PN MED SURG
The home health practical nurse is visiting with a client who has a history of second degree heart block
and pacemaker placement six months ago. Which symptom compliant by the client would be indicative
of pacemaker failure?
Feelings of dizziness
Feelings of dizziness may occur ...
pn med surg the home health practical nurse is visiting with a client who has a history of second degree heart block and pacemaker placement six months ago which symptom compliant by the client wou
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PN MED SURG
The home health practical nurse is visiting with a client who has a history of second degree heart block
and pacemaker placement six months ago. Which symptom compliant by the client would be indicative
of pacemaker failure?
Feelings of dizziness
Feelings of dizziness may occur as the result of a decreased heart rate, leading to decreased cardiac
output as a result of pacemaker failure.
Which foods should the practical nurse encourage a client to eat to increase their potassium intake?
(Select all that apply.)
Green beans
Milk
Flounder
Sweet potatoes
Cantaloupe
Flounder, sweet potatoes, milk, green beans, and cantaloupe are all potassium-rich foods.
The health care provider informed a client diagnosed with stage 4 liver cancer that the cancer has
spread to their spine. The client states to the practical nurse, "I have a cancer, but it is not malignant."
What is the best initial nursing action?
Ask the client to explain his understanding of the term malignancy.
The best initial action is to assess the client's knowledge of the term malignancy when used to describe
cancer. The client appears to have inaccurate knowledge. Stage 4 cancer means the cancer has spread
(metastasized) from where it has started to another body part.
A client sustained a burn injury greater than 25% of total body surface with majority of it lower
extremities during a house fire. During the acute phase of care, which intervention is most important for
the practical nurse to implement?
Administer 0.5 mL of tetanus toxoid IM.
Prevention of infection from Clostridium tetani by administering tetanus toxoid has the highest priority
for care of a client in the acute phase of burn care.
In order to provide culturally competent care, what action must the practical nurse do first?
Understand one's own world views in addition to the client's.
The nurse should understand their own values and views to prevent those beliefs being imparted to
others, in addition to understanding the client's cultural views when providing cultural competent care.
Treating every client the same or assuming that all clients share the same values does not exhibit
cultural competence or sensitivity.
,The practical nurse (PN) is interviewing a male client diagnosed with hypertension. Which finding places
the client at the greatest risk for development of a cerebral vascular accident (CVA)?
A waistline greater than 40 inches (101.6 cm)
Males with waist sizes larger than 40 inches (101.6 cm) and females with waist sizes larger than 35
inches (88.9 cm) are at greater risk of cardiac disease increasing the risk of CVA. The more abdominal fat
an individual has the more the risk goes up.
A client diagnosed with prostate cancer is prescribed radioactive seed implantation (brachytherapy).
What is the most important nursing action for the practical nurse (PN) to do?
Follow radiation exposure precautions.
Clients being treated for prostate cancer with brachytherapy (radioactive seeds implant) should be
placed on radiation exposure precautions. The PN needs to follow the institution's protocols put in place
regarding the amount of time and distance needed to prevent excessive exposure that would pose a
hazard to others.
A client diagnosed with diabetes has a prescription of 5 units of regular insulin and 15 units of NPH
insulin. In which order should the practical nurse prepare to administer the insulin?
List in order the nursing actions to be performed.
Perform hand hygiene according to facility policy.
Inspect insulin vials for type and expiration dates.
Inject 15 units of air into NPH insulin vial.
Inject 5 units of air into regular insulin vial.
Withdraw 5 units of regular insulin from vial.
Withdraw 15 units of NPH insulin from vial.
The first nursing action is to perform hand hygiene. The next action is to inspect vials for type and
expiration dates and then add 15 units of air to NPH insulin vial. Next add 5 units of air into regular
insulin vial, then withdraw 5 units of regular insulin from vial, and withdraw 15 units of NPH insulin from
vial. Note that it is important to fill the syringe with regular insulin (shorter acting insulin) first to prevent
contamination of the NPH insulin (intermediate-acting insulin).
The practical nurse (PN) is reviewing the health histories of the following individuals. Which factor does
have a potential for development of throat cancer?
Tobacco use
The most common risk factors for throat cancer are tobacco use, alcohol abuse, human papillomavirus
(HPV), a diet lacking in fruits and vegetable and gastroesophageal reflux disease (GERD). Foods seasoned
with herbs and spices have shown to have some health benefits in decreasing the risk of developing
cancer.
The practical nurse is reinforcing osteoporosis prevention education to a group of senior citizens. What
life style choices will help decrease the risk of developing osteoporosis? (Select all that apply.)
, Alcohol in moderation and smoking cessation.
Regular weight-bearing exercises.
Consumption of a diet rich in calcium and vitamin D.
Alcohol in moderation and smoking cessation, regular weight-bearing exercises at least 30 minutes a
day, and consumption of a diet rich in calcium and vitamin D are life style choices that decrease the risk
for developing osteoporosis.
A client diagnosed with ulcerative colitis (UC) asks the practical nurse why they are prescribed a low-
residue diet. Which is the most appropriate response?
To reduce the amount and frequency of stool
The purpose of a low-residue diet is to reduce the amount and frequency of stooling to promote healing
of the bowels by consuming foods that do not irritate the intestinal lining and prolong intestinal transit
time to encourage optimal absorption of nutrients.
A 70-year-old client status post-hip replacement is transferred to a rehabilitation facility. Which scale
should the practical nurse (PN) identify as the best tool to predict the client's risk for developing skin
breakdown?
Braden Scale
The Braden Scale is made up of six subscales: sensory perception, moisture, activity, mobility, nutrition,
and friction and shear. A hospitalized adult with a score 16 or below or an older adult with a score of 18
or below is at an increased risk for skin breakdown.
A client with a vaginal discharge and pruritus is diagnosed a yeast infection (Candidiasis) and is
prescribed a 7-day course of an intravaginal tioconazole. What information should the practical nurse
provide to the client about using this form of medication?
Remain recumbent for 5 to 15 minutes after insertion of the medication.
The client should remain recumbent for 5 to 15 minutes after inserting the medication to facilitate
absorption and to prevent loss of medication from the vagina.
The practical nurse has been assigned a client with a history of chronic obstructive pulmonary disease
(COPD) who has been admitted to the hospital with a medical diagnosis of pneumonia. Which
intervention poses the greatest risk of respiratory depression for a client with a history of COPD should
the practical nurse determine is most significant in the development of this client's COPD?
Oxygen administration via nasal cannula 4 L/minute.
Clients with COPD drive to breathe is a hypoxic state. Their body becomes use to the high CO2 levels and
too much oxygen could cause the client to decrease their respiratory drive to breath. Oxygen
administration in clients with COPD needs to be carefully monitored.
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