A child diagnosed with strep throat 3 days ago enters the clinic crying hysterically. The parent tells the practical nurse (PN) that the child screams in pain even with a light touch. The child is short of breath and anxious. Which manifestations warrant immediate intervention by the
PN?

Slightly raised rash with ragged edges.

Red, hot, and swollen joints.

Heart rate 110 beats/minute.

Pulse oximetry of 88% O2 saturation.

Answer and Explanation

Correct Answer : B,D

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Correct Answer is D

Explanation

A. Ineffective pain management reported while using morphine PCA is concerning but may not be immediately life-threatening.
B. Inability to void after discontinuing an indwelling catheter should be addressed but might not require immediate attention.
C. Oral ice chips eaten after vomiting postoperatively might need monitoring, but it's not typically an urgent issue.
D. Coffee-ground secretions draining via nasogastric tube suction could indicate bleeding in the upper gastrointestinal tract, which requires immediate attention due to the potential for severe
bleeding.

A. Determine the means by which residents will be evacuated. B. Close all fire doors and the doors to all the residents' rooms. C. Assist any wandering residents back to their rooms. D. Offer comfort and reassurance to distraught residents.

Correct Answer is A

Explanation

A. Determining the means of evacuation requires understanding the facility's evacuation protocols, coordinating with authorities, and ensuring the safety of residents, which typically falls under the responsibility of the nursing staff, including the practical nurse (PN).
B. Closing fire doors and residents' room doors can be part of fire safety protocols and may involve the immediate safety response handled by both nursing staff and facility personnel.
C. Assisting wandering residents and offering comfort and reassurance to distraught residents can be tasks shared among nursing and support staff to ensure resident safety and well-being during an emergency situation.

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A child diagnosed with strep throat 3 days ago enters the clinic crying hysterically. The parent tells the practical nurse (PN) that the child screams in pain even with a light touch. The child is short of breath and anxious. Which manifestations warrant immediate intervention by the PN?

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Naxlex Comprehensive Predictor Exams

Which client finding should the practical nurse (PN) report to the registered nurse (RN) immediately?

Correct Answer is D

Explanation

When a small fire breaks out in the kitchen of a long-term care facility, which task should be performed by the practical nurse (PN) rather than the unlicensed assistive personnel (UAP)?

Correct Answer is A

Explanation

A female client who has migraine headaches wants to decrease her intake of foods high in tyramine to see if that will reduce the occurrence of headaches. Which snack choice should the practical nurse recommend that she eliminate from her diet?

The practical nurse (PN) reorients a male client to the correct time, day, date, location, and why he is here today but he is only able to remember his name and where he is. Based on these findings, what should the PN document?

A female client is scheduled to begin chemotherapy for breast cancer. She tells the practical nurse (PN) that the healthcare provider explained that her hair is likely to fall out as a result of the treatment. The client asks the PN if her hair will grow back. Which response is best for the

The practical nurse (PN) is assisting with the preparation of a client for fecal diversion surgery. While inserting an indwelling urinary catheter, the client asks if the surgical opening will be visible. Which action should the PN implement?

A 2-day-old infant with hydrocephalus returns from surgery following placement of a ventriculoperitoneal shunt. Which nursing intervention(s) should the practical nurse (PN) implement during postoperative care? (Select all that apply.)

The practical nurse (PN) is administering a saline enema to a client who was admitted because of a fever of unknown origin and is now constipated. Which techniques should the PN use? (Select all that apply.)

A child diagnosed with strep throat 3 days ago enters the clinic crying hysterically. The parent tells the practical nurse (PN) that the child screams in pain even with a light touch. The child is short of breath and anxious. Which manifestations warrant immediate intervention by the
PN?