The practical nurse (PN) is reviewing instructions about use of postoperative analgesia with a client before surgery. The PN should remind the client to ask for pain medication at which time?

When the pain interferes with activities of daily living.

As soon as the client begins to feel pain.

When the client can no longer move comfortably.

Once the pain gets to a moderate level.

Answer and Explanation

The Correct Answer is B

A. When the pain interferes with activities of daily living: Waiting until pain affects daily functioning may cause unnecessary suffering and make pain harder to control. Postoperative pain management aims to address discomfort early before it escalates to a level that impairs normal activity.
B. As soon as the client begins to feel pain: Asking for pain medication at the onset of pain allows for more effective management. Treating pain early prevents the development of severe pain, enhances comfort, and often requires lower doses of medication compared to managing severe pain later.
C. When the client can no longer move comfortably: Delaying pain management until mobility is significantly impaired increases the risk of complications such as immobility, poor wound healing, and longer hospital stays. Early intervention is crucial for better outcomes.
D. Once the pain gets to a moderate level: Allowing pain to reach a moderate intensity before requesting medication can make it more difficult to control. It is better to preemptively manage pain to prevent escalation, leading to faster recovery and improved participation in rehabilitation activities.

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Correct Answer is D

Explanation

A. Provide a Yankauer tip for oral suction: A Yankauer suction device is useful for clearing large amounts of oral secretions but is typically used when secretions are too excessive to manage with swabbing alone. In routine oral care for an unconscious client, gentle cleaning with swabs is safer and minimizes mucosal trauma.
B. Swab the oral cavity with a washcloth: Using a washcloth in an unconscious client's mouth can be unsafe because it is bulky, can cause trauma to delicate tissues, and increases the risk of aspiration if too much fluid or debris is present. Oral swabs are designed to be safer and more appropriate for this purpose.
C. Support the head with a small pillow: While supporting the head ensures comfort, it does not directly address the priority need of safely and thoroughly cleaning the oral cavity to maintain hygiene and prevent infection. Airway protection and thorough cleaning are the primary concerns during oral care.
D. Use oral swabs with normal saline: Using oral swabs moistened with normal saline is the best intervention because it gently cleanses the mucous membranes, maintains moisture, and reduces the risk of mucosal injury. Normal saline is safe and non-irritating, which is critical for unconscious clients at risk for aspiration and mucosal breakdown.

A. Limit ROM assessment to the lower extremities only. B. Defer ROM assessment because of the respiratory rate. C. Ask client to perform flexion and extension of arms 5 times. D. Observe the client performing lateral flexion of the waist.

Correct Answer is B

Explanation

A. Limit ROM assessment to the lower extremities only: Focusing only on the lower extremities does not fully address the concern. Any physical exertion could further strain the respiratory system when the client is already tachypneic and in distress.
B. Defer ROM assessment because of the respiratory rate: A respiratory rate of 30 breaths per minute indicates respiratory distress. Physical exertion, even mild, could worsen oxygenation issues. Protecting respiratory function is the priority, so the ROM assessment should be deferred until the client's condition stabilizes.
C. Ask client to perform flexion and extension of arms 5 times: Even minimal arm movements could increase oxygen demand and fatigue in a client already experiencing respiratory compromise, making this unsafe at the moment.
D. Observe the client performing lateral flexion of the waist: Lateral flexion involves significant muscular effort and could further tax respiratory function. It is not appropriate when the client is tachypneic and needs respiratory support.

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The practical nurse (PN) is reviewing instructions about use of postoperative analgesia with a client before surgery. The PN should remind the client to ask for pain medication at which time?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While providing oral care for a client who is unconscious, the practical nurse (PN) positions the client laterally and uses a basin to collect secretions. Which intervention is best for the PN to implement?

Correct Answer is D

Explanation

While performing a physical assessment on a client with chronic obstructive pulmonary disease (COPD), the practical nurse (PN) determines that the client's respiratory rate is 30 breaths/minute. When the PN begins to assess the client's range of motion (ROM), which is the best plan to implement?

Correct Answer is B

Explanation

A male client who was treated for a draining, infected wound and placed on contact precautions while hospitalized is being discharged to his home where he lives with his wife and adolescent son. Which information should the practical nurse (PN) reinforce with the family?

One week after beginning a new prescription for potassium chloride, a client tells the practical nurse (PN) that there is tingling and numbness in the feet and hands. Which action should the PN take?

While turning and positioning a bedfast client, the practical nurse (PN) observes that the client is dyspneic. Which action should the PN take first?

In assisting a dyspneic client with morning care, which action by the practical nurse (PN) is most important?

After accepting employment in a state different from where a practical nurse (PN) is currently employed, it is most important for the PN to review which reference?

Immediately after completing the total bed bath and linen change for an unconscious client, the practical nurse (PN) observes that the client was incontinent with a large amount of liquid feces. Which action should the PN implement?

At 2100, an older adult client turns on the call light and reports to the practical nurse (PN) the inability to fall asleep. Which is the priority nursing action?