While administering prescription medications to an older resident in an extended care facility, the practical nurse (PN) notices that the client is having difficulty hearing. What action is most important for the PN to take?

Speak louder so the client can hear the conversation.

Determine if the client has had difficulty hearing in the past

Encourage the client to read the practical nurse's lips.

Provide written instructions about how to take medications.

Answer and Explanation

The Correct Answer is B

A. Speak louder so the client can hear the conversation: Raising the voice may distort sounds and make speech harder to understand, especially for those with sensorineural hearing loss. It can also be perceived as shouting, which may cause discomfort or embarrassment for the client.

B. Determine if the client has had difficulty hearing in the past: Assessing whether the hearing difficulty is new or chronic is the most important initial step. This helps identify if the issue is due to a reversible cause, such as earwax buildup, or if accommodations, like hearing aids or alternative communication methods, are needed.

C. Encourage the client to read the practical nurse’s lips: While lip-reading can assist communication, it should not be the first approach before determining the cause and extent of the hearing problem. Some clients may also have visual impairments that limit this strategy.

D. Provide written instructions about how to take medications: Written instructions are useful for clients with known hearing loss, but they should be supplemented with an assessment first to ensure comprehension and to tailor the communication method appropriately.

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Correct Answer is C

Explanation

A: The legs are already in adduction (crossing the midline) and flexion, which are movements that are contraindicated after hip surgery and could cause dislocation.

B: The legs are straight but the feet are externally rotated, which is a movement that needs to be prevented and is not the ideal neutral position for placement.

C. To place an abduction pillow, the PN should have the client lie flat on their back with legs straight and parallel and slightly apart. Afterward, the pillow is positioned between the legs to maintain hip alignment.

A. Small bruises on the lower extremities. B. Refusal to answer simple questions. C. One-inch laceration across center of forehead. D. Several dime-sized circular burns on the back.

Correct Answer is D

Explanation

A. Small bruises on the lower extremities: Minor bruising can be common in toddlers due to normal activity and play. While it should be documented and monitored, it does not require immediate intervention unless there are patterns suggestive of abuse.

B. Refusal to answer simple questions: Hesitation or reluctance to speak can be normal behavior in a fearful or shy toddler. It warrants gentle assessment and observation but is not immediately life-threatening.

C. One-inch laceration across center of forehead: A laceration may require first aid, but a single superficial injury is typically managed without urgent intervention, unless it threatens airway, bleeding control, or infection risk.

D. Several dime-sized circular burns on the back: Multiple patterned burns, particularly on the back, are highly suspicious for intentional injury. These findings indicate possible physical abuse and warrant immediate intervention to ensure the child’s safety and initiate protective measures.

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While administering prescription medications to an older resident in an extended care facility, the practical nurse (PN) notices that the client is having difficulty hearing. What action is most important for the PN to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client needs an abduction pillow placed. How should the practical nurse (PN) position the client prior to placing the pillow?

Correct Answer is C

Explanation

The practical nurse (PN) is assisting with screening examinations at a community clinic where a toddler is brought by a parent for scheduled vaccines. The toddler clings to the caregiver and cowers when approached. Which assessment warrants immediate intervention by the PN?

Correct Answer is D

Explanation

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