HESI Fundamentals Remediation
The practical nurse (PN) observes a psychiatric clinical nurse specialist use cognitive behavioral therapy (CBT) techniques as she works with a bulimic client. Which statement by the nurse is an example of the application of cognitive behavioral therapy principles? A) "Being thin does not seem to solve your problems; you are thin now and still unhappy." B) "What are your feelings about not eating the food that you prepare for others?" C) "You seem to feel much better about yourself when you eat something." D) "is it difficult to talk about your feelings and private matters with someone you've just met?"
A) "Being thin does not seem to solve your problems; you are thin now and still unhappy." Cognitive behavioral therapy (CBT) is the most effective treatment for bulimia. CBT helps the client restructure faulty perceptions and develop accepting attitudes towards themselves and their bodies. This process works by identifying the negative and irrational patterns of thought and then challenging the client based on rational evidence and thoughts. Applying these principles, the nurse challenges the irrational thinking by stating the obvious, that the client continues to be unhappy in spite of being thin.
The home health practical nurse (PN) is visiting an older client plans to use a mini-mental health exam during a focused assessment. The PN notices that the client appears to be confused and slow to respond during a conversation. Which action should the PN perform next? A) Assess the client's sensory status prior to any testing. B) Begin the assessment, documenting the confusion and slow responses. C) Administer the assessment later when the client is less confused. D) Alert the healthcare provider immediately about the client's mental status.
A) Assess the client's sensory status prior to any testing. Vision and hearing changes caused by aging may alter alertness and cause the client to appear confused. The practical nurse (PN) needs to take into consideration that older clients may not be able to hear the questions clearly when a mental status exam is being performed. For these reasons, the PN should check sensory status before assessing any aspect of mental status.
Which medication is indicated for a client who had a total thyroidectomy one week ago secondary to goiter? A) Levothyroxine B) Radioactive Iodine C) Tramadol D) Methimazole
A) Levothyroxine Complete removal of the thyroid gland may be performed due to obstruction of the airway, cosmesis, or if cancer of the thyroid gland is suspected or identified. A client who has undergone a total thyroidectomy will require medication for thyroid replacement, such as levothyroxine.
The practical nurse (PN) is caring for a client whose kidney stones have not resolved with thiazide medication. Which procedure will most likely be prescribed next? A) Lithotripsy B) Ureteroscopy C) Pyelolithotomy D) Percutaneous nephrolithotomy
A) Lithotripsy A lithotripsy is a non-surgical procedure commonly known as shock wave lithotripsy (SWL). This procedure uses sound, laser, or dry shock to break the stone(s) into small fragments to make it easier for the client to pass them through the urinary tract.
Which cells are touch receptors located in the epidermis? A) Merkel Cells B) Langerhans Cells C) Melanocytes D) Keratinocytes
A) Merkel Cells Merkel cells are touch receptors found in the epidermis. These cells are involved in the sensation of light touch.
The practical nurse (PN) is performing a focused assessment on a client with conjunctivitis. Which sign or symptom indicates that the PN needs to report this finding, so a referral to the ophthalmologist can be initiated? A) Photophobia B) Purulent discharge C) Itching D) Redness and swelling
A) Photophobia Photophobia can be a serious sign of worsening conjunctivitis. The client should be referred to an ophthalmologist immediately in order to avoid further complications.
As the practical nurse (PN) inflates the balloon of a client's indwelling urinary catheter, the client reports pain and discomfort. What should the PN do next? A) Stop and deflate the balloon of the catheter B) Continue to inflate as the client takes slow deep breaths. C) Immediately remove the catheter and start over. D) Reposition the client and resume inflating the balloon.
A) Stop and deflate the balloon of the catheter. If the client reports pain as the balloon of a urinary catheter is inflated, the PN should deflate the balloon then advance the catheter another 2.5 cm (1 inch) and reattempt inflation
The practical nurse (PN) is reinforcing teaching to a client about levothyroxine (Eltroxin, Synthroid). Which instructions should the PN emphasize? A) Take the medication on an empty stomach B) Take the medication just prior going to sleep C) Take the medication at different times every other day. D) Take the medication with a glass of milk or antacid.
A) Take the medication on an empty stomach. It is best to take levothyroxine on an empty stomach, at the same time each day and preferably in the morning to avoid insomnia.
The practical nurse (PN) is providing care to a pregnant client who reports constipation. The healthcare provider prescribed a stool softener, and the PN provides reinforcement of education about the medication and prevention of constipation. Which is an indication that the client understands the education? A) The client will call the healthcare provider if constipation occurs B) The client will take stool softeners if constipated C)The client will remove fresh fruits from the diet. D) The client will avoid milk products.
A) The client will call the healthcare provider if constipation occurs. Constipation commonly occurs in pregnancy. The practical nurse (PN) should expect the client to call the healthcare provider if the medication is ineffective in correcting the constipation.
The practical nurse (PN) is reviewing the data of a client who reports severe, spasmodic pain in the right flank. The pain is intermittent and is accompanied by nausea and diaphoresis. The client has a history of gout. On inspection, the client's urine has a pink and cloudy appearance. The client denies any fevers or chills and is presently afebrile. The client's symptoms are most consistent with which condition? A) Urolithiasis B) Urothelial cancer C) Urinary incontinence D) Urinary Tract infection
A) Urolithiasis Urolithiasis (kidney stones) is suspected based on the client's presenting signs and symptoms of sporadic severe, spasmodic pain in the right flank. These signs are accompanied by hematuria, turbidity and being afebrile. Clients with history of diabetes or gout (hyperuricemia) have an increased risk for stone formation.
What are the legal implications of federally initiated healthcare acts on practical nursing (PN) practice? A) Ignorance of health acts is not permissible. B) Requires nurses to obtain malpractice insurance. C) Encourages nurses to keep up with current standards. D) Guides and defines legal boundaries of nursing practice. E) Failure to follow guidelines results in automatic loss of nursing license.
A, C, D The legal implications of federally initiated health acts affect the PN practice by guiding and defining legal boundaries of PN practice as defined in Nurse Practice Acts. Ignorance of the different acts and the guidelines are not permissible, therefore PNs need to keep up with the standards by reviewing the acts and policies and guidelines and keep current such as by reading current PN literature related to their field of practice.
The nurse preceptor is monitoring a practical nurse (PN) who is preparing to instill prescribed ophthalmic ointment into the eye of an older client. Which response by the PN indicates safe nursing practice? A) "I will firmly roll the ointment tube between my palms for five minutes." B) "I will squeeze the tube lightly and release a small thin strip of ointment into the pocket of the bottom eyelid." C) I will gently pull upward on the upper lid to administer the ointment." D) "I will instruct the client to squeeze their eye tight after application of ointment."
B) "I will squeeze the tube lightly and release a small thin strip of ointment into the pocket of the bottom eyelid." Properly instilling ophthalmic ointment requires the practical nurse (PN) to gently pull the lower eyelid, forming a small pocket. This allows the PN to gently squeeze the tube to administer a thin strip of ointment into the pocket of the lower lid.
The healthcare provider prescribes doxazosin (Cardura) for a 74-year-old client with benign prostate hypertrophy (BPH). The practical nurse (PN) should reinforce which instructions to the client to avoid driving or operating machinery for how many hours after taking the initial dose of the medicine? A) 6 B) 4 C) 24 D) 18
B) 4 The first dose of doxazosin (Cardura) may cause syncope. Clients should be instructed to avoid driving and operating machinery for 4 hours after their first dose and/or after an increase in their dosage.
An older client is being evaluated for vertigo. The healthcare provider quickly lowers the client into the supine position with the client's head rotated 45 degrees to one side and the neck extended 20 to 30 degrees. What test is being performed? A) Fukuda B)Dix-Hallpike C) Romberg D) Rinne's
B) Dix-Hallpike Benign paroxysmal positional vertigo (BPPV) is an inner ear problem causing a client to experience vertigo. The Dix-Hallpike maneuver is performed by lowering the client into the supine position with the client's head rotated 45 degrees to one side and the neck extended 20 to 30 degrees; the examiner observes the client's eyes for nystagmus. A positive test indicates the presence of benign paroxysmal positional vertigo (BPPV).
Which information is most important to include when documenting the assessment findings about a child's seizure episode ? A) Classification B) Duration C) Etiology D) Expected Outcome
B) Duration It is most important to document what is observable during a seizure episode. The practical nurse (PN) should record the duration of the seizure, as well as the areas of the body involved and what the child was doing just prior to the onset of the seizure.
The practical nurse (PN) is preparing an older client for irrigation to remove cerumen impaction from the ear. Which action by the PN is recommended? A) Use 100 mL of irrigating fluid at a time B) Ensure that the irrigating fluid is at body temperature C) Speed up the irrigation flow if dizziness develops D) Use blasts or sudden pressure
B) Ensure that the irrigating fluid is at body temperature. When irrigating the ear, improper temperature of the irrigation fluid may stimulate the vestibular sense, which may lead to nausea, vomiting, or dizziness. The practical nurse (PN) should make certain that the irrigating fluid is at body temperature, around 98.6° F (37° C).
A three-month-old infant is suspected to be a victim of "shaken baby syndrome". Which type of intracranial hemorrhage is caused by tearing of a meningeal artery that causes an inward expansion of blood from the inner surface of the skull? A) Subarachnoid B) Epidural C) Subdural D) Intracerebral
B) Epidural Shaken baby syndrome occurs when an infant or toddler is shaken forcefully in a jerky motion. Due to an infant's and toddler's weaker neck muscle strength to hold up the head, the shaking causes the brain to slosh back and forth within the skull causing bleeding in the brain. Epidural hemorrhage is the most serious type of intracranial bleed; it most often occurs as a result of a severe head injury. This type of hemorrhage involves a tear in a meningeal artery that forms a hematoma between the skull and the dura mater. A rapid and dangerous increase in intracranial pressure occurs as a result of the inward expansion of blood into the brain.
An 82-year old client is being treated for senile cataracts. The grandson, who is accompanying the client, expresses concern to the practical nurse (PN) that one day he may also develop cataracts. Which factor increases the risk of senile cataracts? A) Short term use of corticosteroids B) Excessive alcohol consumption C) Omega 3 fatty acids D) Vitamin E
B) Excessive alcohol consumption A cataract is the clouding of the lens of the eye. Although the development of cataracts is directly related to aging, several factors can be related to the development of cataracts such as being diagnosed with diabetes, long-term use of corticosteroids, and exposure to ultraviolet light and radiation. Other elements that have been shown to increase the development of cataracts is exposure to air pollution, cigarette smoke and excessive alcohol consumption.
While obtaining vitals signs at a routine well-child exam, the practical nurse (PN) identifies and reports that a 12-month-old child is unable to pronounce any simple words or syllables. Which possible cause should the child be evaluated for first? A) Brain injury B) Hearing loss C) Autism D) Apraxia of speech
B) Hearing loss Between 6 and 12 months of age, babies typically begin to communicate by babbling simple syllables in imitation of real speech. Children who present with delayed speech should first be tested for hearing loss, which is a common and easily identified cause of delayed speech.
Which lab value should the practical nurse (PN) expect to find when reviewing the laboratory data of a client in the acute phase of burn recovery? A) Hemoglobin 19.2 g/dl B) Hematocrit 29% C) Sodium 145 mEq/L D) Potassium 5.8 mEq/L
B) Hematocrit 29% During the acute phase of burn recovery, fluids shift back into the intervascular spaces from the interstitial spaces. This causes hemodilution, resulting in a decreased hematocrit level (< 36% in women or <40% in men).
The practical nurse (PN) is conducting a focused assessment on a client who has a history of unexplained weight gain, thinning of hair, thickened skin, low blood pressure, and slow pulse. The client reports an inability to concentrate, memory loss, cold intolerance, and constipation. What is the most likely cause of these physical findings? A) Crohn's disease B) Hypothyroidism C) Graves' disease D) Diabetes Mellitus
B) Hypothyroidism Hypothyroidism is one of the most common medical disorders in the United States. It occurs when the thyroid fails to secrete sufficient hormones, slowing down important metabolic processes.
The practical nurse (PN) is providing care to an older client with early stages of diabetic retinopathy. Which reinforcement of teaching should the PN provide the client to help minimize worsening of the disease? A) Have a dilated eye examination every 5 years B) Maintain your blood glucose in your target range c) Avoid exposure to direct sunlight D) Engage in strenuous exercise every day
B) Maintain your blood glucose in your target range. Diabetic retinopathy is a condition in which the blood vessels of the retina become damaged; this condition results from elevated blood glucose levels in clients with diabetes. Strict control of blood glucose, cholesterol, and blood pressure, along with completion of annual dilated retinal examinations, is essential.
The home health practical nurse (PN) is performing a focused assessment with an older client diagnosed who has early stages of decreased renal function. The PN is assessing the client for dehydration. Which is the best way to assess for dehydration? A) Gently pinch skin on the client's clavicle B) Obtain the client's weight C) Ask the client about being thirsty D) Assess the client's mental status
B) Obtain the client's weight As an individual ages their kidney function begins to decrease and the ability to conserve fluid. An older client's weight measurement is the most accurate way to determine hydration status. A weight loss of 3% or more is indicative of fluid loss and dehydration.
The practical nurse (PN) identifies which as a contributing factor to the development of pressure ulcers? A) High protein diet B) Paralysis C) Independent ADLs D) Upper respiratory infection
B) Paralysis Paralysis results in decreased micromovements and decreased sensation. Clients with paralysis are at greater risk for developing pressure ulcers.
The practical nurse (PN) obtains a position at a clinic that is modeled as a Nurse-Managed Health Clinic (NMHC). Besides nurse participants, which two professionals is the PN likely to find on the interdisciplinary team? A) Physicians and specialized therapists B) Physicians and social workers C) Pharmacists and specialized workers. D) Pharmacists and social workers
B) Physicians and social workers Nurse-Managed Health Clinics (NMHCs) predominantly serve populations that have limited access to care and operate under government funding. The interdisciplinary team is led by advanced practice registered nurses, and is supported by physicians, social workers, and public health nurses.
The practical nurse (PN) is caring for a client who was diagnosed with a urinary tract infection and prescribed an antibiotic two days ago. The client has returned to the clinic reporting fever, chills, flank pain, and nausea with vomiting. The PN recognizes that treatment has not yet been effective. Which condition is most consistent with the client's signs and symptoms? A) Cystitis B) Pyelonephritis C) Urothelial Cancer D) Acute kidney injury
B) Pyelonephritis A client who has been recently treated for cystitis or urinary tract infection and presents with fever, chills, tachycardia, tachypnea, flank, back, or loin pain, abdominal discomfort, nausea and vomiting, general malaise or fatigue, burning, urgency, or frequency of urination and nocturia is most likely experiencing pyelonephritis.
While performing a focused assessment on a client's skin turgor, the practical nurse (PN) lifts up a fold of the client's skin. Which action should the PN take next? A) Measure the depth of pitting in the skin B) Release, observe the skin return to place. C) Document how easily the skin is raised D) Inspect the color and texture of the skin
B) Release, observe the skin return to place Skin turgor refers to the ease and speed with which a lifted skin fold returns into place, or the degree of elasticity of the skin. Skin turgor is a measure of hydration.
A 78-year-old client's wife reports that her huband is having difficulty hearing. Which hearing test should be perform to compare bone conduction with air conduction? A) Weber B) Rinne C) Schwabach D) WhisperB
B) Rinne The Rinne test is done with the use of a tuning fork and compares the length of time sound is heard by bone conduction versus air conduction. Air-conducted sound should be heard twice as long as bone-conducted sound.
The practical nurse (PN) witnesses an older client having a seizure with rigid extension of the arms and legs, sudden jerking movements, loss of consciousness, and urinary incontinence. Which term describes this type of seizure? A) Focal seizure B) Tonic-clonic C) Myoclonic D) Complex Partial
B) Tonic-clonic A tonic-clonic (grand mal) seizure is best described as rigid extension of arms and legs followed by sudden jerking movement with loss of consciousness. Bowel and bladder incontinence is also common.
Which practical nursing (PN) tasks would be appropriate for the PN to assign to the unlicensed assistive personnel (UAP)? A) Performing venipuncture for serum CBC, electrolytes, and blood cultures. B) Assisting clients with morning ADLs to include showering and shaving. C) Transporting a client with a broken wrist to the cast clinic for cast placement. D) Placing a urinary indwelling catheter prior to a procedure. E) Assessing breath sounds of a client on admission to the asthma clinic.
B, C Assisting with ADLs (showering and shaving) Transporting for cast placement. Assisting clients with activiites of daily living and with transporting stable clients are within the scope of practice for a UAP.
The practical nurse (PN) is discussing smoking cessation with a male client. Based on the Health Belief Model (HBM), what are effective strategies for the PN to use to encourage the client to stop smoking? SATA A) Inform the client about risk factors related to smoking tobacco B) Ask the client how likely it would be for him to develop lung cancer. C) Encourage the client to list how a smoking cessation program would benefit him D) Refer the client to social services to remove financial barriers. E) Assess whether the client considers lung cancer a serious health condition
B, C, E The constructs of the Health Belief Model include 4 perceptions: perceived susceptibility to disease, perceived seriousness or severity of the disease, perceived benefits of taking on a new behavior, and perceived barriers to adopting new behaviors. The PN should assess these areas before offering advice.
The practical nurse (PN) is teaching a female client who has had frequent urinary tract infections. Which statement by the client indicates the need for additional teaching? A) "I need to urinate after having sexual intercourse." B) I need to drink at least 2000 mL of fluid a day. C) "I need to wipe my perineum from the back to front after using the toilet." D) "It is best to wash my hands before and after using the restroom."
C) "I need to wipe my perineum from the back to front after using the toilet." The proper direction to wipe is from the front of the perineum to the back after voiding and/or defecating to avoid contaminating the urethra.
The practical nurse (PN) is reviewing a male client's medication administration record. The client has told the PN that he uses herbal supplements. Which medication will most likely have an adverse interaction with the herbal supplements? A) Diuretics such as furosemide (Lasix) B) Antibiotics such as Penicillin (Amoxil) C) Antidepressants such as phenelzine (Nardil) D) Antipyretics such as acetaminophen (Tylenol)
C) Antidepressants such as phenelzine (Nardil) Herbs such as valerian, St. John's Wort, and yohimbe may interfere with the therapeutic effects of MAOI antidepressants such as phenelzine (Nardil), and should not be used concurrently.
The practical nurse (PN) is reinforcing teaching to a parent of a 14-day-old infant. Which method of obtaining a temperature is best to teach the parent? A) Temporal B) Rectal C) Axillary D) Oral
C) Axillary An accurate temperature reading depends on the correct application of each particular method. Axillary temperature is recommended for infants younger than 1 month old.
A postoperative surgical client states to the practical nurse (PN), "I feel like something has popped in the wound." Which should the PN suspect that the client is experiencing? A) Scarring B) Drainage C) Dehiscences D) Cicatrix
C) Dehiscences Wound dehiscence is a partial or complete separation of the outer wound layers. The client experiencing dehiscences may feel a popping sensation in the wound area.
The practical nurse (PN) is providing care to a client who has chronic kidney disease (CKD). The PN should be able to identify which health condition has most likely contributed to the development of this condition? A) Cholecystitis B) Hepatitis C) Diabetes mellitus D) Renal calculi
C) Diabetes mellitus The leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States is uncontrolled diabetes mellitus. Chronic high blood glucose levels cause renal hypertension and excess kidney tissue perfusion, which may lead to CKD and renal failure.
The practical nurse (PN) is performing a focused assessment on an 86-year-old client. Which finding is the PN likely to observe as a result of age-related change? A) Isolated diastolic hypertension. B) Increased perspiration C) Hypoactive Bowel sounds D) Thickening of the epidermis.
C) Hypoactive bowel sounds In an 86-year old client, the practical nurse (PN) is likely to discover a history of more frequent constipation due to decreased gastric motility. This is evidenced by hypoactive bowel sounds.
The facility for which the practical nurse (PN) works is undergoing a Magnet ® recognition journey, so the PN has been asked to consider returning to school in order to meet educational requirements of the accreditation. The PN looks at various nursing programs, but is concerned due to a preference for assignments that involve more than just papers. The PN wants to actively demonstrate knowledge and skills learned. Which type of learner is the PN? A) Visual B) Auditory C) Kinesthetic D) Social
C) Kinesthetic Learning styles, or preferences, define how one prefers to gain knowledge. Kinesthetic learners actively need movement and creation to become successful scholars.
Intracranial pressure (ICP) monitoring is required for a child with a severe brain injury. To obtain the most accurate readings, a catheter is inserted into which area of the brain? A) Subdural space B) Epidural space C) Lateral Ventricle D) Anterior fontanel
C) Lateral ventricle ICP monitoring is indicated for clients with suspected ICP elevation, such as those with a severe traumatic brain injury. The most accurate ICP readings are obtained by inserting an intraventricular catheter into the lateral ventricle.
Which should the practical nurse (PN) include when reinforcing teaching to a client with end-stage renal disease? A) Increase dietary protein intake B) Increase fluid intake C) Monitor blood pressure and weight D) Monitor 24 hour urine intake and output
C) Monio Maintaining blood pressure conserves existing kidney function and slows down the progression of end-stage renal disease (ESRD). Fluid overload, a complication of ESRD, is reflected by a weight gain. Daily monitoring of blood pressure and body weight is the best way to obtain accurate data to monitor for problems.
The practical nurse (PN) is providing care to a 78-year-old client with leukopenia due to recent treatment for leukemia. The unlicensed assistant personnel (UAP) reported an oral temperature of 98.1°F (36.7° C) several hours earlier, but the client's temperature is now 99.1°F (37.3° C). Which action should the PN take first? A) Recheck the temperature B) Administer an antipyretic as prescribed. C) Report this finding to the charge nurse. D) No action is needed.
C) Report this finding to the charge nurse A temperature elevation of even 1° F (0.5° C) above baseline is significant for a patient with leukopenia and indicates infection until it has been unproven otherwise. The nurse should report this finding immediately to the health care provider.
A homehealth caretaker of an older client reports to the practical nurse (PN) that the client appears to be more confused than usual and is experiencing increasing occurrences of incontinence. These signs are most consistent with which condition? A) Possible head injury B) Progressive dementia C) Urinary tract infection D) Functional incontinence
C) Urinary tract infection If an older client displays increased in signs and symptoms of confusion and/or unexplained falls and a sudden onset of or worsening of incontinence, the practical nurse (PN) needs to identify and report of a possible urinary tract infection to the nurse care manager to contact the healthcare provider for a prescription for a urinalysis to rule out a possible urinary tract infection.
The healthcare provider has prescribed a treatment for a chronic wound that utilizes a technique which uses a special sponge that is placed in the wound bed and is sealed for 48 hours with a continuous low-level negative pressure. The practical nurse (PN) recognizes the client will need to be prepared for which procedure? A) Electrical Stimulation B) Topical Growth Factors C) Vacuum-assisted closure D) Hyperbaric oxygen chamber
C) Vacuum-assisted closure Wound vacuum-assisted closure is a procedure that uses a special sponge that is placed in the wound bed that is sealed for 48 hours and uses continuous low-level negative pressure to remove any drainage in the wound bed to promote wound healing.
The practical nurse (PN) is assessing the function of a client's blood glucose meter. Which is the best evidence that the meter is accurately measuring blood glucose? A) A sample tested on the clients meter are within 20 mg/dl of the result on a similar meter. B) The PNs blood glucose is WNL when checked on the client's meter. C) An average of the client's blood glucose values are consistent with the A1c value. D) A sample of control solution yields results within the range for the client's meter.
D) A sample of control solution yields results within the range for the client's meter. Control solution is used to verify a blood glucose meter's performance. Other options are not used as quality checks (comparing two meters, using a nurse's sample, or averaging to match A1c).
The practical nurse (PN) is reinforcing teaching to a client diagnosed with psoriasis. What should the client be instructed to avoid? A) Sunlight B) Corticosteroids C) Citrus Fruit D) Antimalarial medication
D) Antimalarial Medication Psoriasis is a skin condition that is often treated with phototherapy and corticosteroids. While some medications can be helpful in management, antimalarial medications, such as chloroquine, may exacerbate psoriasis.
The practical nurse (PN) is unable to complete medication administration within the accepted time limits. The PN reviews time management strategies with the lead nurse and reports difficulty with interruptions and call-lights. The PN identifies which strategy should the lead nurse recommend to improve on-time medication administration? A) Set goals B) Set boundaries C) Avoid procrastination D) Decrease distractions
D) Decrease distractions Strategies to maximize time management include setting goals, prioritizing tasks, increasing concentration, decreasing distractions, avoiding procrastination/increasing self-discipline, and setting boundaries. Decreasing distractions through the use of Do Not Disturb signs on vests is an evidence-based practice that leadership should implement to increase safe, efficient medication administration and eliminate common interruptions. The lead nurse and licensed need to remind the other healthcare personnel to answer the call-lights.
An older client reports cold intolerance, dry skin, dry hair, constipation, and lack of energy. Which change in endocrine function should the practical nurse (PN) recognize as the likely cause of these changes? A) Increased pituitary secretions B) Decreased insulin resistance. C) Increased production of parathyroid hormone. D) Decreased production of thyroxine.
D) Decreased production of thyroxine. As individuals age, decreased thyroid activity (hypothyroidism) slows production of thyroxine (T4). The pituitary responds appropriately by making more thyroid-stimulating hormone (TSH) in an attempt to force more hormone production out of the thyroid. The symptoms of hypothyroidism include cold intolerance, dry skin, dry and thin body hair, constipation, depression, and lack of energy.
The practical nurse (PN) is providing care to an older client who has just been treated for renal calculi. When reinforcing teaching to the client on how to prevent another occurrence of renal calculi formation, which is the most important recommendation for the PN to include? A) Reduce dietary sodium B) Consume calcium-rich foods. C) Limit animal protein D) Increase fluid intake.
D) Increase fluid intake Drinking enough liquid, especially water, is the most important intervention a client can take to prevent renal calculi formation. Unless there is a reason for fluid restriction, it is recommended that a person drinks six to eight 8-ounce (240 ml) glasses of water per day to prevent an occurrence of renal calculi formation.
Which renal system change commonly occurs in older clients the practical nurse (PN) should expect to see? A) Incontinence B) Pyelonephritis C) Renal mass enlargement D) Nocturia
D) Nocturia Decreased renal function occurs with age. Loss of functional nephrons, decrease in glomerular filtration rate (GFR), reduced renal mass, and diminished renal blood flow contribute to impaired renal function in the aging population. Urine production that usually peaks during the waking hours and lessens at sleeping hours with younger clients, diminishes with the aging client. This diminished ability to lessen urine production at nighttime leads to the client experiencing nocturia during their sleeping hours.
A client is admitted for a thyroid scan for suspected Graves Disease. The charge nurse has assigned care of this client to the practical nurse (PN). Which is the most important data that the PN should report to the charge nurse immediately? A) Apical pulse of 110 BPM B) Blood glucose of 150 mg/dl C) Presence of tremors and blurred vision D) Temperature change from 99.1 to 100.1
D) Temperature change from 99.1 to 100.1 For the client with Graves disease (hyperthyroidism), an increase in temperature may indicate worsening of the condition and the onset of a thyroid storm. An increase of 1° F should be reported immediately.
The practical nurse (PN) recognizes which adverse effect on the skin associated with the use of topical steroids? A) Infection B) Swelling C) Coarseness D) Thinning
D) Thinning Treatment of skin conditions often involves the use of topical steroids during periods of exacerbation. Side effects of topical steroids include thinning of the skin.
The practical nurse (PN) observes the nurse planning a client's discharge upon admission. The PN asks the nurse why is comprehensively documenting discharge needs done at this time. The PN identifies which response by the preceptor indicates the reason for this discharge planning process? A) To augment Medicare appeals upon readmission B) To ensure interdisciplinary collaboration and early discharge. C) To increase client recovery by facilitating transitions D) To increases access to resources and improve client recovery.
D) To increase access to resources and improve client recovery. Comprehensive discharge planning improves outcomes and facilitates anticipating the needs of the client upon discharge. Complete documentation of discharge at admission helps identify and initiate referrals necessary to increase collaboration, follow-through, access to resources, improved recovery, and increased positive outcomes.
Which topical antibiotic is the preferred treatment of impetigo? A) Erythromycin B) Clindamycin C) Metronidazole D) Mupirocin
D)Mupirocin Impetigo is a skin infection commonly seen in children. Mupirocin is a topical antibiotic used for the treatment of impetigo.
