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A client with acute pancreatitis should be NP...
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Section & Type of Question
Questions Time (mins) A–E
A Multiple Choice 20 30
B Short Answer 15 30
C Extended Response 4 50
D Challenge Section 2 10
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Directions to Students
Materials
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Ensure that you write your full name on the exam
Answer all questions in space provided
Erase all mistakes completely
,What intervention should the practical nurse (PN) implement to meet the physiologic
integrity of a
client during a manic episode of bipolar disorder?
A. Provide the client with finger foods.
B. Restrict the client's oral fluid intake.
C. Give the client low-protein, low-calorie snacks.
D. Interrupt the client's performance of rituals.
A. Provide the client with finger foods.
During the manic phase of bipolar disorder, a client is often unable to sit still long
enough to eat, so the
client should be provided finger foods that can be eaten while hyperactive.
A client with bipolar disorder is being treated with cognitive therapy. Which actions
should the practical
nurse (PN) implement to reenforce this treatment strategy? Select all that apply.
A. Recommend daily physical activity.
B. Use affirmations and limit setting.
C. Allow the client to talk continuously.
D. Report client's suicidal expressions to the therapist.
E. Encourage substituting positive thoughts for negative thoughts.
F. Reenforce relaxation techniques when experiencing negative thoughts.
B. Use affirmations and limit setting.
D. Report client's suicidal expressions to the therapist.
E. Encourage substituting positive thoughts for negative thoughts.
Clients diagnosed with bipolar disorder may experience depressive thoughts and/or
attempt suicide.
Cognitive therapy sometimes produces relief from troubling symptoms experienced by
clients with
bipolar disorder. Cognitive therapy allows clients to handle "thought errors" and
behaviors to stop
negative thoughts.
The practical nurse (PN) is evaluating a client's self management of type 1 diabetes
mellitus (DM). Which
findings provide the best parameter in the client's goals for the prevention of long-term
complications of
DM?
A. Strict adherence to a diabetic diet.
B. Participation in a regular exercise program.
C. Scheduled administration of accurate insulin doses.
D. Consistent hemoglobin A1c levels no greater than 7%.
D. Consistent hemoglobin A1c levels no greater than 7%.
For optimal diabetic control, evidence-based guidelines recommend an A1c target
level no greater than
7% for a client with DM, which is the primary goal and indicator of effective treatment
and diabetes
management.
Which action should the practical nurse (PN) implement for a young girl with
pulmonary infection who is
receiving chest physiotherapy?
A. Encourage to hold her breath and then cough.
B. Administer bronchodilators after the procedure.
C. Allow the child to sit in a position of choice.
D. Percuss the chest wall in a rhythmic fashion.
,D. Percuss the chest wall in a rhythmic fashion.
Thick secretions that are difficult to cough up can be loosened by tapping, or
percussing, and vibrating
the chest. Percussion is carried out by cupping the hands and lightly striking the chest
wall in a rhythmic
fashion over the lung segment to be drained
The practical nurse (PN) is preparing to administer erythromycin (Ilotycin) 0.5%
ophthalmic ointment to
a newborn. The father asks the PN the purpose of this medication. What rationale
should the PN
provide?
A. To allow the baby's eyes to focus.
B. To lubricate the baby's eyes.
C. To prevent infection in the baby's eyes.
D. Refer the father to the pediatrician.
C. To prevent infection in the baby's eyes.
Erythromycin is prescribed in the prophylaxis of ophthalmia neonatorum caused by
Neisseria gonorrhea
and Chlamydia trachomatis. The PN should explain the ointment is a prophylactic
treatment to prevent
infection in the baby's eyes.
A client's cardiac telemetry reveals sinus bradycardia at 40 beats/minute. An IV dose
of atropine is given
per protocol. Which finding should the practical nurse (PN) identify as a therapeutic
response?
A. A decrease in blood pressure.
B. A decrease in premature contractions.
C. An increase in heart rate.
D. An increase in sensorium.
C. An increase in heart rate.
Atropine increases heart rate (C) by its anticholinergic effects on the sinoatrial (SA)
node.
A client is admitted with a tumor of the hypothalamus. Which finding should the
practical nurse (PN)
report to the charge nurse?
A. A pulse rate of 98 beats/min.
B. Respirations of 20 breaths/min.
C. An oral temperature of 101.8° F.
D. A blood pressure of 130/80 mm Hg.
C. An oral temperature of 101.8° F.
The hypothalamus controls body temperature, so variation in the temperature should be
reported to
determine if the elevation is related to infection or cerebral pathology.
The practical nurse (PN) is reinforcing instructions to a client who is scheduled for a
bone marrow
aspiration. The PN should prepare the client for the procedure at which site?
A. The femur.
B. The scapula.
C. The antecubital fossa.
D. The posterior iliac crest.
D. The posterior iliac crest.
, Bone marrow samples are commonly aspirated from the posterior iliac crest or
sternum, which are
readily accessible obtaining a specimen of bone marrow via the biopsy needle.
Which discharge instructions should the practical nurse (PN) reinforce with a client
who has acute
cholecystitis?
A. Limit oral intake to three regular meals per day.
B. Drink fluids between meals rather than with meals.
C. Consume a low-fat diet in smaller, more frequent meals.
D. Limit dietary fat intake to 35% of the daily calorie intake.
C. Consume a low-fat diet in smaller, more frequent meals.
Clients with acute cholecystitis are placed on small, frequent low-fat meals to decrease
contraction of
the gallbladder, thus decreasing pain, nausea, and vomiting.
A male client draws back when the practical nurse (PN) reaches over the side rails to
take his blood
pressure. To promote effective communication, what should the PN do?
A. Continue to perform the procedure quickly and quietly.
B. Apologize for startling the client and explain the need for contact.
C. Tell the client that the blood pressure can be taken at a later time.
D. Rotate the nurses who are assigned to take the client's blood pressure.
B. Apologize for startling the client and explain the need for contact.
Nurses often have to enter a client's personal space to provide care, which requires
respect for the
client's privacy. Apologizing and explaining the need for contact demonstrates respect
and provides
information so the client may understand the need for personal contact.
A client with delirium is confused and disoriented to time and place. He states he is
experiencing visual
illusions and tactile hallucinations. What actions in the plan of care should the practical
nurse (PN)
implement? Select all that apply.
A. Interact in an energetic manner to dismiss misperceptions.
B. Provide a wide variety of environmental stimuli.
C. Give simple explanations about nursing care to be given.
D. Remove unnecessary furniture and equipment from the room.
E. Encourage self care to promote client independence.
F. Identify oneself each time the client is approached.
C. Give simple explanations about nursing care to be given.
D. Remove unnecessary furniture and equipment from the room.
F. Identify oneself each time the client is approached.
Explanations should be simple, concrete, and concise to ensure the client's
understanding and
cooperation. Simplifying the environment reduces the potential for sensory-perceptual
misinterpretations. The PN should introduce him- or herself with each client contact
when providing
nursing care.
Following a client's bladder surgery, the practical nurse (PN) notes that the ureteral
catheter is no longer
draining urine. What action should the PN implement?
A. Notify the healthcare provider immediately.
B. Change the client's position and continue to monitor.
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