Final Exit Questions
The nurse is very busy and running late with administering medications and ask the practical nurse PC in to administer a medication already drawn up in an unlabeled syringe. How should the PN respond?
I am not comfortable during that, is there something else I can do to help you
Which statement by a mature adult client with advanced prostate cancer best indicates that he has reached a level of acceptance of his prognosis?
I found the support I need from my faith and family
Which statement by an older female client who lost her spouse two years ago should indicate to the practical nurse (PN) that the client may need brement counseling?
I realized that life must go on but sometimes I wonder why
When a small fire breaks out in the kitchen of a long-term care facility, which task is most important for the practical nurse (PN) to perform instead of assigning to an unlicensed list of personnel?
Identify the method for transporting and evacuating each resident
The practical 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 clients care?
Implement ongoing assessments for signs of shallow or slow breathing
The practical nurse PN is assisting with the plan of care for a client with costochondritis who is now experiencing increased discomfort in breathing. The client receives a prescription for tramadol.
Implement ongoing assessments for signs of shallow or slow breathing
. An older female adult who was admitted to a long term care facility yesterday is confused about what day of the week it is. Her history does not indicate 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
. A client with schizophrenia reports auditory hallucinations when admitted to the hospital. What question is most important for the practical nurse PN to include in the assessment for this client?
What are the voices uttering
An order client with metastatic breast cancer is experiencing shortness of breath as a result of 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 care? (select all that apply)
care can be provided in the home where the client resides, care focuses on comfort, dignity, and emotional support, instructions for care should be included in the client living will
While the practical nurse PN and unlicensed assistive personnel (UAP) are turning a client with an abdominal incision, the clients incision eviscerates. What task is best for the PN to assign to the (UAP)?
gather supplies
Which food provides the best source of vitamin B12?
hamburger
The health care 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 it's 8.2 grams/dl. When a list of iron rich foods is given to the client, she tells the practical nurse PN that she is vegetarian and does not eat anything that bleeds. Which instruction should the (PN) provide? (Select all that apply) increase green leafy vegetables in the diet add lentils and black be
increase green leafy vegetables in the diet add lentils and black beans to soups oatmeal is a good choice for breakfast
The practical nurse peeing is documenting the insertion of a urinary catheter for a female client with urinary retention. Which information should the PN include during the electronic documentation of the procedure? (Select all that apply)
size of urinary catheter, amount of urine obtained, appearance of urine obtained
The practical nurse PN administers an antibiotics to a client with a respiratory tract infection period to evaluate the medications effectiveness, which laboratory values should the PN monitor? (Select all that apply)
sputum culture and sensitivity white blood cell count 56.
The practical nurse (PN) is assigning care for a group of clients on the urology medical unit. Which client care interventions should the PN assign to the unlicensed assistive personnel (UAP)? (Select all that apply)
transport a urine culture sample to the laboratory, empty bedside drainage unit four client with indwelling urine catheter
The practical nurse (PN) preparing to assist an elderly client to the bathroom. The PN knows that an elderly adult's center or gravity changes from the hips to another area of the body. And planning to safely assist this client the PN knows that the center of gravity for the elderly client is in which area of the body?
upper torso
The healthcare provider prescribes cefazolin 500 mg IM every 6 hours. The available vial is labeled, Cefazolin 1 gram, and the instructions for reconstitution state, For IM use, add 2.5 ml sterile water for injection to provide a total volume of 3.0 ml. After reconstitution, how many ML should be administered to the client?
1.5
An older client who had a colon resection 8 days ago is straining at stool. The practical nurse (PN) observes sudden spillage of serosanguinous Drainage from the client's wound followed by appearance of bowel on the skin. Which complication has occurred?
Dehiscence
The practical nurse (PN) observes A newly hired unlicensed assistive personnel (UAP) who is counting a client's radial pulse as seen in the picture. Which action should the (PN) take?
Demonstrate the correct pulse site to the UAP
Which intervention is within the scope of practice for practical nurse PN?
Demonstrating deep breathing and coughing to a postoperative client
An adolescent with a history of recurring atopic dermatitis (eczema) tells the practical nurse (PN) of a desire to play high school football. Which action should the PN take?
Describe the problems associated with perspiration for those with eczema
When administering prescription medications to an older resident in an extended care facility, the practical nurse (PN) notices that the client is having difficulty hearing. Which action is most important for the PN to take?
Determine if the client has had difficulty in the past
When obtaining a capillary blood sample for glucose measurement, which intervention should the practical nurse (PN) implement?
Determine which finger was used previously
While assisting the RN with the admission of a toddler, which intervention should the practical nurse (PN) implement to make the experience least stressful for the child?
Do a complete head to do exam in sequence
And caring for a client with bucks traction, the practical nurse (PN) observes that the prescribed amount of weights are hanging freely and the traction rope is on the pulley. Which action should the PN implement next?
Document that the books traction is being maintained
. A client is diagnosed with Clostridium difficile. Which action should the practical nurse (PN) implement to prevent the spread of Organism?
Don non sterile gloves when performing direct care
A college student arrives at the clinic for a physical examination and asks the practical nurse (PN) how he should perform testicle self-examination TSE. Which information should PN provide?
Examine the testicles during bathing
The spouse of a hospitalized client asked the practical nurse PN for acetaminophen for tension headache. Which action should the PN take?
Explain that medication can only be prescribed to clients
Two weeks after a cash application, a client with a fractured right arm returns to the clinic for evaluation. The client seems upset and tells the practical nurse PN that the healthcare provider said a callus has formed on the bone. Which action should the PN take?
Explain that this is an expected part of the bone healing process
The practical nurse PN is auscultating a client's lung sounds. Which description should the PN use to document this sound?
Find crackles
. A male client with bipolar disorder reports to the practical nurse (PN) there he has not taken his prescribed medication, divalproex sodium, for the last six months. Assessment of which parameter is most important for the PN to obtain?
Frame of mind
The parents of a child with acute glomerulonephritis are describing to the practical nurse PN what originally motivated them to seek medical care. Which sign is the child most likely to have exhibited?
Hematuria
The practical nurse PN is providing care for a client who is NPO after a small bowl resection. The clients NG tube is connected to low intermittent suction. The client reports dizziness and tingling in digits. Which assessment finding by the PN should be reported to the health care provider?
Hyperactive bowel sounds on assessment
The practical nurse PN is performing stomach care with the client. While cleaning around the stoma, the PN notices blood on the washcloth. Which action should the PN take next?
Continue to clean around the skin surrounding the stomal site
The Glasgow coma scale is being used to monitor a client who experience a traumatic brain injury. What primary assessment should the practical nurse PN evaluate?
Level of consciousness
A client consumes 8 ounces of broth, 4 ounces of apple juice, 4 ounces of flavor gelatin and one banana. During the same shift, this client receives one liter of IV fluid and voice 700 ml. How many ml total oral and IV intake should the PN document on the client's medical record?
1480
The practical nurse PN is assigned to care for four children. Which child should be assessed first?
18-month-old who has cystic fibrosis and is wheezing
The practical nurse (PN) is obtaining fetal heart rates on four antepartum clients in their third trimester of pregnancy. Which fetal heart rate should be reported to the registered nurse RN immediately?
180
A client receives a prescription for cefaclor suspension 325mg that mouth every 8 hours. The bottle is labeled, cefaclor for oral suspension, USP 375 mg per 5 ml. How many ml should the practical nurse (PN) administer?
4.3
The practical nurse (PN) is giving medications to a client who was admitted to the hospital with a diagnosis of diabetes mellitus. After checking the finger stick glucose at 1630, which dose of insulin should the (PN) administer?
8 units
The practical nurse PN is assessing the recreational director of a long-term care facility plan outdoor activities for the wheelchair bound older residents who are mentally alert. Which activity meets the physical and social needs of these residents?
A team ring toss competition
The practical nurse peeing and ministers an anticonvulsant That causes photosensitivity. Which action should the PN take after administering the medication?
Remind the client to protect skin from sunlight
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?
A continuous headache
The practical nurse (PN) is planning evening shift rounds for a group of postoperative clients who all had surgery earlier that day. Which client should the PN check first?
A preschooler who had an emergency appendectomy for appendicitis
The practical nurse PN learns that a client who is receiving chemotherapy has developed stomatitis. Which information should the PN obtain from the client during a focused assessment?
Ability to swallow
The chest X-ray for a client who is admitted for pneumonia shows pleural effusion with deceased air flow in the entire left upper lobe. What should the practical nurse (PN) expect to hear when auscultating the left upper lobe?
Absent or diminished breast sounds
An older male resident of a long-term care facility is awake at 3:00 AM and wandering down the hall with his pajamas unbutton. Which intervention should the practical nurse PN implement?
Address the client to determine his needs
At the beginning of the shift, in which order of priority should the practical nurse PN assess these four clients?
An older adult with dizziness who's O2 saturation is 86% an adult woman with vomiting whose potassium is 2.8 mEq/L a young adult with a history of asthma who's arterial pH is 7.48 an adult client with an officer whose hemoglobin is 9.5 grams/dL
The practical nurse (PN) is working in a cancer detection mobile clinic. Four individuals come for screening with a complaint of hoarseness, a dangerous sign for cancer of the larynx. Which client has the highest risk for development of cancer of the larynx that the PN should refer to the healthcare provider?
An older male who drinks a six pack of beer nightly and smokes heavily
While turning and positioning a bit fast client, the practical nurse (PN) observes that the client is dyspneic. Which action should the PN take first?
Apply a pulse oximeter
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 a controllably and states she is cold period which intervention should the PN perform?
Apply light warmed blankets and her that this is normal following delivery
The practical nurse (PN) an unlicensed assistive personnel (UAP) for feedback about an assigned client instead of responding, the UAP walks away from the PN, ignoring the question. What action is best for the PN to take?
Approach the UAP to discuss the behavior and obtain the information needed about the client
The parents of 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 parents to explain what they understand about the child's diagnosis
An older adult female is admitted with syncope and laboratory findings indicate that her hemoglobin is 8.0 grams/dl. She has a recent history of headaches and frequent falls. Admission prescription orders includes continuation of all home medication. Which medication should the practical nurse (PN) withhold until consulting with the charge nurse?
Aspirin
The practical nurse (PN) determines that a client who is one day postpartum has a moderate amount of lochia rubra and the uterus is firm, dextroverted, and three fingerbreadths above the umbilicus. Which should be the PN's initial action?
Assess the bladder for distension
The practical nurse pin is assigned to care for a client who had in endoscopic procedure in which a local anesthetic was sprayed on the throat. Which priority actions should the PN include in this client's plan of care?
Assess the gag reflex
The practical nurse PN is assessing an older client with left sided heart failure (HF). Which intervention is most important for the PN to implement?
Auscultate all lung fields
The practical nurse PN is caring for a client with influenza who requires droplet precautions. Which action should the PN take after entering the clients room to provide care?
Close the door to the clients room
The birth weight of an infant delivered by a woman with just stational diabetes is 10.1 pounds (4,581 grams). The infant is jittery and has a heel stick glucose level of 40 mg/dl (2.2 mmol/L or SI units) 30 minutes after birth. Based on this information, which intervention should the practical nurse (PN) implement first?
Begin frequent feedings of breast milk or formula
Which location should the practical nurse palpate to determine if a client's submandibular Lymph nodes are enlarged?
Beneath the lower jaw
The practical nurse (PN) notifies the health care provider about client information using the situation, background, assessment, recommendation SBAR technique. Which information should the PM provide first?
Cholecystectomy 24 hours ago
The practical nurse PN 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?
Instruct the UAP to protect the clients left side when transferring to a chair
In assessing a 2-year-old boy with croup, the practical nurse PN finds that he has become increasingly irritable and has developed tachypnea and resting stridor. Which intervention is best for the PN to implement?
Instruct the mother to play with the child for stimulation and distraction
8. A married woman comes to the clinic for her annual well woman physical examination. During the interview with the practical nurse PN, the client makes minimal eye contact. The PN observes yellow bruising to the lower eye and purple bruising on the client's upper arm, which look like fingerprints. Which question is best for the PN to ask the client?
Is anyone hurting you
At the first dressing change, the practical nurse (PN) 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 P end to the clients silence is best?
It's OK if you don't want to look or talk about the mastectomy. I will be available when you're ready
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? (Select all that apply)
Measure head circumference daily document strict intake and outtake Monitor body temperature every 4 hours
A client receive Ondansetron Prior to a 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 a female client with Cushing's syndrome tell her family in a very loud an angry voice to leave her room and not to come back. The response by the PN is based on recognizing which common manifestation of the syndrome?
Mood and alterations
A client receiving chemotherapy develops a cough that is productive of yellow-tinged sputum. After determining that the client is afebrile, which is the priority action for the practical nurse PN to take?
Notify the charge nurse of the assessment findings
2. A male preoperative client who has already signed the informed consent for surgical procedure confides to the practical nurse (PN) that he is really frightened and unsure about undergoing the surgery. Which priority action should the PN take?
Notify the charge nurse of the clients concerns about surgery
The practical nurse peer views the midline episiotomy of a client whose reports pain in her stitches. Which action should the PN take first?
Observe suture line for separation and hematoma formation
Which client information is most important to the practical nurse (PN) to consider when providing instructions to the unlicensed assistive personnel (UAP) about providing morning care to a postoperative client?
Oriented to person only
A client is scheduled to receive a sublingual tablet and has difficulty swallowing tablets. Which is the best nursing action?
Place the tablet under the client's tongue
. During morning rounds, the client who was admitted with obsessive compulsive disorder is in the day room repeatedly washing the top of the same table. Which intervention should the practical nurse PN implement when approaching the client? Provide time for the behavior then guide the client to other activities
Provide time for the behavior then guide the client to other activities
The practical nurse PN determines that a client's 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 complaints of a persistent dry cough the practical nurse PN should tell the client that this is a common side effect of which daily medication?
Quinapril
Which finding for a client with an arteriovenous Fistula (AV fistula) should the practical nurse PN report to the healthcare provider?
Radial pulse distal to AVF is absent and ulnar pulse is present
The parents of a child with prediabetes report to the practical nurse PN that the child wants to join a soccer team. Which action is best for the pen to implement?
Reassure the patients that increased physical activity reduces the risk for diabetes
Which foot care instruction is most important to the practical nurse LPN to reinforce that minimizes a long term complication for a client who is newly diagnosed type 2 diabetes mellitus (DM)?
Report any foot injury or sore that does not readily heal
A client who had orthopedic surgery three days ago complaints of difficulty sleeping. Which initial intervention is best for the practical nurse PN to implement?
Reposition the client and provide a back rub
When gathering data about a client with dark skin tones, which site should the practical nurse PN observe?
Sclera and mucus membranes
The practical nurse (PN) is observing the client self-administering the known dose of subcutaneous insulin. What step of the injection technique should the practical nurse (PN) reteach?
Selects the same site that was used for the previous injection
The practical nurse PN is assisting a client to cough and deep breathe following surgery. To facilitate effective coughing, the PN should assist the client to assume which position?
Sitting on side of bed with feet flat on the floor
An older client tells the home health practical nurse (PN) about experiencing dizziness when getting out of bed. Which assessment is most important for the PN to obtain?
Standing blood pressure
. A full term 24-hour old infant in the nursery regurgitates and suddenly turns cyanotic. Which immediate intervention should the practical nurse PN implement?
Suction the oral and nasal passages
A practical nurse PN is at the nurses station describing her social life, sexual activities, and alcohol drinking and a boisterous voice that might be heard by clients and visitors. What is the best action that a peer nurse should do?
Suggest going to the nurses lounge if she needs 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 an unlicensed assistive personnel (UAP) has omitted A viral component of the protocol. After implementing the missing component, which action should the PN take?
Supervise the UP after reviewing the protocol
The practical nurse 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?
Take the client to a quiet area and provide reassurance
A male client tells the practical nurse (PN) that the pill he has been taking at home is a different color and size then the one the PN is trying to give him now. How should the PN respond?
Tell the client that the PN will verify the dispensation medication is the valid prescription
The practical nurse (PN) explains to a client how to obtain a spectrum specimen and the client indicates understanding the procedure. After the PN leaves the room, the client obtains the specimen and notifies the PN. When the PN arrives to collect the specimen 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 if the client does not correctly collect the specimen then the PN should assist the client in obtaining another specimen coughed directly into a sterile cup
A client who is being cared for in her home has a low serum sodium level of 125 mEq/L. To determine the cause of this value, which information should the practical nurse (PN) request from the client?
The amount of ice chips and water consumed daily
A client is voiding frequent small amounts 24 hours following the removal of an indwelling catheter, add a post voided residual volume assessment is prescribed. What explanation should the practical nurse PN provide to the client about why the procedure is necessary?
The catheterized volume determines the need to re insert the indwelling catheter
The practical nurse (PN) is caring for a client with coronary artery disease who is admitted with intermittent chest pain. The admission laboratory results indicate elevations in troponin I creatinine phosphokinase myoglobulin isoenzyme (CK-MB) levels. What should the PN consider the most significant risk for this client on the second day of admission?
The client is at risk for recurrent long-term angina pain and subsequent myocardial infarction
The practical nurse (PN) it's changing the abdominal dressing for a male client who was discharged home following a colon resection. Which information should the PN report to the healthcare provider?
The client reports the wound care is painful and would like a prescription for an analgesic
An older postoperative client has the nursing diagnosis, impaired mobility related to fear of falling which desired outcome best directs the practical nurses PN actions for the client?
The client will ambulate with assistance Q4 hours
The single mother of a child with a head injury is sitting at the child's bedside crying when the practical nurse (PN) enters the room. The mother states, why did this happen to my child? I just can't cope with this, what is the best initial response by the PN?
This must appear devastating to you at this moment
Prior to administering pain medication to an adult postoperative client, what information should the practical nurse PN obtain? (Select all that apply)
Time of last administration of pain medication, clients pain rating on a scale of 1 to 10, effectiveness of last pain medication administered
The practical nurse (PN) assesses a child in 90-90 skeletal traction. It is most important for the PN to assess for signs of information at what location?
Toe
And administering nystatin suspension to the gums of an infant with a candida infection, which approach should the practical nurse (PN) use?
Use a gloved finger to rub the suspension over the infected area
When providing oral care to an unconscious client who is a mouth-breather and does not swallow, which action is most important for the practical nurse (PN) to implement? Use a oral suction catheter in the buccal cavity
Use a oral suction catheter in the buccal cavity