PN comprehensive exam 2020 PDF

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PN COMPRHENSIVE PRACTICE 2020 A 1. A nurse is reinforcing teaching with a client who is to self-administer epoetin alfa. Which of the following instructions should the nurse include?

-Administer the medication subcutaneously. 2.

A nurse enters the room of an adolescent client and finds them on the floor experiencing a tonic-clonic seizure. Which of the following actions should the nurse take when the seizure subsides? -Keep the client in a side-lying position.

3.

A nurse is caring for a client who is in the final stages of cancer. Which of the following client situations should the nurse identify as an ethical dilemma? -The client asks the nurse to help them die peacefully in their sleep

4. A nurse is caring for a client who has a phobia of elevators. Which of the following should the nurse recognize as an indication of a positive client response to systematic desensitization? -The client remains relaxed when thinking of the phobia. 5.

A nurse is checking the reflexes of a newborn. Which of the following techniques should the nurse use to elicit the Babinski reflex? -Stroke the sole of the newborn's foot upward and toward the great toe.

6.

A nurse is reviewing the laboratory report of a client who is 2 days postoperative following thoracic surgery. Which of the following laboratory results should the nurse report to the provider? -WBC 25,000/mm3

7.

A nurse in an urgent care clinic is completing a client examination. After listening to the client's lungs, which of the following adventitious sounds should the nurse document? -Wheeze

8.

A nurse is preparing to administer an IM immunization to a preschooler. Which of the following statements should the nurse plan to make prior to performing the injection? -"Let's give the medicine to your doll first."

9. A nurse is reviewing the medical record of a client who is receiving warfarin and has atrial fibrillation. Which of the following laboratory values should the nurse report to the provider? -INR 5.0 10. A nurse is caring for a client who is scheduled for peritoneal dialysis. Which of the

following actions should the nurse take first? -Ensure the dialysate solution is at room temperature.

PN COMPRHENSIVE PRACTICE 2020 A

11. A nurse is reviewing the critical pathway of a client who is 4 days postoperative

following a total knee arthroplasty. The client's vital signs are oral temperature 39.1° C (102.4° F), heart rate 116/min, respiratory rate 24/min, and blood pressure 152/92 mm Hg. Which of the following actions should the nurse take? -Document the findings as a variance. 12. A nurse is performing a dressing change for a client who is 3 days postoperative. Which of the following findings should the nurse report to the provider? -Yellow-green drainage at the incision line 13. A nurse is inspecting the skin of a newborn. Which of the following findings should

the nurse report to the provider? -Generalized petechiae 14. A nurse is caring for a client who is recovering from a stroke and is experiencing

difficulty using eating utensils. The nurse should identify the need for a referral to which of the following interprofessional team members? -Occupational therapist 15. A nurse is assisting with a discussion about STIs with a group of adolescents at a

health fair. Which of the following statements should the nurse make? -"An infection with gonorrhea can result in infertility." 16. A nurse in an outpatient surgery center is reinforcing discharge teaching with a

client following a lithotripsy for uric acid stones. Which of the following instructions should the nurse plan to include in the teaching? -Strain the urine to collect stone fragments. 17. A nurse is assisting with the transfer of a client to a long-term care facility. The

nurse should review which of the following sections of the electronic health record to locate information about the client's personal health insurance? -Admission sheet 18. A nurse is preparing to perform a bladder scan for a client. Which of the following

actions should the nurse take? -Tell the client they should not experience any discomfort. 19. A nurse is collecting data from a client who has schizophrenia. Which of the

following statements by the client should the nurse identify as a delusion? -"My doctor's glasses have lasers that will burn holes in my brain if I look at them."

PN COMPRHENSIVE PRACTICE 2020 A 20. A nurse in a provider's office is reinforcing teaching with a client who is to follow a

2,000 mg sodium-restricted diet. Which of the following client food selections indicates an understanding of the teaching? -Canned peaches 21. A nurse is reinforcing teaching with a female client who has tuberculosis and a

new prescription for rifampin. Which of the following statements by the client indicates an understanding of the teaching? -"I will use condoms in addition to birth control pills to decrease my risk of becoming pregnant." 22. A nurse is participating in a quality improvement study about the effectiveness of

client pain management on the unit. Which of the following strategies should the nurse use to collect data? Review clients' charts for their rating of pain before pain medication was administered and 1 hr after administration. 23. A nurse is caring for a client who is crying and states that their provider informed

them that they have a tumor and will need a biopsy. Which of the following responses should the nurse make? -"What have you done to help yourself get through stressful situations before?" 24. A nurse is contributing to the plan of care for a client who has a continent urinary

diversion. Which of the following interventions should the nurse plan to implement to facilitate urinary elimination? -Use intermittent urinary catheterization for the client at regular intervals. 25. A nurse is caring for a newborn who is 12 hr old. The nurse should expect the

newborn's stool to have which of the following characteristics within the first 24 hr following birth? -Dark greenish-black and viscous 26. A nurse is caring for a newborn who is 1 hr old. The mother received fentanyl 30

min before birth. For which of the following adverse effects should the nurse monitor the newborn? -Respiratory depression 27. A nurse is preparing to perform tracheostomy care for a client. Which of the

following actions should the nurse take first? -Open sterile packages. 28. A nurse is reinforcing teaching about advance directives with a client. Which of the following statements by the client indicates an understanding of the teaching? -"I can change my health care decisions even if I have advance directives."

PN COMPRHENSIVE PRACTICE 2020 A 29. A licensed practical nurse (LPN) is reviewing client assignments for the upcoming

shift. Which of the following clients should the LPN ask the charge nurse to reassign to a registered nurse (RN)? -A client who has a new colostomy and requires the development of a teaching plan

30. A nurse is collecting data from a client who has a gastric ulcer. Which of the

following findings should the nurse identify as a complication to report to the provider? -Hematemesis 31. A nurse is reinforcing teaching with a client who is scheduled for an exercise

electrocardiography (ECG) stress test. Which of the following actions should the nurse take? -Recommend the client wear comfortable shoes during the test. 32. A nurse is collecting data from a client who has chronic pancreatitis and is

receiving pancrelipase. Which of the following client findings indicates a therapeutic effect of this medication? -Reports a decrease in the number of stools 33. A nurse is reinforcing teaching with a client who is receiving radiation therapy for

cancer of the larynx. Which of the following statements made by the client indicates an understanding of the teaching? -"I should wear a soft scarf around my neck when I am outside." 34. A nurse is caring for a client who is 12 hr postoperative following a total hip

arthroplasty. Which of the following actions should the nurse take? -Place an abduction wedge between the client's legs when in bed. 35. A nurse is collecting data from a 5-year-old child at a well-child visit. The parent

reports that the child is having frequent nightmares. Which of the following statements by the parent indicates to the nurse that the child is experiencing sleep terrors rather than nightmares?

-"My child goes back to sleep right away." 36. A nurse is reviewing the techniques for transferring a client from a bed to a chair

with a group of assistive personnel (AP). Which of the following instructions should the nurse include? -Use lower-body strength. 37. A client is requesting information from a nurse about creating a health care

proxy. Which of the following statements should the nurse make? -"The person you appoint will make health care decisions for you if you cannot do so yourself."

PN COMPRHENSIVE PRACTICE 2020 A

38. A client in a mental health facility unjustly accuses a nurse of stealing money

from their room. Which of the following therapeutic responses should the nurse make? -"Tell me how you decided who took your money." 39. A nurse is assisting with the admission of an older adult client. Which of the

following actions should the nurse take first?

-Complete a fall risk assessment on the client. 40.

A nurse is caring for a client who has Alzheimer's disease. Which of the following actions should the nurse take? -Encourage the client to reminisce about the past.

41. A nurse is assisting with the care of a client who is postpartum and has a deep-

vein thrombosis. The client has been receiving heparin via IV infusion. Which of the following medications should the nurse ensure is readily available?

-Protamine sulfate 42. A nurse in a provider's office is caring for four clients. Which of the following

clients should the nurse see first? -A client who is at 36 weeks of gestation and reports painless vaginal bleeding 43. A nurse is documenting client care in the medical record. Which of the following

entries should the nurse make? -"Client remains NPO until x-ray procedure is complete." 44. A nurse is monitoring a client who is receiving telemetry. Which of the following

ECG findings should the nurse report to the provider? -PR interval 0.24 seconds 45. A nurse is collecting data from a client following a lumbar puncture. For which of

the following adverse effects should the nurse monitor? -Headache 46. A licensed practical nurse is assisting with preparation of a client for insertion of a

peripherally inserted central venous catheter (PICC). Which of the following actions should the nurse take? -Witness the client's signature on the informed consent form. 47. A nurse in a long-term care facility is collecting data from a client who has been

receiving betaxolol to treat glaucoma. Which of the following findings is an adverse effect of this medication?

-Bradycardia

PN COMPRHENSIVE PRACTICE 2020 A 48. A nurse is preparing to insert an indwelling catheter for a female adult client.

Which of the following actions should the nurse take? (Select all that apply.)

-Cleanse the client’s labia and meatus using a afront-to-back motion -Use the nondominant hand to expose the client’s urinary meatus -Advance the catheter 5-7.5cm (2-3 in) into the clients urinary meatus -Ask the client to bear down while inserting the catheter 49. A nurse is reinforcing preoperative teaching with a client who will receive

morphine through a PCA pump after surgery. Which of the following information should the nurse include?

"You should increase your fluid intake while receiving this medication through the PCA pump." 50. A nurse is monitoring a client who is receiving IV fluids. For which of the following

findings should the nurse stop the infusion? -Edema above the catheter insertion site 51. A nurse is reinforcing teaching with a client who has a new prescription for

phenytoin. Which of the following instructions should the nurse include as a measure to assist with the possible adverse effects of this medication Perform daily gum massage. 52. A nurse is collecting a urine specimen from a female client who has diabetes

insipidus. Which of the following findings should the nurse expect?

Urine specific gravity of 1.002 53. A nurse is reinforcing teaching about confidentiality with a client who has a new

diagnosis of HIV. Which of the following information should the nurse include in the teaching?

"Your HIV status will be shared with members of your health care team."

54. A nurse is caring for a client who has borderline personality disorder and states, "I

am going to kill my partner when I get out of here." Which of the following actions should the nurse take?

-

Notify the client's care team about the threats against their partner.

55. A nurse is using the FLACC scale to determine the pain level of an 11-month-old

infant who is postoperative. Which of the following factors should the nurse consider when using this pain scale?

-Level of activity

PN COMPRHENSIVE PRACTICE 2020 A

56. A nurse is working in an acute care facility when a natural disaster occurs. The

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facility must discharge clients to provide room for new admissions. Which of the following clients should the nurse recommend to the charge nurse for discharge? A client who has pneumonia and is currently receiving oral antibiotics

57. A nurse is reinforcing teaching with a client who has hypercholesterolemia and a

new prescription for atorvastatin. The nurse should instruct the client that which of the following findings is an adverse effect of this medication and should be reported to the provider?

-MUSCLE PAIN 58. A nurse is reinforcing teaching for a client who has Meniere's disease and a new

prescription for meclizine. The nurse should inform the client that which of the following is an adverse effect of this medication?

-SEDATION 59. A nurse is reinforcing teaching about self-administration of enoxaparin. Which of

the following instructions should the nurse include?

-Administer by subcutaneous injection.

60. A nurse is caring for a client who has a head injury. Using the Glasgow Coma Scale

to collect data, the nurse should obtain which of the following information? -Motor response

61. A nurse is reinforcing teaching about strategies to promote eating with a client

who has COPD. Which of the following instructions should the nurse include in the teaching?

-Drink high-protein and high-calorie nutritional supplements.

62. A nurse is caring for a client who reports an intense headache, nuchal rigidity,

nausea and vomiting, along with fever and chills. Which of the following diagnostic tests should the nurse expect the provider to prescribe?

-Cerebrospinal fluid analysis

63. A nurse is working in a long-term care facility. Which of the following actions

should the nurse take when using computer-based client records?

-Shred printouts of client care information when they are no longer needed.

PN COMPRHENSIVE PRACTICE 2020 A

64. A nurse is reinforcing teaching for a client who is preparing to return to work

after a back injury. Which of the following instructions for safe lifting technique should the nurse include?

-"You should hold a box close to your body when lifting it up."

65. A nurse is assisting a client who is postoperative to sit on the side of the bed.

Which of the following actions should the nurse take?

-Elevate the head of the client's bed.

66. A nurse is reinforcing teaching with a client who has hypertension and is

beginning medication therapy with captopril. Which of the following over-thecounter medications should the nurse instruct the client to avoid?

Ibuprofen

67. A nurse is reinforcing discharge teaching with a client who has a prescription for

home oxygen therapy via nasal cannula. Which of the following instructions should the nurse include?

-"Apply a water-based lubricant around the nostrils to prevent irritation."

68. A nurse is reinforcing teaching with a client who has asthma and a new

prescription for theophylline. Which of the following statements should the nurse make?

"Discontinue drinking caffeinated beverages."

69. A nurse is collecting data from a school-age child who has hypoglycemia. Which of

the following findings should the nurse expect?

-sweating 70. A nurse is reinforcing teaching about managing manifestations of anxiety with a

client who has generalized anxiety disorder. Which of the following information should the nurse include?

-Say the word "stop" when upsetting thoughts occur.

PN COMPRHENSIVE PRACTICE 2020 A

71. A nurse is collecting data from a client who has chronic hepatitis. In which of the

following locations should the nurse expect the client to point to indicate hepatic tenderness? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)

-over the liver (B)

72. A nurse is reviewing a client's medication record and notices that a double dose of

oral digoxin was administered 1 hr ago. Which of the following actions should the nurse take first?

- Obtain a set of the client's vital signs.

73. A nurse is collecting data from a client who reports recent methamphetamine

use. Which of the following manifestations should the nurse expect?

74. A nurse is caring for a client who has asthma and has been taking montelukast for

1 month. Which of the following findings should indicate to the nurse that the client is complying with this medication regimen?

75. A nurse is assisting with the development of an in-service for newly licensed

nurses about seclusion. In which of the following situations should the nurse identify the need to request a prescription for seclusion?

76. A nurse on a medical unit is reviewing a client's medical record. Which of the

following procedures should the nurse identify requires the client to sign a separate informed consent form?

77. A nurse is caring for a client who is refusing a prescribed medication. Which of the

following actions should the nurse take first?

78. A nurse is reinforcing teaching with a client who has osteoarthritis. Which of the

following instructions should the nurse include?

-

PN COMPRHENSIVE PRACTICE 2020 A 79. A nurse is reinforcing teaching about a high-protein diet with a client who has HIV.

Which of the following foods should the nurse recommend as containing the highest amount of protein per serving?

80. A nurse is contributing to the plan of care for a client who has a prescription for

range-of-motion exercises of the shoulder. Which of the following exercises should the nurse recommend to promote shoulder hyperextension?

81. A nu...