PN P

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Sample questions from PN P

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.During a home visit, a 3-month-old infant with a congenital heart condition is feeding slowly and sweating. The caregiver reports the infant has taken only 30 mL of the prescribed 60 mL bottle and has had two wet diapers in 12 hours. The infant's HR is 168/min, RR is 58/min, and SpO2 is 92% on room air. Which action should the practical nurse take first?

   • A.Stop the feeding, keep the infant upright, and promptly report the findings to the RN
   • B.Continue the feeding with frequent pauses and document the intake
   • C.Schedule a routine follow-up visit for the next day
   • D.Teach the caregiver to increase the volume offered at each feeding

   Rationale: Stopping the feeding and maintaining an upright position reduces exertion while the practical nurse promptly reports signs of possible cardiac decompensation, including tachycardia, tachypnea, low oxygen saturation, poor intake, and decreased urine output. Continuing the feeding could worsen the infant's respiratory and cardiac workload. Increasing the feeding volume is not appropriate when the infant is already unable to tolerate the prescribed amount. Waiting until the next day delays evaluation of potentially urgent changes.

2. 2.At change of shift on a medical unit, the practical nurse reviews the chart of a 16-year-old client being treated for diabetic ketoacidosis. The client is receiving an insulin infusion managed by the RN and reports new nausea. Which findings should the practical nurse report promptly to the RN? Select all that apply.

   • A.The client's bedside glucose has fallen from 320 mg/dL to 86 mg/dL in 2 hours
   • B.The client is increasingly drowsy and responds only after repeated verbal prompts
   • C.The client reports nausea and has vomited twice in the past hour
   • D.The client requests a blanket because the room feels cool
   • E.The client asks when a parent can visit

   Rationale: Increasing drowsiness may signal a serious change in neurologic status and requires prompt reporting. Repeated vomiting can worsen fluid and electrolyte losses, and the rapid glucose decline to 86 mg/dL during insulin treatment warrants immediate communication with the RN. Asking about a parent visit and requesting a blanket do not, by themselves, indicate acute deterioration. The practical nurse reports these changes rather than independently adjusting the insulin infusion.

3. 3.In a long-term care facility, a 74-year-old resident with a new prescription for warfarin has a small nosebleed while getting dressed. The resident's BP is 138/76 mm Hg, HR is 84/min, and the most recent INR is 3.6 (reference range for this prescription, 2.0 to 3.0). Which action should the practical nurse take?

   • A.Give an over-the-counter aspirin tablet for discomfort
   • B.Administer the next warfarin dose because the vital signs are stable
   • C.Hold pressure on the nose and promptly notify the RN of the bleeding and INR
   • D.Reassure the resident and document the bleeding at the end of the shift

   Rationale: Applying direct pressure is a basic immediate measure, and the practical nurse should promptly report active bleeding with an INR above the prescribed target. Stable vital signs do not make it safe to ignore the bleeding or independently proceed with a potentially concerning dose. Aspirin can increase bleeding risk and should not be given without an appropriate prescription. Delaying notification could postpone needed evaluation and changes to the treatment plan.

4. 4.A client states, 'I am going home with this new colostomy, but I cannot see the stoma well enough to change the pouch.' The 59-year-old client is preparing for discharge from a surgical unit, has a steady gait, and has stable vital signs. Which action is appropriate for the practical nurse?

   • A.Ask the family to perform all ostomy care without discussing the client's preferences
   • B.Create a new discharge teaching plan and independently determine readiness for discharge
   • C.Tell the client to change the pouch without assistance to build confidence
   • D.Reinforce the pouch-emptying steps already taught and report the vision concern to the RN

   Answer and rationale are in the full material.

5. 5.At 0900 in an outpatient clinic, a 28-year-old client with asthma arrives for a scheduled appointment and reports, 'My chest feels tight, and I am getting more short of breath.' The client is sitting upright, speaking in short phrases, with RR 30/min, HR 122/min, and SpO2 89% on room air. Which action should the practical nurse take first?

   • A.Provide a printed handout about avoiding asthma triggers
   • B.Stay with the client, summon the RN, and follow the clinic's emergency response process
   • C.Ask the client to wait while the practical nurse calls to verify the appointment
   • D.Escort the client to a quiet room and complete the routine medication history

   Answer and rationale are in the full material.