A female client who is scheduled to be discharged within several hours shows the practical nurse (PN) a knife on her tray and states that she could use it to cut herself. What intervention is most important for the PN to implement?

Include guidelines for coping in the discharge plan.

Call dietary and ask them to send plastic utensils.

Inform the family of the client's statement.

Inform the healthcare provider who discharged the client.

Answer and Explanation

The Correct Answer is D

A.   Including guidelines for coping in the discharge plan might be important but doesn’t address the immediate concern of the client having access to a potential means of self-harm.
B.   Calling dietary for plastic utensils might help remove the immediate risk of harm, but informing the healthcare provider takes priority.
C.   Informing the family is essential for support but doesn’t directly address the current risk.
D.   Informing the healthcare provider who discharged the client is crucial as they need to reassess the discharge plan in light of the client's current statement and remove the potential means of self-harm.

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Correct Answer is A

Explanation

A. Keep the hearing aid out of direct sunlight. - This instruction is accurate as exposure to direct sunlight can potentially damage the hearing aid components, such as the battery or delicate electronic parts.
B. Wear the hearing aid while sleeping. - It's generally advised to remove hearing aids before sleeping to allow the ears to rest and prevent potential damage to the device.
C. Clean the hearing aid with baby oil. - Baby oil can damage the hearing aid and should not be used for cleaning. Specific cleaning solutions recommended by the manufacturer should be used.
D. Leave the hearing aid in place while showering. - Water exposure can damage the hearing aid, so it's advisable to remove it before showering or bathing.

A. Document in the chart that the client understands the action and use of the eye drops. B. Remind the client that the action of the eye drops is to decrease internal eye pressure. C. Ask the client to describe the intensity of the eye pain using the numerical pain scale. D. Clarify with the client that eye pain in glaucoma is uncommon so drops are rarely needed.

Correct Answer is B

Explanation

A. Documenting the client's understanding is important, but correcting the misconception about the use of the eye drops is the immediate priority.
B. Reminding the client about the intended action of the eye drops helps clarify their purpose in managing glaucoma by reducing intraocular pressure.
C. Assessing the intensity of eye pain using a numerical pain scale might not be necessary in this context as the client's misconception about the eye drops needs correction.
D . Clarifying that eye pain in glaucoma is uncommon does not address the client's misunderstanding about the purpose of the pilocarpine eye drops.

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A female client who is scheduled to be discharged within several hours shows the practical nurse (PN) a knife on her tray and states that she could use it to cut herself. What intervention is most important for the PN to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An older client is fitted with a hearing aid and instructions are provided for its use. Which instruction is accurate and should be reinforced by the practical nurse (PN)?

Correct Answer is A

Explanation

The practical nurse (PN) is reviewing instructions for the use of pilocarpine eye drops with a client who has glaucoma. The client states, "I should use these drops to anesthetize my eye if I experience eye pain." Which action should the PN implement?

Correct Answer is B

Explanation

The practical nurse (PN) is caring for a client newly diagnosed with diabetes mellitus. Which finding indicates that the PN should obtain a capillary glucose measurement to assess for hypoglycemia?

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) observes a client's initial postoperative dressing and drain as seen in the picture. Which follow-up actions should the PN implement? (Select all that apply.)

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The practical nurse (PN) is assisting with 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?

An older male client who fell down several stairs 4-hours ago is scheduled for magnetic resonance imaging (MRI). What information should the practical nurse (PN) obtain from the client?