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A practical nurse (PN) observes a nursing student taking a selfie with a personal smartphone in the clinical unit hallway. In the background of the photograph, a client is clearly visible walking out of their room. What is the priority nursing action?
A practical nurse (PN) is monitoring a client who returned to the unit two hours ago following a cardiac catheterization via the right femoral artery. The client is resting quietly and denies any discomfort. The PN obtains the following vital signs: heart rate 116 beats/min, blood pressure 96/60 mm Hg, and respiratory rate 16 breaths/min. The client's pre-procedure blood pressure was 136/82 mm Hg. Which action should the PN take first?
A client with chronic respiratory failure requires continuous supplemental oxygen. The practical nurse (PN) is preparing to transport the client via wheelchair to the radiology department using a portable oxygen cylinder. Which action should the PN take regarding the safe use of this equipment?
A practical nurse (PN) is caring for a client who is 3 days postoperative following a laparotomy. The client reports a "popping" sensation after a severe bout of coughing. Upon inspection, the PN observes that the surgical incision has opened and bowel loops are protruding. In which order should the PN perform the following actions? Arrange the actions from first to last.
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A client admitted with an exacerbation of heart failure is scheduled to receive oral digoxin and oral furosemide. The client is also prescribed an annual influenza vaccine. Morning laboratory results indicate a serum potassium level of () and a serum digoxin level of (). The client reports experiencing a new onset of muscle cramps, weakness, and a temperature of (). Which actions should the practical nurse take? Select all that apply.
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A practical nurse is caring for a client who had a stroke resulting in right-sided weakness and expressive aphasia. The client is receiving continuous enteral nutrition via a nasogastric tube and requires repositioning. Which action by the nurse is essential to prevent a care-related error or injury?
A client with a history of heart failure is receiving a continuous intravenous fluid infusion. Which new assessment findings should the practical nurse identify as indicating an acute physiological complication that requires immediate intervention? Select all that apply.
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A practical nurse is providing care for a client who returned to the nursing unit 2 hours ago following a diagnostic cardiac catheterization accessed via the right femoral artery. The client is prescribed strict bed rest and reports mild lower back discomfort. Which interventions are appropriate for the nurse to implement to promote comfort while maintaining safety? Select all that apply.
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A client is resting in a medical-surgical room awaiting a bedside thoracentesis. The physician has recently exited the room after discussing the intervention. The client holds the uncompleted paperwork and remarks to the practical nurse, "I am willing to sign this, but I am still very confused about those other treatment choices the doctor mentioned." Which of the following actions are appropriate for the nurse to perform? (Select all that apply.)
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A practical nurse (PN) is organizing the care environment for a client who is recovering from a right tibial fracture and has a newly placed external fixator device. Which of the following actions demonstrate appropriate ergonomics, safe use of equipment, and adherence to the PN scope of practice? Select all that apply.
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A practical nurse (PN) answers a telephone call at the nurses' station on a cardiac step-down unit. The caller identifies themselves as a coworker of a specific individual and asks, "We are all so worried about our friend. Have they shown any improvement since their heart attack?" Which is the appropriate response by the PN?
During morning rounds, a practical nurse observes that a resident with type 1 diabetes mellitus is pale, sweating profusely, and visibly shaking. The resident is conscious, able to follow commands, and has an intact gag reflex. In what sequence should the practical nurse perform the following actions? Arrange them from the highest priority (first action) to the lowest priority (final action).
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A practical nurse (PN) is preparing to administer a scheduled transdermal nitroglycerin patch to a client with a history of stable angina. The client currently has an active patch on their right upper chest. In what order should the PN perform the following actions to ensure safe medication administration?
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During a busy afternoon in a long-term care facility, a practical nurse (PN) must navigate multiple client needs and coordinate with the healthcare team. Which action by the PN demonstrates a safe and appropriate application of their scope of practice?
A practical nurse is caring for a client who returned to the medical-surgical unit 2 hours ago following a colonoscopy with multiple polyp removals. The client reports feeling "a bit lightheaded" and excessively thirsty. The client's current vital signs are: blood pressure 102/64 mm Hg, apical heart rate 114 beats/minute, and respiratory rate 20 breaths/minute. The client's pre-procedure baseline vital signs were blood pressure 136/84 mm Hg and heart rate 72 beats/minute. Which action should the nurse take first?
A client diagnosed with active pulmonary tuberculosis is scheduled for an essential computed tomography (CT) scan of the chest. The practical nurse (PN) is preparing the client for transport to the radiology department. Which infection control action should the PN implement?
A practical nurse (PN) is caring for a client who is 6 hours postoperative following a total thyroidectomy. Upon entering the room, the PN notes that the client is restless, swallowing frequently, and has a heart rate of 114 beats/min. The client's blood pressure is 98/64 mm Hg. Which of the following immediate actions should the PN take? (Select all that apply.)
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During a routine wound assessment, a licensed practical nurse discovers that a postoperative client's abdominal incision has completely opened, and loops of bowel are visible outside the body cavity. Arrange the following emergency interventions in the correct chronological sequence to mitigate physiological risk.
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An older adult client has been transferred to the medical-surgical unit following a left total hip arthroplasty via a posterior approach. The practical nurse is assisting with the client's initial positioning in bed. Which action should the nurse take to maintain correct body alignment and prevent joint dislocation?
A practical nurse (PN) is preparing to administer scheduled morning medications to a client who is postoperative. The medication administration record includes oral oxycodone for pain management, oral docusate sodium, and subcutaneous heparin. Upon entering the room, the PN observes that the client is somnolent, mumbles incoherently when stimulated, and exhibits shallow breathing. The client's vital signs are: blood pressure , heart rate , respiratory rate , and oxygen saturation on room air. Which of the following is the most appropriate action for the PN to take?