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Sample test
Case 1. Ken Dyer, 40 years old, is admitted to a surgical unit postoperatively following
abdominal surgery. He has a Penrose drain and an incision covered by a dressing.
1. What drainage should the PN expect to observe when changing Mr. Dyer’s drain
dressing on his second postoperative day? Sanguineous Serosanguineous Purulent Serous
2. Which of the following observations would best indicate to the PN that Mr. Dyer’s
postoperative pain is increasing? He clasps his hands behind his head and sighs deeply. He grimaces and holds his hand over his abdomen. His blood pressure decreases, and his pulse increases. His respiratory rate is 26 breaths/min and shallow.
3. The PN is caring for Mr. Dyer the day following his surgery. Which one of the
following measures should the PN take? Encourage coughing exercises q. 6h. Assist Mr. Dyer to sit in a chair. Check the dressing once during the shift. Instruct Mr. Dyer to perform leg exercises q. 6h.
4. When changing Mr. Dyer’s dressing, which one of the following actions by the PN is
most appropriate? Cleanse the incision, then the drain. Wear sterile gloves to remove the soiled dressing. Change the pin in the open drain. Dispose of the soiled dressing in Mr. Dyer’s garbage.
5. Sara is a 6-year-old child with a full right-leg cast. Which one of the following actions
by the PN would be most appropriate when giving Sara a bedpan? Have Sara use the trapeze to lift up her buttocks. Ask Sara to lift herself using her elbows and left leg. Have two people lift her on to the bedpan. Roll Sara laterally toward her affected leg side.
6. Which one of the following procedures is consistent with the principles of medical
asepsis? Use cool water to wash hands Keep hands lower than elbows when washing. Wash hands for a total of 4 minutes.
1 Dry hands from wrists to fingertips
7. The practical nurse is feeding an unfamiliar client who is aphasic. The client is
resistant. What should the PN do? refer to the policy/procedure manual for feeding techniques. Continue feeding the client, allowing more time to swallow. Reposition the client, and continue feeding slowly. Ask someone who is familiar with the client for assistance.
8. How can the PN promote the autonomy of a client wearing dressings on both eyes? Ensure that the client has a call bell. Assist the client to eat. Orient the client to the room. Ask the client to ring before getting out of bed.
9. The PN visits Anna Sabourin, a 25-year-old new mother, in her home. Mrs. Sabourin
asks the PN where she can obtain more information about breastfeeding her newborn.
Which one of the following is the best response? “I can bring you some pamphlets and books when I come tomorrow.” “I have another client with breastfeeding problems who may be able to help you” “I can give you the telephone number for the community breastfeeding support
group.” “After delivery, it is important that you return to your family doctor with these
questions.”
10. Tommy, 12 years old, fell and struck his knee while in the hospital play room. In this
situation, which one of the following activities is an important nursing responsibility? Apply an antiseptic to the injured knee. Restrict Tommy’s access to the playroom. Call Tommy’s parents to explain the incident. Notify the physician on call. 2 Book 1
Case 1 Mrs. Sara Sommers, 66 years old, has a reoccurrence of psoriasis on her
scalp, elbows, and trunk. She is being seen by a PN in her home.
1. which one of the following observations regarding Mrs. Sommers’ skin is most
important for the PN to report? Red, cracked Silvery, scaly Pale, itchy Dry, scaly
2. Which of the following actions by the PN will best promote a safe therapeutic tub bath
for Mrs. Sommers? Prepare the bath and assist Mrs. Sommers in and out of the tub. Leave Mrs. Sommers in the bathroom to ensure privacy Ask Mrs. Sommers to undress in the bathroom to observe her skin lesions. Give Mrs. Sommers towels and tell her to dry well.
3. Which one of the following actions by the PN is a priority for preventing Mrs.
Sommers from developing a skin infection? Wash hands carefully before Mrs. Sommers’ care. Encourage Mrs. Sommers to change her undergarments twice a day. Instruct Mrs. Sommers to change her bed linen once daily. Use sterile gloves when providing Mrs. Sommers care
4. Mrs. Sommers remains quietly in her chair and is refusing to attend her community
social activities. She looks into her hand mirror frequently. Which one of the following
approaches by the PN will best assist Mrs. Sommers to interact socially? Tell Mrs. Sommers that there is nothing wrong with her appearance. Advise Mrs. Sommers how important it is to maintain her social activities. Gain the support of Mrs. Sommers’ family. Encourage Mrs. Sommers to verbalize her feelings.
Case 2 Sandy Smith is an 18-year-old client who is pregnant for the first time.
5. which one of the following instructions would be most appropriate for the PN to give
Sandy with regard to nutrition during pregnancy? “It is important to have enough nutrients as you will be eating for two.” “Eat a balanced diet that includes foods rich in iron.” “The goal of your diet is to minimize your weight gain.” “You are probably already obtaining the nutrients you need.” 3 6. Sandy has developed high blood pressure and is hospitalized. which one of the
following measures by the PN would be most effective to reduce Sandy’s anxiety? Initiate a discussion of her concerns Post a “No Visitors” sign on her door. Reassure her that everything will be all right Encourage her friends to visit
7. Sandy’s pregnancy progresses to term. She has a vaginal delivery of a healthy baby
boy and is transferred to the postpartum unit. In addition to vital signs, which of the
following data are most important for the PN to assess in Sandy’s immediate postpartum
period? Fundus, lochia, perineum Breasts, hemorrhoids, voiding Breasts, fundus, voiding Perineum, hemorrhoids, lochia
8. during the delivery, Sandy had an episiotomy. Which of the following information is
most appropriate for the PN TO GIVE sandy with regard to taking a sitz bath? “The sitz bath is used to cleanse and soothe the perineum.” “The sitz bath should be taken before meals.” “Try to take your sitz bath once a day.” “The sitz bath should be as hot as you can tolerate.”
9. sandy has dedided to breastfeed her baby. Which one of the following actions by the
PN would most effectively provide emotional support to Sandy? Assure Sandy that she has made the right decision. Encourage sandy’s breastfeeding efforts by providing assistance. Inform sandy that the public health nurse will provide guidance at home. Provide Sandy with written information on breastfeeding.
Case 3 Ralph White, 55, years old, has chronic obstructive pulmonary disease.
10. which one of the following manifestations is Mr. White most likely to experience? Severe chest pain. Severe dyspnea on exertion Pleural friction rub Hemoptysis.
11. Mr. White tells the PN that his wife died a year ago. Which one of the following
responses by the PN would be most appropriate? “I know how you feel. I lost my mother 3 years ago.” “That’s too bad. Can I get you a cup of tea?” “How have you been coping?” “Was this your first loss?” 4 12. Mr. White tells the PN that he is having difficulty sleeping at night. Which one of the
following suggestions by the PN would be most appropriate? Postpone bedtime until later in the evening. Have a cup of hot chocolate before retiring. Sleep with the bed flat. Sleep with the head of the bed raised.
13. According to Mr. White’s care plan, he is to increase his activity level gradually.
Which one of the following actions by the PN would best encourage Mr. White’s
participation? Plan Mr. White’s activity schedule with him. Take Mr. White’s for walks three times a shift. Inform Mr. White the physician wants him to walk more. Arrange for Mr. White to see the physiotherapist.
14. Mr. White has discussed with the dietitian ways to obtain adequate nutrition. Which
one of the following would be a recommendation by the dietitian that the PN should
reinforce? Eat three large meals a day. Eat small frequent meals. Avoid high-calorie liquid supplements. Avoid a high protein intake.
Case John Adams is a 34-year-old client who experienced a compound fractur of his
right humerus at work. He has just been transferred from the postoperative
recovery room to the nursing unit following a closed reduction.
15. the PN is admitting John. His colour is pale and he is drowsy. Which of the following
nursing actions should be the first prioprity for the PN? Take his vital signs, obtain an oxygen set-up, and assess intraveneous infusion. Report to the appropriate person , assess the operative site, and obtain an oxygen
setup. Have him take deep breaths, take his vital signs , and assess the operative site. Report to the appropriate person for a directive, assess the operative site, and
have him take deep breath.
16. A cast is applied to John’s arm, and a sling is used for support. Which one of the
following actions by the PN would best promote his level of comfort? Elevate the head of his bed 45? Assist him into a supine position with his arm elevated. Assist him into a lateral position on his nonoperative side. Teach him to splint his arm when he deep breathes.
17. While caring for John, which one off the following manifestations should the PN
report immediately? 5 Chest pain
Absence of bowel sounds
Edematous hand
A capillary refill of less than 3 seconds. 18. The PN has requested the assistance of a colleague to move John up in bed. Which of
the following statements best describes the most efficient procedure? One person moves John’s upper body, while the other person moves John’s
lower body. Each person, one on each side, pulls the lifting/turning sheet, while John pushed
with his heels. Both staff face John; one person lifts one shoulder, and the other person lifts the
other shoulder. The staff divide the lifting load evenly between their arms and use the large
muscles of their legs.
19. As part of discharge instructions, the PN is teaching John to apply his own sling.
Which one of the following instructions should the PN provide when explaining the
position of the hand of the casted arm? The fingertips should touch the clavicle on the opposite shoulder. The hand should be slightly higher than the elbow of the same arm. The fingertips should be at the level of the elbow of the unaffected arm. The hand should be placed approximately at the level of the umbilicus.
Case Jannie, an 18-year-old female client diagnosed with diabetes, is admitted to
hospital in a diabetic coma. After being stabilized, Jannie tells the nurse that she
doesn’t always take her insulin. Jannie lives on the street, smokes heavily, and has
poor hygiene.
20. which one of the following actions is most important for the PN to take after Jannie’s
diabetic coma? Test urine for ketones prior to meals. Explain that early manifestations of hyperglycemia are excessive thirst and
urination. Assess feelings of weakness, diaphoresis, and shakiness as manifestations of
ketoacidosis. Instruct Jannie to report occurrences of “ not feeling lie herself” to the physician.
21. Jannie’s feet are dirty and have numerous calluses from walking barefoot. Which one
of the following actions should the PN take when teaching Jannie about foot care? Tell her she must wash her feet daily with lukewarm water and a mild soap. Suggest that she file her calluses and toenails regularly. Advise her that wearing shoes will prevent foot problem. Explain that walking barefoot can cause injury and infection. 6 22. Which ome of the following suggestions should the PN make when teaching Jannie to
maintain adequate circulation? Rub her feet with alcohol. Avoid tobacco use. Take baths with bath oil Apply baby powder between her toes.
23. The PN observed that Jannie received her insulin but missed her breakfast. What
should the PN do initially? Continue to observe Jannie for a possible insulin reaction. Ensure that Jannie receives a substitute meal. Document in the nurse’s notes Jannie’s missed breakfast. Encourage Jannie to eat a full meal at lunch time.
24. Jannie states, “I just can’t deal with this diabetes anymore” which one of the
following statements would be most appropriate for the PN to make? “Did you know that you can lead a normal life even though you have diabetes?” “Having diabetes is difficult for you; tell me more about that.” “I understand how you are feeling because I have looked after many young
people with diabetes.” “It is very important that you accept your illness and learn to live with it.”
25. Jannie asks the PN if she can leave the hospital to go out with her friends for a few
hours. Which one of the following actions by the [N is most appropriate? Grant Jannie’s request in order to respect her right to autonomy Refuse Jannie’s request in order to be responsible for her safety. Verify the physician’s order for a hospital pass for Jannie. Explain to Jannie that she cannot leave the hospital until her test results have
been evaluated.
Case Joni, 9 years old, is admitted from emergency following a severe asthma
attack. She is sitting upright in bed and has oxygen running per nasal prons. She is
able to give necessary information during her initial assessment and she tells the PN
that when she eats eggs, dairy products and bread, she usually has an asthma attack.
26. When assessing Joni’s respiratory status, which one of the following assessments
would best indicate that she is still in respiratory distress? The use of accessory muscles for breathing A respiratory rate of 26 breaths/min The ability to speak in sentences of 6 to 8 words. A frequent harsh cough.
27. Joni says that she is getting really mad because she cannot eat the same foods as her
friends eat without getting sick. Which one of the following responses should let Joni
know that the PN understands how she is feeling? 7 ‘I know this makes you mad now, but you will probably outgrow your asthma
and then you can eat anything you want.” “Would you like me to give you a list of the foods you can eat safely?” “I know you are mad now, but when you are feeling better, it will not bother you
so much.” “It must be difficult not being able to eat the foods you like.”
28. Joni is receiveing oxygen. Which one of the following statements is correct regarding
oxygen administration? Oxygen flow rate should be verified with the physician’s orders. Oxygen tubing should be changed once per shift. Joni must be in semi-Fowler’s position when receiving oxygen. Oxygen flow should be gradually increased until the ordered level is reached.
29. When discussing food choices with Joni, which one of the following foods should the
PN teach her to avoid? Chicken-with-rice soup Turkey sandwich Green salad Jello
30. Joni is having difficulty getting to sleep at night. Which one of the following
measures taken by the PN would be most effective in helping her go to sleep? Offer her a glass of milk Allow her to stay up an hour later. Play her favorite music quietly. Suggest playing a board game with another child.
Case The Pn is visiting Mrs.Barton, a 64-year-old home care client. Mrs.Barton
describes a heavy feeling in her abdomen and burning on voiding. She states that
she had to go to the bathroom several times throughout the night.
31. the PN assesses Mrs.Barton for a urinary tract infection. Which of the following signs
must be reported immediately? Urinary frequency Types of fluids taken in the past 24 hours. Hematuria Irritation of the perineum
32. Mrs.Barton is diagnosed with a urinary tract infection and is placed on medication
b.i.d. which of the following statements should the PN make to encourage Mrs.Barton to
consistently take her medecation? ‘If you don’t take your medication twice a day, you will need to be hospitalized.” “Your medication must be taken regularly to prevent further infections” “Make sure you take the medication until you feel better”
8 “Try to take your medication first thing in the morning and at bedtime.”
33. Mrs.Barton states that she feels she is not emptying her bladder. What approach
should the PN take to promote Mrs.Barton’s comfort when palpating her bladder? Have Mrs.Barton take slow deep breaths during the procedure. Place Mrs.Barton in a dorsal recumbent position with knees flexed. Place Mrs.Barton on n.p.o. prior to the procedure. Encourage Mrs.Barton to drink cranberry juice prior to the procedure.
34. What should the PN do to maintain medical asepsis when palpating Mrs.Barton’s
bladder? Wear disposable gloves Wear sterile gloves Perform pericare Wash hands.
35. Mrs.Barton develops abdominal pain and is unable to void. Her BP begins to fall, her
pulse is weak and rapid, and shhe has cold, clammy skin. What would the PN expect to
find when assessing Mrs.Barton’s respirations? Bradypnea Tachypnea Cheyne-Stoles respirations Kussmaul’s breathing.
36. When should the PN update the home care coordinator regarding Mrs.Barton’s
decreasing BP, and weak and rapid pulse? At the end of the shift. Following the home visit. At team report the following morning Immediately following the assessment
Case Mrs. Saunders, 42 years old, finds a lump in her left breast while performing a
monthly breast assessment. A biopsy and possible mastectomy are recommended.
She comes to the surgical unit on the morning of surgery accompanied by her
husband and 7-year-old son.
37. which information is most important to report and record during Mrs. Saunders’
admission interview and assessment? Family support Religious affiliation Occupation Community resources.
38. Mrs. Saunders’ biopsy was positive and a left mastectomy was performed. What
should the PN do while assisting Mrs. Saunders with her postoperative breathing
9 exercises? Ask her to turn on her right side, and then breathe deeply. Assist her into the low-Fowler’s (30? Position, and then ask her to take short
breaths. Splint her left upper thoracic region, and then ask her to breathe deeply. Support her entire thoracic region, and then ask her to take short breathe.
39. Mrs. Saunders is concerned about her present appearance and the type of clothing
needed to camouflage the loss of her breast. Which one of the following responses should
the PN give to Mrs. Saunders? “It is unlikely that anyone will notice a difference in your appearance; your
grooming is impeccable.” “You may want to try a temporary prosthesis that is worn under your clothing
until you are healed.” “If you are considering having reconstructive surgery, you do not need to make
any changes in your clothes now.” “You may want to change your hairstyle to draw attention away from the
operative site.”
40. Mrs. Saunders is receiving post-mastectomy chemotherapy and steroids. She has read
that this treatment may cause weight gain. She does not want to gain weight and is not
eating her meals. What should the PN do? Investigate Mrs. Saunders’ concerns further, report the findings, and record all
data related to food intake. Reassure Mrs. Saunders that not all clients gain weight, and encourage more
food intake. Suggest Mrs. Saunders that she consult a nutrition specialist, and weigh herself
daily. Encourage Mrs. Saunders to get more exercise, and suggest a low-fat, low-salt,
low-sugar diet.
Case Mr. Johanson, 68 years old, has pneumonia and is orthopneic.
41. The PN is asked to collect a sputum specimen from Mr. Johanson. What is the most
appropriate collection time? After providing mouth care Immediately following A.M. care At bedtime Before breakfast.
42. The PN is asked to monitor Mr. Johanson’s urinary output. What amout of uurine
output per hour should the PN report immediately? 15 ml 45 ml 60 ml 10 70 ml
43. The physician has ordered Mr. Johanson to ambulate to the bathroom. Which of the
following findings should indicate to the PN that Mr. Johanson is not tolerating the
increase in activity? He becomes flushed His heart rate is lower He becomes agitated His respiratory rate decreases.
44. Mr. Johanson tells the PN, “No one took the time to answer my call light last night.”
Which one of the following responses by the PN would be most appropriate? “We were really short-staffed last night. I’m sorry you felt alone” “It sounds like you had a particularly difficult night last night.” “Were you aware that the client in the next room was very sick last night? “I’m sorry, I know how it feels when no-one takes the time to respond.”
45. Which one of the following is the primary reason why a PN should engage in
continuous learning? Continuous learning activities contribute to the PN’s overall mental health. Opportunities for career advancement for the PN will improve. Contact with other professionals will shape new ideas and opinions. Past learning is enhanced by knowledge of current trends and new technologies.
46. Pamela Flannigan and her newborn are to be discharged. She has started
breastfeeding her baby and asks the PN whom she should contact if she has questions.
Which one of the following responses would be most appropriate? ‘There are community services set up to address the needs of breastfeeding
moms” “Your family doctor is your primary caregiver and will need to speak with you
about breastfeeding” “Any health professional can help you with breastfeeding. Breastfeeding is a
very natural activity” “Clinics for breastfeeding moms are set up only when the mom runs into
difficulty”
47. Which of the following best defines informed consent? It is the responsibility of the person performing the procedure. It may be verbal or written, except in an emergency It prevents delays in completing diagnostic or surgical procedures It is only required when clients are scheduled for surgery.
48. Which of the following chest assessment findings are characteristic of a healthy 82year-old male client? Round-shaped chest; shortness of breath with activities of daily living
11 Barrel-chested; respirations 20 to 30 breaths per minutes Retracted sternum;respiratons deep and irregular Symmetrical chest; respirations 12 to 22 breaths per minute
49. Mr. Smith, 67 years old, has returned from the recovery room following a
cholecystectomy. Which one of the following measures by the PN would best promote
oxygenation in the first 12 hours postoperatively? Assist with early ambulation Check the dressing every 4 hours Give clear fluids in the first 8 hours Encourage deep breathing
50. Which one of the following interventions should be the priority for the PN to
implement when assessing a 70 years old female client with a blood pressure of 200/115
mmHg? Provide her with information on a low-cholesterol diet and report her blood
pressure to the nurse-in-charge. Reinforce with her the importance of taking her medication and encourage her to
reduce her sodium intake. Encourage her to rest, and report her blood pressure to the appropriate person Ensure that the side rails are up and chart her blood pressure on the graphic
record.
51. Margo, 51 years old, underwent surgery for a ruptured appendix 3 days ago. While
changing the incisional dressing, the PN notices a thick, yellow drainage with an odor.
What should the PN understand about this type of drainage? It is normal following a ruptured appendix It indicates wound dehiscence It is the result of poor healing. It is evidence of wound infection.
52. Jane Loeb, 80 years old, has chronic constipation. The physician has ordered a large
volume enemia that Jane asks to receive while on the toilet. Which one of the following
responses is most appropriate for the PN to make? “It is against our rules to administer an enema in the bathroom.” “When you are sitting on the toilet, the solution cannot flow to all parts of the
colon.” “The enema can be given more quickly if you are lying down.” “I will ask the nurse-in-charge for permission.”
53. While performing a bed bath, the PN notices a large callus on Mrs. Grady’s right
great toe. How should the PN address this finding? Help her file her callus Ask her how she usually treats her callus Soak her foot in warm water and apply a dry dressing
12 Document and report the observation
54. Richard, 6 years old, is receiving treatment for leukemia. He is placed in
protective(reverse) isolation. What should the PN wear when giving Richard morning
care? Gown and gloves Gloves and mask Sterile gloves, mask and gown Glove, mask and gown.
55. Mrs. Lepage had abdominal surgery 2 days ago. The PN is at her bedside when Mrs.
Lepage chokes on a piece of food. Mrs. Lepage is unable to speak or breathe. The PN
rings the call bell for help. Which measure is most appropriate for dislodging the object? Perform a mouth sweep Give 2 complete breaths Perform thoracic thrusts Perform abdominal thrusts.
56. The PN is bathing Janelle who was born 6 hours ago. What should the PN do? Assess Janelle during her bath. Lightly soap Janelle’s face. Assess Janelle after her bath Wash Janelle in the bathtub...
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