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    Exam Review

    1. A client admitted with chronic pulmonary obstruction disease (COPD) exacerbation is receiving assisted ventilation with a positive airway pressure (CPAP). The clients vital signs are an oral temperature 98.8 °F (37.1 °C) a respiratory rate of 46 breaths/minute, and a blood pressure of 176/92 mm Hg. While completing the pulmonary assessment, the client's oxygen saturation reading is 78% and he is difficult to arouse. Which action should the nurse implement?
      A)Increase the oxygen delivery by 10%.
      B)Administer PRN nebulizer treatment.
      C)Complete neurological assessment.
      D)Prepare for rapid sequence intubation.
    2. A client who is receiving a statin medication reports the onset of muscle soreness and fatigue, and the practical nurse (PN) notes that the client's skin is warm to the touch. Which action by the PN takes priority?
      A)Monitor the client's serum lipid levels.
      B)Encourage the client to drink fluids.
      C)Report the findings to the charge nurse.
      D)Administer a PRN dose of acetaminophen.
    3. The practical nurse (PN) is removing the personal protective equipment (PPE) worn when caring for a client. Which PPE should be removed first?
      A)Gloves.
      B)Cap.
      C)Face mask.
      D)Disposable gown.
    4. A client who is receiving chemotherapy has developed stomatitis. Which instruction should the practical nurse (PN) provide the unlicensed assistive personnel (UAP) who is assisting with the care of this client?
      A)Provide gentle and meticulous mouth care.
      B)Keep the room environment free of unpleasant odors.
      C)Assist the client with feeding at meal times.
      D)Gather supplies for protective environment precautions.
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    Exam Review

    1. A client is seen in the clinic after a failed in-vitro fertilization. Which nursing problem has the highest priority?
      A)Impaired verbal communication.
      B)Ineffective individual coping.
      C)Altered sexuality patterns.
      D)Impaired social isolation.
    2. The practical nurse (PN) identifies an electrolyte imbalance, a generalized edema, and a weight gain of 4.4 lbs (2 kg) in 24 hours for a client with chronic kidney disease. Which intervention in the plan of care should the PN implement?
      A)Encourage a low carbohydrate diet.
      B)Use a cushion when sitting.
      C)Perform range of motion exercises.
      D)Discuss a low sodium diet.
    3. While changing the dressing of a client who is immobile, the practical nurse (PN) observes a red and swollen wound with a moderate amount of yellow and green drainage and a foul odor. Before reporting this finding to the healthcare provider, the PN should evaluate which of the client's laboratory values?
      A)Serum blood glucose level.
      B)Culture for sensitive organisms.
      C)C-reactive protein level.
      D)Serum albumin.
    4. The practical nurse (PN) is caring for a client receiving chemotherapy who has thrombocytopenia. Which intervention is most important to include in the nursing plan of care?
      A)Watch the client for abnormal bleeding.
      B)Obtain the client's blood pressure frequently.
      C)Maintain protective isolation precautions.
      D)Observe for signs of dehydration.
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    Exam Review

    1. When caring for a child with sickle cell disease, the practical nurse (PN) expects that the child will most likely describe which symptom when experiencing a sickle cell crisis?
      A)Infection.
      B)Joint pain.
      C)Fatigue.
      D)Decreased hemoglobin.
    2. While assisting a client with acquired immunodeficiency syndrome (AIDS) with basic hygiene care, the practical nurse (PN) observes a small amount of blood on the sheets. Which action should the PN take?
      A)Rinse soiled linen with water before sending it to laundry.
      B)Place soiled linen in a leak-proof laundry bag.
      C)Send soiled linen to laundry in a red biohazard bag.
      D)Double bag soiled linen to be put in a biohazard box.
    3. Several residents of a long-term care facility are receiving eye drops to treat glaucoma. The practical nurse (PN) should caution the unlicensed assistive personnel (UAPS) caring for these clients to observe for which effect because it places the clients at risk for falls?
      A)Conjunctival redness.
      B)Elevated blood pressure.
      C)Pupillary constriction.
      D)Increased heart rate.
    4. An older adult client with cancer of the liver is in a hepatic coma and unresponsive. How should the practical nurse (PN) respond to family members who are inquiring about the condition of their loved one?
      A)Convey that their loved one's condition is very critical, and there has been no response in the last 24 hours.
      B)Relay that the nurses have not been able to arouse the client and the healthcare provider knows the outcome.
      C)Explain the client's extremely critical condition and ask if funeral arrangements have been made.
      D)Refer the family to the charge nurse to discuss the client's condition in a family conference.
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    Exam Review

    1. The nurse is very busy and running late with administering medications and asks the practical nurse (PN) to administer a medication already drawn up in an unlabeled syringe. How should the PN respond?
      A)"I am not comfortable doing that;. Is there something else I can do to help you?"
      B)"Teamwork is the best approach. I will be glad to help you get caught up."
      C)"You should know that I cannot administer the medication in this syringe."
      D)"As long as the charge nurse checks the syringe, I can give the medication."
    2. An elderly client is 12-hours postoperative for a hernia repair and suddenly becomes agitated, staggers out into the corridor, and demands to be set free. After assisting the client back to bed and administering pain medication, which intervention is best for the practical nurse (PN) to implement?
      A)Instruct a UAP to keep the upper side rails up and check on the client every 15 minutes until the client is resting.
      B)Administer a prescribed narcotic antagonist to reverse the effects of any analgesic accumulation.
      C)Notify the healthcare provider and request a prescription for restraints to minimize the client's danger to self.
      D)Raise the side rails and notify the family to come and stay until the client is reoriented and cooperative.
    3. The healthcare provider prescribed ear drops for a 5-year-old girl with otitis externa. Which technique should the practical nurse (PN) advise the mother to use when administering the ear drops?
      A)Gently pull the upper aspect of the ear lobe upwards and backwards.
      B)Gently pull the lower aspect of the ear lobe downwards and forward.
      C)Hold the upper aspect of the ear lobe downwards and against the skull.
      D)Instill one drop q5 minutes with the child in a Trendelenburg position.
    4. 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 of this client?
      A)What are the voices uttering?
      B)Which medication works best?
      C)When are the voices most disturbing?
      D)How does the client cope with the voices?
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    Exam Review

    1. The practical nurse (PN) is administering a subcutaneous injection of epoetin to a client with chronic kidney disease (CKD). This medication is being administered to treat which manifestation of chronic kidney disease (CKD)?
      A)Anemia.
      B)Edema.
      C)Hypertension.
      D)Anuria.
    2. A male client who is anxious and fearful removed his rebreather face mask. The mask now needs to be reapplied. Which action should the practical nurse (PN) take first?
      A)Request that a respiratory therapist come to the room.
      B)Secure the straps around each of the client's ears.
      C)Place mask over the bridge of the nose and then the mouth.
      D)Check that the reservoir bag inflates during exhalation.
    3. TIME INTAKE 0800 4 ounce apple juice 1200 8 ounces milk 4 ounces broth 1500 4 ounces tea A client remains on strict intake and output (I&O) on the first postoperative day and documents the last 8 hours of intake on the I&O bedside record above. How many mL will the nurse document in the client's electronic medical record (EMR)? (Enter numeric value only.)
    4. A client receives a prescription for dextromethorphan 30 mg every 6 to 8 hours PO as needed for cough. The bottle is labeled "Dextromethorphan for Oral Suspension, USP 30 mg per 15 mL." How many tablespoons should the nurse instruct the client to with each dose? (Enter numerical value only.)
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    Exam Review

    1. A practical nurse (PN) is caring for clients on a locked Alzheimer's unit. Which client situation requires the PN's immediate attention?
      A)Move the client who is knocking on the exit door and trying to get out.
      B)Remind a confused client of today's date and the time lunch will be served.
      C)Talk to a client who is wandering the halls looking in everyone's room.
      D)Assist a client who is lying on the dayroom floor to sit in the chair.
    2. The practical nurse (PN) observes that an unlicensed assistive personnel (UAP) is preparing to disconnect a client's IV tubing to remove the client's hospital gown during a bed bath. Which action should the PN implement?
      A)Remind the UAP to clean the ends of the tubing with an alcohol swab.
      B)Help the UAP disconnect the IV tubing to ensure sterility.
      C)Obtain a hospital gown with snap sleeves to put on the client.
      D)Demonstrate how to remove the client's gown without disconnecting the IV.
    3. The nurse is planning care for a client with chronic kidney disease who is a resident at a long-term nursing facility. The client is anuric and has hemodialysis 3 times a week. Which intervention should the nurse include in the client's plan of care?
      A)Initiate toileting schedule.
      B)Provide perineal skin barrier cream.
      C)Encourage intake of high potassium foods.
      D)Monitor for signs of anemia.
    4. A client receiving care on a palliative care unit is unable to swallow and is becoming dehydrated, which is exhibited by inelastic skin turgor and dry mucous membranes. Which action should the practical nurse (PN) implement to provide comfort?
      A)Apply warm cloths to the skin.
      B)Administer an as needed (PRN) analgesic.
      C)Provide oral care frequently.
      D)Elevate the extremities.
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