Final Exit Questions
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
At the beginning of the shift, in which order of priority should the practical nurse PN assess these four clients? 1. An adult client with an ulcer whose hemoglobin is 9.5 grams/dL 2. A young adult with a history of asthma who's arterial pH is 7.48 3. An adult woman with vomiting whose potassium is 2.8 mEq/L 4. An older adult with dizziness who's O2 saturation is 86%
4,3,2,1
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
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. maternal hypotension B. a continuous headache C. a vaginal hematoma D. urinary retention
A
A client is scheduled to receive a sublingual tablet and has difficulty swallowing tablets. Which is the best nursing action? A. place the tablet under the client's tongue B. crush medication and administer in applesauce C. obtain a liquid form of the medication D. place the tablet inside the client's cheek
A
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? A. the catheterized volume determines the need to reinsert the indwelling catheter B. the catheterization procedure is an exercise and stimulus-response conditioning C. the catheterization is part of the prescribed bladder retraining program D. the catheterization will stimulate the bladder to empty more completely
A
A client receive Ondansetron Prior to a chemotherapy treatment. How should the practical nurse evaluate the effectiveness of the medication? A. monitor the client for nausea or vomiting following the treatment B. determine if the client feels calm and relaxed before the treatment C. observe the client for signs of pain or discomfort during the treatment D. assess for changes in vital signs during and after the treatment
A
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? A. Quinapril B. Spironolactone C. Losartan D. Clonidine
A
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? A. examine the testicles during bathing B. manipulate the testicles upon rising C. inspect the testicles using a mirror D. compare both testicles concurrently
A
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? A. address the client to determine his needs B. administer a night time sedative C. bring the client to sit in the nurses station D. direct the client to go back to bed
A
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? A. document that the Buck's traction is being maintained B. adjust the traction rope so it is free from the pulley C. place the weights on blocks to increase their stability D. contact the orthopedic technician to adjust the traction
A
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? A. Instruct the mother to play with the child for stimulation and distraction B. monitor the child's oxygen saturation level via pulse oximeter C. administer a dose of acetaminophen per PRN prescription D. encourage the child to drink adequate amounts of cool, clear liquids
A
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? A. Hematuria B. Polydipsia C. a sore throat D. weight loss
A
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? A. reassure the parents that increased physical activity reduces the risk for diabetes B. suggest a less strenuous activity to reduce the risk for dehydration C. recommend an increased in caloric intake to avoid excessive weight loss D. instruct the family about the need to adjust the insulin dose before exercise
A
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? A. The lab results indicate myocardial damage, and the client is at risk for cardiac dysrhythmia B. the client is at risk for pulmonary embolism, and lifestyle modifications need to be implemented C. the lab results indicate risk factors for transient ischemic attack (TIA) and neuro vital signs should be monitored D. the client is at risk for recurrent long-term angina pain and subsequent myocardial infraction
A
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? A. Selects the same site that was used for previous injections B. Insert the needle at a 90° angle to the skin surface C. use a circular action when applying an alcohol pad to the site injects air into the insulin vial to displace the dose
A
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. a preschooler who had an emergency appendectomy for appendicitis B. an adult with osteomyelitis who had a necrotic bone fragment removed in the foot C. a postmenopausal client with breast cancer who had a right breast lumpectomy D. an adolescent with type one diabetes (DM) who had an open cholecystectomy
A
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? A. upper torso B. Head C. upper extremities D. feet
A
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? A. demonstrate to the UAP how to approach the client from the client's left side B. carefully observe the interaction between the client and family members C. instruct the UAP to protect the client's left side when transferring to a chair D. ask the UAP to leave the room and assess the client's body for bruising
A
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? A. Auscultate all lung fields B. measure urinary output C. inspect for sacral edema D. check mental acuity
A
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? A. Sitting on side of bed with feet flat on the floor B. left lateral with pillow between flexed knees C. lying prone with the head turned to one side D. leaning forward over the bedside table
A
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? A. close the door to the client's room B. disinfect all flat surfaces in the room C. apply a fitted N95 respirator D. ask client to apply a face mask
A
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) A. Client positioning during procedure B. size of urinary catheter C. amount of lubricant used D. amount of urine obtained E. appearance of urine obtained
B,D,E
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? A. the percent of processed or canned foods eaten B. the number of vegetable servings consumed daily C. the amount of ice chips and water consumed daily D. the amount of salt substitute used in meal preparation
C
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? A. report the situation to the nursing supervisor or peer review committee B. determine if the conversation was overheard by the clients C. suggest going to the nurses lounge if she needs to discuss these topics D. ask the PN to lower her voice when visitors walk by
C
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? A. Encourage the client to join the swim team instead of the football team B. discuss with the coach the client skin condition and manifestations C. Emphasize showing with non-perfumed soap immediately after practice D. describe the problems associated with perspiration for those with eczema
C
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? A. mental status B. cranial nerve status C. level of consciousness D. ability to communicate
C
Prior to administering pain medication to an adult postoperative client, what information should the practical nurse PN obtain? (Select all that apply) A. high and weight of a client prior to admission B. history of pain medication used during the past year C. time of last administration of pain medication D. client's pain rating on a scale of 1 to 10 E. effectiveness of last pain medication administered
C,D,E
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
Which food provides the best source of vitamin B12?
hamburger
The practical nurse PN is providing care for a client who is NPO after a small bowl resection. The client's 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? A. hyperactive bowel sounds on assessment B. regular heart rate of 100 beats per minute on telemetry C. hypoactive bowel sounds on assessment D. heart rate of 90 beats per minute with PVCs noted on telemetry
A
The practical nurse peer views the midline episiotomy of a client whose reports pain in her stitches. Which action should the PN take first? A. Observe suture line for separation and hematoma formation B. apply an ice pack for 20 minutes to the episiotomy C. initiate daily warm sitz baths during onset of pain D. check medication administration record for last PRN analgesic
A
The spouse of a hospitalized client asked the practical nurse PN for acetaminophen for 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 is most important for the practical nurse (PN) to perform instead of assigning to an unlicensed list of personnel? A. identify the method for transporting and evacuating each resident B. Offer comfort and reassurance to each resident C. close the doors to all of the residents rooms D. provide blankets to each of the residents for use during evacuation
A
When obtaining a capillary blood sample for glucose measurement, which intervention should the practical nurse (PN) implement? A. determine which finger was used previously B. remove all nail Polish from the fingernails C. apply a tourniquet above the antecubital fossa D. Graphs the subcutaneous tissue and pull upward
A
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? A. Blood pressure of 144/84 B. urinary output of 50 mL/hour C. saturation measurement of 95 to 96% D. oriented to person only
A
Which finding for a client with an arteriovenous Fistula (AV fistula) should the practical nurse PN report to the healthcare provider? A. radio pulse distal to AVF is absent and ulnar pulse is present B. bruising at the AVF site is purple and green in color C. descriptions of numbness and tingling in fingers distal to the AVF D. a loud and constant bruit is auscultated at the AVF site
A
Which intervention is within the scope of practice for practical nurse PN? A. Demonstrating deep breathing and coughing to a postoperative client B. discharge teaching about newly prescribed medications C. teaching the use of a glucometer to newly diagnosed diabetic client D. presenting support options that are available to those with cancer
A
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? A. I've realized that life must go on but sometimes I wonder why B. it depend on children who fortunately live close by C. I hate that my health does not allow me to do what I used to do D. sometimes I have trouble remembering simple things
A
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? A. do a complete head-to-toe exam in sequence B. remove child's clothing down to the diaper C. explain all procedures to child and caregiver D. suggest the primary caregiver hold the child
A
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) A. transport a urine culture sample to the laboratory B. empty bedside drainage unit for a client with indwelling urinary catheter C. obtain a post-voided residual (PVR) volume D. teach the client with fluid restrictions how to measure urine output E. irrigate an indwelling urinary catheter for a client with bladder suspension
A,B
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) A. sputum culture and sensitivity B. capillary glucose C. white blood cell count D. urinalysis E. serum potassium F. prothrombin time
A,C
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) A. increase green leafy vegetables in the diet B. eat red meat just until the anemia is resolved C. add lentils and black beans to soups D. take two prenatal vitamins with iron daily E. oatmeal is a good choice for breakfast
A,C,E
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) A. measure head circumference daily B. place in Trendelenburg position C. irrigation and pump valve every 12 hours D. document strict intake and output E. monitor body temperature every four hours
A,D,E
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) A. instructions for care should be included in the client's living will B. the family should plan to make all decisions about the care C. medications are only used to manage plan and symptoms D. care can be provided in the home where the client resides E. care focuses on comfort, dignity, and emotional support
A,D,E
Which statement by a mature adult client with advanced prostate cancer best indicates that he has reached a level of acceptance of his prognosis? A. I don't have any use for those who say this disease is going to win B. I found the support I need from my faith and family C. I think I've had this disease for a long time but the doctor did not find it D. I understand that this is a disease that occurs mostly in older men
B
. 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? A. Headache pain B. frame of mind C. hyperactivity D. speech pattern
B
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? A. remind the client that the consent has already been obtained B. notify the charge nurse of the clients concerns after surgery C. document that the client has expressed concerns about the surgery D. encourage the client to continue with the scheduled surgery
B
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? A. is there something you want to tell me? B. Is anyone hurting you? C. How is your marital relationship? D. Do you want to see a social worker?
B
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? A. Measure the record the clients intake and output B. notify the charge nurse of the assessment findings C. plan to reassess the clients temperature in two hours D. provide oral hygiene on a regular frequent schedule
B
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? A. administer a PRN prescription for pain B. reposition the client and provide a back rub C. offer the client a prescribed sleep medication D. provide a cup of hot chocolate at bedtime
B
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? A. Assign EU AP to more stable clients the next day B. supervise the UAP after reviewing the protocol C. report the UAP's omission to the charge nurse D. complete in unusual occurrence report
B
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? A. oxygens saturation B. standing blood pressure C. pulse deficit D. apical heart rate
B
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? A. whatever the parent decide the staff will be available to support the decision B. ask the parents to explain what they understand about the child's diagnosis C. some children do outgrow this type of problem and waiting may be beneficial D. the child's prognosis will not develop complications if surgery is delayed
B
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? A. Recognize that EAP may be upset and asked someone else for the information B. approach the UAP to discuss the behavior and obtain the information needed about the client C. in a private setting, as the other nurses for feedback about the UAP's behavior D. submit an occurrence report identifying the UAP's lack of motivation to perform assigned job tasks
B
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? A. Massage the uterus to decrease Atony B. assess the bladder for distention C. check the hemoglobin to determine uterine hemorrhage D. provide a stool softener for Constipation
B
The practical nurse peeing and ministers an anticonvulsant That causes photosensitivity. Which action should the PN take after administering the medication? A. Dim the lights in the clients room for one hour B. remind the client to protect skin from sunlight C. provide a snack rich in vitamin C and D D. monitor the clients temperature hourly X 4
B
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? A. prepare to assist in applying a new cash to reduce pressure points B. explain that this is an expected part of the bone healing process C. report the client's concern to the health care provider D. teach the client strategies to prevent further calluses
B
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? A. speak louder so the client can hear the conversation B. determine if the client has had difficulty hearing in the past C. encourage the client to read the practical nurses lips D. provide written instructions about how to take medications
B
When gathering data about a client with dark skin tones, which site should the practical nurse PN observe? A. forehead and face B. sclera and mucous membranes C. hands and feet D. finger and toenails
B
. 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? A. which medication works best? B. When are the voices most disturbing? C. What are the voices uttering? D. How does the client cope with the voices?
C
. 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? A. encourage the client to be calm and relax for a little while B. assist the client to identify stimuli that precipitate the activity C. Allow time for the behavior then guide the client to other activities D. assist the client to a chair after taking away the cleaning materials
C
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? A. take her temperature and assess for additional signs of infection B. elevate her legs in a shock position and apply external heat C. apply light, warmed blankets and assure her that this is normal following delivery D. encourage the client to turn to her left side and administer oxygen by face mask
C
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? A. repeat the heel stick for glucose in one hour B. offer nipple feedings of 10% dextrose C. begin frequent feedings of breast milk or formula D. assess for signs of hypocalcemia
C
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? A. you should know that I cannot administer the medication in this syringe B. teamwork is the best approach I will be glad to help you get caught up C. I am not comfortable doing that is there something else I can do to help you? D. As long as the charge nurse checks the syringe I can give the medication
C
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? A. Use a wooden applicator to place the sputum specimen in a sterile container B. place a biohazard bag over the basin and seal the bag securely for transport to the lab C. 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 D. apply gloves and place the tissue and specimen in a container for transport to the lab
C
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? A. 152 B. 118 C. 180 D. 136
C
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? A. An office manager whose mother has laryngeal cancer B. a farmer who smokes 1/2 a pack of cigarettes daily C. an older male who drinks a six pack of beer nightly and smokes heavily D. an opera singer who does not smoke but drinks a glass of wine each day
C
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? A. confirm accuracy of the pulse rate obtained by the UAP B. instruct the UAP to report an abnormal findings C. demonstrate the correct pulse site to the UAP D. remind the UAP to check the client's pulse volume
C
The practical nurse PN is assigned to care for four children. Which child should be assessed first? A. 4-year-old who needs to stand to void before going to X-ray B. 3-year-old who is in isolation with chickenpox lesions and MRSA C. 18-month-old who has cystic fibrosis and is wheezing D. 2-year-old who is admitted for gastroenteritis and vomiting
C
The practical nurse PN is auscultating a client's lung sounds. Which description should the PN use to document this sound? A. stridor B. wheeze C. fine crackles D. Rhonchi
C
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? A. Urinary output B. frequency of bowel movements C. ability to swallow D. blood pressure while standing
C
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? A. observe for belching B. inquire about a sore throat C. assess the gag reflux D. instruct the client to speak
C
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? A. you can best help your child by remaining calm and positive B. do you have someone who can help you cope with this? C. This must appear devastating to you at this moment D. what was happening right before your child was injured?
C
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)? A. after washing feet dry thoroughly between toes B. monitor finger stick glucose daily for tight control C. report any foot injury or sore that does not readily heal D. make sure shoe size fit to minimize rubbing and blisters
C
Which location should the practical nurse palpate to determine if a client's submandibular Lymph nodes are enlarged? A. lateral to the trachea B. above the upper jaw C. beneath the lower jaw D. anterior to the temporal bone
C
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? A. measure blood pressure B. observe pressure areas C. notify the charge nurse D. apply a pulse oximeter
C
And administering nystatin suspension to the gums of an infant with a candida infection, which approach should the practical nurse (PN) use? A. Irrigate the infected area with medicated solution after applying sterile gloves B. measure the prescribed amount of solution into the infants bottle C. draw up the medication in a needle less syringe which the infant can suck D. use a gloved finger to rub the suspension over the infected area
D
. A client is diagnosed with Clostridium difficile. Which action should the practical nurse (PN) implement to prevent the spread of Organism? A. keep the door closed to the clients room at all times B. where is particulate respirator masks when in the room C. place a surgical mask on the client during transport D. Don non sterile gloves when performing direct care
D
. A full term 24-hour old infant in the nursery regurgitates and suddenly turns cyanotic. Which immediate intervention should the practical nurse PN implement? A. turn the infant onto the right side B. stimulate the infant to cry C. give oxygen by positive pressure D. suction the oral and nasal passages
D
. 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? A. document the clients loss of memory in the record B. encourage the client to rest during the day C. notify the family of the change in the clients condition D. remind the client what day of the week it is
D
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? A. explain that the pharmacy often substitutes generic equivalents for more expensive brands B. explain that the health care provider probably prescribed a different medication while he is hospitalized C. tell the client that he is probably confused since being hospitalized tends to disorient clients D. tell the client that the PN will verify that the dispense medication is the valid prescription
D
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? A. docusate sodium B. calcium citrate C. levothyroxine D. aspirin
D
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? A. hemorrhage B. dehiscence C. infection D. evisceration
D
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? A. the PN will place the gate belt on the client prior to ambulation B. the client will use self-affirmation statements to decrease fear C. the physical therapist will instruct the client in the use of a Walker. D. The client will ambulate with assistance Q4 hours
D
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 client's silence is best? A. would you like me to call another nurse to be here while I show you the wound? B. You will feel better when you see that the incision is not as bad as you may think C. part of recovery is accepting your new body image and you will need to look at your incision D. it's OK if you don't want to look or talk about the mastectomy I will be available when you're ready
D
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? A. loud crackling sounds B. a rubbing plural sound C. wheezing D. absent or diminished breath sounds
D
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? A. Encourage the client to resume normal activities after medication administration B. observe the client for involuntary movements of the lips and tongue C. assess the scan daily for areas of ecchymosis or other signs of bleeding D. implement ongoing assessments for signs of shallow or slow breathing
D
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? A. The client spouse is interested in learning about foods that will promote wound healing B. after the dressing change the client insists on changing his shirt and washing his hands C. the wound edges are approximated and the skin edges are dry and without inflammation D. the client reports the wound care is painful and would like a prescription for an analgesic
D
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? A. a 26 year old client B. intravenous fluids infusing at 75 mmHg C. blood pressure is 80/48 mmHg D. cholecystectomy 24 hours ago
D
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? A. memory loss B. hearing loss C. impair cognition D. mood alterations
D
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? A. Consensual pupillary constriction present B. Peripheral vision intact C. nystagmus present with pupillary focus D. pupils reactive to accommodation
D
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. a tea party in the courtyard B. an open-air concert C. a picnic in the park D. A team ring toss competition
D
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. What intervention should the PN include in the client's plan of care? A. Perform a daily whisper test of the client's hearing to detect symptoms of a ototoxicity B. Examine the client for stomatitis and erosion of teeth enamel C. In shore peak and the trough serum levels are collected with the third medication dose D. implement ongoing assessments for signs of shallow or slow breathing
D
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? A. place a pre moistened dressing on the stoma site B. apply firm pressure with a dry gauze to the stoma C. stop the stomal care and notify the health care provider D. continue to clean around the skin surrounding the stomal site
D
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? A. obtain a cooling blanket from the hospital central supply department B. administer a PRN prescription for benzodiazepine and acetaminophen C. take the client to a quiet area and provide reassurance D. withhold the next dose and contact the health care provider
D
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? A. inspect the oral cavity using gloved fingers B. perform oral cleansing with a sponge toothette C. apply a petroleum based lubricant to the client's lips D. use an oral suction catheter in the buccal cavity
D
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)? A. cover the wound B. keep the client calm C. reposition the client D. gather supplies
D
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