Exit study questions
The practical nurse (PN) is assisting the nurse with the admission physical assessment of a client diagnosed with pneumonia. What symptoms are this client likely to exhibit? (Select all that apply) A. Bradycardia B. Dyspnea C. Painful cough D. Ankle edema E. lung crackles
B,C,E
To determine a hospitalized client's orientation, the practical nurse should ask the client questions related to which information? (select all that apply) A. Past surgeries B. Season of the year C. present location D. when spouse died E. reason for hospitalization F. clients name
B,C,E,F
The practical nurse (PN) is caring for a child who was admitted after experiencing a generalized tonic-clonic seizure. When witnessing the child begin to seize again, which actions should the PN implement immediately? (Select all that apply) A. hold the extremities close to the body B. Observe the progression of the seizure. C. Insert a tongue blade between the teeth D. Loosen clothing around the neck. E. Pad the side rails with pillow.
B,D,E
A client's daughter phones the charge nurse to report that the night nurse did not provide good care for her mother. Which response should the practical nurse make? A. Ask for a description of what happened during the night B. reassure the daughter that the mother will get better care C. Tell the daughter to talk with the unit's nurse manager. D. Explain that all of the staff are doing the best they can
C
A client's most recent vital signs and blood pressure (BP) 122/70mm hg, heart rate 78 beats/minute, respiratory rate 20 breaths/minute, and oxygen saturation 97%. When the client reports dizziness after quickly rising, which finding should the practical nurse (PN) expect on reassessment? A. Oxygen saturation 96% B. respiratory rate 12 breaths/minute C. Blood pressure 100/64 mm Hg D. heart rate 88 beats/minute
C
A community hit by a hurricane has suffered mass destruction and flooding. Sewage facilities are non-functioning and water is contaminated in the area. The practical nurse (PN) is assisting with the plan of care for patients diagnosed with cholera after an outbreak. Which intervention has the highest priority? A. Isolate all infectious diarrhea victims B. administer cholera vaccines C. Provide fluid and electrolyte replacement. D. Administer prophylactic antibiotics as prescribed
C
An older client is fitted with a hearing aid and instructions are provided for its use. Which instruction is accurate and should be reinforced by the practical nurse (PN)? A. Wear the hearing and while sleeping B. leave the hearing aid in place while showering C. Keep the hearing aid out of direct sunlight D. clean the hearing aid with baby oil
C
During a routine prenatal visit at the antepartum clinic, a multipara at 35-weeks gestation presents with 2+ edema of the ankles and feet. Which additional information should the practical nurse (PN) report to the registered nurse? A. Fundal height B. due date C. Blood Pressure D. gravity and parity
C
The charge nurse brings a #18 urinary catheter with a 30ml balloon to the practical nurse (PN) who is preparing to insert a catheter in a female client who weighs 50 kg. Which action should the PN take first? A. Ask the client if she has previously been catheterized B. position a client and observe the urinary meatus C. consult with the charge nurse about the catheter D. Obtain a 30 ml syringe and a vial of sterile water
C
The home health practical nurse (PN) observes a client attempting to open a childproof medication container. After being unsuccessful in opening the container, the client throws it across the room and curses loudly. Which action should the PN implement? A. Allow the client to display acts of frustration B. transfer the medication to a bottle that easily opens C. Retrieve the medication bottle and remove the cap. D. Discuss medication containers that are available
C
The practical nurse (PN) is assigned to provide care for a client with rheumatoid arthritis who is preparing for discharge. In planning the client's care, the PN- should identify which client goal as the most important? A. Acquire coping skills B. adapt self-care skills C. Conserve energy D. improve body image
C
The practical nurse (PN) is completing a focused assessment on a client who is prescribed oxygen at 3 liters per minute by nasal cannula. Which assessment finding by the PN require immediate action? A. The cannula is pressed snugly against the client's cheeks B. the flow meter shows 1 liter of oxygen being delivered C. The client is lying in a supine position in the bed D. there is no humidifier attached to the delivery system
C
The practical nurse (PN) is observing a newly hired PN who is prepared to administer a liquid medication via a client's feeding tube system as seen in the picture. What action should the PN take? A. Determine if the medication is compatible with the solution B. confirm that the medication is only administered once daily C. Demonstrate how to administer medication via feeding tube D. offer to assist in calculating the rate of flow for the mixture
C
The practical nurse (PN) is performing stoma care with the client. While cleansing around the stoma, the PN notices blood on the washcloth. Which action should the (PN) take next? A. Stop the stomal care and notify the health care provider B. place a pre moistened dressing on the stomal site C. continue to clean around the scan surrounding the stoma site. D. Apply firm pressure with a dry gauze to the stoma
C
The practical nurse (PN) learns in report that a client has jugular vein distention (JCD). Which technique should the (PN) use to confirm this finding? A. Palpation B. Auscultation C. Inspection D. percussion
C
The practical nurse (PN) observes a client with the diagnosis of schizophrenia sitting all alone and talking quietly. Which action should the PN take? A. Have you UAP escort the client down to his room B. record the event but do not disturb the client C. Ask the client if he is currently hearing voices. D. Administer a PRN dose of halopendol
C
The practical nurse (PN) receives shift report for four newborns in the full-term newborn nursery. Which infant should the PN assess first? 1 day old with a positive Babinski 's reflex B. 6 hour old with a large Sacco start bite C. 10 hour old with a circumoral cyanosis D. 2 day old with negative Ortolani's sign
C
The practical nurse PN is caring for a client who has a prescription for loratadine by mouth daily as needed. Which signs indicate to the PN that there is a need to administer the medication? A. Ecchymosis and petechiae on the legs B. Ulceration on the corner of the upper lip C. Red papules and pustules on the face D. Red welts widespread over the chest
C
The practical nurse PN is caring for an older client who is receiving chemotherapy for lung cancer. Which finding is the highest priority for the PN to report to the charge nurse? A. Periodic nausea and vomiting B. decrease deep tendon reflexes C. Blood urea nitrogen 75 mg/dL D. platelet count 135.000/mm3
C
To minimize separation anxiety in the hospitalized 2-year-old child, which nursing intervention is best for the practical nurse (PN) to implement? A. Private for privacy B. explain procedures and routines C. Encourage parents to room-in D. encourage contact with children of same age
C
When administering an analgesic to a client with low back pain, which intervention should the practical nurse PN implement to promote the effectiveness of the medication? A. Give medication with a full glass of water and offer high roughage foods B. assist client in performing passive and active range of motion exercises C. Encourage the client to ambulate frequently and take deep breaths D. massage the lower back and position the client in proper alignment
C
A client who has four gold seeds implants on a chest wall tumor is on radiation precautions. What basic precautions should the practical nurse (PN) observe when administering direct care to this client? A. Rotate the assignment with other staff during the shift B. minimum time maximum distance and protective shielding C. standard precautions with negative pressure isolation D. Virtual observation and wear film badge for exposure
D
A client whose first child was delivered by cesarean section is 20 weeks pregnant with her second child and wishes to have a vaginal birth after cesarean (VBAC). What information is most important for the practical nurse (PN) to obtain? A. Clients intent regarding breastfeeding of a newborn B. history of contracting herpes simplex virus C. religious preference of the client's family D. The type of uterine incision used for previous birth
D
A client with irritable bowel syndrome is receiving dicyclomine, an anticholinergic drug. Prior administering the next dose, the practical nurse (PN) determines that the client's mucous membranes are dry, and the client reports having a dry mouth. Which action should the PN take? 1. A. Check vital signs B. notify charge nurse C. monitor hemoglobin D. Provide oral care
D
A male client attends a community support program for mentally impaired and chemical abusing clients. The client tells the practical nurse PN that his drugs of choice are cocaine and heroin. What is the greatest health risks for the client? A. Glaucoma B. Hypertension C. Diabetes D. Hepatitis
D
A male client tells the practical nurse (PN) that he is afraid of getting cancer so he plans to quit smoking cigarettes by switching to a smokeless tobacco product. How should the PN respond? A. Encouraged client to continue with the pain to reduce his risk for cancer B. explain to the client that obesity is a more significant health risk than smoking C. remind the client that he is likely to gain weight when attempting to stop smoking D. Provide information to the client about the risk associated with smokeless tobacco
D
1. The health care provider prescribed octreotide 150 mcg/day subcutaneously for a client with dumping syndrome. The medicine is available in 0.2 mg/ml vials. How many ml should the practical nurse (PN) administer?
math
A female client with metastatic endometrial cancer receives a prescription for medroxyprogesterone acetate 600 mg IM weekly. The medication vial is labeled, 400 mg/ml.' How many ml should the practical nurse (PN) administer?
1.5
A client reports that she ingested 1/2 of a liter of a prep solution for a colonoscopy. How many ML of fluid intake should the practical nurse document?
500ml
1. The practical nurse administers galantamine to a client with early onset Alzheimer's disease. Which nursing problem addresses its therapeutic use? A. Disturbed thought processes B. Altered breathing pattern C. Fluid volume excess D. Chronic pain
A
A chronically depressed older male resident of a long-term care facility has become more reclusive and today refuses to leave his room. His family has moved away and are unable to visit as much as in the past. Which comment by the practical nurse (PN) is likely to be most helpful to this client? A. "May I sit with you for a while?" B. I know you are sad about not seeing your family as often but they are visiting as much as they can C. come into the recreation area. We have your favorite card game and I will play it with you D. why do you want to stay in your room today?
A
A client who is at full term gestation is in active labor and complains of a cramp in her leg. Which intervention should the practical nurse (PN) implement? A. Extend the leg and flex the foot B. check the pedal pulse in the affected leg C. massage the calf and foot D. elevate the leg above the heart
A
After administering carbamazepine to a client with trigeminal neuralgia, which finding indicates of the practical nurse PN that the medication has produced the desired outcome? A. no seizure activity observed. B. Able to ambulate without assistance C. distal pulses intact with strong volume D. client denies pain
A
Based on the computer documentation in the electronic medical record (EMR), which action should the practical nurse PN implement? A. Give rubella vaccine subcutaneously B. call the nursery for the infants blood type results C. administer hydrocodone/acetaminophen one tablet for pain D. observe the mother breastfeeding her infant
A
Prior to an invasive examination of a hospitalized client, a consent form should be obtained. Which action best describes the responsibility of the practical nurse PN? A. Checks the medical record for the consent signed prior to the examination. B. Explain the examination and ask the client to sign the consent form C. explains to a family member and obtain their signature on the consent form D. ask if the client understands the exam and why the consent form must be signed
A
The practical nurse (PN) administered 5 units of regular insulin subcutaneously to the client with type 2 diabetes mellitus. One hour later, the client is found very confused, shaky, and diaphoretic. Which action should the PN take first? A. Obtain a finger stick glucose reading B. Provide 240 ml of juice orally C. Notify the healthcare provider D. Review last dose of oral hypoglycemic
A
The practical nurse (PN) is assisting with preparation of a client for fecal diversion surgery. While inserting an indwelling urinary catheter, the client asks if the surgical opening will be visible. Which action should the PN implement? A. Ask the client if he finished the bowel sterilization prescription. B. Verify that the client has been in PO for the past 24 hours C. review the clients expectations of elimination after surgery D. determine if this is the first indwelling catheter the client has had
A
The practical nurse (PN) is caring for a client newly diagnosed with diabetes mellitus (DM). Which finding is an early sign of hypoglycemia? A. Tremors B. Polyuria C. Bradycardia D. Difficulty swallowing
A
The practical nurse (PN) is feeding a 2-month-old infant with heart failure due to a ventricular septal defect (VSD). Which intervention should the PN implement? A. Allow infant to rest before feeding B. weigh before and after feeding C. feed the infant when he cries D. insert a nasogastric feeding tube
A
The practical nurse (PN) is reinforcing dietary information to a young adult female who was diagnosed with iron deficiency anemia after she has voluntarily started a lacto-vegetarian diet. Which nutrition should the PN suggest this client eat to best meet her nutritional needs while allowing her to adhere to a lacto-vegetarian diet? A. Increase the amounts of dark yellow vegetables such as carrots to fortify iron stores B. combine several legumes and grains such as beans and rice to form complete proteins C. drink whole milk instead of skim milk to enhance the body's production of amino acid D. take vitamin K 10 mg PO daily to enhance production of red blood cells
A
The practical nurse (PN) is assessing a client's blood pressure using a manual sphygmomanometer on the left arm. In which sequence should the PN implement these? A. Position the blood pressure cuff. B. Pump the cuff while palpating the pulse. C. Release air from the cuff slowly. D. Listen for the systolic pressure reading. E. Listen for the diastolic pressure reading.
A,B,D,C,E
The practical nurse (PN) who is working as the charge nurse on the night shift of a long-term-care facility notices that an unlicensed assistive personnel (UAP) uses poor handwashing techniques. The UAP is assigned to care for a client who had uncontrollable diarrhea for the past 8 hours. Which intervention should the PN implement? A. Demonstrate good handwashing technique to the UAP and observe for compliance. B. Reassign the UAP to another client who does not currently have an infection C. Encourage the UAP to use antiseptic gel when entering and exiting the clients room D. Report the evaluation of EU AP's hand washing technique to the supervisor
A
The practical nurse PN notices that the client's urine is pale yellow, with a cloudy appearance, and has a foul odor. Which assessment should the PN complete next? A. Asked the client about urinary frequency B. palpate the bladder area for distention C. access skin appearance and elasticity D. observe the feet and legs for swelling
A
The practical nursing (PN) is charting vital signs on a hand-written flow sheet and realizes that an error has been made. What should the PN do to rectify this error? A. Draw one line through the entry and insert the correct information. B. Chart the correct information in the next column C. obliterate the entry and insert the correct information D. notify the charge nurse that the entry needs to be revised
A
The spouse of a hospitalized client asked the practical nurse PN for and acetaminophen for a tension headache. Which action should the PN take? A. Explain that medication can only be provided to clients B. determine if the spouse has any medication allergies C. request the pharmacy to send acetaminophen to the unit D. give the spouse acetaminophen from the nurses personal supply
A
When a small fire breaks out in the kitchen of a long-term care facility, which task should be performed by the practical nurse PN rather than the unlicensed assistive personnel (UAP)? A. Determine the means by which residents will be evacuated. B. Close all fire doors and the doors to all the residents rooms C. assist in the wandering residence back to their room D. offer comfort and reassurance to distract residents
A
While caring for a client one day following a thyroidectomy, the practical nurse (PN) notes that the client's voice is hoarse. What action should the PN take? A. Administer humidified oxygen per nasal cannula B. ensure that the drainage device is compressed C. notify the unit charge nurse of the finding D. obtain a cup of ice chips for the client
A
The surgical team is about to begin a renal transplant for a client with chronic renal failure. What question(s) should the practical nurse (PN) expect during the surgical tenant's 'time out?' (Select all the apply A. Was surgical asepsis monitored during set up? B. Has the client been verified for this procedure? C. Is the preoperative teaching complete? D. Is the client ready to be transported to the surgical suite? E. Have the right procedure and correct site been established?
A,B,E
Which action should the practical nurse include when accessing a client for signs and symptoms of fluid volume access? (Select all that apply) A. palpate the rate and volume of the pulse B. measure body weight at the same time daily C. Compare muscle strength of both arms D. check fingernails for the presence of clubbing E. observe the color and amount of urine
A,B,E
Prior to administering pain medication to an adult postoperative client, what information should the practical nurse (PN) obtain? (Select all that apply) A. Effectiveness of last pain medication administration B. History of pain medication used during the past year C. Time of last administration of pain D. high and weight of client prior to admission E. Client's pain rating on a scale of 1 to 10
A,C,E
Based on annual physical assessments, an older adult female's blood pressure readings have changed from 120/82 to 155/86 mm Hg over the past two years. The practical nurse (PN) should recognize which factors in the client's history are likely to be associated with this finding? (Select all that apply) A. History of diabetes mellitus B. leads and aerobics class C. body mass index of 2/2 D. hyperlipidemia E. Increase in age
A,D,E
1. The practical nurse (PN) observes two unlicensed assistive personnel (UAP) turning an older client who had a hip arthroplasty with prosthesis placement 4 hours ago. Which observation by the PN indicates that the UA`P's need additional information about the turning procedure? A. They turning sheet is used under the client for turning and repositioning B. The client is told to keep both legs straight and together while turning. C. An abduction pillow is placed between the client's leg when positioned D. the UAPs keep their backs straight and knees bent when moving the client
B
A 15-year-old male who is mildly mentally disabled is admitted to the adolescent unit because he repeatedly refuses to complete personal hygiene. The healthcare provider prescribes that the client brush his teeth three times a day. In the psychiatric team conference, a behavior modification program is recommended to engage the client's participation. When implementing this technique, which reinforcement is best for the practical nurse (PN) to provide? A. Candy for each successful hygiene task like brushing his teeth B. Preferred activities or tokens for each compliance C. privilege restriction or fines for refusal to complete a hygienic task D. unit test for each omission of teeth brushing
B
A client is using an incentive spirometer on the first postoperative day after an inguinal herniorrhaphy. The practical nurse PN should reteach the proper use of the spirometer when the client demonstrates which action? A. Using a tight seal around the mouth piece B. Blowing forcefully into the mouthpiece C. exhaling slowly after two seconds D. sitting upright during the treatment
B
A client who had orthopedic surgery 3 days ago complains of difficulty sleeping. Which initial intervention is best for the practical nurse (PN) to implement? A. Provide a cup of hot chocolate at bedtime B. Reposition the client and provide a back rub C. administer a PRN prescription for pain D. offer the client a prescribed sleep medication
B
A client who is receiving a statin medication reports the onset of muscle soreness and fatigue, and the practical nurse (PN) notes that the client's skin is warm to the touch. Which action by the PN takes priority? A. Administer a PRN dose of Acetaminophen B. Report the findings to the charge nurse C. monitor the clients serum lipid levels D. encourage the client to drink fluids
B
A client with diabetic ketoacidosis (DKA) is receiving regular insulin. Which action should the practical nurse implement to evaluate the effectiveness of the insulin dosage? A. Smell the client's breath for resolution of a fruity odor B. Check fingerstick blood glucose for a decrease in the level. C. Measure declines urinary output for an increased volume D. determine class orientation to time and space
B
A male client with polycythemia vera is scheduled for phlebotomy in the unit's procedure room. What action should the practical nurse implement when coordinating department services for this procedure? A. Notify the blood bank and the scheduled phlebotomy procedure B. Schedule the treatment with the Special Procedures department C. ensure that chest X-ray and other radiological reports are available D. ask pharmacy to deliver an additional PRN dose of an analgesic
B
A new unlicensed assistive personnel (UAP) is completing an orientation assignment and is caring for an immobilized client who needs a complete bed bath. Which is the best way for the practical nurse PN to evaluate this UAP's performance? A. Request the UAP to report and chart when the bath is complete B. Inspect the clients skin near the end of the bathing procedure C. add another UAP to help the orientee to ensure satisfactory care D. verify with the client that the bath was complete and thorough
B
An older client tells the home health care practical nurse (PN) about experiencing dizziness when getting out of bed. Which assessment is most important for the PN to obtain? A. Pause deficit B. Standing blood pressure C. apical heart rate D. oxygen saturation
B
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 strider. Which intervention is best for the PN to implement? A. Encourage the child to drink adequate amounts of cool clear liquids B. Monitor the child's oxygen saturation level via pulse oximeter C. administer a dose of Acetaminophen per PRN prescription D. instruct the mother to play with the child for stimulation and distraction
B
The Practical nurse PN is providing care for a client who is receiving an intravenous antibiotic to treat an infection. Which assessment findings require the most immediate action by the PN? A. Low grade fever with diaphoresis B. Hives with pruritus. C. Warm skin with elastic turgor D. dry mouth with thirst
B
The practical nurse (PN) is preparing for shift change. Which task has the highest priority and should be completed first? A. Clean up and organize the nurses workstation B. Verify completion of all new prescriptions C. calculate and record intake and output totals D. write a narrative shift summary for each client
B
The practical nurse (PN) observes an unlicensed assistive personnel (UAP) prepare to exit a client's room. The UAP's hands appear visibly soiled as the UAP uses a hand rub for 10 seconds to cleanse the hands. Which action should the PN take? A. Ask the UAP why the hands were so obviously soiled B. Instruct the UAP to wash the hands for one minute C. advise the UAP to use the hand rub for 30 seconds D. confirm that the UAP completed hand hygiene correctly
B
The practical nurse (PN) works in a facility that has just been placed on "lock-down" for a radiation dispersion event. Which action should the PN take to protect the clients? A. Cover entryways with plastic sheeting B. Move clients to an interior room. C. Open the windows and vents D. turn exhaust fans to high
B
The practical nurse PN finds a postoperative client lying in bed with an unsecured surgical dressing as seen in the picture. After reinforcing the dressing, which follow up assessment is most important for the PN to implement? A. Incisional pain scale rating B. vital sign measurements C. volume of peripheral pulses D. fluid volume intake and output
B
The practical nurse PN who is working on a skilled nursing unit delegates the two-hour turning schedule for a group of bedfast clients to unlicensed assistive personnel (UAP). To minimize lower back pain injury, which strategies should the PN instruct the UAP to implement while moving the client in bed? (Select all that apply) A. Avoid use of assistive devices B. Keep the bed low to the ground C. Relax the abdominal muscles D. Encourage the client to help E. Maintain a broad base of support
B,D,E
A client who was recently diagnosed with Parkinson's disease is receiving levodopa carbidopa. Which should the practical nurse pee in monitor during the first weeks of therapy to evaluate the effectiveness of the prescription? A. On off phenomenon and abrupt motor functions swings B. postural blood pressure changes and heart rate C. gait, mobility, drooling D. bowel and bladder functioning
C
A client with paranoia is admitted to the mental health unit and immediately goes to the corner of the room and sits quietly without communicating. In approaching the client, what intervention should the practical nurse (PN) implement first? A. Describe functions of the PN B. review client rights of hospitalization C. Explain daily schedule of unit activities D. offer the client a PRN medication
C
A client is receiving an epidural anesthesia during labor. Which observations is the most important adverse effect that the practical nurse (PN) should assess for following the administration of the epidural? A. Urinary retention B. a continuous headache C. Maternal hypotension D. a vaginal hematoma
C
A client reports experiencing persistent pain, redness, and warmth in the right elbow. Which information should the practical nurse obtain to effectively document the medical history? A. Use of pain medication B. Pattern of inflammation C. Duration of pain d. Mechanism of injury
C
1. A client with obsessive-compulsive disorder (OCD) reports 'thoughts stick in my mind and the rituals I use are stupid, but I cannot control them. People laugh at me, but they don't understand how awful it is. I am a burden to my family because I cannot hold a job. I do not know how much longer I can live this way.' Which information is most important for the practical nurse (PN) to ask in response to the client's statement? A. Question about which rituals are most often used to reduce anxiety B. Ask if the obsessions and compulsions interfering with sleep C. determine what makes the client think people are laughing D. inquire if the distress could lead to consider suicide as an option
D
A client reports pain, numbness, and tingling sensations in the lower legs. How should the practical nurse (PN) document this finding? A. Acute pain B. visceral pain C. Nociceptive pain D. Neuropathic pain
D
A client tells the practical nurse (PN) that he is afraid about his scheduled surgery. How should the PN respond? A. I was afraid before I had surgery too B. it is normal to have some fears before surgery C. would you like to speak with the surgeon D. Tell me what is making you feel afraid
D
After change of shift report the practical nurse (PN) makes rounds on a postoperative unit. Which client finding necessitates the immediate attention of the PN? A. An older client whose blood pressure is 100/70 after receiving meperidine foot pain related to a hip fracture. B. a client who has pink urine draining from the indwelling catheter following a transurethral prostatectomy C. a client who is having bright red drainage from the rectum following a colonoscopy with polyp removal D. A client who has brown, green bile draining from a t-tube after cholecystectomy for cholelithiasis
D
An older client with degenerative joint disease asks about using the rubber jar openers that are available. The practical nurses PN response should be based on which information about assistive devices? A. They diminish range of motion ability B. They promote muscle tone and strength C. They can decrease the risk for joint dependency D. They decrease the risk for joint trauma
D
An older client with pernicious anemia uses hot packs to loosen psoriatic plaques. The practical nurse PN who assists with home care twice weekly should refer which finding to the home health care charge nurse? A. Areas of decreased pigmentation B. yellow white scales on the skin C. brown spots on hands and arms D. Erythema and edematous areas
D
In describing the "at-risk" individual for developing breast cancer, the practical nurse (PN) should recognize which female client as having the highest risk? A. 35 year old with trauma to the breast B. 50 year old Caucasian who has never had a mammogram C. 40 year old African American with hypertension D. 32-year-old whose mother had breast cancer
D
The birth weight of an infant delivered by a woman with gestational 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? A. Repeat the heel stick for glucose in one hour B. assess for signs of hypocalcemia C. offer nipple feedings of 10% dextrose D. Begin frequent feedings of breast milk or formula
D
The mother of a young child with eczema ask about the type of clothing that is best for her child's comfort. Which choice should the practical nurse (PN) recommend? A. Rayon B. Silk C. polyester D. Cotton
D
The mother of an 8-year-old boy tells the practical nurse (PN) that he fell out of a tree and hurt his arm and shoulder. Which assessment finding should the practical nurse (PN) note as the most significant indicator of possible child abuse? A. The mother's version of the injury is different from the child's version B. the child looks at the floor when answering the nurse's questions C. the mother refuses to answer questions about the family history D. The child has several abrasions on the chest and legs.
D
The parents of a child with pre-diabetes report to the practical nurse (PN) that the child wants to join a soccer team. Which action is best for the PN to implement? A. Instruct the family about the need to adjust the insulin dose before exercise B. Recommend an increase in calorie intake to avoid excessive weight loss C. suggest a less strenuous activity to reduce the risk of dehydration D. reassure the parents that increased physical activity reduces the risk for diabetes
D
The parents of a four-week-old male infant report that he eats well but vomits after each feeding. Which finding should the practical nurse PN identify if the baby is receiving inadequate nutrition? A. Absent moral reflux B. hyperactive bowel sounds C. Tachypnea D. Sunken fontanels
D
The practical nurse (PN) and unlicensed assistive personnel (UAP) are providing care for a client who exhibits signs of neglect syndrome following a stroke affected the right hemisphere. Which action should the PN implement? A. Ask UAP to leave the room and assess the clients body for bruising B. carefully observe the interaction between the client and family members C. instruct the UAP to protect the clients left side when transferring to a chair D. Demonstrate to the UAP how to approach the client from the client's left side.
D
The practical nurse (PN) is assigning tasks to an unlicensed assistive personnel (UAP) who is giving basic care to a group of residents in a long-term care facility. Which client's task should be completed by a PN rather than a UAP? A. A client with urinary urgency and incontinence who is asking for a bedpan B. a client with a full urinary bedside drainage unit after receiving a diuretic C. a client with paraplegia who needs a urinary condom catheter change D. A client with continuous urinary bladder irrigation via 3-way catheter.
D
The practical nurse (PN) is auscultating a client's lung sounds. Which description should the (PN) use to document this sound? A. Rhonchi B. Wheezing C. Stridor D. Fine crackles
D
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 and creatine phosphokinase myoglobulin isoenzyme (CK-MB) levels. What should the PN consider the most significant risk for this client on the second day of admission? A. The lab results indicate risk factors for transient ischemic attack (TIA), and neuro vital signs should be monitored B. the client is at risk for pulmonary embolism and lifestyle modifications need to be implemented C. the client is at risk for recurrent long term angina pain and subsequent myocardial infraction D. The lab results indicate myocardial damage, and the client is at risk for cardiac dysrhythmias
D
The practical nurse (PN) is caring for a client with human immunodeficiency virus (HIV) who is receiving a nucleoside/nucleotide reverse transcriptase inhibitor (NRTI). The client reports experiencing malaise, fatigue, and anorexia. The PN observes the client's respirations are 30 breaths/minute. Which laboratory result is most important for the PN to review? A. Liver function tests B. Basic metabolic panel C. Complete blood count D. Arterial blood gases
D
The practical nurse (PN) is making a home visit to an older male adult who was recently diagnosed with herpes zoster (shingles). The client reports the onset of severe burning pain along the right side of his trunk. Which action should the PN take? A. Notify the nursing supervisor of the uncontrolled pain B. obtain an oxygen tank for home administration C. give the next prescribed dose of antiviral medication D. Administer a prescribed PRN dose of analgesic.
D
The practical nurse (PN) is reviewing instructions for the use of pilocarpine eye drops with a client who has glaucoma. The client replies that the drops should be used to anesthetize the eye if eye pain is experienced. What action should the PN implement? 1. A. We teach the client about the action of the eye drops to decrease pressure in the eyes B. Document in the chart the client understands the action and use of the eye drops C. Reassure the client that the drops will not be needed often since I pain in glaucoma is not common D. Explain to the client that they eye drops do provide pain relief, but do not anesthetize the eyes.
D
The practical nurse (PN) observes an unlicensed assistive personnel (UAP) bathing a bed fast client with the bed in the high position. Which action should the PN take? A. Determine if the UAP would like assistance B. remain in the room to supervise the UAP C. assume care of the client immediately D. Instruct the UAP to lower the bed for safety
D
The practical nurse PN is assisting the recreational director of a long-term care facility in planning outdoor activities for the wheelchair-bound older residents who are mentally alert. Which activity should the PN suggest that meets the physical and social needs of these residents? A. An outdoor concert B. a picnic in the park C. a tea party in the courtyard D. outdoor games of balloon volleyball
D
What is the first intervention for the practical nurse (PN) to implement when a client refuses to take a prescribed medication? A. Explain to the client the potential harm and not taking the medication B. instruct the client about the purpose of the medication C. document the clients refusal on the medication record D. Determine the client's reason for refusing the medication.
D
Which action by a practical nurse (PN) indicates the best understanding of the principle related to medical asepsis and effective handwashing? A. Turn the water volume to a low level to decrease splashing B. dry the hands above the wrist first to dry from clean to dirty C. use antibacterial hand gel instead of hand washing between clients D. Hold the hands lower than the elbows to promote microbe removal.
D
The practical nurse (PN) enters a client hospital room and sees smoke and flames in the wastebasket. Which sequence of actions should the PN implement? (Arrange from first on top to least on bottom) A. Activate the fire alarm. B. Get the fire extinguisher C. Shut the doors to all client rooms. D. Move clients in immediate danger.
D,A,C,B
The practical nurse (PN) selects the ventrogluteal site to administer an IM injection to an adult. Identify the injection site. Click the chosen location to change click on the new location.
The side/hip