Question: The practical nurse (PN) is in charge of the evening shift of a 16-bed nursing home unit. Two unlicensed assistive personnel (UAP) are also assigned to the unit. Which factor is most important for the PN to consider when making assignments?
Answer Options: The UAP that the client compliments often. The UAPs’ preference for assignments. Who cared for which clients the evening before. Which UAP has had a day off most recently.
Answer: Who cared for which clients the evening before.
Question: In preparing a client for a lumbar puncture, which action should the practical nurse (PN) implement?
Answer Options: Apply a pulse oximeter to the client’s finger. Teach the client to cough and do deep breathing exercises. Assist the client to the bathroom to void. Ensure that the client has been NPO for six hours.
Answer: Assist the client to the bathroom to void.
Question: The practical nurse (PN) plans to insert a urinary catheter in a female client with Buck’s traction for a left hip fracture. To perform the catheterization, what action should the PN take?
Answer Options: Bend the unaffected leg while maintaining the affected leg in traction. Turn the client to the affected side and bend only the unaffected leg. Remove the traction and assist the client to bend both legs at the knees. Ensure that both legs remain straight and externally rotated.
Answer: Turn the client to the affected side and bend only the unaffected leg.
Question: An infant with developmental hip dysplasia is placed in a Pavlik harness, and the practical nurse (PN) reinforces teaching with the mother on how to care for her infant. In evaluating the mother’s learning, which information indicates that the mother understands proper care of her child?
Answer Options: The harness can be removed intermittently during the day. The harness straps should be adjusted to increase leg movement. The skin should be checked frequently for reddened areas. The harness straps should be placed next to the skin.
Answer: The skin should be checked frequently for reddened areas.
Question: When preparing a client for surgery, the practical nurse (PN) reviews the client’s chart and finds that there is no signature on the operative permit. What should the PN do first?
Answer Options: Take an operative permit to the client for signature. Ask a family member to sign the operative permit. Call surgery to report that no permit has been signed. Report to the charge nurse that no permit has been signed.
Answer: Report to the charge nurse that no permit has been signed.
Question: Penicillin 750,000 units IM is prescribed for a client with an infection. The vial contains 300,000 units/2 mL. How many mL should the practical nurse (PN) administer?
Answer Options: 2.5 mL 0.8 mL 5 mL 10 mL
Answer: 5 mL.
Question: A healthcare provider tells the practical nurse (PN) that a neighbor is a client on the unit and asks to review their medical record. How should the PN respond?
Answer Options: Ask the healthcare provider to review the medical record in a private location. Remind the healthcare provider that medical records are confidential. Show the healthcare provider where the medical records are kept. Obtain the medical record for the healthcare provider as requested.
Answer: Remind the healthcare provider that medical records are confidential.
Question: The practical nurse (PN) is taking the blood pressure of a client admitted with a possible myocardial infarction. When taking the client’s blood pressure at the brachial artery, the PN should place the client’s arm in which position?
Answer Options: At the level of the heart. At a level of comfort for the client. Below the level of the heart. Slightly above the level of the heart.
Answer: At the level of the heart.
Question: The practical nurse (PN) is caring for a client admitted to the hospital with heart failure exacerbation. The client is demonstrating wet lung sounds and 3+ dependent pitting edema. Which other parameters should the PN monitor to evaluate for fluid retention?
Answer Options: Pulse oximetry at rest and with supplemental oxygen. Telemetry monitoring for sinus tachycardia. Frequency of requests for pain medications. Weight gain of more than one pound per day.
Answer: Weight gain of more than one pound per day.
Question: A client is complaining of a tingling sensation in the fingers, nose tip, and earlobes 24-hours after a total thyroidectomy. The practical nurse (PN) should be prepared to implement what measure first?
Answer Options: Initiate prescribed L-thyroxine replacement therapy. Obtain prescribed calcium gluconate for tetany. Check for bleeding behind the neck and back. Prepare for emergency tracheotomy at the bedside.
Answer: Obtain prescribed calcium gluconate for tetany.
Question: The practical nurse (PN) applies a do not resuscitate (DNR) bracelet to a client’s wrist in accordance with the client’s advance directive and the prescription of the healthcare provider. The client asks the PN about the bracelet. Which action should the PN take?
Answer Options: Explain the purpose of the bracelet to the client. Remove the bracelet until the healthcare provider is available. Encourage the client to discuss his feelings about dying. Redirect the client’s attention to another topic.
Answer: Explain the purpose of the bracelet to the client.
Question: A client is admitted for observation after experiencing a transient ischemic attack (TIA). The practical nurse (PN) anticipates implementing care for which client problem?
Answer Options: Altered breathing patterns. High risk for infection. Ineffective airway clearance. High risk for injury.
Answer: High risk for injury.
Question: The practical nurse (PN) is administering warfarin to a client who has endocarditis. Which serum laboratory value should be assessed by the PN prior to administering the next dose?
Answer Options: Coagulation and bleeding times. Prothrombin time (PT). Partial thromboplastin time (PTT). Platelet count.
Answer: Prothrombin time (PT).
Question: The practical nurse (PN) is caring for a client on the first postpartum day after a normal vaginal delivery and finds the client’s fundus firm, three fingerbreadths above the umbilicus, and displaced to the right. What is the next intervention the PN should do?
Answer Options: Inspect the perineum for a hematoma. Encourage the client to empty her bladder. Massage the fundus for uterine atony. Administer a stool softener for constipation.
Answer: Encourage the client to empty her bladder.
Question: The healthcare provider prescribes 300 mg of a medication that is manufactured only in a 325 mg spansule. Which action should the practical nurse (PN) take?
Answer Options: Administer the 325 mg spansule. Calculate the portion of the spansule to be administered. Contact the healthcare provider to correct the prescription. Clarify the prescription with the charge nurse.
Answer: Contact the healthcare provider to correct the prescription.
Question: While changing the diaper of a 3-day-old baby girl, the practical nurse (PN) notices that the infant has a pinkish discharge that appears to be coming from the vagina. Which action should the PN take?
Answer Options: This is pseudomenstruation and no action is required. Keep the diaper so the healthcare provider can observe the discharge. Notify the charge nurse because the infant is menstruating. Report the parents to child protective services for child abuse.
Answer: This is pseudomenstruation and no action is required.
Question: The practical nurse (PN) is providing morning care for a comatose client and observes that the client’s corneal reflex is absent. Which action should the PN take?
Answer Options: Starting at the outer canthus, irrigate the eyes with sterile saline solution. Use paper tape and cotton balls to ensure that both eyes stay open. Obtain a prescription to administer artificial tear drops to each eye. Keep moisture away from the eyes when washing the client’s face.
Answer: Obtain a prescription to administer artificial tear drops to each eye.
Question: The practical nurse (PN) is assessing an 8-month-old who has a cough, auxiliary temperature of 100°F, and rhinorrhea. Which information is most important for the PN to obtain from this child?
Answer Options: Living conditions. Labor and delivery history of the infant. Alcohol and drug intake of the mother. Immunization status of the infant.
Answer: Immunization status of the infant.
Question: After report, the practical nurse (PN) receives the laboratory values for four clients. Which client requires the PN’s immediate intervention?
Answer Options: The client trembling and has a glucose level of 50 mg/dL. The client bleeding from a fingerstick and has a prothrombin time of 30 seconds. The client febrile and has a WBC count of 14,000/mm³. The client short of breath after a shower and has a hemoglobin of 8 grams.
Answer: The client trembling and has a glucose level of 50 mg/dL.
Question: Several children at a day camp return from playing in a tick-infested field. What action should the camp practical nurse (PN) take first?
Answer Options: Ask the children if they were using tick repellant. Encourage the children to lie down and rest quietly. Observe the children’s skin for attached ticks. Assess the children for the presence of a bull’s eye rash.
Answer: Observe the children’s skin for attached ticks.
Question: A client with obsessive-compulsive disorder (OCD) reports, “All these thoughts that stick in my mind and the rituals I use are stupid, but I cannot control them. People laugh at me, but they don’t understand how awful it is. I cannot hold a job, so I am a burden to my family. I do not know how much longer I can live this way.” Which question is most important for the practical nurse (PN) to ask this client?
Answer Options: “Have you been thinking about suicide as a way out of your distress?” “What makes you think people are laughing at you?” “Are the obsessions and compulsions interfering with your sleep?” “Have you lost weight due to the rituals that interfere with your eating?”
Answer: “Have you been thinking about suicide as a way out of your distress?”