lpn study exit test
The nurse is very busy and running late with administering medications and asks thepractical nurse (PN) to administer a medication already drawn up in an unlabeled syringe. How should the PN respond?
"I am not comfortable doing that. Is there something else I can do to help you?
Which statement by an older female client who lost her spouse 2 years ago should indicate to the practical nurse (PN) that the client may need bereavement counseling?
"I realize that life must go on, but sometimes I wonder why."
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 registerednurse (RN) immediately?
. 180
The practical nurse (PN) asks an unlicensed assistive personnel (UAP) for feedback about an assigned client. Instead of responding, the UAP walks away from the PN, ignoring the question. What action is best for the PN to take?
. Approach the UAP to discuss the behavior and obtain the information needed aboutthe client
An older male resident of a long-term care facility is awake at 3:30 AM and wanderingdown the hall with his pajamas unbuttoned. Which intervention should the practical nurse (PN) implement?
. Bring the client to sit in the nursing station
The practical nurse (PN) observes a newly hired unlicensed assistive personnel (UAP) who is counting a client's radial pulse as seen in the picture. Which action should the PN take
. Demonstrate the correct pulse site to the UAP (follow the thumb for the radial pulse,follow the pinky for the brachial)
An adolescent with a history of recurring atopic dermatitis (eczema) tells the practicalnurse (PN) of a desire to play high school football. Which action should the PN take?
. Emphasize showering with non-perfumed soaps immediately after practice
The healthcare provider gives a pregnant woman a prescription for one prenatal vitaminwith iron daily and tells her that she needs to increase iron rich foods in her diet becauseher hemoglobin is 8.2 grams/dl. When a list of iron rich foods is given to the client, she tells the practical nurse (PN) that she is vegetarian and does not eat anything that "bleeds!" Which instruction should the PN provide? (Select all that apply.)
. Increase green leafy vegetables in the diet c. Oatmeal is a good choice for breakfast d. Add lentils and black beans to soups
Which intervention should the practical nurse (PN) reinforce for a client with pruritis?
. Keep fingernails trimmed short
A client is receiving an anticonvulsant, diazepam, intravenously for status epilepticus.Which intervention is most important for the practical nurse (PN) to implement?
. Monitor the client's respiratory rate and effort
The practical nurse (PN) administers an antibiotic to a client with a respiratory tract infection. To evaluate the medication's effectiveness, which laboratory values should thePN monitor? (Select all that apply.)
. Sputum culture and sensitivity White blood cell count
A full-term, 24-hour-old infant in the nursery regurgitates and suddenly turns cyanotic.Which immediate intervention should the practical nurse (PN) implement?
. Suction the oral and nasal passages
The PN is preparing to administer a prescription for Cefazolin (Kefzol) 600 mg IMevery six hours. The available vial is labeled, "Cefazolin (Kefzol) 1 gram," and the instructions for reconstitution state, "For IM use, add 2 mL sterile water for injection. Total volume after reconstitution = 2.5 mL." When reconstituted, how many milligramsare in each mil of solution?
1 g 1000 mg = 1000 mg/mL / 2.5 mL = 400 mL
The healthcare provider prescribes cefazolin 500 mg IM every 6 hours. The available vialis 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? (enter numeric valueonly. If rounding is required, round to the nearest tenth.
1.3 mL
The practical nurse (PN) is assigned to care for four children. Which child should beassessed first?
18-month-old who has cystic fibrosis and is wheezing
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 fingerstick glucose at 1630. which dose of insulin should the PN administer? (Enter numeric value only.) (Click on each chart tab for additional information. Please be sure to scroll to the bottom rightcorner of each tab to view all information contained in the client's medical record.
8
A client consumes 8 ounces (oz) of broth, 4 oz of apple juice, 4 ounces of flavored gelatinand 1 banana. During the same shift, this client receives 1 liter of IV fluid and voids 700 mL. How many mL total oral and IV intake should the PN document on the client's medical record? (Enter numeric value only).
8 oz x 30 mL = 240 mL 4 oz x 30 mL = 120 mL 4 oz x 30 mL = 120 mL 1 L = 1000 mL Total intake = 1480 ml
The practical nurse (PN) is planning evening shift rounds for a group of postoperativeclients who all had surgery earlier that day. Which client should the PN check first?
A preschooler who had an emergency appendectomy for appendicitis
The practical nurse (PN) is assisting the recreational director of a long-term care facility plan outdoor activities for the wheelchair-bound older residents who are mentally alert.Which activity meets the physical and social needs of these residents?
A team ring-toss competition
Two weeks after cast application, a client with a fractured right arm returns to the clinicfor evaluation. The client seems upset and tells the practical nurse (PN) that the healthcare provider said a callus has formed on the bone. Which action should the PN take?
Explain that this is an expected part of the bone healing process
The practical nurse (PN) and unlicensed assistive personnel (UAP) enter a client's roomand find the client lying on the bed. The PN determines that the client is unresponsive. Which instruction should the PN give the UAP first?
Feel for a carotid pulse
The practical nurse (PN) is auscultating a client's lung sounds. Which description should the PN use to document this sound? (Please listen to the audio file to select the optionthat applies.)
Fine crackles b. Rhonchi Snoring c. Wheeze d. Stridor Get help
A male client with bipolar disorder reports to the practical nurse (PN) that he has not taken his prescribed medication, divalproex sodium, for the last 6 months. Assessmentof which parameter is most important for the PN to obtain?
Frame of mind
While the practical nurse (PN) and unlicensed assistive personnel (UAP) are turning a client with an abdominal incision, the client's incision eviscerates. Which task is best forthe PN to assign to the UAP?
Gather supplies
What are the final parameters that produce blood pressure? (Select all thatapply)
Heart rate, Stroke, volume Peripheral resistance
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 childmost likely to have exhibited?
Hematuria
The practical nurse (PN) is providing care for a client who is NPO after a small bowel 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 bereported to the healthcare provider?
Hyperactive bowel sounds on assessment
Which statement by a mature adult client with advanced prostate cancer best indicatesthat he has reached a level of acceptance of his prognosis?
I've found the support I need from my faith and family
When a small fire breaks out in the kitchen of a long-term care facility, which task ismost important for the practical nurse (PN) to perform instead of assigning to a unlicensed assistive personnel
Identify the method for transporting and evacuating each resident
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 ofcare?
Implement ongoing assessments for signs of shallow or slow breathing
The practical nurse (PN) is caring for a client with fractured metatarsals after slamming ahand in the car door. After administering the prescribed hydrocodone/acetaminophen for pain, which intervention should the PN include in the client's care?
Implement ongoing assessments for signs of shallow or slow breathing
The practical nurse (PN) and unlicensed assistive personnel (UP) are providing care for aclient who exhibits signs of neglect syndrome following a stroke affecting the right hemisphere. Which action should the PN implement?
Instruct the UAP to protect the client's left side when transferring to a chair
In assessing a 2-year-old boy with croup, the practical nurse (PN) finds that he has become increasingly irritable and has developed tachypnea and resting stridor. Whichintervention is best for the PN to implement?
Instruct the mother to play with the child for stimulation and distraction
The practical nurse (PN) is caring for a client whose urine drug screen is positive for cocaine. Which behavior should the PN document as evidence of cocaine withdrawal?
Intense cravings
A married woman comes to the clinic for her annual well-woman physical examination. During the interview with the practical nurse (PN), the client makes minimal eye contact.The PN observes yellow bruising to the lower eye and purple bruising on the client's upper arm, which look like fingerprints. Which question is best for the PN to ask the client?
Is anyone hurting you?
A male client with tuberculosis returns to the clinic for daily antibiotic injections for a urinary infection. The client has been taking antitubercular medications for 10 weeks and states he has ringing in his ears. Which prescribed medication should the practicalnurse (PN) report to the healthcare provider
Isoniazid 300 mg PO daily
The Glasgow Coma Scale is being used to monitor a client who experienced a traumaticbrain injury. What primary assessment should the practical nurse (PN) evaluate?
Level of consciousness
The practical nurse (PN) determines that a client who is one day postpartum has amoderate amount of lochia rubra and the uterus is firm, extroverted, and three fingerbreadths above the umbilicus. Which should be the PN's initial action?
Massage the uterus to decrease atony
A client is receiving an epidural anesthesia during labor. Which observation is the mostimportant adverse effect that the practical nurse (PN) should assess for following the administration of the epidural?
Maternal hypotension
A client receives ondansetron prior to a chemotherapy treatment. How should thepractical nurse evaluate the effectiveness of the medication?
Monitor the client for nausea and vomiting following the treatment
A client receiving chemotherapy develops a cough that is productive of yellow-tingedsputum. After determining that the client is febrile, which is the priority action for thepractical nurse (PN) to take?
Notify the charge nurse of the assessment findings
A male preoperative client who has already signed the informed consent for a surgicalprocedure confides to the practical nurse (PN) that he is really frightened and unsure about undergoing the surgery. Which priority action should the PN take?
Notify the charge nurse of the client's concerns about surgery
The practical nurse (PN) is caring for a client who has been taking nonsteroidal anti- inflammatory drug ibuprofen for arthritic pain. Which action will the PN include in thisclient plan of care?
Observe for signs of gastrointestinal bleeding
The practical nurse (PN) administers filgrastim to a client with neutropenia. The clientlater complains of bone pain. Which action should the PN take?
Offer to administer a prescribed PRN analgesic to the client
Which client information is most important for the practical nurse (PN) to consider whenproviding instructions to the unlicensed assistive personnel (UAP) about providing morning care to a postoperative client?
Oriented to person only
A client is scheduled to receive a sublingual tablet and has difficulty swallowing tablets.Which is the best nursing action?
Place the tablet under the client's tongue
During morning rounds, a client who is admitted with obsessivecompulsive disorder isin the dayroom repeatedly washing the top of the same table. Which intervention should the practical nurse (PN) implement when approaching the client?
Provide time for the behavior then guide the client to other activities
A client with hypertension complains of a persistent dry cough. The practical nurse (PN)should tell the client that this is a common side effect of which daily medication?
Quinapril
The parents of a child with pre-diabetes report to the practical nurse (PN) that the childwants to join a soccer team. What action is best for the PN to implement?
Reassure the parents that increased physical activity reduces the risk for diabetes
The unlicensed assistive personnel (UAP) reports to the practical nurse (PN) that a bedfast client was not turned during the night. After turning the client, the UAP noted areddened area on the client's hip. The reddened area lightened when light fingertip pressure was applied by the PN. Which action should the PN take?
Remind the UAP of the need to turn the client every 2 hours to prevent skinbreakdown
The practical nurse (PN) administers an anticonvulsant that causes photosensitivity.Which action should the PN take after administering the medication?
Remind the client to protect skin from sunlight
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 wasconfused prior to admission. What action should the practical nurse (PN) take
Remind the client what day of the week it is
Which foot care instruction is most important for the practical nurse (PN) to reinforce that minimizes a long-term complication for a client who is newly diagnosed with type 2diabetes mellitus (DM)?
Report any foot injury or sore that does not readily heal
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?
Reposition the client and provide a back rub
When gathering data about a client with dark skin tones, which site should the practicalnurse (PN) observe?
Sclera and mucous membranes
The practical nurse (PN) is observing a client self-administering a dose if subcutaneousinsulin. What step of the injection technique should the practical nurse (PN) reteach?
Selects the same site that was used for the previous injection
A client who is primigravida at term comes to the prenatal clinic and tells the practical nurse (PN) that she is having contractions every 5 minutes. The PN monitors the client for one hour using an external fetal monitor and determines that the client's contractions are 7 to 15 minutes apart, lasting 20 to 30 seconds, with mild intensity bypalpation. Which action should the PN take?
Send the client home and instruct her to call the clinic when her contractions occur 5minutes apart for one hour
The practical nurse (PN) is assisting a client to cough and deep breathe following surgery.To facilitate effective coughing, the PN should assist the client to assume which position?
Sitting on the side of bed with feet flat on the floor
Which foods should the practical nurse (PN) recommend to a client as good sources ofvitamin K?
Spinach e. Broccoli
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 toobtain?
Standing blood pressure
A practical nurse (PN) is at the nurses' station describing her social life, sexual activities,and alcohol drinking in a boisterous voice that might be heard by clients and visitors. What is the best action that a peer nurse should do?
Suggest going to the nurses' lounge if she needs to discuss these topics
While assisting the PN with the admission of a toddler, which intervention should the practical nurse (PN) implement to make the experience least stressful for the child?
Suggest the primary caregiver hold the child
A new protocol for fall prevention is being implemented on the medical unit. During safety rounds, the practical nurse (PN) identifies that unlicensed assistive personnel (UAP) has omitted a vital component of the protocol. After implementing the missing component, which action should the PN take?
Supervise the UAP after reviewing the protocol
A male client tells the practical nurse (PN) that the pill he has been taking at home is adifferent color and size than the one the PN is trying to give him now. How should the PN respond?
Tell the client that the PN will verify that the dispensed medication is the validprescription
Which food provides the best source of vitamin B12? (Click on the correct location. Tochange, click on a new location.)
meat- Animal sources such as meat are high in vitamin B12. Vitamin B12 is not found in cleaned fruits and vegetables. B12 is a water-soluble vitamin necessary for healthy function ofthe brain and nervous system
A female client with immune thrombocytopenic purpura is transferred to a long-term care facility for physical rehabilitation. To prevent injury, which action is most importantfor the practical nurse to implement?
Ensure the client has minimal clutter in the room
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 afocused assessment?
Ability to swallow
The chest x-ray for a client who is admitted for pneumonia shows pleural effusion withdecreased air flow in the entire left upper lobe. What should the practical nurse (PN) expect to hear when auscultating the left upper lobe?
Absent or diminished breath sounds
The practical nurse (PN) is working in a cancer detection mobile clinic. Four individuals come for screening with a complaint of hoarseness, a danger sign for cancer of the larynx. Which client has the highest risk for development of cancer of the larynx that thePN should refer to the healthcare provider
An older male who drinks a six pack of beer nightly and smokes heavily
While turning and positioning a bedfast client, the practical (PN) observes that the clientis dyspneic. Which action should the PN take first?
Apply a pulse oximeter
A client who is a gravida 1, para 0, is transferred to the recovery room following a normalvaginal delivery of a healthy newborn. The practical nurse (PN) observes that the client isshaking uncontrollably and states she is cold. Which intervention should the PN perform?
Apply light, warmed blankets and assure her that this is normal following delivery
The practical nurse (PN) is assigned to care for a client who had an endoscopic procedure in which the local anesthetic was sprayed on the throat. Which priority actionshould the PN include in the clients plan of care?
Assess the gag reflex
The nurse is taking blood pressure of a client admitted with a possible myocardial infarction. When taking the client's BP at the brachial artery, the nurse should place theclient's arm in which position?
At the level of the heart
The practical nurse (PN) is assessing an older client with left-sided heart failure (HF).What intervention is most important for the PN to implement?
Auscultate all lung fields
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?
Begin frequent feedings of breast milk or formula
Which location should the practical nurse palpate to determine if a client's submandibular lymph nodes are enlarged?
Beneath the lower jaw
The practical nurse (PN) notifies the healthcare provider about client information usingSituation, Background, Assessment, Recommendation (SBAR) technique. Which information should the PN provide first?
Blood pressure is 80/48 mmHg
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 woundfollowed by appearance of bowel on the skin. Which complication has occurred?
Evisceration
An older client with metastatic breast cancer is experiencing shortness of breath as the 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 clientand family regarding hospice care? (Select all that apply.)
Care can be provided in the home where the client resides Care focuses on comfort, dignity, and emotional support Instructions for care should be included in the client's living will
`The practical nurse (PN) observes hematuria in the urinary catheter drainage tubing of aclient who is receiving intravenous heparin. Which action should the PN implement first
Check the client's gums for bleeding
The practical nurse (PN) is caring for a client with influenza who requires droplet precautions. Which action should the PN take after entering the client's room to providecare?
Close the door to the client's room
The practical nurse (PN) plans to use distraction techniques while a client undergoes abrief painful procedure. Which action should the PN implement during the procedure?
Encourage the client to reminisce about a favorite past family event
The practical nurse (PN) explains the 2-week dosage prescription of prednisone to a client who has poison ivy covering multiple skin surfaces. What should the PN emphasizeabout the dosing schedule
Decrease dosage daily as prescribed
Which intervention is within the scope of practice for a practical nurse (PN)?
Demonstrating deep breathing and coughing to a postoperative client
While administering prescription medications to an older resident in an extended care facility, the practical nurse (PN) notices that the client is having difficulty hearing. What action is most important for the PN to take?
Determine if the client has had difficulty in the past
When obtaining a capillary blood sample for glucose measurement, which interventionshould the practical nurse (PN) implement?
Determine which finger was used previously
In caring for a client with Buck's traction, the practical nurse (PN) observes that the prescribed amount weights are hanging freely, and the traction rope is on the pulley.Which action should the PN implement first?
Document that the Buck's traction is being maintained
A client is diagnosed with Clostridium difficile. Which action should the practical nurse(PN) implement to prevent the spread of the organism?
Don non-sterile gloves when performing direct care
In administering nystatin suspension to the gums of an infant with candida infection,which approach should the practical nurse (PN) use?
Draw up the medication in a needle-less syringe which the infant can suck
The practical nurse (PN) reviews instructions for use of polyethylene glycol, a laxative,with a client scheduled for a colonoscopy. Which instruction should the PN include?
Drink each glass of solution rapidly at regular specified time intervals
The practical nurse (PN) is assigning care for a group of clients on the urology medicalunit. Which client should the PN assign to the unlicensed assistive personnel (UAP)? (Select all that apply.)
Empty beside drainage unit for a client with indwelling urinary catheter Transport a urine culture sample to the laboratory
The practical nurse (PN) explains to a client how to obtain a sputum specimen and theclient indicates understanding the procedure. After the PN leaves the room, the client obtains the specimen and notifies the PN. When the PN arrives to collect the specimen,it appears as seen in the picture. What action should the PN take?
The PN should teach the client how to obtain a sputum specimen and if the client does not correctly collect the specimen, then the PN should assist the client in obtaining another specimen coughed directly into a sterile cup
An older postoperative client has the nursing diagnosis, "Impaired mobility related to fear of falling." Which desired outcome best directs the practical nurse (PN) actions forthis client?
The PN will place a gait belt on the client prior to ambulation.
A client who is being cared for in her home has a low serum sodium level of 125 mEq/L. To determine the cause of this value, which information should the practical nurse (PN) request from the client?
The amount of ice chips and water consumed daily
A client is voiding frequent small amounts 24-hours following the removal of an indwelling catheter, and a post-voided residual volume assessment is prescribed. Whatexplanation should the practical nurse (PN) provide to the client about why the procedure is necessary?
The catheterized volume determines the need to re-insert the indwelling catheter
The practical nurse (PN) is caring for a client with coronary artery disease who is admitted with intermittent chest pain. The admission laboratory results indicate elevations in troponin I and creatine phosphokinase myoglobulin isoenzyme (CK-MB) levels. What should the PN consider the most significant risk for this client on the secondday of admission?
The lab results indicate myocardial damage, and the client is at risk for cardiacdysrhythmias
The practical nurse (PN) is preparing to assist an elderly client to the bathroom. The PN knows that an elderly adult's center of gravity changes from the hips to another area ofthe body. In planning to safely assist this client, the PN knows that the center of gravity for the elderly client is in which area of the body?
Upper torso
When providing oral care to an unconscious client who is a mouthbreather and does not swallow, which action is most important for the practical nurse (PN) to implement?
Use an oral suction catheter in the buccal cavity
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 theassessment of this client?
What are the voices uttering?
The practical nurse (PN) is caring for a client receiving a prescription for paroxetine whosuddenly exhibits restlessness, tachycardia, fever, and elevated blood pressure. Which action should the PN implement first?
Withhold the next dose and contact the health care provider
