Canadian Practical Nurse Registration Examination (CPNRE) 3rd EDITION EXAM ANSWER KEY
Mrs. Campbell, 73 years old, is diagnosed with right breast cancer and admitted to the medical unit. She is now
undergoing radiation therapy on her right breast.
1. The health care team has established a goal t...
ANSWER KEY FOR BOOK I
CASE I
Mrs. Campbell, 73 years old, is diagnosed with right breast cancer and admitted to the medical unit. She is now
undergoing radiation therapy on her right breast.
1. The health care team has established a goal to maintain skin integrity at the radiation site. Which of the
following actions would meet this goal when bathing Mrs. Campbell?
a. Antiseptic soap is too harsh on the fragile skin.
b. Gentle wash with water will assist with maintaining skin integrity. Mild or gentle soaps (dove
or ivory) can be used.
c. Contraindicated on irradiated area.
d. Contraindicated on irradiated area
2. Which nursing intervention is appropriate for the practical nurse to do following Mrs. Campbell’s right
mastectomy?
a.! Only the right arm must be elevated to decrease edema and promote drainage.
b.! Safe to obtain BP from left arm; this does not jeopardize client safety.
c.! Unsafe; this can restrict circulation and increase the risk of injury and infection to arm.
d.! Hourly exercise may be too frequent. Right arm requires regular exercise.
3. The treatment plan for Mrs. Campbell includes a slow-release dermal analgesic (Fentanyl) patch. Which
of the following actions is most appropriate for the practical nurse to take?
a.! The client can shower if she wishes since the patch is waterproof and left on for 72 hours.
b.! It should be a different site to prevent potential skin irritation. Site should be washed when
removing old patch.
c.! The patch should not be trimmed or cut since this changes the medication.
d.! Securing correctly ensures patch efficiency and durability. Pressing other than around the
edges may cause immediate release of medication and potential patch malfunction.
4. Mrs. Campbell has a right mastectomy. The practical nurse has just assessed Mrs. Campbell after
receiving her from the recovery room. She is moaning and restless. Which of the following goals should
be the first priority?
a.! Pain must be relieved before dressing (skin), education (teaching) or anxiety can be dealt with.
b.! Not a priority when the client is in pain.
c.! Pain is the priority.
d.! Pain is the priority.
5. A personal care aide is assisting Mrs. Campbell with her morning care. The practical nurse arrives to
give Mrs. Campbell her morning medication and observes that Mrs. Campbell is wearing a tight
polyester shirt. What should the practical nurse do?
a.! This may be offensive to the personal care aide.
b.! No direction provided to the personal care aide.
c.! Offers an explanation, providing an understanding, motivational, courtesy to the health care
aide out of the client’s presence.
d.! No explanation provided to the personal care aide.
CASE 2
Sally, 17 years old, has come to the clinic with symptoms of gonorrhea.
6. Tom is the practical nurse working with Sally. What should Tom consider prior to completing a health
history with Sally?
a.! Past history is not much of a concern as sexual history.
b.! Sally’s parents do not have to be present.
c.! Revealing information about one’s sexuality is usually difficult, especially with a member of
the opposite sex.
, d.! This is one component, but not the most important one.
7. Sally is very embarrassed about her diagnosis of gonorrhea. Which one of the following statements
would be most appropriate for Tom to make?
a.! “Sally, you’re not the only person this has happened to. Don’t worry about this.”
b.! “I know this can be embarrassing, but I’ve cared for many people with this
condition.”
c.! “This type of infection is treatable but it can be upsetting for the person.”
d.! “You should not be embarrassed. This condition is easy to treat.”
8. Sally has asked Tom not to tell anyone about her diagnosis. Which one of the following statements
would be most appropriate for Tom to make?
a.! “Don’t worry Sally, your diagnosis will not be shared with anyone.”
b.! “The law requires the health nurse to notify your sexual contacts.”
c.! “Unfortunately, this information is difficult to keep confidential.”
d.! “I understand your concern. I know how you must feel.”
CASE 3
Mrs. Ng, 71 years old, has recently been discharged from hospital following an acute episode of Crohn’s disease.
She lives in a basement apartment in the home of her daughter, son-in-law, and their two children, aged 8 and 6
years. Both the daughter and son-in-law work out of the home. The practical nurse is scheduled to make an initial
visit with Mrs. Ng.
9. Based on Mrs. Ng’s diagnosis, which of the following pieces of equipment would be beneficial for the
practical nurse to bring with her on the initial home visit?
a. Portable weight scale.
b. Glucometer
c. Sterile urine container
d. Pulse oximeter
10. During the visit, the practical nurse performs an assessment on Mrs. Ng. which one of the following
statements by Mrs. Ng may indicate an exacerbation of Crohn’s disease?
a. “My chest feels tight and my eyes are dry and burning.”
b. “I tire easily and I am experiencing diarrhea.”
c. “I am quite constipated and my stool is very dark in colour.”
d. “My head hurts and all my joints are swollen and aching.”
11. Mrs. Ng expresses her concern that she will not be able to attend functions at her
local church and that she really misses seeing her friends there. What is the most
appropriate response on the part of the practical nurse?
a. “Can you think of some new activities you would like to try at home?”
b. “Would you like me to call your minister and friends and have them visit you
here?”
c. “What makes you feel that you cannot attend functions at your local
church?”
d. “Have you thought about joining a church closer to your home?”
, 12. Until she became ill, Mrs. Ng was responsible for ensuring the children received
their lunch and made it home from school safely. She is now finding this task
overwhelming. How should the practical nurse address this situation?
a. Call the children’s school and see whether it has a lunch program.
b. Reassure her that it will take time for her energy to return to normal.
c. Encourage a family conference with Mrs. Ng to discuss her concerns.
d. Suggest that Mrs. Ng explore the idea of an assisted-living arrangement.
13. During a conversation with Mrs. Ng, the practical nurse observes a bruise on the
client’s upper arm. When asked about this, Mrs. Ng replies that she must have
bumped into something. What is the most appropriate action for the practical nurse to
take at this time?
a. Document the findings and check the bruise again during the next visit.
b. Question the daughter and son-in-law about the bruising.
c. Accept Mrs. Ng’s statement as true and respect her response.
d. Notify the supervisor and report a case of abuse.
CASE 4
Ms. Ouellette, 29 years old has been recently diagnosed with systemic lupus erythematosus. She is admitted to
hospital for stabilization of chronic pain. Ms. Ouellette is being transferred to bed following a renal biopsy.
14. When transferring Ms. Ouellette to the bed, the practical nurse notices a pool of
blood on the stretcher and that the IV has stopped infusing. Ms. Ouellette is crying,
“It hurts, it hurts!” what is the most appropriate sequence of actions to respond to this
situation?
a. Administer analgesic, assess dressing, assess IV, assess vital signs.
b. Assess dressing, assess IV, assess dressing, administer analgesic.
c. Assess IV, assess vital signs, assess dressing, administer analgesic.
d. Assess dressing, assess IV, administer analgesic, assess vital signs.
15. The practical nurse assesses that the renal pressure dressing is saturated with fresh
blood. What action should the practical nurse take first?
a. Remove the dressing and assess.
b. Request that the physician be notified.
c. Assess for hematuria.
d. Reinforce the existing dressing.
16. The physician has ordered subcutaneous morphine sulfate 20 mg q4h. Ms. Ouellette
weighs 50 kg. what action should be taken first?
a. Monitor baseline vital signs.
b. Verify the dosage in the drug reference.
c. Administer the morphine sulfate as ordered.
d. Confirm the order with pharmacy.
, 17. Ms. Ouellette is requesting morphine sulfate every 4 hours for abdominal pain. She
rates her pain as 8 on a scale of 0 to 10. She is ambulating well and leaves the unit
between medication administrations. How should this be documented?
a. Requesting morphine for abdominal pain of 8 on a scale of 0 to 10. Off unit following
administration of same.
b. Only on unit to request morphine for abdominal pain rated as 8 on scale from 0 to 10. Physician
aware.
c. Returned to unit requesting morphine for pain. Morphine administered, client left unit immediately.
Physician notified as to overuse.
d. Requesting morphine for abdominal pain rating 8 on a scale of 0 to 10. Rates pain as 0 prior to
leaving unit.
CASE 5
Mrs. Hanlon, 77 years old, was found semi-conscious in her apartment by her neighbour who called the ambulance.
Her admitting diagnoses are congestive heart failure and anemia.
18. After assessing Mrs. Hanlon, the physican orders an IV solution of 500 ml of normal
saline to run at 150ml/h for the next 4 hours and then reduce the rate to 75ml/h. how
should the practical nurse proceed?
a. Check the order in the procedure manual.
b. Verify the order written by the physician.
c. Discuss the order with the nurse-in-charge.
d. Proceed with setting up the IV equipment.
19. During Mrs. Hanlon’s hospital stay, the IV tubing is due to be changed. Which action
by the practical nurse represents appropriate medical aseptic technique?
a. Wash hands before starting procedure.
b. Cleanse the IV site first and then move outward.
c. Place clean gauze under the hub before disconnecting the tubing.
d. Wear sterile gloves during the procedure.
20. Mrs. Hanlon’s IV is interstitial and it is removed. After applying a dressing, the
practical nurse assesses that clear fluid continues to drain from the site. What should
the practical nurse do first?
a. Elevate the extremity.
b. Apply saline compress.
c. Apply a larger dressing
d. Ask her to held the dressing in place.
21. Five days after admission, Mrs. Hanlon has stabilized. She is receiving a unit of
packed cells for anemia. Which assessment finding should alert the practical nurse to
a possible circulatory overload?
a. Back pain.
b. Increased temperature.
c. Erythema
d. Chest congestion.
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