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CPRNE EXAM 2024 | 2 ACCURATE CURRENTLY TESTING EXAMS, Exams of Nursing

CPRNE EXAM 2024 | 2 ACCURATE CURRENTLY TESTING EXAMS WITH A VERIFIED STUDY GUIDE | EXPERT VERIFIED FOR GUARANTEED PASS | LATEST UPDATE CPRNE EXAM 2024 | 2 ACCURATE CURRENTLY TESTING EXAMS WITH A VERIFIED STUDY GUIDE | EXPERT VERIFIED FOR GUARANTEED PASS | LATEST UPDATE

Typology: Exams

2023/2024

Available from 09/13/2024

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CPRNE EXAM 2024 | 2 ACCURATE CURRENTLY

TESTING EXAMS WITH A VERIFIED STUDY GUIDE |

EXPERT VERIFIED FOR GUARANTEED PASS |

LATEST UPDATE |

Case # A 32-year-old client has tested positive for the human immunodeficiency virus (HIV). Recently, the client was diagnosed with gallbladder disease and has been admitted to hospital for a cholecystectomy.

  1. Which of the following indicates that the client is an active participant in his care?
  2. The client reads the care plan thoroughly.
  3. The client demonstrates an indifference to changes in his care.
  4. The client asks questions about his care.
  5. The client follows the directions of his family. Correct Answer: 3
  6. This demonstrates an ability to read, but does not reflect active participation.
  7. Indifference does not demonstrate interest or participation.
  8. This demonstrates participation in the care plan by asking questions.
  9. Following directions does not demonstrate active participation.
  10. The client was provided with preoperative teaching on deep breathing and coughing. How should the practical nurse best evaluate the outcomes of the teaching?
  11. Have the client explain deep breathing and coughing.
  12. Have the client identify barriers to performing the exercise.
  13. Ask the client to demonstrate deep breathing and coughing.
  14. Demonstrate deep breathing and coughing to the client. Correct Answer: 3
  15. This is part of the evaluation, but it does not measure application of the technique.
  16. This does not measure that the client has learned the skill.
  17. Client demonstrates learning. This provides an opportunity for the practical nurse to evaluate client learning.
  18. This does not measure client learning.
  19. What is the primary objective for the practical nurse using aseptic technique when changing a postoperative dressing?
  20. It allows the practical nurse to maintain a sterile field.
  21. It helps to prevent the spread of HIV.
  22. It reduces the risk of contamination and wound infection.
  23. It promotes the repair of abdominal tissues.

Correct Answer: 3

  1. This does not explain the primary outcome of aseptic technique.
  2. The practical nurse may or may not dispose of the dressings correctly. Aseptic technique may not minimize the spread of HIV.
  3. The primary objective of aseptic technique is to prevent microorganisms from being introduced to the surgical wound, therefore reducing the risk of contamination.
  4. Aseptic technique helps prevent infection and does not directly impact tissue integrity. Case # Mr. Bell, 76 years old, has been on the unit for the past 3 weeks with liver failure. His treatment includes IV therapy of normal saline infusing at 100 mL per hour.
  5. Since the initial assessment and his admission to the unit, Mr. Bell's abdominal girth has increased by 14cm. What order should the practical nurse anticipate first?
  6. Decrease his IV therapy to keep the vein open.
  7. Apply oxygen at 2L per minute via nasal cannula.
  8. Apply anti embolic stockings to his legs.
  9. Decrease his caloric intake to 1400 calories daily. Correct Answer: 1 1.Fluid accumulation can be increased by IV therapy.
  10. Oxygen is only applied when oxygen saturation is decreased.
  11. This will not have any effect on the abdomen.
  12. Weight gain in liver failure is due to fluid accumulation, not caloric intake.
  13. What manifestations associated with liver failure should the practical nurse report first?
  14. Yellowing of sclerae.
  15. Decreased appetite.
  16. Increased respirations.
  17. Decreased consciousness. Correct Answer: 4
  18. This is suggestive of disease decompensation and early liver failure.
  19. Decrease in appetites is a manifestation of many diseases and would require further investigation but is not life threatening.
  20. Increased respirations are related to increased pressure on the diaphragm due to ascites. This would require further intervention; however, this is not life threatening compared to decreased consciousness.
  21. Hepatic encephalopathy is a central nervous system manifestation that often leads to coma and death.
  22. Mr. Bell's family has arranged for a meeting with the transplant coordinator. Mr. Bell does not agree with this consultation and yells at his family. What should the practical nurse do first?
  23. Arrange for a meeting between the client, his family and a social worker.
  24. Explore Mr. Bell's understanding of the pros and cons of a transplant.
  1. Reinforce Mr. Bell's disinterest in meeting with the transplant coordinator.
  2. Respect his right to refuse and accept the clients decision. Correct Answer: 2
  3. This disregards the client.
  4. This would help the client make an informed decision.
  5. Mr. Bell's informed decision-making in his treatment options has not been established.
  6. Exploration of the client's understanding of his options and wishes is necessary in order to ensure that he is making an informed decision.
  7. Mr. Bell has been transferred to a long-term care facility. As the team leader in the facility, what should the practical nurse do first?
  8. Refer Mr. Bell to a dietician for a high-iron diet.
  9. Delegate Mr. Bell's total care to an unregulated health worker.
  10. Discuss with the team Mr. Bell's increased need for skin care.
  11. Continue to educate Mr. Bell on the advantages of a liver transplant. Correct Answer: 3
  12. A high iron diet would not be helpful.
  13. This client requires skills and expertise of the practical nurse and is beyond the scope of practice and skill set of the unregulated health worker.
  14. This uses the practical nurse's leadership skills within the interprofessional team.
  15. This is not a priority action. Ongoing education can continue when the client is settled in the long-term care facility. Case # Mrs. Tang, a healthy 28-year-old woman, is pregnant with her first child. She is attending prenatal classes at the local public health office.
  16. Mrs. Tang recalls that the first day of her last menstrual period was December 14. What should the practical nurse document as the client's expected date of delivery using Naegele's rule?
  17. September 21
  18. October 7
  19. August 17
  20. November 11 Correct Answer: 1
  21. Naegele's rule states to count back 3 months and add 7 days from the first day of the last menstrual period.
  22. Naegele's rule states to count back 3 months and add 7 days from the first day of the last menstrual period.
  23. Naegele's rule states to count back 3 months and add 7 days from the first day of the last menstrual period.
  24. Naegele's rule states to count back 3 months and add 7 days from the first day of the last menstrual period.
  1. Mrs. Tang delivered a healthy baby girl 2 hours ago. What is the practical nurse's priority assessment of the mother?
  2. Location and tone of the uterus.
  3. Parent and infant attachment behaviours.
  4. Vital signs, especially blood pressure.
  5. Perineal edema and lochia. Correct Answer: 1
  6. Hemorrhage is frequently caused by uterine atony and it is a major complication during the recovery period.
  7. These behaviours are observed but this is not the priority nursing assessment. Assessing uterine tone is the priority to monitor for postpartum hemorrhage.
  8. Significant bleeding may not be immediately reflected by a change in vital signs.
  9. Edema is not typically associated with hemorrhage and the presence of lochia does not indicate the tone of the uterus. Assessing uterine tone is the priority.
  10. At the second feeding, Mrs. Tang asks the practical nurse how to recognize when breastfeeding is going well. How should the practical nurse respond?
  11. The newborn has at least 6 wet diapers a day.
  12. The mother breastfeeds 8-12 times a day.
  13. The newborn falls asleep readily after each feed.
  14. The mother experiences let-down and cramping after each feed. Correct Answer: 1
  15. This is a good indicator of adequate intake and hydration.
  16. Frequency of feeding does not ensure quality feeding.
  17. This indication could imply lethargy, dehydration and fatigue, not necessarily satiety.
  18. This implies an effective latch, but the duration and frequency is needed to ensure adequate hydration.
  19. After attempting a variety of breastfeeding techniques, Mrs. Tang says that she is considering switching to formula feeding. What should the practical nurse do first?
  20. Agree with the client's decision to switch to bottle feeding.
  21. Reinforce techniques to use for successful breastfeeding.
  22. Recommend that the client meet with a lactation consultant.
  23. Provide the client with literature on the benefits of breastfeeding. Correct Answer: 3
  24. This action does not explore the client's reasons for wanting to stop breastfeeding.
  25. This action ignores the client's desire to stop breastfeeding and does not provide support.
  26. It is the practical nurse's responsibility to support the client in her decision-making and promote her self-confidence. The client may still change her mind at a later time.
  27. This action ignores the client's desire to stop breastfeeding.
  28. In preparing the newborn for discharge, the practical nurse notices that the baby is jaundiced. What strategy should the practical nurse teach Mrs. Tang to address this concern?
  1. Supplement with sterile water between feedings.
  2. Feed the newborn a minimum of every 4 hours.
  3. Feed the newborn whenever she demands.
  4. Supplement with glucose water between feedings. Correct Answer: 2
  5. Supplementation with sterile water or glucose water causes bilirubin levels to rise even further.
  6. An adequate caloric intake is necessary for formation of hepatic binding proteins. The jaundiced newborn is likely to be lethargic and should be awakened for feedings.
  7. Baby may be lethargic and have no interest in feeding. Little or no intake would cause the bilirubin level to rise even further.
  8. This is an appropriate intervention but not the best. Case # Mrs. Burke, 26 years old, had a spinal cord injury at the T5 level 8 weeks ago and has been transferred to the rehabilitation unit. She has an indwelling urinary catheter.
  9. Mrs. Burke states that she has had some episodes of diarrhea as well as constipation. What action should the practical nurse take first?
  10. Prepare to perform a digital rectal exam.
  11. Consult the dietician to increase Mrs.Burke's fibre intake and add prune juice to her diet.
  12. Place an incontinence product on Mrs. Burke.
  13. Review with Mrs. Burke her bowel movement elimination pattern and ask for her last documented bowel movement. Correct Answer: 4
  14. There is no indication that the client is impacted with stool; therefore, this procedure is not warranted at this time.
  15. This is not the most appropriate action until bowel function is assessed.
  16. This does not address the Clint's concern.
  17. This is the most appropriate action because it is necessary to complete an assessment in order to determine her current bowel function.
  18. Mrs. and Mr. Burke tell the practical nurse that they would like to become pregnant but are unsure if this is possible due to Mrs. Burke's spinal cord injury. What information should the practical nurse share with the couple?
  19. The only way for Mrs. Burke to become pregnant is by in vitro fertilization.
  20. Mrs. Burke may experience a higher incidence of complications during pregnancy and delivery.
  21. Mrs. Burke's ability to reproduce is unaffected by her injury.
  22. If pregnancy occurred, a Caesarean section would be required. Correct Answer: 2
  23. Sexual activity and conception is possible for clients with a spinal cord injury.
  24. The couple should understand that pregnancy can be dangerous for Mrs. Burke and the practical nurse should refer them to an expert.
  1. Conception and pregnancy will be impacted; however, it is possible for her to become pregnant.
  2. A spinal cord injury does not effect the ability to become pregnant or to deliver normally.
  3. Mrs. Burke has skin breakdown on her coccyx. She rarely rings for assistance in repositioning and sits for prolonged periods in her wheelchair. What should the practical nurse do initially?
  4. Ensure the Mrs. Burke understands the importance of relieving pressure to reduce risk of skin breakdown.
  5. Make a note on the chart to reposition Mrs. Burke every 2 hours to prevent pressure on the coccyx.
  6. Cleanse the coccyx with sterile water and place a sterile dressing over the broken skin.
  7. Recommend that Mrs. Burke remain in bed until her coccyx is completely healed. Correct Answer: 1
  8. It is important to provide the client with the information to assume responsibility for her health.
  9. This action does not involve the client or address knowledge deficit.
  10. This action does not address the cause of the problem.
  11. This action does not address the cause of the problem and may further increase risk for skin breakdown and other complications.
  12. Mrs. Burke tells the practical nurse that she suddenly has a headache and feels nauseous. She is diaphoretic and her face is flushed. Mrs. Burke's blood pressure is assessed and is now significantly elevated. What should the practical nurse do next?
  13. Check Mrs. Burke's temperature, heart rate and respiration and administer a prn analgesic.
  14. Reassess Mrs. Burke's vital signs and assess the urinary drainage system.
  15. Place Mrs. Burke in the Trendelenburg position and administer antiemetic medication.
  16. Perform a neurological assessment prior to notifying the physician. Correct Answer: 2
  17. This is inappropriate because it does not identify the cause of autonomic dysreflexia.
  18. Mrs. Burke is presenting with manifestations of autonomic dysreflexia which can be fatal if the triggering stimulus is not removed as quickly as possible.
  19. This is inappropriate because the client should be placed in a sitting position to lower blood pressure.
  20. A neurological assessment may not identify the cause of the autonomic dysreflexia. Case # Mr. Sutherland, a 34-year-old obese Aboriginal man, has recently been diagnosed with type 2 diabetes and requires diabetes education.
  21. The practical nurse is explaining the goals of diabetes management and prevention complications. What should the practical nurse do first in order to develop an individualized plan of care for Mr. Sutherland?
  22. Provide knowledge related to the disease process.
  1. Teach about disease processes and therapeutic management.
  2. Reassure him that he will be able to manage his own care.
  3. Assess health literacy to ascertain his understanding. Correct Answer: 4
  4. Although this is an appropriate nursing action, the client's ability to understand the information should be assessed first.
  5. Although this is an appropriate nursing action, the client's ability to understand the information should be assessed first.
  6. Although this is an appropriate nursing action, the client's ability to understand the information should be assessed first.
  7. Individuals with marginal health literacy may have difficulty to read and interpret directions.
  8. The physician's order reads intermediate-duration NPH (novolin ge NPH) 36 units with regular insulin 12 units subcutaneously. What process should the practical nurse use?
  9. Inject 36 units of air into the insulin NPH followed by 12 units of air into the regular insulin, invert the vial and withdraw the regular insulin.
  10. Inject 12 units of air into the regular insulin followed by 36 units of air into the insulin NPH, invert vial and withdraw insulin NPH.
  11. Withdraw 12 units of regular insulin followed by withdrawal of 36 units of insulin NPH.
  12. Withdraw 36 units of insulin NPH followed by withdrawal of 12 units of regular insulin. Correct Answer: 1
  13. This is the correct sequence to use when mixing an intermediate-duration insulin.
  14. The syringe should always be filled with rapid or short acting insulin firs to prevent contamination of the rapid or short acting insulin with intermediate duration or long acting insulin.
  15. This is not the correct sequence because air was not injected.
  16. This is not the correct sequence because air was not injected.
  17. Mr. Sutherland's nursing diagnosis is powerlessness related to perceived lack of personal control over his health. How can the practical nurse involve him in developing and prioritizing his plan of care to promote his self-care and wellness?
  18. Provide written material describing strategies other people with diabetes have used successfully.
  19. Create a plan of care to help manage the client's diabetes.
  20. Develop an information booklet on signs of hyperglycemia to which the client may independently refer.
  21. Assist the client to specify his health goals and then prioritize those goals with regard to his immediate concerns. Correct Answer: 4
  22. The client is not involved in this intervention.
  23. Creating a plan of care to help manage diabetes does not provide the client the opportunity to be a part of his health care. The practical nurse needs to tailor any plan of care with input from

the client.

  1. The client is not involved in the intervention.
  2. It is important to establish goals that are valuable and realistic to the client. Accomplishing personal goals will enhance self-efficacy. Case # Mrs. Henderson, 45 years old, diagnosed with multiple sclerosis has been admitted to a long- term care facility because her husband is not able to cope with her care at home.
  3. Mrs. Henderson has a history of frequent urinary tract infections. What should the practical nurse do first?
  4. Insert an indwelling catheter.
  5. Offer cranberry juice.
  6. Assess urinary elimination patterns.
  7. Obtain a urine specimen. Correct Answer: 3
  8. There is no indication that there is a need for an indwelling catheter.
  9. Although this intervention may be appropriate, an assessment is needed at this Tim.
  10. This is the first step in assessment and may indicate whether a urinary tract infection is present.
  11. This is appropriate but would be done after assessing the client's voiding patterns.
  12. Mrs. Henderson's health rapidly declines, and she is no longer able to speak or swallow without choking. Her husband requests that tube feedings be started. There is an advance directive on her chart that states she does not want heroic measures. What should the practical nurse do?
  13. Support the husband's concerns and notify the physician.
  14. Explain to her husband that tube feedings will prolong her life.
  15. Remind her husband of the directive.
  16. Follow the advance directive as indicated. Correct Answer: 3
  17. This does not allow the advance directive as expressed by the client.
  18. This disregards the client's wishes as stated in the advance directive.
  19. This action advocates on behalf of the client's wishes not only on admission but on an ongoing basis.
  20. This is appropriate but disregards the husband's concerns.
  21. Mr. Henderson asks why his wife is rapidly becoming more debilitated. He states that her aunt has had this condition for years but is in better health than his wife. What is the practical nurse's best response?
  22. Discuss with Mr. Henderson further treatment options to slow the disease progression.
  23. Inform him that people with multiple sclerosis each have their own pattern of progression.
  24. Ask Mr. Henderson why he is concerned about his wife's condition.
  25. Explain to Mr. Henderson that intensive physiotherapy will improve his wife's condition.

Correct Answer: 2

  1. This does not address Mr. Henderson's question.
  2. Clinical manifestations vary according to areas of the central nervous system involved.
  3. Although this validates his concerns, it does not address the question.
  4. Physiotherapy may improve her condition but this is not a certainty. However, it would bot be intensive physiotherapy. Case # Ms. Moher, 20 years old, presents with a fever and sore throat. She is homeless, has bipolar disorder, uses street IV drugs and is hepatitis C positive. She is elated, easily distracted and disruptive and states that she is married to the Prime Minister. She has not taken her lithium (Lithane) in 4 months claiming she has been cured.
  5. Based on Ms. Moher's clinical presentation, what should the practical nurse do first?
  6. Refer Ms. Moher to a social worker to assist with housing.
  7. Inform Ms. Moher that she is not married to the Prime Minister.
  8. Request that the physician assess Ms. Moher's throat and begin antibiotic treatment.
  9. Discuss the importance with Ms. Moher of resuming her lithium. Correct Answer: 3
  10. Social situation is important but the fever and sore throat should be addressed first.
  11. While reality orientation is important, doing this initially may cause a lack of trust.
  12. While it is important to address the other concerns, Ms. Moher could have strep throat. The antibiotics can be working while the other issues are being addressed.
  13. While it is important to treat the bipolar disorder this is not a first priority.
  14. What should the practical nurse consider as the priority health teaching when Ms. Moher resumes her lithium?
  15. Encourage Ms. Moher to have her serum lithium level checked regularly.
  16. Ensure Ms. Moher is taking her lithium at the same time every day.
  17. Ensure Ms. Moher is taking her lithium after meals.
  18. Advise Ms. Moher to lower sodium intake while taking lithium. Correct Answer: 1
  19. Dosages may need to be altered to maintain a therapeutic level. Blood tests also conform compliance. Toxicity can also be determined by serum levels.
  20. While this can help sustain a balance in the blood stream it is not the priority.
  21. This is not an important priority when restarting lithium.
  22. Lowering sodium can increase the toxicity of the medication.
  23. What manifestations would indicate that Ms. Moher is in the manic phase?
  24. Distractibility, disruptive behaviour and fever.
  25. IV drug use, elated presentation and distractibility.
  26. Medication non-compliance, disruptive behaviour and distractibility.
  27. Distractibility, elated presentation and delusions of grandeur.

Correct Answer: 4

  1. Fever is not a manifestation of mania.
  2. IV drug use is not a manifestation of mania.
  3. Medication non-compliance is not specific to mania.
  4. These are all signs of mania.
  5. To prevent the spread of hepatitis C, what health teaching should the practical nurse provide to Ms. Moher?
  6. Use sterile needles and start oral contraceptives.
  7. Use condoms and avoid sharing needles.
  8. Abstain from drug use and sexual intercourse.
  9. Wash hands frequently and avoid touching blood products. Correct Answer: 2
  10. Oral contraception does not prevent the spread of hepatitis C.
  11. Both can help decrease the spread of hepatitis C.
  12. This is not realistic for someone who is 20 years old.
  13. Incorrect. While these measures reduce risk, they are not the best choice. Case # Mrs. Nicholson, an 80-year-old client with Parkinson's disease, is admitted to a nursing home. She is very unhappy about leaving her home. She has one daughter, Pam.
  14. Mrs. Nicholson asks the practical nurse to assist in arranging a religious ceremony for her in the nursing home. What should the practical nurse do to support Mrs. Nicholson?
  15. Suggest that she call her religious leader to arrange the ceremony.
  16. Call her daughter and inform her of her mother's request.
  17. Inform her that the religious ceremony should be performed in a place of worship.
  18. Offer to assist her in contacting someone to make the arrangements. Correct Answer: 4
  19. Mrs. Nicholson is asking for assistance to meet her needs.
  20. Mrs. Nicholson may not want her daughter involved in the process.
  21. This is judgmental.
  22. This meets and respects Mrs. Nicholson's religious needs and empowers her.
  23. Mrs. Nicholson offers the practical nurse $20 for being so kind and helpful. After thanking her, how should the practical nurse respond?
  24. Accept the money and donate it to charity.
  25. Refuse the money and explain that staff cannot accept money.
  26. Refuse the money and tell Mrs. Nicholson to buy something for herself.
  27. Accept the money and return it to her daughter. Correct Answer: 2
  28. This is unethical conduct because the practical nurse should not accept money from the client.
  29. This is proper ethical conduct and it will not negatively impact the therapeutic relationship

with her.

  1. This does not provide Mrs. Nicholson with a reason why the offer was declined.
  2. This is unethical because the practical nurse should never accept money from the client.
  3. During the admission procedure, Mrs. Nicholson states that she has frequent urinary tract infections (UTI's). What should the practical nurse recommend to Mrs. Nicholson to address her recurring infections?
  4. Drink more fluids, void frequently and maintain good hygiene.
  5. Take antibiotics and drink plenty of cranberry juice.
  6. Finish all her antibiotics and then collect a urine sample for analysis.
  7. Notify her physician about her recurrent UTI's. Correct Answer: 1
  8. These actions are preventative measures for UTI's.
  9. This helps treat UTI's, not prevent them; in addition antibiotics would need to be ordered by thee physician.
  10. This suggestion would not prevent recurring UTI's, but would evaluate the presence of a UTI.
  11. This action does not address the client's concern.
  12. During the initial interview, Pam is very frustrated and angry. How should the practical nurse best respond to Pam's behaviour?
  13. Suggest that Pam tour the facility while the practical nurse talks to her mother.
  14. Listen to Pam's concerns and report her behaviour to the supervisor.
  15. Explain to Pam that her behaviour is further upsetting her mother.
  16. Ask Pam what suggestions she has to help plan her mother's care. Correct Answer: 4
  17. This may alleviate the practical nurse's stress but does not address the problem.
  18. The practical nurse realizes that Pam is under stress but reporting her behaviour to the supervisor does not help Pam.
  19. This would make Pam feel more inadequate and helpless and would inflame the situation.
  20. This gives Pam a chance to aid in her mother's care. Involving Pam in planning the care may alleviate her guilt somewhat. Case # Ms. Slater, 35 years old, cut her toe with a gardening tool 3 days ago. She is admitted for IV antibiotic therapy after wound and blood cultures are taken.
  21. What manifestations would indicate that Ms. Slater has a systemic infection?
  22. White blood cell counts within normal range and red streaking from injury to ankle.
  23. Decreased red blood cell counts and decreased heart rate.
  24. White blood cell counts elevated and increase in heart rate.
  25. Decreased red blood cell counts and increase in temperature. Correct Answer: 3
  26. WBC count would bot be normal in systemic infection.
  1. Heart rate would not be decreased in an infection.
  2. Systemic response impacts vital signs, and WBC count is abnormal.
  3. Decreased RBC count is a sign of anemia and many other disorders, but not infection.
  4. Ms. Slater is to receive 100 mL of normal saline with 1g of the prescribed antibiotic over 20 minutes via IV pump. At what rate should the practical nurse program the pump to deliver the medication as ordered?
  5. 10 mL per hour
  6. 30 mL per hour
  7. 200 mL per hour
  8. 300 mL per hour Correct Answer: 4
  9. IV pumps are programmed in mL per hour; 10 mL per hour/60 minutes X 20 minutes = 3. mL of normal saline.
  10. IV pumps are programmed in mL per hour; 30 mL per hour/60 minutes X 20 minutes = 10 mL of normal saline.
  11. IV pumps are programmed in mL per hour; 200 mL per hour/60 minutes X 20 minutes = 66. mL of normal saline.
  12. IV pumps are programmed mL per hour; 300 mL per hour/60 minutes X 20 minutes = 100 mL. This will deliver the right amount.
  13. Ms. Slater is being discharged later today with a prescription for oral Penicillin V. What should the practical nurse teach her prior to discharge?
  14. Discontinue when symptoms resolve.
  15. Take entire prescription.
  16. If experiencing heartburn, take antacids.
  17. Birth control pills reduce effectiveness of oral antibiotics. Correct Answer: 2
  18. If the medication is discontinued when the symptoms resolve, the infection may not have resolved and the symptoms could return.
  19. The client should be taught to take the entire prescription of antibiotics.
  20. Antacids may decrease the absorption of Penicillin V.
  21. Many antibiotics can interfere with the action of birth control pills. Case # Mrs. Matiko, 72 years old, is diagnosed with right-sided heart failure. She reports swollen feet.
  22. What other manifestations would the practical nurse expect?
  23. Nausea, ascites, and a distended jugular vein.
  24. Cyanosis, hemoptysis and activity tolerance.
  25. Oliguria, loss of vascular tone and hypotension.
  26. Hypotension, warm flushed skin and confusion.

Correct Answer: 1

  1. These are manifestations of right-sided heart failure.
  2. These are the clinical manifestations associated with left sided heart failure.
  3. These are manifestations commonly associated with shock.
  4. These are manifestations commonly associated with shock.
  5. When answering the call bell, the practical nurse notices that while Mrs. Matiko is supine with her legs elevated to decrease edema, she is also experiencing dyspnea. What should the practical nurse do first?
  6. Document the clinical finding.
  7. Call the physician to reassess her as soon as possible.
  8. Assess vital signs including oxygen saturation.
  9. Assist Mrs. Matiko into a high Fowler's position. Correct Answer: 4
  10. This would be done after elevating the bed and assessing the client.
  11. This would be dine after elevating the bed and assessing the client.
  12. This would be dine after elevating the bed and assessing the client.
  13. The first nursing action is to decrease venous return and improve the client's ventilation.
  14. The physician has ordered digoxin. What is the primary action of this medication?
  15. To decrease the preload pressure on the heart muscle.
  16. To stimulate the distal tubule of the kidney to excrete fluid.
  17. To improve the strength and contraction and slow the heart.
  18. To increase vasodilation in the heart muscle. Correct Answer: 3
  19. Digoxin does not affect the preload pressure on the heart.
  20. Digoxin does not work on the tubules of the kidney.
  21. The main effect is to increase the contractility of the heart.
  22. This is not the primary action digoxin.
  23. The physician has also ordered hydrochlorothiazide 25mg oral, daily. What potential adverse effect should the practical nurse monitor when Mrs. Matiko is taking this medication?
  24. Increased hearing loss.
  25. Increased potassium levels.
  26. Orthostatic hypotension.
  27. Osteoporosis. Correct Answer: 3
  28. This medication does not cause ototoxicity.
  29. This medication causes hypokalemia.
  30. This is a common side effect. This client should rise slowly from laying to sitting to standing.
  31. This medications protects against post-menopausal osteoporosis.

Case # Christine, a 17-year-old primipara, gave birth to a girl yesterday whom she is breastfeeding. She lives alone and states that her friends, who are currently visiting, are her only support. She will be discharged home with her baby tomorrow.

  1. What stage is Christine according to Erikson's theory?
  2. Identity vs. role confusion
  3. Intimacy vs. isolation
  4. Generativity vs. stagnation
  5. Ego integrity vs. despair Correct Answer: 1
  6. The stage for those between 11-21 years of age is identify vs. role confusion.
  7. According to Erikson's theory, intimacy vs. isolation is the stage for adolescence: 12-18 years of age (???).
  8. According to Erikson's theory, generativity vs. stagnation is the stage for middle adulthood: 35 - 65 years of age.
  9. According to Erikson's theory, ego integrity vs. despair is the stage for old age: 65 years and older.
  10. Christine says that she has cared for children before and can look after her newborn. How should the practical nurse best identify her learning needs?
  11. Ask Christine to write out a list of questions to identify her needs regarding care for her newborn.
  12. Wait for Christine's friends to leave and then giver her some pamphlets and videos.
  13. Ask Christine's friends to leave and then give her some pamphlets and videos.
  14. Incorporate teaching in small segments while observing Christine handle and interact with her newborn. Correct Answer: 4
  15. Despite having previously cared for children, Christine may bot be able to identify areas in which she requires further teaching and knowledge.
  16. Despite having previously cared for children, teenagers may have a knowledge deficit relating to care of a newborn and postpartum self-care.
  17. Peer groups are very important to teenagers. IF her friends are her support group, they should be included in the teaching.
  18. The amount of postpartum teaching that is required is overwhelming to many new mothers. Breaking it into smaller segments makes it easier to retain.
  19. What is the priority nursing diagnosis for Christine?
  20. Knowledge deficit related to newborn care.
  21. Risk for altered parent/newborn attachment related to client age.
  22. Risk for ineffective health maintenance related to client age.
  23. Effective breastfeeding as evidenced by infant weight gain.

Correct Answer: 1

  1. Christine is a primipara with a limited support group.
  2. There is no evidence to support this diagnosis.
  3. There is no evidence to support this diagnosis.
  4. Infants lose weight after birth.
  5. What strategies should the practical nurse include in order to ensure that Christine's health teaching needs are met?
  6. Complete as much teaching as possible while including Christine's friends.
  7. Wait for Christine's friends to leave so as not to embarrass her in front of them.
  8. Provide Christine with community resource pamphlets.
  9. Have the public health nurse follow up with Christine to complete the teaching at home. Correct Answer: 1
  10. Peer groups are very important to teens and Christine's friends are her support group.
  11. Peer groups are very important to teens and Christine's friends are her support group.
  12. Peer groups are very important to teens and Christine's friends are her support group.
  13. Peer groups are very important to teens and Christine's friends are her support group. Case # Mrs. Dennis, 68 years old, is a widow who is morbidly obese. She is admitted with a diagnosis of a urinary tract infection. She has had an extended stay in hospital, and her condition has deteriorated. She is now reluctant to weight-bear and is incontinent.
  14. Mrs. Dennis has developed a pressure ulcer on her coccyx. What short-term goal should the practical nurse establish to manage the client's pressure ulcer?
  15. Regain bladder function to eliminate incontinence.
  16. Adhere to strict caloric intake to facilitate weight loss.
  17. Prevent further deterioration of the pressure ulcer.
  18. Work with the client to increase standing tolerance. Correct Answer: 3
  19. It may not be possible for the client to regain bladder function in the short term.
  20. This responds to the issue of weight loss but would be a long-term goal.
  21. This is a realistic short-term goal for managing a pressure ulcer.
  22. Increased standing tolerance would be a long-term goal that may or may not have an immediate impact on the pressure ulcer. This would need to be done in collaboration with the physiotherapist.
  23. The physiotherapist has assessed Mrs. Dennis and recommended increased physical activity. How should the practical nurse develop a successful plan that will be maintained by the client?
  24. Recognize Mrs. Dennis' reluctance to ambulate and discuss any concerns she may have.
  25. Collaborate with the physiotherapist to develop arm exercises using weights that Mrs. Dennis can use at her bedside.
  26. Understand that morbid obesity contributes to decreased physical activity.
  27. Discuss the proposed plan with Mrs. Dennis and set a target date to begin implementation.

Correct Answer: 1

  1. The practical nurse must address the client's concerns; the client must feel safe to ambulate.
  2. This exercise may aggravate the pressure ulcer and does not address the need for increased ambulation.
  3. The practical nurse must take into consideration morbid obesity; however, it cannot be assumed that this is the reason the client is reluctant to ambulate.
  4. The client must be at a stage of readiness to change her behaviour.
  5. While the practical nurse is assisting Mrs. Dennis with her personal care, she begins to cry quietly and states "Look at what my life has become. My niece will not be able to care for me now and my husband is dead. How will I cope at home?" What should the practical nurse do?
  6. Ask Mrs. Dennis how she has been coping since her husband died.
  7. Explore Mrs. Dennis' feelings about her care needs.
  8. Meet with Mrs. Dennis' niece to discuss family dynamics.
  9. Comfort Mrs. Dennis and tell her that things have a way of working out. Correct Answer: 2
  10. Although this is potentially important ground to cover in the context of an interpersonal relationship, it does not address the current issue of coping at home.
  11. It is essential to explore and validate Mrs. Dennis' thoughts and feelings related to her care needs. This promotes therapeutic communication, trust and respect.
  12. This does not include the client or the health-care team in the collaboration.
  13. This provides false reassurance.
  14. Mrs. Dennis informs the practical nurse that she is not satisfied with the lunch provided and states, "I told the dietician that I do not have enough to eat." What should the practical nurse do?
  15. Reassure Mrs. Dennis that her caloric intake was sufficiently calculated by the dietician.
  16. Explain to Mrs. Dennis that she must follow the nutritional plan developed by the dietician.
  17. Inform the dietician that Mrs. Dennis is not satisfied with her lunch.
  18. Discuss the goal of wellness in order to assist Mrs. Dennis in evaluating her dietary choices. Correct Answer: 4
  19. This does not speak to maintaining wellness. This is a very clinical statement.
  20. This does not encourage collaboration or reinforce information.
  21. The practical nurse is not taking the opportunity to reinforce information.
  22. This option reinforces the partnership between health-care professionals and the client with the common goal of well-being for the client.
  23. The practical nurse overhears a colleague angrily respond to the client's call bell by stating, "Mrs. Dennis, you have just been up; it is not time for you to go again?" The colleague then leaves the unit to go on a break. What should the practical nurse do first?
  24. Assist Mrs. Dennis to the bathroom.
  25. Apologize to Mrs. Dennis for the colleague's behaviour.
  26. Answer the call bell the next time Mrs. Dennis rings.
  27. Confront the colleague in the break room.

Correct Answer: 1

  1. Mrs. Dennis' request to go to the bathroom requires immediate nursing action. Mrs. Dennis has impaired skin integrity; therefore, it is imperative that she be given excellent elimination care.
  2. Apologizing for the colleague's behaviour does not address the poor professional performance.
  3. This action ignores the client's immediate need for assistance.
  4. This does not address the client's immediate need. Case # The practical nurse is caring for 2-year-old Tanner who has a diagnosis of acute asthma exacerbation.
  5. What are the practical nurse's priority assessments?
  6. Urinary output, muscle tone and vital signs.
  7. Neurological status, chest sounds and urinary output.
  8. Hydration status, vital signs and chest sounds.
  9. Neurological status, hydration status and muscle tone. Correct Answer: 3
  10. Activity level and vital signs are important to monitor; output would not be a priority unless intake was diminished.
  11. Neurological changes are a late sign of worsening condition.
  12. Dehydration can occur quickly and cause thickening of mucous. Changes to vital signs and a detailed respiratory assessment are most important.
  13. Although hydration should be monitored and activity level may be impacted, neurological changes are a late sign of worsening condition.
  14. When the practical nurse enters the room, Tanner begins crying and clings to his mother. In order to administer a nebulizer, how should the practical nurse proceed?
  15. Restrain Tanner and instruct him to breathe deeply.
  16. Ask the physician for a sedative for Tanner to calm him down.
  17. Advise the mother to take Tanner onto her lap to administer the medication.
  18. Ensure Tanner stops crying before administering the medication. Correct Answer: 3
  19. This should be used as a last resort.
  20. Sedation is an excessive action and should not be used.
  21. This decreases fear and is appropriate given the growth and development of a 2-year-old child.
  22. According to the development milestones of a. 2-year-old, it is not possible to ensure the child will stop crying before administering the medication.
  23. Tanner is ready for discharge. What is the priority action to limit asthma exacerbations?
  24. Identify Tanner's asthma triggers.
  25. Improve air quality in the family home.
  26. Maintain a diary of asthma symptoms.
  27. Minimize outdoor activities.

Correct Answer: 1

  1. Identifying and avoidance will prevent further exacerbations.
  2. Although important, this is not the priority action. The practical nurse should begin with an assessment. This is an intervention.
  3. Although important, this is not the primary action. This is an intervention that reflects only symptoms not triggers.
  4. This intervention is not realistic given the growth and developmental needs of a 2-year-old child. In addition, Tanner's triggers may be indoors. Case # Mrs. Danielson, 24 years old, is 1 week postpartum. She lives with her husband and 2-year-old son. During her cesarean section, her bowel was accidentally perforated resulting in a colostomy that she will have for the next 6 months. Home care will be provided upon discharge.
  5. During the first home care visit, Mrs. Danielson is lying on the bed crying while her husband is caring for their infant and son. How should the practical nurse establish the nurse-client relationship?
  6. Acknowledge the client's emotions.
  7. Explore her treatment options and plans.
  8. Offer support and reassurance to the family.
  9. Ask the husband about her emotional health. Correct Answer: 1
  10. This is proper protocol to initiate a therapeutic environment.
  11. It is too soon to discuss the plan.
  12. This does not acknowledge the client's emotional state.
  13. The discussion should begin with the client.
  14. During the fourth visit, the practical nurse finds Mrs. Danielson alone in her room. Later her husband says she has been avoiding the children. What is the priority nursing diagnosis?
  15. Exhaustion related to low hemoglobin.
  16. Discomfort related to postoperative incision.
  17. Ineffective coping related to postpartum transition.
  18. Altered body image related to colostomy. Correct Answer: 3
  19. She is 2 weeks postoperative and should be more active.
  20. Although this may be true, it should not affect her relationship/interaction with her children.
  21. Apathy and lack of interest are early signs of postpartum depression.
  22. Although this may be true, it should not affect her relationship/interaction with her children.
  23. During wound care, the practical nurse has difficulty maintaining a seal on the colostomy because it is within 2.5cm of the surgical incision. What is the best course of action?
  24. Consult with enterostomal nurse to determine possible solutions.
  25. Place the flange over the surgical incision.
  1. Use extra tape for reinforcement.
  2. Cleanse the incision twice daily to avoid infection from the effluent discharge. Correct Answer: 1
  3. The practical nurse should collaborate with the enterostomal nurse to ensure best outcomes for the client. Moreover, this action supports critical thinking.
  4. This would increase the risk of infections and delay healing.
  5. This could work but may only be temporary, because it does not solve the problem.
  6. This is not best practice, nor does it solve the problem. Case # Ms. Karch, 60 years old, was admitted 5 days ago with abdominal pain and a diagnosis of diverticulitis and a bowel abscess. On admission, vital signs were T 36.5, HR 82, RR 18, and BP 120/64. She has been on analgesics, IV fluids and IV antibiotics since admission.
  7. Ms. Karch reports that her abdominal pain is increasing. Her vital signs are T 39.8. HR 110. RR 24 and BP 100/70. Her lung fields are clear on auscultation. What should the practical nurse do next?
  8. Obtain blood for a complete blood count and cultures.
  9. Notify the physician of the assessment findings.
  10. Administer acetaminophen as prescribed for the pain and fever.
  11. Perform an abdominal assessment and pain scale. Correct Answer: 4
  12. This is not a decision made by the practical nurse; obtaining blood requires an order.
  13. Further assessment should be done before notifying the physician.
  14. Further assessment should be done before treating pain and fever.
  15. The client shows signs of peritonitis and sepsis, a common complication of diverticulitis. Further assessment of her abdominal status is needed.
  16. The physician visits Ms. Karch and orders: full fluid diet, morphine 5-10mg IV every 4- 6 hours prn for pain, increase IV rate to 125 mL per hour and activity as tolerated. What order should the practical nurse question?
  17. Activity as tolerated
  18. Morphine
  19. Full fluid diet
  20. IV rate Correct Answer: 3
  21. This is an appropriate order. Activity should not be restricted.
  22. The narcotic dose is within normal range.
  23. With diverticulitis the goal is to rest the bowel; the client should receive nothing by mouth because she has signs of perforation.
  24. IV fluid is appropriate for hydration.
  1. Three days post-bowel resection and colostomy, Ms. Karch reports feeling tired and short of breath. Her HR is 88 and RR 24. On auscultation of the lungs, the practical nurse notices diminished air entry. What should the practical nurse do next?
  2. Check arterial blood gases.
  3. Notify the physician.
  4. Monitor oxygen saturation.
  5. Assess the abdominal wound. Correct Answer: 3
  6. This is not within the practical nurse's scope of practice.
  7. Further assessment should be done before notifying the physician.
  8. Clinical manifestations indicate possible postoperative pulmonary complications and hypoxemia.
  9. Clinical manifestations indicate a pulmonary problem, not a wound problem. Case # Mr. Miller, 56 years old, is scheduled for a laparoscopic cholecystectomy. He has been attempting to cut down on smoking in anticipation of his surgery.
  10. Mr. Miller's wife tells the practical nurse that, although the surgeon explained the procedure, her husband is still apprehensive about the surgery. What should the practical nurse do?
  11. Inform Mrs. Miller that client's tend to have positive outcomes from this surgery.
  12. Arrange for the surgeon to meet with Mr. Miller again to discuss his concerns.
  13. Explain the surgery and postoperative procedure to Mr. Miller again.
  14. Determine why Mr. Miller is apprehensive about the surgery. Correct Answer: 4
  15. This is false reassurance. Moreover, any communication should also involve the client.
  16. The practical nurse should investigate further to see what is causing this apprehension prior to contacting the surgeon.
  17. This is outside the practical nurse's scope of practice.
  18. This provides an opportunity to reinforce information given by the surgeon.
  19. What should the practical nurse do first when providing preoperative teaching to Mr.Miller?
  20. Explain to the client about the harmful effects of smoking and its impact on his health.
  21. Discuss the need to strictly follow a low-fat diet following his surgery.
  22. Instruct the client about deep breathing, coughing and the use of the incentive spirometer.
  23. Inform him that he will not be able to ambulate for 2 days after his surgery. Correct Answer: 3
  24. This is more appropriate later.
  25. This does not affect recovery.
  26. This will have an impact on his recovery because deep breathing and coughing promote optimal lung expansion and oxygenation after anesthesia.
  27. Although this is important, it is not the priority.
  1. Day 1 postoperatively, Mr. Miller reports slight pain in his right shoulder. How should the practical nurse respond?
  2. Call the surgeon immediately for orders.
  3. Administer an antacid to control heartburn.
  4. State that this a common side effect of laparoscopic surgery.
  5. Assure Mr. Miller that the pain is only temporary. Correct Answer: 3
  6. This would be an overreaction and is not the first action to take.
  7. Antacids will not be effective.
  8. This pain results from migration of carbon dioxide used to insufflate the abdominal cavity during the procedure.
  9. This does not address his concern
  10. Day 2 postoperatively Mr. Miller informs the practical nurse that he is nauseated and does not "feel well." What should the practical nurse do first?
  11. Assess Mr. Miller's vital signs and abdomen.
  12. Encourage him to ambulate.
  13. Administer a prn antiemetic.
  14. Encourage Mr. Miller to rest and eat ice chips. Correct Answer: 1
  15. The practical nurse must check for postoperative complications, including fever, nausea, abdominal pain or distention.
  16. Although ambulation is important, this is not a priority action.
  17. Prior to administering a medication, the practical nurse should complete a thorough assessment.
  18. The priority is to assess the cause of the manifestations.
  19. What is an important consideration for the practical nurse to discuss with Mr. Miller during discharge planning?
  20. He should avoid lifting heavy objects for 7-12 days.
  21. He should contact his physician if he develops abdominal discomfort.
  22. He should return to work in 6 weeks.
  23. He can resume normal activities 4 weeks following discharge. Correct Answer: 2
  24. This is the appropriate instruction for open incision cholecystectomy but not for laparoscopic cholecystectomy. He could resume usual activities sooner.
  25. Because of earlier discharge of laparoscopic clients, these symptoms may not occur until after discharge.
  26. He is able to return to work in 1 week.
  27. He could resume usual activities within 1 week. Case #16 Mrs. Koskella, 74 years old, has type 1 diabetes, is positive for methicillin-resistant

Staphylococcus aureus (MRSA) and had a previous cerebrovascular accident (CVA) with right- sided weakness. The client has an abdominal wound that requires a daily dressing change.

  1. After performing hand hygiene, what actions should the practical nurse take in preparing to change the client's dressing when the client is on contact isolation precautions?
  2. Apply mask, gown and non-sterile gloves and prepare equipment.
  3. Apply gown, mask and sterile gloves and prepare equipment.
  4. Gather supplies and apply gown and sterile gloves.
  5. Gather supplies and apply gown and non-sterile gloves. Correct Answer: 4
  6. The equipment must be gathered prior to donning personal protective equipment, and the gown is donned before the mask.
  7. The equipment must be gathered prior to donning personal protective equipment, and sterile gloves are not required.
  8. The gown is applied prior to the mask when donning personal protective equipment.
  9. This sequence is correct for donning personal protective equipment and gathering supplies prior to entering an isolation room.
  10. In addition to type 1 diabetes, what risk factors for wound healing should the practical nurse identify?
  11. Dehiscence and demographic information.
  12. Poor nutritional status and impaired mobility.
  13. CVA and increased weakness.
  14. Isolation and decreased activity. Correct Answer: 2
  15. Dehiscence is not a risk factor.
  16. Both are risk factors for wound healing.
  17. CVA is not a risk factor for wound healing.
  18. Isolation is not a risk factor for wound healing.
  19. What observations would the practical nurse document to support a nursing diagnosis of risk for depression?
  20. Right-sided weakness, anorexia and daily dressing changes.
  21. Type 1 diabetes, right-sided weakness and isolation precautions.
  22. 74 years of age, impaired mobility and glucometer testing.
  23. Decreased appetite, impaired wound healing and isolation precautions. Correct Answer: 4
  24. Daily dressing changes would not be a risk factor for depression.
  25. Type 1 diabetes would not be a risk factor for depression.
  26. Glucometer testing and age would not be risk factors for depression.
  27. This is a complete list of objective factors from the case that contribute to the nursing diagnosis of risk for depression.

Case #17 Tom, a 17-year-old, arrives at the clinic. He has been previously diagnosed with genital herpes. He states to the practical nurse, "It hurts when I urinate, and I've got sores on my penis and anal area."

  1. A urine specimen for culture and sensitivity is ordered. What should the practical nurse do to ensure that the specimen is free from external contamination?
  2. Wash the outside of the specimen container before sending it to the laboratory.
  3. Instruct Tom not to touch the inside of the container.
  4. Provide a clean container for the specimen collection.
  5. Have Tom place the tip of his penis on the edge of the container. Correct Answer: 2
  6. Washing the exterior of the container will do nothing to prevent contamination of the specimen inside the container.
  7. The inside of the container is sterile and touching it would introduce external contamination.
  8. A specimen for culture and sensitivity should be collected in a sterile container.
  9. By touching the side of the container with his penis, the client has contaminated the specimen.
  10. How should the practical nurse encourage Tom to assume responsibility for his own health?
  11. Assist Tom to identify healthy behaviours.
  12. Tell Tom that his lifestyle must be changed.
  13. Demonstrate to Tom how to use condoms.
  14. Help Tom identify the source of his condition. Correct Answer: 1
  15. Assisting Tom to identify responsible health behaviours allows him to have some control in his health care.
  16. Changing his lifestyle is important, but telling him what to do does not encourage him to be responsible for his own health.
  17. The use of a condom is only part of the information that the client needs to take responsibility for his own health.
  18. Identification of the source of his condition will not contribute to his taking responsibility for his own health.
  19. Tom states, "I don't want my parents to know." What should the practical nurse consider when responding to Tom?
  20. Tom's parents have a right to know his diagnosis.
  21. Visits to the clinic by minors must be reported to their parents.
  22. It is Tom's responsibility to inform his parents.
  23. Tom's physician will determine if the parents must be informed. Correct Answer: 3
  24. To protect client confidentiality, the client mist giver permission for any release of information.
  25. Telling the parents about the clinic visit violates confidentiality.
  1. Confidentiality is maintained because the client is giving out the information.
  2. To protect client confidentiality, the client must give permission for any release of information.
  3. Which of the following would indicate that Tom requires health teaching?
  4. He can tell when the infection is going to start again.
  5. He knows that even if he cannot see the sores, the condition is still there.
  6. He indicates that he must wash his hands after urinating.
  7. He verbalizes that he does not need to wear a condom in the absence of sores. Correct Answer: 4
  8. This statement demonstrates that Tom is aware of his body and the signs it gives of an impending reactivation of the virus. No learning is required.
  9. Knowing that the virus is still in his body, even though the lesions are gone, is important in the prevention of a further spread of the virus. No learning is required.
  10. Washing of the hands is the most effective method of preventing the spread of the virus. No learning is required.
  11. Herpes can still be active during the absence of sores and thus transmitted to others. Independent Questions
  12. Mr. Doucette, 77 years old, is admitted with severe abdominal pain that has lasted 1 week. He is lying on his left side and his face is tense. The practical nurse asks Mr. Doucette, "on a scale of 0 to 10, how would you rate your pain?" Which communication technique has the practical nurse used?
  13. Paraphrasing
  14. Open-ended question
  15. Closed-ended question
  16. Summarizing Correct Answer: 3
  17. The client has not verbalized anything.
  18. The open-ended question invites the client to describe the pain.
  19. The pain scale would describe the quality of the pain more effectively. This helps the client to describe his pain objectively. Closed-ended questions require a precise response.
  20. Summarizing is a technique used to bring closure to a conversation.
  21. Mr. Moncion, 65 years old, has pneumonia. What can the practical nurse suggest to facilitate clearing of respiratory secretions?
  22. Longer rest periods
  23. Pursed-lip breathing
  24. Increasing fluids
  25. Lying on the unaffected side Correct Answer: 3
  26. Activity is required to help facilitate movement of the secretions.
  27. This does not facilitate expectoration of the secretions.
  1. The increase in fluids helps aid the expectoration of secretions.
  2. The client should be moving about in bed and changing positions frequently.
  3. Mr. Wise, 63 years old, has been admitted with a diagnosis of myocardial infarction (MI). Two hours after admission, he asks the practical nurse if he can go outside to smoke. What should the practical nurse do?
  4. Obtain a nicotine patch for the client.
  5. Educate the client about the risk factors of smoking with a heart condition.
  6. Advise the client of the hospital's no smoking policy.
  7. Remind the client that the physician ordered bed rest. Correct Answer: 4
  8. Smoking cessation is indicated for cardiovascular health; however, this might not be the most appropriate time to commence smoking cessation options.
  9. This would not be the best time to do health teaching about smoking cessation options because the client has not identified a desire for education at this time.
  10. The client is not interested in the hospital's no smoking policy. He has asked to smoke outside.
  11. Initially, he will be on bedrest with a gradual increase in exercise according to client's tolerance.
  12. Mrs. Turcotte, 74 years old, had a left total hip replacement. The practical nurse notices that she is unsteady while using her walker. What should the practical nurse do?
  13. Request further instructions form the orthopaedic surgeon.
  14. Suggest that the client use a quad cane rather than a walker.
  15. Talk to a nurse manager for assistance in developing a plan.
  16. Discuss these observations with the physiotherapist. Correct Answer: 4
  17. The surgeon does not need to be directly involved in the rehabilitation process.
  18. This action requires consultation with the physiotherapist prior to recommending this to the client.
  19. Although the nurse manager may be able to help, the practical nurse should seek out a physiotherapist if possible.
  20. Physiotherapists are specialists in this area of client care.
  21. The practical nurse observes two colleagues arguing about client assignments. What should the practical nurse do?
  22. Direct them to draw up a schedule that has an equal number of clients.
  23. Let them resolve the situation and bring a new schedule to the next team meeting.
  24. Meet with them individually so their personal issues can be addressed.
  25. Mediate a session with both of them to discuss alternative scheduling. Correct Answer: 4
  26. This is not a person-centred approach.
  27. This is a laissez-faire approach. Unresolved conflict and a lack of communication in the workplace can lead to workplace incivility and can gave serious consequences.