Remediation HESI
The practical nurse (PN) needs to administer 50 mg of ranitidine (Zantac) as an intermittent IV infusion. The medication is diluted in 100 mL of 5% Dextrose solution. The PN plans to administer the infusion through an infusion pump over 15 minutes. The PN should set the pump to infuse how many mL per hour?
400 mL/hr Calculate as Volume/Time: 100 mL/15 minutes = 100 mL/.25 hour = 400 mL/hour Calculate as Ratio: Proportion:100 mL : .25 hr :: X mL : 1 hr100 = .25X100/.25 = X = 400
The practical nurse (PN) needs to administer a prescription of furosemide (Lasix) oral solution to a child. The prescribed dose is 2 mg/kg. The child weighs 55 pounds. The medication is available in a concentration of 10 mg/mL. The PN should administer how many mL?
5mL First, calculate the weight in kg by dividing 55 by 2.2 (1 kg = 2.2 pounds) = 25 kg.Using ratio : proportion, calculate the correct dose in mg for the child's weight in kg:25 kg : X mg :: 1 kg : 2 mg = 50 mg Now, use Desired/Have X Volume:50 mg/10 mg X 1 mL = 5 mL
The practical nurse (PN) is assisting a client who is unsure if she is releasing an adequate supply of milk during breastfeeding. Which maternal sign indicates that the let-down reflex is occurring? Tingling sensation in the breasts with milk ejection. Painful tugging sensation on the nipple as infant suckles. Overall feeling of increased energy during feeding. A decreased in the mother's vaginal bleeding.
Tingling sensation in the breasts with milk ejection.
The practical nurse (PN) is caring for an older client with frailty and failure to thrive (FTT). The PN is reinforcing client and family education. Which nutrient should the care provider increase in the client's diet? Carbohydrates. Proteins. Fats. Vitamins.
Proteins
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? Cystitis. Pyelonephritis. Urothelial cancer. Acute kidney injury.
Pyelonephritis
The practical nurse (PN) listens to a client being treated for depression share a story during group therapy regarding his divorce. He smiles and states that he is not really hurt about her leaving him for a coworker because he knows that she really loves him and is just trying to make him jealous. Which defense mechanism is the client displaying? Reaction formation. Sublimation. Idealization. Rationalization.
Reaction formation.
While performing a focused assessment on a client's lungs, the practical nurse (PN) auscultates and hears stridor. The PN should take which action in response to this finding? Listen again after the client coughs. Document the normal finding. Assess for signs of fluid overload. Notify the healthcare provider.
Listen again after the client coughs.
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? Lithotripsy. Ureteroscopy. Pyelolithotomy. Percutaneous nephrolithotomy.
Lithotripsy
The practical nurse (PN) is caring for a confused and withdrawn older client who was admitted for malnutrition and dehydration. The PN suspects that elder abuse and neglect may be present. Which element is required before abuse or neglect can be reported? Proof. Suspicion. Witness's written testimony. Client's written consent.
Suspicion
Which medication is administered to premature infants to reduce the severity of symptoms associated with respiratory syncytial virus (RSV) infection? Respaire. Singulair. Menomune. Synagis.
Synagis.
The practical nurse (PN) is providing care to a client who has developed diarrhea after taking a prescribed antacid for the past two days for heartburn as needed. Which type of antacid may have caused this non-therapeutic outcome? Aluminum-based. Magnesium-based. Sodium bicarbonate. Calcium bicarbonate.
Magnesium-based
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? Have a dilated eye examination every 5 years. Maintain your blood glucose in your target range. Avoid exposure to direct sunlight. Engage in strenuous exercise every day.
Maintain your blood glucose in your target range.
Which medication is indicated for a client who had a total thyroidectomy one week ago secondary to goiter? Levothyroxine. Radioactive iodine. Tramadol. Methimazole.
Levothyroxine.
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? "Being thin does not seem to solve your problems; you are thin now and still unhappy." "What are your feelings about not eating the food that you prepare for others?" "You seem to feel much better about yourself when you eat something." "Is it difficult to talk about your feelings and private matters with someone you've just met?"
"Being thin does not seem to solve your problems; you are thin now and still unhappy."
A client with stage 3 Alzheimer's disease is living with his son and daughter-in-law. The visiting practical nurse (PN) is reinforcing teaching to the family about the progression of the illness, including "sundown syndrome," and is assisting with strategies and comfort measures. The PN recognizes which statement by the daughter-in-law reflects that the teaching has been effective? "We will have locks placed at the top of all the outside doors." "We will not take him out in public because it increases his confusion." "We will remove the TV from his room." "We will limit visitors because he does not recognize anyone."
"We will have locks placed at the top of all the outside doors."
The practical nurse (PN) is reviewing the assessment of a client with a six-week history of a persistent cough, rusty colored mucus, 10 pound (4.54 kg) weight loss, decreased appetite, and night sweats. Based on the client's history which nursing action should be done next? A prescription by the healthcare provider for chest x-ray and lab work. A mask to be placed on the client and the client moved to a private room. An assessment of the client's vital signs to include a pulse oximetry reading. Auscultation of the lung fields as the client takes deep and slow breaths.
A mask to be placed on the client and the client moved to a private room.
A 4-year-old child is referred to a mental health clinic for evaluation of hyperactivity and impulsive behaviors. At the first visit, nursing staff begin observing and assessing the child's behavior. Which developmental task should the child have achieved by this age? A sense of autonomy. Satisfactory relationships with peers. The ability to establish goals. Separation from parents and the ability to socialize.
A sense of autonomy
The practical nurse (PN) is reinforcing teaching to a new staff member about the causes of personality disorders. The PN is correct to identify which causes? Abnormal brain structure and disturbances involving serotonin and GABA. Abnormal brain structure and disturbances involving dopamine and GABA. Nutritional deficiencies and damage to the brain stem. Nutritional deficiencies and damage to the limbic system.
Abnormal brain structure and disturbances involving serotonin and GABA.
A child recently treated for strep throat presents with gross hematuria, facial swelling, and elevated blood pressure. Laboratory tests reveal proteinuria and azotemia. Which condition should the practical nurse (PN) suspect? Acute pyelonephritis. Acute glomerular nephritis. Nephrotic syndrome. IgA nephropathy.
Acute glomerular nephritis
The practical nurse (PN) is preparing to begin fluid replacement therapy to treat severe volume depletion in an infant. Which method of administration for the initial phase of therapy should be implemented? Administer oral rehydration solution. Administer isotonic fluid by intravenous push. Administer rehydration solution via nasogastric route. Administer isotonic fluid slowly by IV drip.
Administer isotonic fluid slowly by IV drip.
The practical nurse (PN) is assisting in the care of an 84-year-old client with aspiration pneumonia who was recently admitted for pelvic trauma sustained in a motor vehicle crash. Since admission, the client has developed multiple organ dysfunction syndrome (MODS). In addition to the client's injury and pneumonia, which other risk factor likely contributed to MODS in this client? Advanced age. Malnutrition. Immobility. Hypovolemia.
Advanced age.
A 7-year-old client is prescribed medication to treat ADHD. The mother of the child reports to the practical nurse (PN) that the child has a decreased appetite, complains of abdominal pain, and has been unable to sleep. The PN should anticipate which nonstimulant ADHD medication to be prescribed for this client? Atomoxetine (Strattera). Methylphenidate (Ritalin). Fluphenazine (Prolixin). Fluoxetine (Prozac).
Atomoxetine (Strattera).
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? "Being thin does not seem to solve your problems; you are thin now and still unhappy." "What are your feelings about not eating the food that you prepare for others?" "You seem to feel much better about yourself when you eat something." "Is it difficult to talk about your feelings and private matters with someone you've just met?"
Being thin does not seem to solve your problems; you are thin now and still unhappy."
The practical nurse (PN) is caring for an older client who is in hospice because of multiple organ dysfunction syndrome (MODS). The client is not expected to live beyond 48 hours. The client seems restless and confused. Which factor is contributing to the client's behavior? Dementia. Delirium. Depression. Dyspnea.
Delirium
The practical nurse (PN) is providing care to a client who is receiving parenteral nutrition. The client all of a sudden displays a decreased oxygenation saturation level, shortness of breath, and coughing. The PN is correct to take which action? Remove the central catheter and insert a chest tube. Obtain an order for intravenous antibiotics. Clamp the catheter and position the patient in a left-sided Trendelenburg position. Perform blood glucose monitoring and retest the levels in 15 to 30 minutes.
Clamp the catheter and position the patient in a left-sided Trendelenburg position.
The practical nurse (PN) is assisting the nurse with a client diagnosed with diabetes insipidus who has a recorded weight loss of 4 kg (8.8 pounds) in 24 hours and an increased dryness of the oral mucosa. Which finding will this client most likely exhibit? Decreased thirst. Decreased blood pressure. Decreased heart rate. Decreased muscle movement.
Decreased blood pressure.
The practical nurse (PN) is assigned to care for an adolescent who has a past history of anorexia nervosa. Anorexia nervosa puts the client at risk or which condition? Hyperthermia. Oily skin and hair. Decreased bone density. Tachycardia and hypertension.
Decreased bone density
The practical nurse (PN) is caring for a client who had brain surgery yesterday. The client is becoming more restless and exhibiting increasing muscle weakness. The client reports extreme thirst and is voiding large amount of diluted urine. Recent laboratory results reflect high serum sodium and high osmolarity. The client's findings are most consistent with which condition? Diabetes insipidus. Cerebral salt wasting. Increase intracranial pressure. Syndrome of inappropriate antidiuretic hormone.
Diabetes insipidus
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? Cholecystitis. Hepatitis. Diabetes mellitus. Renal calculi.
Diabetes mellitus.
The practical nurse (PN) is assisting in providing care to a 3-year-old client diagnosed with sepsis who has begun bleeding from multiple sites. The registered nurse's assessment reveals widespread petechiae and bleeding from the nose, mouth, and rectum. Laboratory results reveal a prolonged prothrombin time (PT), elevated d-dimer, and low platelet count. Which disorder should the practical nurse (PN) suspect? Von Willebrand disease. Disseminated intravascular coagulation. Hemophilia type A. Hypoplastic anemia.
Disseminated intravascular coagulation.
The practical nurse (PN) is administering the first dose of chlorpromazine via intramuscular injection. Which method is ideal for administering the medication? Use the Z-track method to administer the medication. Slowly inject the medication over a two minute period. Inject into an area with adequate adipose for maximize absorption. Ensure the client remains lying down for 30 minutes after the injection.
Ensure the client remains lying down for 30 minutes after the injection.
A 12-month-old client is being discharged with a body spica cast. Which instructions should the practical nurse (PN) reinforce from the parent's teaching plan? Foul odor from cast may indicate infection or skin breakdown. Pillows should not be placed under cast. The child can be safely transported in a stroller. Use pillows to elevate the child's head.
Foul odor from cast may indicate infection or skin breakdown.
The practical nurse (PN) is providing care to a stable client diagnosed with dementia and epilepsy. The client's spouse reports that they have started a new herbal regimen. The PN should reinforce teaching to discourage the use of which herbal supplement? Garlic. Ginger. Ginseng. Ginkgo biloba.
Ginkgo biloba
The practical nurse (PN) plans to assess a client's cardinal fields of vision. The PN should take which action? Position the client 20 feet from Snellen chart. Dim the lighting in the exam room. Hold one finger up in front of the client. Explain use of the opthalmoscope to the client.
Hold one finger up in front of the client.
The practical nurse (PN) is providing care to an older client with chronic kidney disease (CKD). As the CKD progresses which condition will occur as a result of the failing function of the kidneys? Hypercalcemia. Hypotension. Hyperkalemia. Hypovolemia.
Hyperkalemia.
The practical nurse (PN) is caring for a client diagnosed with heart block. The client has been prescribed atropine. Which clinical outcome indicates that the medication is effective? Bilateral pupil constriction. Decreased ectopic heart beats. Increase in heart rate. Presence of the vagal reflex.
Increase in heart rate
The practical nurse (PN) is reinforcing teaching to a female client with neurogenic bladder. Which potential complication should the PN discuss with the client? Infection. Functional incontinence. Polyuria. Abdominal pain.
Infection
The practical nurse (PN) is reviewing the white blood cell differential for an infant admitted for suspected sepsis. The PN should expect the client to have elevated levels of which cells? Monocytes. Neutrophils. Eosinophils. Lymphocytes.
Neutrophils.
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? Gently pinch skin on the client's clavicle. Obtain the client's weight. Ask the client about being thirsty. Assess the client's mental status.
Obtain the client's weight.
Which dosing routes are acceptable for the practical nurse (PN) to administer fentanyl to a client diagnosed with cancer who is suffering with chronic pain? PCA pump. Transdermal patch. Transmucosal swab. Slow intravenous push. Intramuscular injection.
PCA pump Transdermal patch Transmucosal swab Slow IV push
During a home care visit for a client diagnosed with schizophrenia, the wife reports to the practical nurse (PN) that the client is refusing to eat or drink anything that is prepared for him. Which intervention should the PN recommend? Instruct the caregiver to place the prepared food next to the client and leave the room. Teach the caregiver how to gently force feed the client with soft mechanical diet. Recommend that unopened, prepackaged food be given to the client. Suggest that nutrition therapy with tube feeding be initiated.
Recommend that unopened, prepackaged food be given to the client.
The practical nurse (PN) is providing care to a client with a newborn who primarily consumes formula. The client expresses to the PN that she is stressed and concerned over the high cost of formula and diapers. Which intervention should be implemented for this client? Referrals to local social agencies for assistance. Advice to ask family members for financial help. Encouragement to switch to breastfeeding. Guidance to set up a household budget.
Referrals to local social agencies for assistance.
The practical nurse (PN) is conducting a Mini-Mental State Exam (MMSE) with an older client. Which instruction assesses for recall? Describe this item to me. Read what is on this card and explain it. Repeat back the three words I said to you. Tell me where and what date you graduated high school.
Repeat back the three words I said to you.
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? Recheck the temperature. Administer an antipyretic as prescribed. Report this finding to the charge nurse. No action is needed.
Report this finding to the charge nurse.
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? Weber. Rinne. Schwabach. Whisper.
Rinne.
The practical nurse (PN) identifies which nursing diagnosis is the priority for a client who is being treated with lithium? Risk for Infection. Self-care deficit. Risk for fluid imbalance. Nutritional deficit.
Risk for fluid imbalance.
Modular nursing is used on the nurse's unit. The practical nurse (PN) recognizes modular nursing as a modification of which client care delivery model? Functional nursing. Primary care. Team nursing. Total patient care.
Team nursing
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? The client will call the healthcare provider if constipation occurs. The client will take stool softeners if constipated. The client will remove fresh fruits from the diet. The client will avoid milk products.
The client will call the healthcare provider if constipation occurs.
The practical nurse (PN) is caring for a client who has been diagnosed with diabetes mellitus, chronic pancreatitis, and alcoholism. The client has a prescription for pancrelipase (Creon, Pancrease). The practical nurse (PN) identifies which data would be correct to evaluate the effectiveness of this medication? The absence or presence of delirium tremors. The character and quality of abdominal pain. Results of glucose meter readings before and after each meal. The number, frequency, and consistency of stools per day.
The number, frequency, and consistency of stools per day.
The practical nurse (PN) observes that multiple assigned tasks were left uncompleted at the end of a shift on the unit. The PN then provides feedback to a newly hired unlicensed assistant personnel (UAP) regarding strategies for improvement. The PN identifies which statement by the PN demonstrates the use of reflective encouragement? What were the exact steps performed today that led to this situation? What are some things that could have been handled differently? What goals should be put in place to remedy the incorrect actions? What should the healthcare provider have done differently?
What are some things that could have been handled differently?
The practical nurse (PN) is assisting the nurse who is caring for an older client who was admitted with shock of unknown etiology. Which clinical manifestation of septic shock should the PN identify and notify the nurse? Bleeding from the IV site. Hypotension. Pale, clammy skin. Decreased urine output.
Bleeding from the IV site.
The practical nurse (PN) is providing care to a client with acute pancreatitis. Which prescription should the PN anticipate to be included in the client's plan of care? High carbohydrate diet. Daily weights. Neurologic checks. Blood glucose levels.
Blood glucose levels
The practical nurse (PN) is reinforcing teaching about dietary nutrition to a client diagnosed type 2 diabetes mellitus. The PN identifies which statement by the client demonstrates an understanding about the teaching? "I should focus on eating plant-based food with occasional fish and poultry." "I should purchase my sweets from the diabetic aisle of the grocery store." "If I get a fever, I should drink regular soda to stay hydrated and keep my sugar levels up." "Fruit, popcorn, rice, and bread can be eaten only on special occasions."
"I should focus on eating plant-based food with occasional fish and poultry."
The practical nurse (PN) is reinforcing teaching about sildenafil (Viagra) with an older client diagnosed with erectile dysfunction. Which statement by the client indicates a need for further instruction? "I should avoid alcohol when on the drug or it might not work well." "If I have chest pain during sex, I should take a nitroglycerin tablet." "I might get a stuffy nose or headache when I take the drug." "I should have sex within an hour after taking the drug."
"If I have chest pain during sex, I should take a nitroglycerin tablet."
The practical nurse (PN) is preparing to administer a dose of nafcillin 200 mg IM. The available medication vial is labeled, "Add 3.4 mL diluent for a concentration of 250 mg/mL." The PN should administer how many mL?
0.8 mL After mixing, the medication is available in a concentration of 250 mg/mL.Using Desired/Have X Volume:200 mg/250 mg X 1 mL = 0.8 mL
The practical nurse (PN) offers a client a 16-ounce soft drink. The client drinks half. How many mL should the PN document on the fluid intake record?
240 mL One ounce = 30 mL.30 mL x 16 ounces = 480 mL x 1/2 = 240 mL
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? 6. 4. 24. 18.
4
The practical nurse (PN) identifies and reports that a client diagnosed with quadriplegia is experiencing constipation while receiving bolus enteral feedings via percutaneous endoscopic gastrostomy (PEG) tube. The PN should anticipate the healthcare provider to write which prescription? Administration of 120 ml of water in-between feedings. Placement of a glycerin suppository twice a day. Thickening of enteral feeds with rice cereal. Passive range of motion exercises three times a day.
Administration of 120 ml of water in-between feedings.
The clinic practical nurse (PN) receives a call from a client who is at 32 weeks' gestation. The client states, "I'm having some pain and burning when I urinate." Which action should the PN take? Suggest the client increase her fluids until the symptoms subside. Instruct the client that these symptoms often occur in pregnancy. Advise the client to come to the clinic immediately for further evaluation. Reinforce perineal hygiene with the client.
Advise the client to come to the clinic immediately for further evaluation.
Four clients are requesting pain medication and it is within their prescribed dosing time. All clients achieved pain relief after their last dose. Now the clients have reported their pain on a 1 to 10 pain scale. Which should be the first client the practical nurse (PN) administers pain medication? After the last dose, pain was 6 out of 10; now pain is 8 out of 10. After the last dose, pain was 4 out of 10; now pain is 7 out of 10. After the last dose, pain was 2 out of 10; now pain is 5 out of 10. After the last dose, pain was 1 out of 10; now pain is 6 out of 10.
After the last dose, pain was 1 out of 10; now pain is 6 out of 10.
A client inquires to which condition tamsulosin (Flomax) treats. Which response should the practical nurse (PN) provide? Parkinson's disease. Chronic kidney disease. Coronary artery disease. Benign prostatic hyperplasia.
Benign prostatic hyperplasia
The practical nurse (PN) is providing care to a stable client diagnosed with asthma, hypertension and atrial fibrillation. Which antiarrhythmic class of medications is contraindicated for this client? Renin inhibitors. Catecholamines. Vasopressin antagonists. Beta-adrenergic blockers.
Beta-adrenergic blockers.
At what minimal ages should a referral be made to a healthcare provider for delay in sexual maturity/puberty of a male and/or female client? Boys by the age of 12; girls by the age of 12 years old. Boys by the age of 13; girls by the age of 10 years old. Boys by the age of 14; girls by the age of 13 years old. Boys by the age of 16; girls by the age of 14 years old.
Boys by the age of 14; girls by the age of 13 years old.
The home health practical nurse (PN) performs a focused skin assessment for an older client. Which finding should be immediately reported to the healthcare provider? Multiple cherry angiomas on the trunk. Bruises of several different colors. Thin, flakey appearance of the skin. Several small, round symmetric moles.
Bruises of several different colors
The practical nurse (PN) is reviewing the results of a urinalysis and notes the presence of crystals. Which action should the PN take? Collect another specimen to be sent to the lab. Contact the physician to request an order for an antibiotic. Obtain a strainer and begin straining the urine. Begin a 24-hour urine collection.
Collect another specimen to be sent to the lab.
A practical nurse (PN) is reinforcing teaching to a client about the best way to manage their diagnosis of dumping syndrome. The PN should recommend which dietary recommendation to the client? Avoid dairy products and sweets. Limit food consumption to two meals a day. Consume a diet of high fat and high protein content. Ensure to drink at least one glass of water with meals. Advised to eat whole grains, fresh fruit and vegetables.
Consume a diet of high fat and high protein content. Avoid dairy products and sweets.
The home health practical nurse (PN) is visiting an older client who has trouble ambulating without assistance. The client's cognition is intact. The client often has urine incontinence despite having normal urethra and bladder function and no evidence of infection. What is likely contributing to the functional urinary incontinence in this client? Fluid and electrolyte imbalances. Difficulty accessing a toilet. Detrusor muscle spasms. Weakened perineal muscles.
Difficulty accessing a toilet.
A client on the unit is scheduled for weighing. The practical nurse (PN) asks an unlicensed assistant personnel (UAP) to weigh the client. The UAP acknowledges and accepts the assignment. The PN six hours later reviews the client's record and notes an increased 4.2 kg difference in weight from the previous day. The PN should be most concerned with which right of delegation? Circumstance. Person. Direction/communication. Supervision.
Direction/communication
A client has been treated for a blood glucose of 55 mg/dL (3.1 mmol/L). Following treatment the practical nurse (PN) repeats the blood glucose check and finds a level of 150 mg/dL (8.3 mmol/L). In addition to the carbohydrate, which hormone is most likely responsible for the immediate change in blood glucose? Testosterone. Thyroid hormone. Growth hormone. Glucagon.
Glucagon
The practical nurse (PN) is reinforcing teaching to an older client with chronic obstructive pulmonary disease (COPD). Which information should the PN include in the reinforcement of teaching? The benefits of limiting smoking to twice a day. A recommendation for bed rest for 1 week. Information about the pneumococcal vaccine. Instruction to use the prescribed bronchodilator after meals.
Information about the pneumococcal vaccine.
The practical nurse (PN) is assessing the thorax and lungs, the PN should use which technique to assess the client's AP diameter? Inspection. Percussion. Palpation. Auscultation.
Inspection
The practical nurse (PN) is performing a focused assessment on the abdomen of a child who is four days post-op for surgical removal of a Wilms tumor. The child has developed abdominal pain and distension, absence of bowel sounds, and vomiting. The PN suspects which complication? Intestinal obstruction. Abdominal peritonitis. Ureteral stenosis. Pyelonephritis.
Intestinal obstruction.
A practical nurse (PN) is reinforcing teaching to a 14-year-old client regarding calcium intake. The client explains to the PN they do not like milk. The PN identifies which other foods that should be recommended to ensure adequate nutrition? Kale and bok choy. Strawberries and kiwi. Molasses and liver. Avocados and bananas.
Kale and bok choy
The practical nurse (PN) is providing care to a client receiving chemotherapy. Based on the client's laboratory values, which nursing action has the priority? RBC: 3.8 x 1,000,000/mm3 Hgb: 10g/dL Obtain a pulse oximetry reading from the client. Provide care with bleeding precautions for the client. Provide the client with additional protein-enriched snacks. Move the client into a private room with positive pressure airflow.
Move the client into a private room with positive pressure airflow. An absolute neutrophil count (ANC) lab value of less than 500 g/dL is the most concerning. Low ANC indicates too few neutrophils to fight infection. This client should be placed on protective isolation due to depleted neutrophils and a compromised immune system.
The practical nurse (PN) is reviewing the electrocardiogram of an older client. The rhythm strip indicates a PR interval of 0.16 seconds. Which is the most accurate interpretation? First-degree atrioventricular (AV) block. Second-degree atrioventricular (AV) block. Impending myocardial infarction. Normal cardiac rhythm.
Normal cardiac rhythm.
What must a licensed practical nurse (PN) do when moving from one state to another? Retake and pass the NCLEX-PN to work in the new state. Notify the previous state board of the change of address. Inactivate the current license before obtaining a new one. Review the nurse practice act and practice guidelines in the new state. Seek permission from the new state board to work as a nurse.
Notify the previous state board of the change of address. Review the nurse practice act and practice guidelines in the new state. Seek permission from the new state board to work as a nurse.
The practical nurse (PN) is reviewing a client's electronic medical record (EMR). Which procedure would confirm a positive diagnosis of tuberculosis? AP and lateral chest x-ray views. Purified protein derivative (PPD). Bacillus Calmette-Guerin (BCG). Nucleic acid amplification test (NAAT).
Nucleic acid amplification test (NAAT).
The practical nurse (PN) calculates a client's body mass index (BMI). The client's height is 6 feet and 6 inches (198cm) and the BMI is 30. How should the nurse categorize this BMI? Obesity. Overweight. Underweight. Normal weight.
Obesity
The practical nurse (PN) noted in a client's electronic medical record that the client had exhibited both a positive Trousseau's sign and a positive Chvostek's sign. These signs are indicative of which hormonal deficit? Pituitary. Glucagon. Parathyroid. Somatostatin.
Parathyroid.
An older client with osteoporosis asks the practical nurse (PN) about complications that may result from this condition. Which information should the PN include in the client reinforcement of teaching about osteoporosis? Fat embolism. Swan neck deformity. Heberden's nodes. Pathologic fracture.
Pathologic fracture.
The practical nurse (PN) is reviewing the medical record of a client who has a history of alcoholism. The client has reported a sudden, sharp abdominal pain which began in the epigastric area and has radiated over their entire abdominal area. The PN notes that the client's abdomen was tender, rigid and board-like and bowel sounds were diminished. The client's vital signs were temperature 102.2° F (39° C), pulse 120 beats/minute, respiration 24 breaths/minute, and BP 88/48 mmHg. The PN notes that the client is most comfortable lying in the fetal position. The PN identifies these signs and symptoms to be indicative of which condition? Peritonitis. Duodenal ulcer. Alcohol poisoning. Pyloric obstruction.
Peritonitis
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? Correct Purulent drainage. Itching. Redness and swelling. Rationale
Photophobia.
The practical nurse (PN) is working with a client who was born with an inherited disorder in which the nephrons of their kidneys are affected and usually do not become symptomatic until they reach their 30's when their nephron and kidney function become less effective. These clients usually experience hypertension as a result of this condition. This client is most likely to be diagnosed with which condition? Cystitis. Urolithiasis. Polycystic disease. Urothelial cancer.
Polycystic disease.
THe practical nurse (PN) is performing a focused assessment with a 78-year-old female client who had recently fallen. The PN suspects the client may have a fractured hip. Which findings and contributing facts are most likely associated with hip fracture? Post-menopausal status. Reports of groin pain. Right leg is internally rotated. Leg lengthening of the right leg. Limping present with ambulation.
Post-menopausal status Reports of groin pain Right leg is internally rotated Limping present with ambulation
The practical nurse (PN) is providing care to a client with chronic kidney disease. When reviewing the client's electronic medical record (EMR), which laboratory value is an expected finding for this client? Red blood cells 5.0 cells/mcL. Potassium 5.4 mEq/L. Creatinine 0.8 mg/dL. Blood urea nitrogen 13 mg/dL.
Potassium 5.4 mEq/L
Which nursing actions are most likely to reduce the risk of a client developing acute respiratory distress syndrome (ARDS)? Practicing scrupulous infection control measures. Implementing restricted fluid intake and documenting all output. Rooming clients with active tuberculosis in a negative pressure room. Adhering to aspiration precautions for clients with impaired swallowing and gag reflexes. Raising the head of the bed to 30-45° for clients receiving enteral feedings.
Practicing scrupulous infection control measures. Adhering to aspiration precautions for clients with impaired swallowing and gag reflexes. Raising the head of the bed to 30-45° for clients receiving enteral feedings.
A twelve-year-old female client was in a bicycle accident approximately 2 hours ago. The client has an injury to her right eye consisting of bruising and swelling with a small deep jagged laceration on the outer aspect of the right orbital socket. While obtaining vital signs, the client reports to the practical nurse (PN) that she is starting to see dark floating spots in the right eye. The client's report is consistent with which condition? Corneal abrasion. Retinal detachment. Macular degeneration.
Retinal detachment.
The practical nurse (PN) notifies the lead nurse that a medication error occurred without causing any apparent harm. The PN identifies which statement by the lead nurse best exemplifies leadership within a just culture? Filing an incident report and observing correct procedures will help prevent future reoccurrences. Certainly a distraction caused the error and the unit will have to be more careful in observing the do not disrupt policy. Reviewing medication administration policies can aid in preventing errors that could potentially be more harmful. Reviewing the process that led to the error can help prevent reoccurrence and potential harm to someone else.
Reviewing the process that led to the error can help prevent reoccurrence and potential harm to someone else.
The practical nurse (PN) is reinforcing teaching to a client about levothyroxine (Eltroxin, Synthroid). Which instructions should the PN emphasize? Take the medication on an empty stomach. Take the medication just prior to going to sleep. Take the medication at different times every other day. Take the medication with a glass of milk or an antacid.
Take the medication on an empty stomach.
The nurse assumes a leadership position that involves the coordination of care for several clients. As the leader of a group of practical nurses (PN) and unlicensed assistant providers (UAP) , the nurse will assess and educate all clients, provide direct care, delegate care assignments, direct and educate the group, and manage all client and group activities. The PN recognizes which type of nursing delivery model the facility is using? Total patient care. Functional nursing. Team nursing. Primary nursing.
Team nursing
The practical nurse (PN) is reviewing the electronic medical record (EMR) of a four-year-old child who is scheduled for an outpatient cardiac catheterization. The child has midazolam prescribed pre-procedure to alleviate anxiety. Which action is likely to be included in the client's plan of care? The child is to be accompanied with resuscitative equipment during transport to cardiac suite. The child may have solids up to two hours prior to administration of the medication. Parents may administered the medication just prior to coming to the hospital. Parents are not allowed to accompany the child during transportation to cardiac procedure room.
The child is to be accompanied with resuscitative equipment during transport to cardiac suite.
The practical nurse (PN) witnesses a child experiencing an asthma attack. The child's mother pulls from her bag a medicated discus dispenser of salmeterol xinafoate, a long-acting beta2 agonist, and immediately administers it to the child. What is the anticipated outcome of the administration of this medication to this child? Asthmatic symptoms should resolve within 5 to 10 minutes after administration of medication. The child's asthma attack will be unresponsive to the administration of the medication. The medication administration will cause an increase in the child's heart rate. The bronchioles and alveoli in response to the medication will dilate and lung expansion will increase.
The child's asthma attack will be unresponsive to the administration of the medication.
What are the reasons practical nurses (PN) should manage professional stress? To avoid nurse burnout. To safeguard client safety. To promote self-absorption. To decrease empathetic care. To reduce compassion fatigue.
To avoid nurse burnout. To safeguard client safety. To reduce compassion fatigue.
The practical nurse (PN) performs a focused assessment with a client who had a corneal transplant one week ago. The PN observes inflammation in the cornea near the edge of the graft site and reports to the healthcare provider. The healthcare provider prescribes corticosteroids to be placed in the client's eye. What is the purpose of opthalmic corticosteroids? To treat the infection in the eye. To inhibit the rejection process. To alleviate the intraocular pressure. To prep the eye for surgical removal of the cornea.
To inhibit the rejection process.
The practical nurse (PN) suspects that a toddler may be deficient in nutrients secondary to an extremely limited acceptance of foods. The PN identifies which laboratory test will help assess the client's nutritional status? Transferrin. Whole blood. Calcium, ionized. Total cholesterol.
Transferrin
The healthcare provider recommends that a client take 10 mL of an over-the-counter liquid cold preparation. The practical nurse (PN) should instruct the client to take how much of the medicine using a household measuring device? One tablespoon. Two teaspoons. One quarter cup. Two soup spoons.
Two teaspoons 5 mL= one teaspoon
The practical nurse (PN) is performing a focused assessment on a client with reports of abdominal discomfort, rusty colored urine and increase frequency of urination. Upon inspection some bladder distention is present and abdominal tenderness noted. The client's social history includes smoking 1.5 - 2 packs of cigarettes per day for 35 years and 20 year employment history as a hair dresser/beautician. The PN anticipates the client to be diagnosed with which medical diagnosis? Urolithiasis. Urothelial cancer. Urinary incontinence. Urinary tract infection.
Urothelial cancer.
The practical nurse (PN) is providing care to a client who reports painful, cracked nipples due to breastfeeding. The PN should recommend which action to the client? Use breast shells for protection. Wear a breast binder for support. Apply lotion to moisturize nipples. Transition to bottle feeding.
Use breast shells for protection.
The practical nurse (PN) is assessing a client who expresses feeling overwhelmed with the care of an elderly parent. Which questions best uncover the client's perception of this event as challenging? Have you started drinking or smoking as a result of this stressor? What impact does this stressor have on your life? Are you having trouble getting to sleep or staying asleep? What do you believe is causing you stress right now? Who else is helping with the caregiving and household chores?
What impact does this stressor have on your life? What do you believe is causing you stress right now?
