A client with unstable angina pectoris receives a prescription for nitroglycerin 0.4 mg sublingually PRN chest pain every 5 minutes x3. The prescription directions include leaving the medication at the bedside for self-administration. Which assessment finding should the practical nurse (PN) obtain first?

Number of tablets taken in past 24 hours.

Level of orientation and compliance.

Heart rate and blood pressure.

Hourly urinary output and daily weight.

Answer and Explanation

The Correct Answer is B

A. While knowing the number of tablets taken is important for managing chest pain, it is secondary to ensuring that the client can safely administer the medication.
B. Assessing the client's level of orientation and compliance is crucial because the client needs to understand how and when to use the nitroglycerin properly. Misunderstanding or non-compliance could lead to ineffective treatment or potential harm.
C. Checking heart rate and blood pressure is important for assessing the effects of nitroglycerin, but before leaving the medication for self-administration, it is vital to ensure that the client understands how to use the medication.
D. Monitoring hourly urinary output and daily weight is not relevant to the immediate concern of ensuring safe and effective nitroglycerin self-administration.

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Correct Answer is A,B,C,D

Explanation

A. Exposing the left side of the chest is the first step to access the area where the apical pulse is assessed. This step ensures that the nurse has clear access to the chest for auscultation.

B. Locating the point of maximal impulse (PMI) is the next step once the chest is exposed. The PMI, typically located at the 5th intercostal space at the midclavicular line, is where the heart’s apex is closest to the chest wall.

C. Positioning the diaphragm of the stethoscope on the PMI is the step where the actual auscultation begins. The diaphragm is used to listen for heart sounds.

D. Listening for heart sounds at the PMI is the final step to assess the apical heart rate. This step completes the assessment by allowing the PN to count the heart rate and evaluate the rhythm.

A. Misses the child every day. B. Drinks 4 to 6 bottles of beer each evening. C. Expresses that drunk driving is inexcusable. D. Sleeps through the night often.

Correct Answer is D

Explanation

A. Missing the child every day is a normal part of the grieving process but does not indicate improvement in managing depression.
B. Drinking 4 to 6 bottles of beer each evening suggests the client may be using alcohol as a coping mechanism, indicating poor management of depression.
C. Expressing that drunk driving is inexcusable shows the client has a strong opinion on the matter, but it does not necessarily indicate improvement in the client’s emotional health.
D. Sleeping through the night often indicates an improvement in the client’s ability to rest and manage depressive symptoms, suggesting a positive response to treatment.

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Naxlex Comprehensive Predictor Exams

In assessing the apical heart rate of an adult, in what order should the practical nurse (PN) perform the needed tasks?

Correct Answer is A,B,C,D

Explanation

An older adult client returns to the clinic for a follow-up visit with the healthcare provider for management of depression related to the death of a child, who was killed 6 months ago by a drunk driver. Which finding indicates to the practical nurse (PN) that the client is improving?

Correct Answer is D

Explanation

A client is receiving an epidural anesthesia during labor. Which observation is the most important adverse effect that the practical nurse (PN) should assess for following the administration of the epidural?

Exhibits Drag from statement options to complete the sentence. To assess outcomes, the practical nurse (PN) should consider information reported by the client and caregiver and focus on evaluating the client's dropdown and dropdown

A client with recurrent ascites from cirrhosis describes having no appetite or energy to the home health practical nurse (PN). What diet suggestions should the PN provide for the client? Select all that apply.

The practical nurse (PN) and unlicensed assistive personnel (UAP) are providing care for a client who exhibits signs of neglect syndrome following a stroke affecting the right hemisphere. Which action should the PN implement?

The practical nurse (PN) is assisting with the plan of care for a client who is receiving the nonsteroidal anti-inflammatory drug ketorolac for painful muscle spasms of the back. Which intervention should the PN include in the client's plan of care?

At 1200, the practical nurse (PN) learns that a client's 0900 dose of an anticonvulsant was not given. The next scheduled dose is at 2100. Which action should the PN take?

Exhibits Given the client's current treatment for fluid volume deficit, what condition(s) should the practical nurse (PN) monitor the client for? Select all that apply.