the hospital". Which intervention should the PN implement? A. Teach the client the importance of implementing the prescribed to chemotherapy regimen B. Act as the client advocate when discussing the issue with the healthcare provider C. Consult with a Native American healer regarding the proper use of a medicine wheel D. Report the client feelings of culture shock to the health care provider

B. Act as the client advocate when discussing the issue with the healthcare provider

10. A practical nurse is completing a focused assessment of an older adult skin. the PN notes crusted 0.7cm lesion on the client's forehead. Which action should the PN take in response to this finding? A. Report the findings to the health care provider B. Apply a warm compress to remove the crusted area C. Place a clear occlusive dressing over the site D. Explain that this is a normal skin change with aging

B. Apply a warm compress to remove the crusted area

84. During a routine prenatal visit at the antepartal clinic, a multipara at 35 weeks gestation presents with 2 + edema of the ankles and feet. Which additional information should the PN report to the registered nurse? A. Due date B. Blood pressure C. Gravida and parity D. Fundal height

B. Blood pressure

80. while conducting a mental status examination of a newly admitted client the pianos that his head is lowered and he shows no emotion when speaking. Based on these observations what documentation should the PN include? A. Impaired verbalization B. Depressed mood C. Flat affect D. Diminished level of consciousness

B. Depressed mood

47. When administering an analgesic to a client with low back pain, which intervention should the PN Implement to promote the effectiveness of the medication? A. Massage the lower back and position the client and proper alignment B. Encourage the client to ambulate frequently and take deep breaths C. Assist client in performing passive and active range of motion exercises D. Give medication with a full glass of water and offer high roughage foods

B. Encourage the client to ambulate frequently and take deep breaths

25. The Practical Nurse identifies an electrolyte imbalance, exhibited changes in mental status, and an elevated blood pressure for a client with progressive heart disease. Which intervention should the PN implement first? A. Record usual eating patterns B. Evaluate for muscle cramping C. Document abdominal girth D. Elevate both legs on pillows

B. Evaluate for muscle cramping

44. A male client with tuberculosis returns to the clinic for daily antibiotic injections for a urinary infection. The client has been taking antitubercular medication for 10 weeks and states he has ringing in his ear. Which prescribed medication should the Practical Nurse report to the healthcare provider? A. Pyridoxine with a B complex multivitamin B. Gentamicin 160 mg IM daily C. Rifampin 600 mg PO daily D. Isoniazid 300 mg PO daily

B. Gentamicin 160 mg IM daily

66. Prior to giving digoxin the PN assesses that a 2 month old infants heart rate is 120 beats/minute. Based on this finding, what action should the PN take? A. Withhold the medication and notify the charge nurse B. Give the medication nd document the heart rate C. Withhold the medication until the next scheduled dose D. Request the charge nurse to administer the medication

B. Give the medication nd document the heart rate

11. While taking the vital signs of an older male client who take psychotropic medications, the piano notes that he has uncontrollable hand movements and is excessively blinking his eyes. which information in the client's medical record should the PN review? A. Prescription for Lorazepam B. History of Parkinson's disease C. Screening for tardive dyskinesia D. Recent urine drug screen report

B. History of Parkinson's disease

83. A homeless male client with a history of alcohol abuse had a cerebrovascular accident 10 years ago that resulted in left hemiparesis. Today he was brought to the clinic reporting pain in his left leg. He is afebrile, has 4 + pitting edema in the lower left leg and has minimal swelling of the right leg. Which action should the PN Implement first? A. Obtaining blood alcohol level B. Inspect legs for infection or trauma C. Complete a mental status exam D. Inquire about dietary salt intake

B. Inspect legs for infection or trauma

33. At the first dressing change, the Practical Nurse tells the client that her mastectomy incision is healing well, but the client refuses to look at the incision and refuses to talk about it. Which response by the PN to the client silence is best? A. You would feel better when you see the incision is not as bad as you may think B. It's okay if you don't want to look or talk about the mastectomy. I will be available when you're ready C. Part of recovery is accepting your new body image and he will need to look at your incision D. Would you like me to call another nurse to be here while I show you the wound?

B. It's okay if you don't want to look or talk about the mastectomy. I will be available when you're ready

32. When caring for a child with sickle cell disease, the PN expects that the child will most likely describe which symptom when experiencing a Sickle Cell crisis? A. Decreased hemoglobin B. Joint pain C. Fatigue D. Infection

B. Joint pain

37. The practical nurse is reviewing care instructions with a client who has a diabetic retinopathy and is experiencing glare around lights. What should the PN reinforce with the client? A. Cover eyes with moist cool compresses to reduce fasciculations B. Make adjustments to personal schedule to avoid driving at night C. Exert pressure on the inner canthus whenever tearing occurs D. Applying an eyeshield at bedtime after instilling eye drops

B. Make adjustments to personal schedule to avoid driving at night

70. The PN has added a feeding solution to a clients tube feeding system as seen in the picture. Which action should the PN take next? A. Remove the air from the solution bag B. Obtain a piston syringe and irrigation set C. Record the solution added as fluid intake D. Calculate the rate of flow of the solution

B. Obtain a piston syringe and irrigation set

52. The PN is assigned to care for an older male client who is recovering from a stroke. When assisting this client to ambulate with the use of a cane, where should the PN place the cane in relation to the client's body? A. In front of the body to lean on while stepping forward B. On the opposite side of the affected extremity C. Approximately one foot away from the body to stabilize balance D. On the same side of the affected extremity

B. On the opposite side of the affected extremity

1. The practical nurse enters a male client's room to administer routine morning medications and the client is on the phone. What action is best for the PN to take? A. Leave the medication with the client and tell him to take it when he finishes the conversation B. Wait for the client to excuse himself from the telephone conversation and observe the client taking the medication C. Return the medication to the client's drawer on the car and documented the client refused the dose D. Ask another nurse to go back with the medication when the client hangs up the phone

B. Wait for the client to excuse himself from the telephone conversation and observe the client taking the medication

46. Which action should the Practical Nurse Implement when using standard precautions to provide client care? A. Apply Sterile gloves to obtain a finger stick blood sample B. Wear clean exam gloves to perform perineal catheter care C. Replace the needle cap after giving an intramuscular injection D. Wear a paper gown to prevent transmission of droplet pathogens

B. Wear clean exam gloves to perform perineal catheter care

18. At 1200, the Practical Nurse learns that a clients 0900 dose of an anticonvulsant was not given the next scheduled dose is at 2100. which action should the PN take? A. Give the missed dose with the next scheduled dose B.Administer the missed dose as soon as possible C. With hold the missed dose unless seizure activity occurs D. Administer half of the missed dose immediately

B.Administer the missed dose as soon as possible

45. An older client is admitted to the psychiatric unit for assessment of a recent onset of dementia. The PN notes that in the evening hours the client often becomes restless, confused, and agitated. Which intervention is most important for the PN to implement? A. Ask family members to remain with the client in the evenings from 5 to 8 p.m. B. Administer a prescribed PRN benzodiazepine at the onset of confused state C. And sure the client is assigned to a room close to the nurses station D. Postpone administration of nighttime medication until after 11 p.m.

C. And sure the client is assigned to a room close to the nurses station

40. The PN is caring for a client who had an acute brain attack with resulting expressive aphasia and urinary incontinence. To help care for this client, which tasks should the PN delegate to the UAP? A. Explain How to use a communication board B. Document progress and use of communication board C. Encourage voiding by assisting client to bedside commode D. Establish bladder training schedule and training methods

C. Encourage voiding by assisting client to bedside commode

50. The single mother of a child with a head injury sitting at the child's bedside crying when the Practical Nurse enters a room. The mother states "why did this happen to my child? I just can't cope with this" How should the PN respond? A. Ask her to share how the injury occurred to her child B. Recommend that she remain calm and positive for her child C. Express that the present situation must be overwhelming D. Determine if someone else can help her cope with this tragedy

C. Express that the present situation must be overwhelming

51. While ambulating in the hallway following an appendectomy yesterday, a client complains of chest tightness and shortness of breath. Which should the PN Implement first? A. Administer sublingual nitroglycerin B. Assist the client back to the room C. Have the clients it down in the hall D. Obtain a 12-lead electrocardiogram

C. Have the clients it down in the hall

31. A client reports being able to swallow only small bites of solid food and liquids for the last 3 months. The PN should assess the client for what additional information? A. Past traumatic injury to the neck B. Daily consumption of hot beverages C. History of alcohol and tobacco use D. Daily dietary intake and roughage

C. History of alcohol and tobacco use

72. What intervention should the PN Implement when taking the rectal temperature of an adult client? A. Lubricate the tip of the thermometer with water B. Gently insert the thermometer 3 inches into the rectum C. Hold a thermometer the entire time while taking a temperature D. Place the client in the right Fowler's position

C. Hold a thermometer the entire time while taking a temperature

23. 30 minutes after receiving IV morphine, a postoperative client continues to rate pain as 7 on 10 point scale. Which action should the Practical Nurse implement first? A. Call healthcare provider to request a different analgesic B. Determine when morphine can be given again C. Implement complementary pain relief methods D. Observe dressing to determine presence of bleeding

C. Implement complementary pain relief methods

74. A female client who has been taking oral contraceptives for the past year comes into the clinic for an annual exam. Which finding is most important for the PN to report to the healthcare provider? A. Breast tenderness B. Change in menstrual flow C. Left calf pain D. Weight gain of 5 lbs

C. Left calf pain

69. While turning and positioning a bedfast client, the PN observed that the client is dyspneic. What action should the PN take first? A. Apply a pulse oximeter B. Measure blood pressure C. Notify the charge nurse D. Observe pressure areas

C. Notify the charge nurse

88. A client is complaining of a tingling sensation in the fingers, nose tip, and ear lobes 24 hours after a total thyroidectomy. Which measure should the PN be prepared to implement first? a. b. c. d. A. The discharge of electricity will distract the clients focus on the pain B. An infusion of medication and the spinal canal will block pain perception C. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus D. A mild electrical stimulus on the skin surface closes the gates of nerve conduction for severe pain

C. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus

79. A female client taking a liquid iron preparation expresses concern that her tooth color has darkened since starting the medication. What should the PN implement? A. Teach the client to use a straw when taking the medication to reduce further tooth stain B. Advise the client to withhold further doses until consulting with a healthcare provider C. Reassure the client that this change indicates the medication is having the desired effect D. Determine if the clients also experiencing mouth or gum pain and difficulty swallowing

C. Reassure the client that this change indicates the medication is having the desired effect

24. The practical nurse is caring for a laboring client whose last sterile vaginal examination revealed the cervix was 3 cm dilated, 50% effaced and the presenting part was at 0 station. An hour later, the client tells the PN she wants to go to the bathroom. Which action is most important for the PN to implement? A. Review the fetal heart rate and contraction pattern B. Check the perineum for increase and bloody show C. Request nurse to check client cervical dilation D. Palpate the clients bladder for distention

C. Request nurse to check client cervical dilation

30. A full-term, 24-hour old infant in the nursery regurgitates and suddenly turned cyanotic. Which immediate intervention should the Practical Nurse implement? A. Stimulate the infant to cry B. Give Oxygen by positive pressure C. Suction the oral and nasal passages D. Turn the infant on to the right side

C. Suction the oral and nasal passages

58. The Pn observes a UAP performing oral hygiene on an unconscious client who is lying in a flat side-lying position with an emesis basin on a towel under the chin. Which action should the PN take? A. Stop the procedure and tell the UAP to palace the client in a Fowler's position B. Praise the UAP for doing the oral hygiene but encourage family participation C. Tell the UAP to continue because the unconscious client is positioned safely D. Enroll the UAP in a hospital education class on conducting safe client care

C. Tell the UAP to continue because the unconscious client is positioned safely

34. A client with blood type AB negative delivers a newborn with blood type A positive. the cord blood reveals a positive indirect Coombs test. Which is the implication of this finding? A. The newborn is infected with an infectious blood borne disease B. The new mother needs phototherapy for physiologic jaundice C. The mother's Rh antibodies are present in the neonatal serum D. The mother no longer needs RHo (D) immune globulin injections

C. The mother's Rh antibodies are present in the neonatal serum

3. The mother of a 9 month old child who was diagnosed with respiratory syncytial virus (RSV) yesterday calls the clinic to inquire if it will be alright to take her infant to the 1st birthday party of her friend's child the following day. Which response should the practical nurse provide the mother? A. The child can be around other children but should wear a mask at all times B. make sure there are no children under the age of six months around the infected child C. do not expose other children as a virus is very contagious even without direct oral contact D. the child will no longer be contagious no need to take any further precautions

C. do not expose other children as a virus is very contagious even without direct oral contact

43. The PN observes a UAP prepare to exit a client's room. The UAP's hands appear visibly soiled as the UAP uses a hand rub for 10 seconds to cleans the hands. Which action should the PN take? A. Confirm that the UAP completed hand hygiene correctly B. Instruct the UAP to wash the hands for 1 minute C. Ask the UAP why the hands were so obviously soiled D. Advise the UAP to use the hand rub for 30 seconds

D. Advise the UAP to use the hand rub for 30 seconds

60. Which client information is most important for the PN to consider when providing instructions to the UAP about providing morning care to a postoperative client? A. Oriented to person only B. Oxygen saturation measurement of 95% to 96% C. Urinary output of 50 mL/hr D. BP of 144/84

D. BP of 144/84

7. The practical nurse is assigned to administer medication in a long-term care facility. A disoriented resident has no identification band or picture. What is the best nursing action for the PN to take prior to administering the medication to this resident? A. Ask a regular staff member to confirm the residents identity B. Hold the medication until a family member arrives C. Reorient the resident to name, place, and situation D. Confirm the room and bed numbers with those on the medication record

D. Confirm the room and bed numbers with those on the medication record

36. The practical nurse is reviewing instructions for the use of pilocarpine eye drops with a client who has glaucoma. The client replies that the drops should be used to anesthetize the eye if eye pain is experienced. What action should the PN implement? A. Document in the chart that the client understands the action and use of the eye drops B. Reassure the client that the drops will not be needed often since eye pain in glaucoma is not common C. Reteach the client about the action of the eye drops to decrease pressure in the eyes D. Explain to the client that the eye drops do provide pain relief but do not anesthetize the eyes

D. Explain to the client that the eye drops do provide pain relief but do not anesthetize the eyes

54. Which statement by a mature adult client with advanced prostate cancer best indicates that he has reached a level of acceptance of his prognosis? A. I don't have any use for those who say this disease is going to win B. I found the support I need from my faith and family C. I think I've had the disease for a long time but the doctor did not find it D. I understand that this is a disease that occurs mostly in older men

D. I understand that this is a disease that occurs mostly in older men

5. During the immediate postoperative period following a total hip replacement, which intervention is most important to the Practical Nurse to implement? A. Encourage the client to use walker or cane when ambulating B. Teach client to say on the side of the bed before standing C. Monitor urinary flow via indwelling catheter D. Keep clients hip aligned with knees abducted

D. Keep clients hip aligned with knees abducted

77. At the end of a 12-hour shift the PN observes the urine in a client's drainage bag as seen in the picture. Which action should the PN take next? A. Offer to administer a prescribed pain analgesic B. Obtain a finger stick capillary glucose level C. Determine if the clients bladder feels distended D. Note the most recent white blood cell count

D. Note the most recent white blood cell count

12. The practical nurse is caring for an elderly female client who tells the PN, "When I sneeze, I wet my pants" after discussing the clients complaint with the charge nurse, the PN plans to reinforce teaching that the client has received about the importance of kegel exercises. What muscles are involved in these exercises? A. Pectoral muscles B. Buttock muscles C. Abdominal muscles D. Pelvic floor muscles

D. Pelvic floor muscles

20. The practical nurse is caring for a client whose urine drug screen is positive for cocaine. Which behavior is the client likely to exhibit during cocaine withdrawal? A. Euphoria B. High self esteem C. Elevated energy level D. Powerful craving for more

D. Powerful craving for more

59. When preparing for bone marrow aspiration, the PN should place the client in which position to ensure access of the aspiration site? A. Supine with a pillow under the lumbar area B. Sitting up and leaning across the over bed table C. Side lying with the posterior chest exposed D. Prone with the posterior iliac cred draped

D. Prone with the posterior iliac cred draped

67. The PN reviews a client's medication history and learns that the client takes an anticoagulant and has recently started taking phenytoin. Which instruction should the PN provide when assigning the clients morning care to an UAP ? A. Measure temperature every 4 hours B. Elevate both feet on two pillows C. Initiate hourly turning schedule D. Protect skin from injury and bruising

D. Protect skin from injury and bruising

42. When caring for a client with a colostomy, which topical skin preparation should the Practical Nurse apply around the stoma? A. Antiseptic cream B. Petroleum jelly C. Cornstarch D. Stoma adhesive

D. Stoma adhesive

8. An adult client who weighs 150 pounds has partial thickness and full-thickness burns over 40% of the body from a house fire. After admission, which observation is most important for the PN to report immediately? A. Poor appetite and refusing to eat B. Systolic blood pressure of 102 C. Painful moaning and crying D. Urine output of 20 mL/HR

D. Urine output of 20 mL/HR

4. The practical nurse is assisting the nurse with the admission of a young adult female Korean exchange student with acute abdominal pain. Although the client has been able to easily answer questions, when asked about sexual activity, she looks away. Which action should the PN take? A. Omit completing this section of the assessment form B. Reword the question in case the client did not understand C. Ask her if she would like an interpreter to ask the question D. Watch the client's response when asked a different question

D. Watch the client's response when asked a different question

22. The Practical Nurse observes an unlicensed assistive personnel (UAP) bathing a bedfast client with the bed and high position. Which action should the PN take? A. Remain in the room to supervise the UAP B. Determine if the UAP would like assistance C. Assumed care of the client immediately D. Instruct the UAP to lower the bed for safety

D. White blood cell count

26. The practical nurse is caring for an older client who was informed about the diagnosis of terminal cancer two days ago. Which intervention would be most helpful for the client's spouse at this time? A. Consultation with the case manager and hospital chaplain B. Visiting procedures are done to avoid seeing the client in pain C. participating in the client's care within his/hers capabilities and desires D. information about palliative and hospice care services

D. information about palliative and hospice care services

2. A client is admitted to the postoperative surgical unit with two chest tubes after a left lobectomy. The practical nurse observes that the____ Chambers are set at the prescribed suction of 20 cm water pressure and tubing occurs with respirations And bubbling. What action should the PN implement? A. Apply a partially occlusive dressing to chest B. notify the registered nurse of the malfunction C. clamp the chest tube to see if the activity stops D. maintain system integrity to promote lung reexpansion

D. maintain system integrity to promote lung reexpansion

73. Before administering a scheduled dose of insulin to a 10 year old child who is learning diabetic self care, which information is most important for the PN to ask the child? How much did the child exercise today? Did the child perform a finger stick? When did the child last urinate? Has the child eaten recently?

Did the child perform a finger stick?

62. A male client attends a commonly supported program for mentally impaired and chemical abusing clients. The client tells the PN that his drugs of choice are cocaine and heroin. What is the greatest health risk for this client? a. Hypertension b. Hepatitis c. Glaucoma d. Diabetes

a. Hypertension

55. In obtaining an orthostatic vital sign measurement, which action should th ePN take first? a. Instruct the client to lie supine b. Assist the client to stand upright c. Count the clients radial pulse d. Apply a BP cuff

a. Instruct the client to lie supine

64. The PN uses an ultrasound stethoscope to auscultate a client's left dorsalis pedis pulse. Where should the PN place the transducer?

a. Know placement of L pedal pulse

61. The PN notes that an older female client has developed a nonproductive cough and seems more confused than the previous day. Vital signs are temperature 99.8 F, pulse 94, respiration 22, and BP 108/54. Which intervention is most important for the PN to implement? a. Report findings to the charge nurse b. Monitor the client's temperature hourly c. Offer the client fluids frequently d. Provide care to moisten oral mucosa

a. Report findings to the charge nurse

68. The UAP reports to the PN that an assigned client experienced shortness of breath when the bed is lowered for bathing. Which action should the PN implement? a. Obtain further data about the clients activity intolerance to position changes b. Advise the UAP to allow the client to rest before completing the bath c. Direct the UAP to obtain vital signs and a pulse oximetry reading d. Notify the healthcare provider about the clients episode of shortness of breath

b. Advise the UAP to allow the client to rest before completing the bath

57. A client who is receiving chemotherapy has developed stomatitis. Which instruction should the PN provide the UAP who is assisting with the care of this client? a. Keep the room environment free of unpleasant odors b. Gather supplies for protective environment precautions c. Assist the client with feeding at meal times d. Provide gentle and meticulous mouth care.

b. Gather supplies for protective environment precautions

56. A female client tells the PN that her hemorrhoids are inflamed and hurt constantly. Which intervention is best for the PN to implement to complete a focused assessment? a. Determine if the client use any over the counter preparations for hemorrhoids b. Place the client in a standing position, leaning over the exam bed for inspection c. Position client in left lateral position to inspect perineal area for fissures d. Ask the client how long she has experience discomfort related to hemorrhoids

d. Ask the client how long she has experience discomfort related to hemorrhoids

81. A client tells the PN that she has a family history of cancer and has increased the amount of dairy products in her diet to reduce her risk. How should the PN respond? a. Encourage the client to get plenty of exercise as well as dietary change b. Provide written information about the seven warning signs of cancer c. Remind the client to make sure the dairy products are fortified with vitamin D d. Suggests that an increase in fruits and vegetables is more beneficial

d. Suggests that an increase in fruits and vegetables is more beneficial