PRACTICAL NURSING PROGRAM

COMPREHENSIVE I

Name: ________________________

1. Put your name on this exam package

2. Put your name on the scoring sheet

3. Read each question carefully

4. Mark the best answer on the scoring sheet

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1. 82 year-old Mary has been diagnosed with a stage I pressure ulcer on her left hip
despite a q2h turning schedule. Which of the following would be an appropriate
nursing diagnosis for this client?
a. Impaired skin integrity r/t effects of pressure and friction
b. High risk for impaired skin integrity
c. Activity intolerance r/t Stage I pressure ulcer
d. Risk for pressure ulcer

2. Jack is postoperative for an abdominal surgical procedure. When assessing the

abdominal suture line, which characteristics indicate a delay in would healing?
a. Suture line dry and intact
b. Incision approximated and pink
c. Purulent drainage on dressing
d. Jackson-Pratt drain collecting serosanguineous drainage

3. The dose ordered for a client is Demerol 75 mg IM. The medication is available in a 50
mg/ml solution. The nurse prepares:
a. 0.5 ml
b. 0.75 ml
c. 1 ml
d. 1.5 ml

4. Wally uses a cane to assist with ambulation. Which of the following statement would
indicate the need for addition teaching?
a. My elbow should be slightly flexed when using the cane.
b. I should hold the cane on my affected side.
c. I should use the can every time I am walking.
d. Just having socks on my feet may cause me to slip and fall.

5. The practical Nurse is measuring the clients urine output and straining the urine to
assess for kidney stones. Which of the following should the nurse record as objective
data?
a. Client c/o abdominal pain.
b. Urine output was 450 mL.
c. Client stated I didnt see any stones in my urine.
d. Kidney stone not passed as of 1900.

6. A client who is alert and responsive has been admitted with a diagnosis of to rule out
myocardial infarction. Of the following alterations found on assessment, which is of
greatest concern to the Practical Nurse?
a. Supine BP 138/76
b. Resp 28 and laboured
c. Temp 37C
d. Pulse between 68 to 74 BPM with slight arrhythmia noted

7. The Practical Nurse enters Wilmas room and asks how she is doing. Wilmas
response is I am a little nervous this morning. What is the Practical Nurses best
reply to Wilma?
a. What do you mean by the word nervous?
b. Why are you feeling nervous?
c. You are fine; there is nothing to be nervous about.

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 d. Would you like a back rub?

8. The LPN is doing a home visit; the goal is to teach a clients partner how to change the
clients dressing. Which of the following would best promote teaching?
a. Show the partner a video explaining sterile technique
b. The LPN completes the wound care while the partner watches
c. Have the partner perform the wound care with the LPN present
d. Ask the partner to review a pamphlet on wound care, then answer any questions

9. A client tells the nurse, I want to die. The nurse responds most appropriately by
saying:
a. Why would you say that?
b. Tell me more about how you are feeling.
c. The doctor should be told how you feel.
d. You have too much to live for to think that way.

10. Administration of controlled substances requires that the nurse:

a. Discard and sign for unused quantities
b. Count the amount of medication daily
c. Keep narcotics to be given with the other client medications
d. Notify the charge nurse of discrepancies in medication counts

11. Which of the following statement given during 0700 shift report provides the most
important information regarding priority setting for the LPN coming on shift?
a. A client had a catheter removed 8 hours ago and has not voided
b. A client with Alzheimers has been up walking most of the night
c. A client who is 3 days post-op has been complaining of incision pain
d. A client admitted with congestive heart failure has a BP of 138/80

12. At 1100, the unlicensed care provider reports a client has an elevated temperature.
The Practical Nurse assesses the client and finds the skin flushed and very warm. The
client is orientated to person, place and time but expresses extreme fatigue. Which of
the following is the most appropriate nursing action to take at this time?
a. Cancel the clients lunch
b. Place an ice pack on the clients forehead
c. Assist the client in to light weight clothes and offer fluids
d. Ask the unlicensed care provider to recheck the temperature in 1 hour

13. The LPN has been assigned to a group of clients. Based on the information provided,
which client should be seen first?
a. A 68-year-old client who had total hip replacement surgery 6 hours ago and is
complaining of moderate discomfort at the surgical site.
b. A 32-year-old client with a urinary tract infection who is receiving an intravenous
antibiotic and complaining of itching and a rash.
c. An 82-year-old client with emphysema who is receiving 2 liters of oxygen and is
concerned about a pulse oximetry reading of 90%.
d. A 48-year-old client with hemoglobin of 9.5 g/dL, is receiving ferrous sulfate
supplements, and is complaining of feeling tired.
14. When assessing a postoperative client, a nurse finds that there is tenderness, redness,
and swelling in the left calf. The nurse should:
a. Massage the lower leg

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 b. Notify nurse in charge or physician
c. Keep the leg in a dependent position
d. Have the client exercise that extremity

15. To decrease the potential for complications related to IV therapy, the nurse should:
a. Use clean technique for dressing changes
b. Change the IV tubing every 12 hours
c. Palpate the insertion site through the intact dressing during each shift
d. Routinely apply antimicrobial ointment to the IV insertion site

16. A client is receiving intravenous therapy. At the beginning of shift, the LPN enters the
clients room and assesses the site and infusion. The skin around the insertion site is
swollen and cool to the touch. The drip rate on the gravity-fed intravenous is lower
than expected. Which of the following actions should the nurse take next?
a. Stop the infusion
b. Increase the drip rate to the ordered rate
c. Elevate the intravenous pole
d. Cover the area with a 2x2 and secure

17. The client complains of pain and asks the nurse for pain medication. Vitals are as
follows: BP 134/92, P90, R26. Which of the following actions most appropriate?
a. Administer the pain medication as ordered
b. Assess the client further for anxiety
c. Assess the clients dressing for bleeding
d. Withhold the medication, recheck vital in 30 minutes

18. To promote comfort for the terminally ill client specific to nausea and vomiting, which
of the following interventions is most appropriate?
a. Increase fluid intake
b. Provide frequent mouth care
c. Provide suctioning of oral secretions
d. Administer 50mg of dimenhydrinate po regularly

19. In using communication skills with clients, the nurse evaluates which response as
being most therapeutic?
a. Why dont you stick to your diabetic diet?
b. I noticed you didnt eat your lunch.
c. Have you ever thought about changing physicians?
d. We can continue talking about your financial problems after your bath.

20. A nurse is doing a home visit for a client who is due to have staples removed. The
nurses notes the edges of the wound are separated. Which of the following actions
should the nurse take?
a. Notify physician
b. Remove the staples as ordered then apply pressure dressing
c. Remove every other staple, plan to reassess in 1 day
d. Cleanse incision with normal saline, reassess in 1 day

21. What should the practical nurse do initially for an elderly client who is suddenly
shivering, reporting chills and has a temperature of 38.2 C?
a. Cover the client with a blanket.
b. Change the clients clothing and bed linen.

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 c. Begin oral hygiene procedures.
d. Provide cool, circulating air

22. What device should the practical nurse use when administering an oral liquid
medication to a 16- month-old infant?
a. A plastic teaspoon
b. A disposable syringe
c. A disposable dropper
d. A plastic medication cup

23. What should the practical nurse do to facilitate a clients acceptance of an altered body
image following a total laryngectomy and tracheostomy?
a. Emphasize what the client can do within the limitations resulting from the
treatment.
b. Encourage the clients family to refrain from discussing the tracheostomy while
visiting.
c. Demonstrate a sympathetic approach when providing the clients tracheostomy
care.
d. Reassure the client that following discharge there can be a complete return to pre-
hospitalization activities.

24. The practical nurse returns from break to find that the status of two clients has
changed. Both clients need vital signs assessed every 15 minutes and several stat.
medications. A third client requires insulin. In evaluating this, what should the
practical nurse conclude?
a. The present workload is unrealistic for the practical nurse to manage.
b. The practical nurse does not have enough knowledge to prioritize the clients.
c. The practical nurse needs to reprioritize the care plans for each of the clients.
d. The practical nurse should administer the insulin first then attend to the other
clients.

25. Mr. Lowry, had experienced a cerebrovascular accident (CVA), regains consciousness
and is found to have loss of movement on his left side and hemianopsia. How should
the practical nurse respond when Mrs. Lowry asks questions regarding her husbands
recovery?
a. It sounds as though you may be somewhat anxious to resume your former
lifestyle.
b. Its difficult to know, but most people take at least a year to recover completely.
c. Concern about recovery is common. Rehab takes time and progress can be slow.
d. To be anxious is normal. Unfortunately, there is no way of estimating your
husbands recovery potential.

26. A client at a Long Term Care facility has glaucoma affected vision in her right eye.
What should the practical nurse do to encourage the client feed herself?
a. Assist with positioning the cutlery in her hands.
b. Suggest that she take the elevator to the cafeteria.
c. Allow sufficient time for her to cut up her own food.
d. Arrange food items on her tray so that she can see them.

27. A medication that is ordered t.i.d. is best given at:

a. 1000
b. 1000 and 1800

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 c. 1000, 1800 and 0200
d. 1000, 1400 and 1800

28. An appropriate IV solution for the nurse to use as a piggyback with a blood transfusion
is:
a. 0.9% saline
b. 5% saline
c. Ringers solution
d. 10% dextrose in water

29. When completing a client's discharge, an activity that may be delegated to assistive
personnel is:
a. Providing prescriptions to the client
b. Completing the discharge summary
c. Gathering the client's personal care items
d. Providing instructions on community health resources

30. During admission of a client, the nurse notes that the client speaks another language
and may have difficulty understanding English. The nurse should:
a. Use hand gestures to explain
b. Request and wait for an interpreter
c. Work with the family to gather information
d. Complete as much of the admission assessment as possible using simple
phrases

31. Upon entering a clients room, a nurse finds that the abdominal surgical wound has
eviscerated. Which of the following should the nurse do first?
a. Notify the physician
b. Sit the client upright
c. Assess the incision and document
d. Cover with saline-soaked sterile gauze

32. A client tells the nurse, I think that I must be really sick. All of these tests are being
done. The nurse uses the specific communication technique of reflection by saying:
a. I sense that you are worried.
b. I think that we should talk about this more.
c. You think that you must be very sick because the doctor ordered lots of tests.
d. Ive noticed that this is an underlying issue whenever we talk.

33. A responsibility of a nurse during the assessment and maintenance of a peripheral IV

site is:
a. Inspection of the insertion site
b. Changing of the site every 24 hours
c. Having the client keep the arm elevated
d. Putting up new solution when the bag or bottle is completely emptied

34. Bleeding is noted around a dressing at an IV insertion site. A nurse should:

a. Discontinue the IV
b. Assess the insertion site
c. Leave the dressing intact, but reinforce it
d. Elevate and apply warm compresses to the extremity

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35. During a transfusion, a clients heart rate has increased and that the client is
complaining of chills and lower back pain. The nurses first action after stopping the
transfusion is:
a. Notifying the physician
b. Notifying the blood bank
c. Maintain IV patency with normal saline
d. Checking the vital signs every 15 minutes

36. An appropriate principle of wound irrigation that a nurse can apply is:
a. Moving from infected to healthy tissue
b. Using clean irrigation solutions
c. Cleaning from the least to the most contaminated area
d. Moving toward and cleaning the suture line last

37. A client is being transferred after abdominal surgery to a room on the surgical unit.
Upon transfer, the nurse should do which of the following first?
a. Remove the indwelling urinary catheter
b. Use a pen to circle the drainage on the dressing
c. Administer 75mg of Demerol IM q4hprn as ordered
d. Change the dressing when the client reaches the room

38. When teaching about medication use in the home, the nurse instructs the client to:
a. Double bag all used needles
b. Always keep insulin in the refrigerator
c. Put all of the medication to be taken in one bottle
d. Return unused or expired medication to the pharmacy

39. A client with a cognitive deficit becomes agitated and upset about not being able to
remember daily activities. The nurse should:
a. Tell the client not to worry about it
b. Provide an easy-to-follow calendar and reinforce the information
c. Explain that staying calm may help the memory
d. Remind the client that it is his or her time to rest and relax

40. The parenteral route of a drug is ordered. The nurse administers this medication:
a. Orally
b. Topically
c. Sublingually
d. Intramuscularly

41. A client requires a sterile dressing change for a mid-abdominal surgical incision. An
appropriate intervention for the nurse to implement in maintaining sterile asepsis is to:
a. Put sterile gloves on before opening sterile packages
b. Discard instruments that may have been in contact with the area below waist level
c. Place the cap of the sterile solution well within the sterile field
d. Place sterile items on the very edge of the sterile drape

42. If all of the protective barriers are for a client in isolation, the nurse should first remove
the:
a. Mask
b. Gown
c. Gloves

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 d. Goggles

43. The nurse recognizes that which of the following is the most appropriate
documentation?
a. 1230 Clients vital signs taken
b. 0700 Client drank adequate amount of fluids
c. 0900 Meperidine (Demerol) given for lower abdominal pain
d. 0830 Increased intravenous (IV) fluid rate to 100 ml/hour as ordered

44. A nurse has made a medication error. Which of the following should the nurse do
initially?
a. Correct the error as quickly as possible.
b. Notify the patient and family of the error.
c. Document the incident on the patients chart.
d. Note the medication administered and notify the physician.

45. A nurse is proving care to a client in their home. The client is scheduled for 24-hour
nursing care. The nurse assigned to relieve the day shift has not arrived. What is the
most appropriate action for the day nurse to take?
a. Notify the agency before going home
b. Remain with the client until relieved by another nurse
c. Instruct family members on how to monitor the IV prior to leaving
d. Report the evening nurse to the regulatory body for disciplinary action

46. A nurse is administering a sodium phosphate (Fleet) enema to a client. Which of the
following should the nurse encourage the client to do to ensure optimum
administration?
a. Expel the enema contents immediately following administration
b. Administer the enema while the client is seated on a commode
c. Have the client rest quietly in bed following administration of the enema
d. Have the client retain the enema for a minimum of five minutes

47. A client has spent several weeks in traction for a left leg fracture. During his morning
care he tells the nurse that he keeps hearing voices in his room although he knows he
is alone. What is the most appropriate response by the nurse?
a. Tell the client not to worry about it
b. Tell me more about the voices.
c. Thats interesting. Youve been alone in this room to long.
d. What you are hearing is the intercom system in the hall.

48. The nurse is completing a dressing change on an abdominal incision. How should the
nurse dispose of the soiled sterile dressing?
a. In the bedside trash
b. On a sterile waterproof barrier pad
c. In a waterproof bag away from the sterile field
d. Ensure the dressing is placed within 1 inch of the edge of the sterile field

49. A clients IV Ampicillin piggyback began infusing 30 minutes ago. She is complaining
of itching, physical exam reveals large, red, macular wheals on her back and abdomen.
Which of the following actions does the nurse take first?
a. Stop the infusion, notify the charge nurse or physician.
b. Stop the infusion, discontinue the IV, restart in the opposite arm

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 c. Reassure the client this is a temporary reaction, apply cream, continue to monitor
d. Reduce rate to Keep Vein Open, notify the charge nurse or physician.

50. A 70 year old client is a client at a rehabilitation centre following a CVA. He is

scheduled for ROM every 4 hours during the day. Which action by the nurse will help
to maintain maximum muscle tone for the patient?
a. Move each joint to the point of resistance
b. Move each joint to just a bit beyond the point of resistance
c. Only assist with those movements the client cannot perform himself
d. Stop exercises once the client complains of fatigue

51. Which of the following pieces of information is important to include in documentation

when emptying a patients nasogastric intermittent suction?
a. Time since last emptying
b. Characteristics of fluid
c. How client tolerated procedure
d. Amount of residual fluid remaining
Case 1
Questions 52 to 56 refer to the following case study.
Mandy Poole, 32 year old primigravida, delivered a healthy baby girl 3600 gms two
days ago.

52. Mandy asks the practical nurse ways to prevent diaper rash. The practical nurses
response is based on which of the following principles?
a. Warming commercially prepared wipes will prevent skin breakdown.
b. Daily bathing will provide the cleansing necessary to remove irritants.
c. Allowing the area to air dry will help prevent diaper rash.
d. Frequent diaper changes will help maintain skin integrity.

53. Which of the following assessments requires the practical nurse to consult with a
charge nurse or physician?
a. Infant weight 3420 gm
b. Neonatal heart rate of 130 bpm
c. Fundus 2 fingers breaths above umbilicus
d. Perineal ecchymosis extending to rectum, client states area is sore to touch

54. Mandy expresses concern related to Sudden Infant Death Syndrome (SIDS). Which of
the following statements indicate the need for further teaching?
a. So once the baby is about a year old, I do not need to worry about SIDS
b. Do you have signs that say smoke free house.
c. I should always place my baby on her back to sleep.
d. Bumper padding in the crib will help prevent a head injury.

55. The nurse is completing a discharge assessment on the baby. Which of the following
assessment findings is consistent with a healthy neonate?
a. Presence of lanugo and vernix
b. Positive Babinski and Moro reflexes
c. Nasal flaring, respirations 72 breaths per minute
d. Lying flat, supine, with her arms and legs splayed out

56. Prior to discharge Mandy is diagnosed with mastitis and is started on amoxicillin.
What advice is most appropriate regarding mastitis and antibiotic treatment?

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 a. Antibiotics should be discontinued once redness, fever and pain subside.
b. An alternate feeding plan is required until redness, fever and pain subside.
c. Mom needs to monitor baby for signs and symptoms of oral thrush.
d. Amoxicillin is contraindicated for breastfeeding mothers, call physician to change
medication order.

Case 2
Questions 57 to 62 refer to the following case study.
Henry Wall, 67 year old, admitted for a bowel resection returns from the operating
room with a nasogastric tube connected to intermittent suction, IV of Ringers Lactate
running at 100 mls/hr and a longitudinal abdominal incision with Jackson-Pratt drain.

57. Which of the following is a critical nursing measure when caring for clients undergoing
nasogastric suctioning?
a. Mouth care every 2 hours
b. Thorough skin care to the nares
c. Turn and reposition every 2 hours
d. Maintain accurate intake and output record

58. The physician has ordered daily dressing changes. The nurse is aware that the
following principle related to sterile asepsis must be applied?
a. Sterile gloves are worn to empty the Jackson-Pratt drain
b. The area around the drain is cleansed using clean technique
c. When cleansing, the nurse starts at the drain insertion site and moves outward in a
circular movement.
d. When cleansing, the nurse starts 1 inch from the drain and moves toward the
insertion site in a circular movement.

59. At the start of shift 100 mls of IV fluid is left to be absorbed. What does the nurse do
prior to hanging a new bag of Ringers Lactate?
a. Explain the procedure to the client
b. Read the facility policy regarding the procedure
c. Gather all supplies including IV fluid
d. Check chart for latest doctors orders

60. When cleansing the clients abdominal incision, the nurse uses sterile gauze soaked in
saline and cleanses the wound. Which direction of cleansing maintains wound
sterility?
a. Long strokes from the top of the incision toward the umbilicus
b. Long strokes from umbilicus towards the top of the incision

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 c. Short strokes, starting from the incision outward
d. Short strokes, starting 1 inch away from the incision toward the sutures

61. On the clients third post-operative day, during report, the charge nurse indicates the
physician has ordered the Jackson-Pratt drain to be discontinued. Which of the
following observations does the practical nurse know will affect the implementation of
this order?
a. The practical nurse notes serosanguinous drainage in the drainage bulb.
b. The drainage bulb is empty and no drainage noted after 4 hours.
c. After 2 hours the drainage bulb is emptied of 50mls of sanguinous drainage.
d. Serosanguinous drainage is noted on the dressing at the drain insertion site.

62. Prior to discharge Henry tells the practical nurse he is unable to afford the medications
the doctor has prescribed. Which of the following describes the practical nurses
responsibility?
a. Bring information forward at discharge team meeting
b. Obtain an application form for the seniors pharmacy program, assist client with
completing.
c. Document clients concerns and leave a note in the physician communication
book.
d. Collaborate with facility social worker to develop possible solutions.

Case 3
Questions 63 to 68 refer to the following case study.
Myra Lee, 63 years old, lives at home with her daughter and son-in-law. Myra is
showing signs of dementia. Nurses complete weekly home visits to pre-pour Myras
medication including insulin for her Type 2 Diabetes Mellitus.

63. During a home visit, Myra appears fearful and withdraws her arm when the nurse
attempts to use soothing touch to relay trust and caring. The nurse recognizes this
likely a sign of which of the following?
a. Delirium
b. Dementia
c. Elder abuse
d. Hypogycemia

64. When Mrs. Lees daughter asks about long-term care placement for her mother, which
of the following demonstrates a therapeutic response?
a. I can start the paper work today if youd like.
b. Tell me more about what you would like to know.
c. Why do you want to place your mother in long-term care facility?
d. It will be a while yet before your mother requires long-term care placement.

65. When preparing to pre-pour Mrs. Lees medications, you read the physicians order for
Aricept 5 mg po daily at hs. What does the nurse do next?
a. Call the physician to clarify the hs order
b. Assess the clients serum glucose prior to administering
c. Use a pill splitter to split the scored 10 mg tab of Aricept
d. Read the medication label, check patients name, drug name, dose, route and time

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66. One goal established by the family, was to have Mrs. Lees daughter learn how to
administer her mothers insulin. Which of the following would indicate more teaching
is necessary?
a. The daughter prepares the syringe with a 5/8 needle
b. The daughter prepares to administer the insulin in her mothers deltoid
c. The injection site is cleansed with an alcohol swab prior to administration
d. Mrs. Lees daughter has attended an insulin in-service at the local health centre

67. Mrs. Lees daughter asks the nurse to come back after the shift, she has a little gift to
give the nurse. Which of the following responses is most appropriate?
a. I certainly appreciate the thought but it is not appropriate for me to accept any
gifts.
b. As long as it is just a little gift, I wouldnt be comfortable taking anything
extravagant.
c. Is it okay with you if I pick it up tomorrow during my shift.
d. Are you sure? You didnt need to get me anything.

68. Mrs. Lees son-in-law asks you questions about a community adult-day respite
program. Which of the following does the nurse base the response?
a. Clients with dementia are not good candidates for day-programs
b. Adult-day programs may not only benefit Mrs. Lee but the entire family as well.
c. There are fewer costs associated with hiring an in-home respite care-giver.
d. This information will need to be brought to the clients case-conference

Independent questions
Questions 69 to 100 do not refer to a case.

69. The client is 4 weeks pregnant. Her 3-year-old child was born with spina bifida. Which
of the following would the practical nurse expect the health care provider to prescribe
for this client?
a. Vitamin K
b. Thiamine
c. Niacin
d. Folic acid

70. Which of the following nursing actions is the most appropriate to stop the bleeding
from an occipital laceration?
a. Applying pressure to the site
b. Applying ice to the site
c. Elevating the head of the bed
d. Elevating the extremities

71. Clients with sensory dysfunction, such as persons with paraplegia, have many
teaching needs. Which of the following teaching needs is of highest priority?
a. Importance of doing frequent weight shifts every hour
b. Importance of decreasing calcium intake
c. Importance of avoiding very cold or very hot foods
d. Importance of adequate fluid intake of 2000ml/day

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72. A client has returned from the recovery room following a thyroidectomy. In which of
the following positions should the client be placed?
a. Supine
b. Left Sims
c. Trendelenburg
d. Semi-Fowlers

73. A 60-year-old client is being discharged after undergoing cardiac catheterization.

Which of the following important instructions should the practical nurse include at the
time of discharge?
a. Do not change the bandage for 48 hours, report site soreness to the physician
b. Rest for 3 days, avoid heavy lifting or strenuous activity
c. Drive a car that has an automatic transmission
d. Tub baths are permitted after 24 hours

74. Which one of the following nursing interventions should receive highest priority when
a client is admitted from the post-anaesthesia care unit (recovery)?
a. Positioning the client
b. Observing the operative site
c. Checking the postoperative orders
d. Receiving report from recovery room personnel

75. A 77-year-old client who is NPO has dry oral mucous membranes, which following
nursing intervention is most appropriate?
a. Increase oral fluid intake.
b. Perform oral hygiene frequently.
c. Swab the inside of the mouth with petroleum.
d. Increase the rate of IV fluid administration.

76. A nurse has received permission to observe a surgical procedure in the hospital in
which the nurse is employed. While the client is being draped, the nurse notices that a
break in sterile technique occurs. Which following action on the nurses part is most
appropriate?
a. Tell the surgeon before an incision is made.
b. Tell the circulating nurse before the surgeon enters the operating room.
c. Say nothing, this is not the practical nurses role or area of expertise.
d. Point out the observation immediately to the personnel involved.

77. A nurse is caring for clients on a medical-surgical unit. The nurse plans the clients
care and instructs the nursing assistant to assist in repositioning clients every 2
hours. Which following client is at the greatest risk for complications if not
repositioned properly?
a. A 20-year-old post-operative client
b. A 50-year-old hearing impaired client
c. A 65-year-old client who is visually impaired
d. A 40-year-old client who has paraplegia

78. A client with diabetes mellitus is planning to do strenuous activity. Which of the
following snacks would the practical nurse suggest the client consume before the
activity?
a. An orange
b. A can of diet-soda

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 c. A chocolate candy bar
d. Cheese and whole-wheat crackers

79. A mother of an 18-month-old tells the practical nurse the child has had two diarrhea
stools and asks what fluids and foods can be given. How should the practical nurse
respond?
a. Keep the child NPO until 24 hours after the diarrhea stops.
b. Continue to offer normal diet items, but substitute foods the child especially
likes.
c. Encourage fluids and offer small frequent meals and snacks.
d. Stop all milk products, offer electrolyte supplements such as Pedialyte until
stools firm.

80. Assessment of motor function in a client who has had a stroke includes assessing
which of the following?
a. Cranial nerves VIII through XII
b. Body position, level of consciousness, and mental status
c. Muscle movement, strength, and coordination
d. Intellectual function and speech pattern

81. A 32-year-old client is being admitted to the medical floor with a diagnosis of
bronchiectasis. The client has a chronic cough with expectoration of copious amounts
of purulent sputum and hemoptysis. Which of the following would the practical nurse
identify as an appropriate client outcome? The client will:
a. Demonstrate improved ventilation and adequate oxygenation
b. The clients arterial blood gases are improved
c. Encourage alternating rest and activity
d. Administer oxygen as ordered

82. A client is ordered to receive acetaminophen 650 mg per rectum every 6 hours as
needed for fever greater than 39 C. Which of the following would the nurse monitor,
other than temperature, if the client requires this medication?
a. Oxygen saturation
b. Pain level
c. Intake and output
d. Level of consciousness

83. Which of the following strategies by the practical nurse would be most helpful in
treating a client who is experiencing chills because of an infection?
a. Turn up the thermostat in the clients room
b. Encourage a hot shower
c. Provide a light blanket
d. Monitor temperature every hour

84. When teaching a client infected with HIV regarding transmission of the virus to others,
which of the following statements made by the client would identify a need for further
education?
a. I will need to isolate any tissues I use, so as not to infect my family.
b. I will notify all of my sexual partners so they can get tested for HIV.

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 c. I do not need to worry about spreading this virus to others by sweating at the
gym.
d. Unprotected sexual contact is the most common mode of transmission.

85. The nurse is caring for a client suffering from anorexia secondary to chemotherapy.
Which of the following strategies would be most appropriate for the nurse to use to
increase the client's nutritional intake?
a. Increase intake of liquids at mealtime to stimulate the appetite.
b. Serve three large meals per day, plus snacks between each meal.
c. Add items such as skim milk powder, cheese, or honey to selected foods.
d. Avoid the use of liquid protein supplements, to encourage eating at mealtime

86. The nurse is caring for a client admitted with heart failure. The morning laboratory
results reveal a serum potassium level of 2.9 mmol/L. Which of the following
classification of medications should the nurse withhold until consulting with the
physician?
a. Antibiotics
b. Loop diuretics
c. Antihypertensives
d. Bronchodilators

87. What should the nurse do when administering low-molecular-weight heparin after an
operation?
a. Explain that the drug will help prevent clot formation in the legs.
b. Check the results of the partial thromboplastin time before administration.
c. Administer the dose with meals to prevent GI irritation and bleeding.
d. Inform the client that blood will be drawn every 6 hours to monitor the prothrombin
time

88. A client who is 27 just gave birth to a child with Down syndrome. When explaining the
disorder to the client, what should the practical nurse do first?
a. Describe the disorder as a trisomy involving the 21st chromosome.
b. Explain that the child will be mentally challenged.
c. Find out how much the client knows about the disease.
d. Discuss the care required for a mentally disabled child.
89. A client is hearing voices that are telling him to do harmful things to himself. Which of
the following nursing diagnosis should be included on this clients plan of care?
a. Potential for violence
b. Altered self concept
c. Sensory perception alteration
d. Impaired communication

90. The practical nurse is assigned to administer medications to 20 clients. The gold
standard for administering medications is to adhere to:
a. The five rights of medication administration: right drug, dose, route, client,
and time.
b. The six rights of medication administration: right drug, dose, route, client,
time, and documentation.
c. The seven rights of medication administration: right drug, dose, route,
client, time, documentation and right to refuse.

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 d. The eight rights of medication administration: right drug, dose, route, client,
time, physician, documentation and right to refuse.

91. Frequent assessment of a client with a fractured left leg would include maintaining
proper alignment and which of the following?
a. Checking temperature and performing ROM in the right leg
b. Taking the apical pulse every 2 hours
c. Checking sensation and circulation of the leg
d. Increasing the weight of traction as necessary to maintain counter traction

92. A practical nurse is caring for a client taking haloperidol (Haldol) an antipsychotic.
What common side effect should the practical nurse observe for in this client?
a. Sedation
b. Weight loss
c. Dry mouth
d. Anxiety

93. When caring for the client with COPD, the practical nurse notes that the client is more
comfortable after which of the following?
a. Being placed in low-Fowlers position
b. Having postural drainage
c. Fluids are restricted
d. He has provided all his own care

94. A client is admitted for possible obstructive urinary retention caused by an enlarged
prostate gland. During the assessment the practical nurse would expect the client to
complain of which of the following?
a. Hematuria
b. Burning on urination
c. Urinary incontinence
d. Hesitancy in initiating voiding

95. Which of the following nursing actions should be the priority after a fall has occurred?
a. Move the client to a bed or stretcher
b. Assess for skin intactness, bruising, or swelling
c. Assess the extremities for symmetry and alignment
d. Assess the clients level of awareness

96. The practical nurse prepares to interview the client for a nursing history but finds the
client is in obvious pain. Which of the following is the best action at this time?
a. Delay the interview until the client is more comfortable
b. Administer IM pain medication
c. Gather as much information as quickly as possible, use close ended
questions that require one or two worded answers
d. Ask only questions pertinent to the specific problem then complete the
interview when the client is more comfortable

97. During an admission assessment, the client tells the practical nurse, I am so tired and
anxious; I dont know what to do. Which of the following actions by the practical
nurse would help develop the therapeutic relationship?
a. Ask the client when would be a better time to complete the interview

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 b. Stop the interview, assist the client to settle for sleep
c. Encourage the client to further describe how she is feeling
d. Reassure that these feelings are normal and will improve soon

98. A client is taking a diuretic that causes sodium loss from the kidneys. Which of the
following electrolyte imbalances is this client most likely to experience?
a. Hyperkalemia
b. Hyponatremia
c. Hypocalcemia
d. Isotonic fluid loss

99. Which of the following procedures is the most accurate way to assess fluid balance in
the client with renal failure?
a. Voiding patterns
b. Daily weights
c. Laboratory results
d. Skin turgor

100. When assessing a client who has sustained second and third degree burns to the
neck and face, which of the following findings would be most concerning?
a. Large, clear vesicles on the face and neck
b. Respirations of 32 per minute
c. Urine output greater than 40cc per hour
d. Client history of dermatitis

END OF COMPREHENSIVE I

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