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    Exam Review

    1. The practical nurse (PN) is caring for a client who has a prescription for loratadine by mouth daily as needed. Which sign indicates to the PN that there is a need to administer the medication?
      A)Ulceration on the corner of the upper lip.
      B)Ecchymosis and petechiae on the legs
      C)Red welts widespread over the chest.
      D)Red papules and pustules on the face.
    2. A client has a prescription for NPH insulin 25 units before breakfast and insulin aspart before meals and hour of sleep per sliding scale. The sliding scale parameters are:. 0 units for finger stick glucose less than 170 mg/dL;. 5 units for finger stick glucose 171 to 219 mg/dL;. 10 units for finger stick glucose 220 to 269 mg/dL;. 15 units for finger stick glucose 270 to 300 mg/dL. Call healthcare provider for finger stick glucose greater than 300 mg/dL. The client's 0730 finger stick glucose is 271 mg/dL. What is the total amount of insulin this client should receive? (Enter numeric value only.).
    3. At a prenatal visit, a primigravida client confides to the practical nurse (PN) that her partner is abusive. Which information should the PN provide?
      A)Safety plan to keep in a purse at all times.
      B)Paperwork needed to file a restraining order.
      C)Visit summary documenting the report of abuse.
      D)Contact information for a women's shelter.
      E)None
      F)None
    4. The practical nurse (PN) learns that a client who is receiving chemotherapy has developed stomatitis. Which information should the PN obtain from the client during a focused assessment?
      A)Urinary output.
      B)Blood pressure while standing.
      C)Ability to swallow.
      D)Frequency of bowel movements.
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    Exam Review

    1. In assessing a 2-year-old boy with croup, the practical nurse (PN) finds that he has become increasingly irritable and has developed tachypnea and resting stridor. Which intervention is best for the PN to implement?
      A)Instruct the mother to play with the child for stimulation and distraction.
      B)Administer a dose of acetaminophen as needed.
      C)Monitor the child's oxygen saturation level via pulse oximetry.
      D)Encourage the child to drink adequate amounts of fluids.
    2. The practical nurse (PN) determines that a client's pupils constrict as they change focus from a far object to a near object. How should the PN document this finding?
      A)Peripheral vision intact.
      B)Nystagmus present with pupillary focus.
      C)Consensual pupillary constriction present
      D)Pupils reactive to accommodation
    3. Prior to giving digoxin, the practical nurse (PN) assesses that a 2-month-old infant's heart rate is 120 beats/minute. Based on this finding, which action should the PN take?
      A)Hold the medication and recheck the heart rate in l hour.
      B)Administer the medication and document the heart rate.
      C)Administer the medication and alert the charge nurse.
      D)Hold the medication and document cardiac assessment.
    4. The practical nurse (PN) is providing care for a client who is ordered nothing by mouth (NPO) after a small bowel resection. The client's nasogastric (NG) tube is connected to low intermitent suction. The client reports dizziness and tingling in digits. Which assessment finding by the PN should be reported to the healthcare provider?
      A)Hyperactive bowel sounds on assessment.
      B)Heart rate of 90 beats per minute with premature ventricular contractions (PVCs) noted on telemetry.
      C)Hypoactive bowel sounds on assessment
      D)Regular heart rate of 100 beats per minute on telemetry
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    Exam Review

    1. A 15-year-old adolescent male with a mild mental disability is hospitalized for minor surgery and tells the practical nurse (PN), "Wow! You have big breasts." Which response is best for the PN to provide?
      A)The size of my breasts is of no concern to you.
      B)That language is not allowed.
      C)Do you really think so?
      D)If you talk like that again, I will tell your parents.
    2. The practical nurse (PN) is making a home visit to an older male adult who was recently diagnosed with Herpes zoster (shingles). The client reports the onset of severe burning pain along the right side of his trunk. What action should the PN take?
      A)Administer a prescribed PRN dose of analgesic.
      B)Obtain an oxygen tank for home administration.
      C)Give the next prescribed dose of antiviral medication.
      D)Notify the nursing supervisor of the uncontrolled pain.
    3. A client who had knee replacement surgery receives a prescription for enoxaparin 30 mg subcutaneously every 12 hours for 10 days. The medication is available in 30 mg per 0.3 mL prefilled syringes. How many mL should the practical nurse (PN) administer each day? (Enter numerical value only.).
    4. A client who is in active labor is admitted with her cervix dilated to 3 cm with 50% effacement and the presenting part at 0 station. An hour later, she tells the practical nurse (PN) that she wants to go to the bathroom to empty her bladder. The nurse examines the client again and determines her vaginal exam is unchanged. Which action should the PN implement?
      A)Review the fetal heart rate pattern.
      B)Obtain a straight catheter kit to empty her bladder.
      C)Check perineum for changes in "show”. or discharge.
      D)Assist the client up to the bathroom.
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    Exam Review

    1. The unlicensed assistive personnel (UAP) reports to the practical nurse (PN) that a male clientwith fluid volume overload will not allow the UAP to obtain his daily weight. Which action should the PN implement?
      A)Include "Noncompliance”. as a priority problem in the client's plan of care.
      B)Advise the UAP to re-attempt the daily weight after the client eats breakfast.
      C)Consult with the client about the reasons for his refusal to be weighed
      D)Calculate the client's weight based on the 24-hour fluid intake and output.
    2. Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?
      A)White blood cell count (WBC).
      B)Serum creatinine.
      C)Hemoglobin and Hematocrit.
      D)Serum calcium
    3. The healthcare provider prescribes cefazolin 500 mg IM every 6 hours. The available vial is labeled, "Cefazolin 1 gram,”. and the instructions for reconstitution state, "For IM use, add 2.5 mL sterile water for injection to provide a total volume of 3.0 mL.”. After reconstitution, how many mL should be administered to the client? (Enter numeric value only. If rounding is required, round to the nearest tenth.). [No changes needed].
    4. The practical nurse (PN) is providing instructions to the unlicensed assistive personnel (UAP) preparing to give a total bed bath to an immobile client who has continuous feeding via a gastrostomy tube (GT). Which instruction is most important for the PN to emphasize?
      A)Report any drainage observed around the GT insertion site.
      B)Use plenty of pillows to position the client on the side after bathing.
      C)Keep the head of the bed raised while the tube feeding is infusing.
      D)Raise the entire bed while bathing the client to reduce back strain.
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    Exam Review

    1. A client with diabetic ketoacidosis (DKA) is receiving regular insulin. Which action should the practical nurse (PN) implement to evaluate the effectiveness of the insulin dosage?
      A)Smell the client's breath for resolution of a fruity odor.
      B)Determine the client's orientation to time and space.
      C)Measure the client's urinary output for an increased volume.
      D)Check fingerstick blood glucose for a decrease in the level.
    2. A new unlicensed assistive personnel (UAP) is completing an orientation assignment and is caring for an immobilized client who needs a complete bed bath. Which is the best way for the practical nurse (PN) to evaluate this UAP's performance?
      A)Inspect the client's skin near the end of the bathing procedure.
      B)Verify with the client that the bath was complete and thorough.
      C)Request the UAP to report and chart when the bath is complete.
      D)Ask another UAP to help the orientee ensure satisfactory care.
    3. Chest x-ray: Consolidation in the right lower lobe consistent with pneumonia Review H and P, nurse's notes, flow sheet, doctor's order, and Imaging studies. What statements indicate the client's confusion is resolving? Select all that apply.(SATA)
      A)Asks how long he has been in the hospital
      B)Drinking broth
      C)States he is hungry
      D)Clawing at the air
      E)Keeps trying to get out of bed to find the swimming pool
      F)Recognizes his daughter
      G)Oriented to time, place, and self
      H)Oxygen saturation on 0.5L of 100%
    4. A college student brings his roommate to the clinic because the roommate has been talking to someone who is not present. The student tells the practical nurse (PN) that his roommate is acting strange. Which question should the PN ask the client next?
      A)"Are you planning to obey the voices?"
      B)"Have you taken any hallucinogens?"
      C)"When did these voices begin?"
      D)"Do you believe the voices are real?"
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    Exam Review

    1. Which intervention is the most important for the practical nurse (PN) to implement when applying an ice pack to a client?
      A)Wrap the bag in place for comfort.
      B)Secure a protective cover over the bag.
      C)Give directions to leave the pack in place.
      D)Fill the ice pack with crushed ice
    2. The practical nurse (PN) is caring for a client with coronary artery disease who is admitted with intermittent chest pain. The admission laboratory results indicate elevations in troponin I and creatine phosphokinase myoglobulin isoenzyme (CK-MB) levels. What should the PN consider the most significant risk for this client on the second day of admission?
      A)The lab results indicate risk factors for transient ischemic attack (TIA), and neurological vital signs should be monitored.
      B)The lab results indicate myocardial damage, and the client is at risk for cardiac dysrhythmias.
      C)The client is at risk for pulmonary embolism, and lifestyle modifications need to be implemented.
      D)The client is at risk for recurrent long-term angina pain and subsequent myocardial infarction (MI).
    3. A male client tells the practical nurse (PN) that the pill he has been taking at home is a different color and size than the one the PN is trying to give him now. How should the PN respond?
      A)Explain that the healthcare provider probably prescribed a different medication while he is hospitalized.
      B)Tell the client that he is probably confused since being hospitalized tends to disorient clients.
      C)Tell the client that the PN will verify that the dispensed medication is the valid prescription.
      D)Explain that the pharmacy often substitutes generic equivalents for more expensive brands.
    4. Which intervention is most important for the practical nurse (PN) to implement for a client who is receiving total parenteral nutrition (TPN)?
      A)Collect fingerstick glucose levels.
      B)Implement bleeding precautions.
      C)Obtain daily weights.
      D)Check urine for albumin.
      E)Check urine for albumin.
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