All practice questions

An older adult client with a history of heart failure is prescribed a daily dose of oral digoxin. Before providing the medication, the practical nurse notes an apical pulse of 74 beats/minute and a newly resulted serum potassium level of 2.8 mEq/L (2.8 mmol/L). Which action should the practical nurse take first?

A practical nurse (PN) is preparing to administer amoxicillin/clavulanate to a pediatric client who weighs $31.9\text{ lb}$. The healthcare provider prescribed $45\text{ mg/kg/day}$ by mouth, divided into equal doses to be given every $12$ hours. The pharmacy provides an oral suspension with a concentration of $400\text{ mg}/5\text{ mL}$. How many $\text{mL}$ should the PN administer for each dose? (Record answer to the nearest tenth. Do not include units in answer.)

Following a right eye retinal detachment repair utilizing an intraocular gas bubble injection (pneumatic retinopexy), a client is transferred to the surgical unit. The provider's prescriptions specify strict positioning to ensure the gas bubble maintains continuous contact with the posterior retina. Which of the following positions should the practical nurse assist the client to maintain?

An older adult client is receiving care on a medical-surgical unit two days after a partial gastrectomy. The practical nurse (PN) notes that the client has become newly agitated. Current vital signs reveal a heart rate of 118 beats/min, a respiratory rate of 26 breaths/min, and a blood pressure of 92/54 mmHg. The client's vital signs from four hours ago were a heart rate of 82 beats/min, a respiratory rate of 16 breaths/min, and a blood pressure of 128/74 mmHg. Which of the following actions should the PN take? (Select all that apply.)

A practical nurse (PN) is documenting assessment findings in a client's electronic health record (EHR) at a mobile workstation in a busy hospital corridor. Another nurse calls out for urgent assistance with a client who has fallen in a nearby room. What is the priority action for the PN regarding the workstation before responding to the situation?

A practical nurse is monitoring a client who recently started taking warfarin, an oral anticoagulant. Which findings indicate an increased risk for severe complications and require immediate escalation to the registered nurse? (Select all that apply)

During a preoperative home health assessment, a client scheduled for a cardiac catheterization hands a signed consent form to the practical nurse (PN). The client states, "I signed this earlier, but I still do not understand what the surgeon meant by potential vascular complications." Which of the following actions should the PN take? Select all that apply.

During the shift handoff, a licensed practical nurse receives a new client with confirmed bacterial meningitis (*Neisseria meningitidis*). Which of the following are appropriate infection control measures and care actions for this client? Select all that apply.

A practical nurse (PN) is monitoring the care environment to ensure adherence to proper ergonomics and the safe use of equipment. Which of the following observations indicate safe and appropriate practice? Select all that apply.

A client with bipolar disorder is prescribed oral lithium carbonate. The practical nurse is implementing the client's plan of care. Which of the following actions should the practical nurse take to ensure safe pharmacological therapy? (Select all that apply.)

A practical nurse is caring for a client who underwent a percutaneous kidney biopsy 3 hours ago. The client reports new-onset severe flank pain. The current vital signs are: heart rate 116 beats per minute and blood pressure 86/54 mm Hg. The morning laboratory report shows a hemoglobin level of 7.9 g/dL. Which action should the practical nurse take first?

While providing care on an inpatient psychiatric unit, a practical nurse (PN) receives a list of delegated activities from the supervising nurse. Which of the following client care activities is appropriate for the PN to accept?

A practical nurse (PN) is working in a specialized wound care clinic. A client is scheduled for a complex surgical debridement of a lower extremity ulcer. The healthcare provider has just left the room after discussing the procedure. As the PN presents the informed consent document, the client hesitates and states, "I forgot to ask the doctor what happens if we just use antibiotics instead of doing this surgery." Which action should the PN take first?

During mealtime on the rehabilitation unit, a practical nurse observes a client with a recent stroke holding unchewed food inside their cheek. The client then produces a weak, gargling cough. Which immediate intervention should the nurse implement?

A practical nurse is planning ambulation interventions for a client who has left-sided hemiplegia and requires a quad cane. Which action by the nurse demonstrates the safest and most appropriate use of this assistive equipment?

Match each client information scenario with the appropriate practical nursing determination regarding confidentiality.

A practical nurse is caring for a client receiving treatment for hypertension. The client's medication administration record includes scheduled oral doses of spironolactone $50\text{ mg}$ and amlodipine $5\text{ mg}$. Upon reviewing the morning assessment data, the nurse notes a blood pressure of $128/82\text{ mmHg}$, a serum sodium level of $138\text{ mEq/L}$, and a serum potassium level of $5.9\text{ mEq/L}$. Which action should the practical nurse take first?

A practical nurse (PN) receives the handoff report for a client who is two hours postoperative following a right total hip arthroplasty. The client requires contact precautions for a methicillin-resistant Staphylococcus aureus (MRSA) infection. Which of the following actions should the PN take to prevent errors and ensure client safety? Select all that apply.

A practical nurse (PN) is caring for a client who is receiving continuous enteral tube feedings. The client suddenly begins to cough forcefully and expel vomitus. In which order should the PN perform the following actions? Arrange the actions from first to last.

A practical nurse is reviewing the electronic health record of an adult client who has been receiving a continuous intravenous heparin infusion for a pulmonary embolism for the past four days. The practical nurse notes the following morning laboratory results:

- Activated partial thromboplastin time (aPTT): $62$ seconds (Control: $30$ seconds)
- Hemoglobin: $13.2 \text{ g/dL}$
- Platelet count: $105,000 \text{ /mm}^3$ (Baseline on admission: $240,000 \text{ /mm}^3$)

During the morning assessment, the client's vital signs are within expected parameters, but the client reports a new onset of coldness, intense pain, and tingling in the right foot. Which action should the practical nurse take first?