An older adult man who manages all his personal affairs is admitted to a long-term care facility because of mobility problems related to rheumatoid arthritis. When the practical nurse (PN) presents the client with a blank advanced directives form, he explains that he is not dying and not cognitively impaired and informs he does not need to complete such a form. Which action is most important for the PN to take?

Explain that the form identifies his personal health care wishes for any future event.

Acknowledge the client's concerns and notify the healthcare provider of the client's wishes.

Ask a family member to describe the client's stated wishes regarding end-of-life care.

Document his refusal in his electronic medical record using his exact words.

Answer and Explanation

The Correct Answer is A

A. Explaining that the advanced directives form helps identify personal health care wishes for any future health event is crucial because it clarifies the importance of the form in planning for future health care decisions, even if the client is not currently ill.
B. Acknowledging the client’s concerns and notifying the healthcare provider is less immediate and does not directly address the client's understanding of the advanced directives form.
C. Asking a family member about the client's wishes is unnecessary since the client has communicated his own wishes and concerns, and the focus should be on informing the client about the form.
D. Documenting the client’s refusal is important but secondary to educating the client on the purpose and importance of advanced directives.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["B","E","G"]

Explanation

A. Respiratory rate 18 breaths/minute
The respiratory rate is within the normal range for an adult (12-20 breaths/minute). No immediate follow-up is required for this vital sign.
B. Heart rate 101 beats/minute
An elevated heart rate (tachycardia) can indicate several issues, including fever, infection, or pain. In the context of a surgical site infection and elevated temperature, tachycardia is a sign of systemic response and needs to be evaluated further to determine the cause and appropriate intervention.
C. Capillary refill 2 seconds
Capillary refill time of 2 seconds is within the normal range (≤ 2 seconds) and indicates adequate perfusion. No immediate follow-up is needed.
D. Breath sounds clear and equal bilaterally
This finding indicates no acute respiratory issues. No immediate follow-up is necessary based on this assessment.
E. Turban dressing is saturated with serosanguinous drainage
Saturation of the dressing with serosanguinous drainage indicates a significant amount of wound drainage, which could suggest worsening of the infection or a new complication. This finding requires immediate follow-up to assess the wound and determine if additional interventions or changes in treatment are necessary.
F. Blood pressure 140/84 mm Hg
While slightly elevated, this blood pressure reading is not excessively abnormal and does not require immediate follow-up in the absence of other symptoms. Monitoring is required but not urgent.
G. Temperature 101.9° F (38.8° C)
An elevated temperature indicates a fever, which is a sign of infection. Given the positive MRSA culture and the need for infection control, this temperature warrants immediate follow-up to assess for worsening infection and determine the need for antipyretics or antibiotics.
H. Client is awake and alert
Being awake and alert is a positive finding and does not require immediate follow-up

A. Eggs. B. Broccoli. C. Spinach. D. Dairy products. E. Bananas.

Correct Answer is ["B","C"]

Explanation

A. Eggs are not a significant source of vitamin K. Foods rich in vitamin K are primarily green leafy vegetables and certain other plant-based foods.
B. Broccoli is a good source of vitamin K. It is rich in this nutrient, which plays a crucial role in blood clotting and bone health.
C. Spinach is an excellent source of vitamin K. It is one of the top leafy greens that provide this vitamin and supports various bodily functions.
D. Dairy products do not contain significant amounts of vitamin K. They are more associated with calcium and vitamin D.
E. Bananas are not a notable source of vitamin K. They are rich in potassium but not in vitamin K.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits The practical nurse (PN) performs a focused assessment and documents it in the computer. Select what items require immediate follow-up by the PN. Select all that apply.

Correct Answer is ["B","E","G"]

Explanation

What foods should the practical nurse (PN) recommend to a client as good sources of vitamin K? Select all that apply.

Correct Answer is ["B","C"]

Explanation

The practical nurse (PN) is assigning tasks to an unlicensed assistive personnel (UAP) who is giving basic care to a group of residents in a long-term care facility. Which client's task should be completed by a PN, rather than the UAP?

When the practical nurse (PN) prepares to transfer a 12-hour-old newborn from the birthing suite to the nursery, which question is most important for the PN to ask the mother?

Exhibits Choose the most likely options for the information missing from the statement by selecting from the lists of options provided. When the laboratory results are available, the practical nurse (PN) would expect the child to have dropdown related to dropdown during the submersion.

The practical nurse (PN) is documenting the insertion of a urinary catheter for a female client with urinary retention. What information should the PN include during the electronic documentation of the procedure? Select all that apply.

The practical nurse (PN) observes an unlicensed assistive personnel (UAP) obtain a client's vital signs. The PN should intervene when observing the UAP performing which technique?

Which client information is most important for the practical nurse (PN) to consider when providing instructions to the unlicensed assistive personnel (UAP) about providing morning care to a postoperative client?

The practical nurse (PN) is assigning care for a group of clients on the urology medical unit. What client care interventions should the PN assign to the unlicensed assistive personnel (UAP)? Select all that apply.

Exhibits The practical nurse (PN) would like to encourage the client to take oral fluids so that the IV fluids can eventually be discontinued. Which three strategies would be most effective in getting a client to consume adequate oral fluids?