Mosby's Comprehensive Review
Questions for the Canadian PN Exam
with Complete Solutions
21. Mr. Lewis reports that he takes a combination inhaler that contains a long-acting
beta2-agonist as well as a steroid. What is the therapeutic action of these two
medications?
1. The medications act in combination to decrease airway inflammation.
2. They work in combination to decrease airway bronchoconstriction.
3. They provide bronchodilation and reduced airway inflammation.
4. The two medications potentiate each other and provide longer-acting symptom
control. - ANSWER-3. They provide bronchodilation and reduced airway inflammation.
A 2-day-old 36-week gestation infant is receiving oxygen in the neonatal intensive care
unit. He is not able to tolerate oral feeds as yet. His mother is upset as she had planned
to breastfeed. What would be appropriate for the practical nurse to say to her?
1. "I will bring you the electric breast pump so that you may start pumping your breasts
for when your baby can start feedings."
2. "Your baby will probably need feeds through an intravenous infusion for several
weeks and perhaps after that you may be able to provide him with breast milk."
3. "It is best to give premature infants formula when they start feedings as the exact
amounts of milk can be determined."
4. "As soon as the baby is out of oxygen, you will be able to put him to breast." -
ANSWER-1. "I will bring you the electric breast pump so that you may start pumping
your breasts for when your baby can start feedings."
A 2-year-old child in respiratory distress has the following physician order: "Give oxygen
by face mask to keep the O2 saturation above 95%." The nurse notes that the oxygen
saturation has fallen to 80%. What should be the initial action by the practical nurse?
1. Double-check the order with the physician.
2. Administer additional oxygen.
3. Arrange for arterial blood gases to confirm the O2 saturation reading.
4. Perform a chest assessment. - ANSWER-2. Administer additional oxygen.
A 6-year-old has been admitted to the pediatric unit with a new diagnosis of type1
diabetes mellitus. The practical nurse is to health teach about monitoring blood glucose
levels. This health teaching needs to include:
1. Taking the blood glucose level is completed only once in the morning before
breakfast.
,2. The ideal blood glucose level is between 4 to 7 mmol/L.
3. Dietary restrictions need to be followed to keep the blood glucose levels low.
4. The child will need to monitor his or her own blood glucose levels at school. -
ANSWER-2. The ideal blood glucose level is between 4 to 7 mmol/L.
A child at the Tiny Tots daycare centre has been diagnosed with impetigo. What advice
should the practical nurse working at the daycare provide to the centre's child-care
workers?
1. Place the daycare centre under quarantine.
2. Close the daycare until complete cleaning has been performed.
3. No special precautions are required.
4. Suspend attendance for the infected child for 48 hours. - ANSWER-4. Suspend
attendance for the infected child for 48 hours.
Impetigo is an infection of the skin caused by Streptococcus or Staphylococcus bacteria
and is transmissible to other children. The child with impetigo must be isolated from
other children until 24-48 hours after treatment has started.
A client in the thoracic unit pulls out his right-side chest tube. What is the immediate
action by the practical nurse?
1. Place an occlusive dressing over the puncture site.
2. Call for the on-site physician.
3. Position the client on his right side.
4. Place a saline dressing over the exit site. - ANSWER-1. Place an occlusive dressing
over the puncture site.
A client is ordered 325 mg of acetylsalicylic acid (ASA) prn for headache. The practical
nurse is aware that this client is also receiving warfarin (Coumadin). Which of the
following is the most appropriate action to be taken by the practical nurse?
1. Contact the doctor for clarification of the orders.
2. Ask the client if he has taken Aspirin before while also taking Coumadin.
3. Contact the pharmacist about the potential drug interaction.
4. Consult with nursing colleagues about whether to give the ASA to the client. -
ANSWER-1. Contact the doctor for clarification of the orders.
A client is ordered venlafaxine (Effexor) for depression. The client refuses to take the
medication, stating that it causes headaches. What should the practical nurse do?
1. Do not give the medication because the client has withdrawn her consent.
2. Tell the charge nurse the situation to see if she can convince the client to take the
medication.
3. Administer the medication because the client has been diagnosed with depression.
,4. Insist that the client take the medication but tell her she will give her Tylenol for the
headache. - ANSWER-1. Do not give the medication because the client has withdrawn
her consent.
A community practical nurse is concerned because many of her chronically ill clients do
not have a primary care provider. What short-term solution should the practical nurse
suggest to the clients?
1. Advise them to go to the local community walk-in clinic as necessary.
2. Provide them with a list of all the community physicians for them to call.
3. Advise them to call the provincial telephone health information line for advice.
4. Provide the clients with comprehensive health care to the best of her ability. -
ANSWER-1. Advise them to go to the local community walk-in clinic as necessary.
A community practical nurse is training a family member to care for her 92-year-old
mother who has diabetes. What should the practical nurse teach the family member
about foot care for her mother?
1. Soak both feet daily for less than 15 minutes.
2. File the mother's toenails straight across and square.
3. Inspect the mother's feet at least twice a month for problems.
4. Keep the mother's feet warm with heavy socks and a hot water bottle. - ANSWER-2.
File the mother's toenails straight across and square.
A family visits the child health clinic. The father tells the practical nurse, "I have read on
several Web sites that there is scientific evidence vaccines are not effective, so I will not
consent to immunizing my child." What would be the best response by the practical
nurse?
1. "Has your child, or any child you know, ever had a serious adverse effect after an
immunization?"
2. "Do you have any cultural, religious, or personal beliefs regarding immunization?"
3. "Which vaccines have you read about that are not effective?"
4. "I agree there is much conflicting information. Can you tell me more about what you
read?" - ANSWER-4. "I agree there is much conflicting information. Can you tell me
more about what you read?"
A first-year practical nursing student about to enter her first clinical practice experience
has artificial nails. Her nursing professor tells her the policy states she must have the
nails removed. What is the most appropriate rationale for this policy?
1. Artificial nails are too long and may injure the client.
2. Artificial nails may accidentally be ripped off during client care, injuring the nurse.
3. Artificial nails are not professional looking.
4. Artificial nails may harbour micro-organisms. - ANSWER-4. Artificial nails may
harbour micro-organisms.
, A moderately active female requires 18 kcal per 0.45 kg to maintain an ideal weight.
How many kilocalories would a 56.7 kg woman require per day?
A mother brings her 2-month-old infant to the health clinic, stating that the child has long
episodes of crying with apparent abdominal pain and cannot be comforted. The infant is
formula-fed. What would be an appropriate initial nursing intervention?
1. Obtain a detailed history of the infant's diet, daily routine, and description of the crying
episodes/
2. Suggest a change to another formula as the symptoms are likely colic caused by an
allergy to cow's milk/
3. Discuss the advisability of initiating breastfeeding using techniques to re-establish the
production of breast milk.
4. Tell the mother that her infant is displaying classic manifestations of colic, and
burping the infant more often along with comfort measures will correct the problem. -
ANSWER-1. Obtain a detailed history of the infant's diet, daily routine, and description
of the crying episodes/
A newly graduated practical nurse obtains employment at a psychiatric outpatient clinic.
A young client in distress confides to the practical nurse that he has a gender identity
disorder. He feels he is a female trapped in the body of a man. What is the most
effective action taken by the practical nurse?
1. Provide him with relaxation exercises to decrease the anxiety associated with his
distress.
2. Refer him to a qualified sexual therapist.
3. Enroll him in the clinic's sexual disorders psychotherapy group.
4. Perform a complete physical examination to determine any contributing physical
problems. - ANSWER-2. Refer him to a qualified sexual therapist.
A nurse educator has revised the hospital's orientation program in anticipation of the
hospital orientating many new graduate practical nurses within the next 3 months. The
nurse educator decides to use sample client health records to highlight areas of
professional practice. He conducts his first education session with the new graduates.
Questions 1-5 refer to this case.
During the documentation session, one of the new practical nurses asks what
abbreviations can be used within the client's health record. What abbreviations should
the practical nurse use?
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