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EXITHESI
-
Comprehensive
PN
Exam
A
Practice
Questions
A
nurse
who
has
recently
completed
orientation
is
beginning
work
in
the
labor
and
delivery
unit
for
the
first
time.
When
making
assignments,
which
client
should
the
charge
nurse
assign
to
this
new
nurse?
-
ANSA
multiparous
client
who
is
dilated
5
cm
and
50%
effaced
A
client
with
human
immunodeficiency
virus
(HIV)
infection
has
white
lesions
in
the
oral
cavity
that
resemble
milk
curds.
Nystatin
(Mycostatin)
preparation
is
prescribed
as
a
swish
and
swallow.
Which
information
is
most
important
for
the
nurse
to
provide
the
client?
-
ANSOral
hygiene
should
be
performed
before
the
medication.
A
client
who
is
admitted
with
emphysema
is
having
difficulty
breathing.
In
which
position
should
the
nurse
place
the
client?
-
ANSSitting
upright
and
forward
with
both
arms
supported
on
an
over
the
bed
table
A
client
with
chronic
renal
insufficiency
(CRI)
is
taking
25
mg
of
hydrochlorothiazide
(HCTZ)
PO
and
40
mg
of
furosemide
(Lasix)
PO
daily.
Today,
at
a
routine
clinic
visit,
the
client's
serum
potassium
level
is
4
mEq/L.
What
is
the
most
likely
cause
of
this
client's
potassium
level?
-
ANSThe
client's
renal
function
has
affected
his
potassium
level.
A
registered
nurse
(RN)
delivers
telehealth
services
to
clients
via
electronic
communication.
Which
nursing
action
creates
the
greatest
risk
for
professional
liability
and
has
the
potential
for
a
malpractice
lawsuit?
-
ANSSending
medical
records
to
health
care
providers
via
the
Internet
Which
pathophysiologic
response
supports
the
contraindication
for
opioids,
such
as
morphine,
in
clients
with
increased
intracranial
pressure
(ICP)?
A.Sedation
produced
by
opioids
is
a
result
of
a
prolonged
half-life
when
the
ICP
is
elevated.
B.Higher
doses
of
opioids
are
required
when
cerebral
blood
flow
is
reduced
by
an
elevated
ICP.
C.Dysphoria
from
opioids
contributes
to
altered
levels
of
consciousness
with
an
elevated
ICP.
D.Opioids
suppress
respirations,
which
increases
Pco2
and
contributes
to
an
elevated
ICP.
-
ANSD
The
greatest
risk
associated
with
opioids
such
as
morphine
(D)
is
respiratory
depression
that
causes
an
increase
in
Pco2,
which
increases
ICP
and
masks
the
early
signs
of
intracranial
bleeding
in
head
injury.
(A,
B,
and
C)
do
not
support
the
risks
associated
with
opioid
use
in
a
client
with
increased
ICP.
The
charge
nurse
of
a
medical
surgical
unit
is
alerted
to
an
impending
disaster
requiring
implementation
of
the
hospital's
disaster
plan.
Specific
facts
about
the
nature
of
this
disaster are
not
yet
known.
Which
instruction
should
the
charge
nurse
give
to
the
other
staff
members
at
this
time?
A.Prepare
to
evacuate
the
unit,
starting
with
the
bedridden
clients.
B.UAPs
should
report
to
the
emergency
center
to
handle
transports.
C.The
licensed
staff
should
begin
counting
wheelchairs
and
IV
poles
on
the
unit.
D.Continue
with
current
assignments
until
more
instructions
are
received.
-
ANSD
When
faced
with
an
impending
disaster,
hospital
personnel
may
be
alerted
but
should
continue
with
current
client
care
assignments
until
further
instructions
are
received
(D).
Evacuation
is
typically
a
response
of
last
resort
that
begins
with
clients
who
are
most
able
to
ambulate
(A).
(B)
is
premature
and
is
likely
to
increase
the
chaos
if
incoming
casualties
are
anticipated.
(C)
is
poor
utilization
of
personnel.
The
nurse
assesses
a
client
while
the
UAP
measures
the
client's
vital
signs.
The
client's
vital
signs
change
suddenly,
and
the
nurse
determines
that
the
client's
condition
is
worsening.
The
nurse
is
unsure
of
the
client's
resuscitative
status
and
needs
to
check
the
client's
medical
record
for
any
advanced
directives.
Which
action
should
the
nurse
implement?
A.Ask
the
UAP
to
check
for
the
advanced
directive
while
the
nurse
completes
the
assessment.
B.Assign
the
UAP
to
complete
the
assessment
while
the
nurse
checks
for
the
advanced
directive.
C.Check
the
medical
record
for
the
advanced
directive
and
then
complete
the
client
assessment.
D.Call
for
the
charge
nurse
to
check
the
advanced
directive
while
continuing
to
assess
the
client.
-
ANSD
Because
the
client's
condition
is
worsening,
the
nurse
should
remain
with
the
client
and
continue
the
assessment
while
calling
for
help
from
the
charge
nurse
to
determine
the
client's
resuscitative
status
(D).
(A
and
B)
are
tasks
that
must
be
completed
by
a
nurse
and
cannot
be
delegated
to
the
UAP.
(C)
is
contraindicated.
The
nurse
is
preparing
a
client
for
surgery
scheduled
in
2
hours.
A
UAP
is
helping
the
nurse.
Which
task
is
important
for
the
nurse
to
perform,
rather
than
the
UAP?
A.Remove
the
client's
nail
polish
and
dentures.
B.Assist
the
client
to
the
restroom
to
void.
C.Obtain
the
client's
height
and
weight.
D.Offer
the
client
emotional
support.
-
ANSD
By
using
therapeutic
techniques
to
offer
support
(D),
the
nurse
can
determine
any
client
concerns
that
need
to
be
addressed.
(A,
B,
and
C)
are
all
actions
that
can
be
performed
by
the
UAP
under
the
supervision
of
the
nurse.
Until
the
census
on
the
obstetrics
(OB)
unit
increases,
an
unlicensed
assistive
personnel
(UAP)
who
usually
works
in
labor
and
delivery
and
the
newborn
nursery
is
assigned
to
work
on
the
postoperative
unit.
Which
client
would
be
best
for
the
charge
nurse
to
assign
to
this
UAP?
A.An
adolescent
who
was
readmitted
to
the
hospital
because
of
a
postoperative
infection B.A
woman
with
a
new
colostomy
who
requires
discharge
teaching
C.A
woman
who
had
a
hip
replacement
and
may
be
transferred
to
the
home
care
unit
D.A
man
who
had
a
cholecystectomy
and
currently
has
a
nasogastric
tube
set
to
intermittent
suction
-
ANSC
The
charge
nurse
will
be
responsible
for
providing
a
report
to
the
home
care
unit
if
the
transfer
occurs
(A).
The
client
is
infected
and
an
employee
who
works
on
an
OB
unit
should
be
assigned
to
clean
cases
in
case
the
employee
is
required
to
return
to
the
OB
unit
(B).
This
requires
the
skills
of
a
registered
nurse
(RN)
to
do
discharge
teaching
and
provide
emotional
support
(D).
This
may
require
skills
beyond
the
level
of
this
UAP.
A
male
client
is
admitted
for
observation
after
being
hit
on
the
head
with
a
baseball
bat.
Six
hours
after
admission,
the
client
attempts
to
crawl
out
of
bed
and
asks
the
nurse
why
there
are
so
many
bugs
in
his
bed.
His
vital
signs
are
stable,
and
the
pulse
oximeter
reading
is
98%
on
room
air.
Which
intervention
should
the
nurse
perform
first?
A.Administer
oxygen
per
nasal
cannula
at
2
L/min.
B.Plan
to
check
his
vital
signs
again
in
30
minutes.
C.Notify
the
health
care
provider
of
the
change
in
mental
status.
D.Ask
the
client
why
he
thinks
there
are
bugs
in
the
bed.
-
ANSC
One
of
the
earliest
signs
of
increased
intracranial
pressure
(ICP)
is
a
change
in
mental
status
(C).
It
is
important
to
act
early
and
quickly
when
symptoms
of
increased
ICP
occur.
Because
his
oxygen
saturation
is
normal,
the
administration
of
oxygen
(A)
is
not
the
top
priority.
Vital
signs
should
be
monitored
frequently
(B),
but
the
client's
confusion
should
be
reported
immediately.
(D)
is
not
a
useful
intervention.
The
nurse
is
monitoring
a
client
who
is
receiving
bedside
conscious
sedation
with
midazolam
hydrochloride
(Versed).
In
assessing
the
client,
the
nurse
determines
that
the
client
has
slurred
speech
with
diplopia.
Based
on
this
finding,
what
action
should
the
nurse
take?
A.Open
the
airway
with
a
chin
lift-head
tilt
maneuver.
B.Obtain
a
fingerstick
glucose
reading.
C.Administer
flumazenil
(Romazicon).
D.Continue
to
monitor
the
client.
-
ANSD
The
desired
level
III
in
conscious
sedation
includes
slurred
speech,
glazed
eyes,
and
marked
diplopia.
Because
this
is
the
desired
outcome
of
the
medication
regimen,
no
action
is
needed
but
continuing
to
monitor
the
client
(D).
The
airway
is
open
if
the
client
is
able
to
talk
(A).
There
are
no
signs
of
hypoglycemia
(B).
No
reversal
is
necessary
for
the
benzodiazepine
(Versed)
without
signs
of
oversedation,
such
as
respiratory
depression
(C).
The
nurse
is
assessing
a
client
using
the
Snellen
chart
and
determines
that
the
client's
visual
acuity
is
the
same
as
in
a
previous
examination,
which
was
recorded
as
20/100.
When
the
client
asks
the
meaning
of
this,
which
information
should
the
nurse
provide?
A.This
visual
acuity
result
is
five
times
worse
that
of
a
normal
finding.
B.This
line
should
be
seen
clearly
when
the
client
wears
corrective
lenses.
C.A
client
with
normal
vision
can
read
at
100
feet
what
this
client
reads
at
20
feet.
D.This
client
can
see
at
100
feet
what
a
client
with
normal
vision
can
see
at
20
feet.
-
ANSC
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