Nclec PN

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Sample questions from Nclec PN

This material has 150 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift, the practical nurse receives report on four clients. Which client should the nurse report to the registered nurse first?

   • A.A client with chronic heart failure who gained 0.5 kg (1.1 lb) overnight and has unchanged ankle edema
   • B.A client with pneumonia whose temperature is 38.0 C (100.4 F) and who is due for prescribed acetaminophen
   • C.A client with diabetes who has a premeal glucose of 68 mg/dL and is awake, oriented, and requesting breakfast
   • D.A client 6 hours after knee replacement who reports new calf tenderness and has unilateral swelling

   Rationale: New unilateral calf tenderness and swelling after surgery may indicate deep vein thrombosis, which can progress to a life-threatening pulmonary embolism, so this change requires prompt reporting. The heart failure finding needs monitoring and reporting according to the care plan, but it is not as immediately concerning as a possible thrombus. The awake client with a mildly low glucose can receive the prescribed meal or other protocol-based treatment while being monitored. The fever and due medication also need attention but are less urgent than the possible postoperative complication.

2. 2.Refer to the client's chart. Which actions are appropriate for the practical nurse to take now? Select all that apply.

   • A.Tell the client to stop taking digoxin after discharge without consulting the prescriber.
   • B.Document the apical pulse and the client's symptoms in the health record.
   • C.Administer the scheduled digoxin because the pulse is above 60/min.
   • D.Ask the client whether the visual changes and nausea are new, and report the response.
   • E.Withhold the scheduled digoxin dose and promptly report the findings to the registered nurse.

   Rationale: The chart shows a new apical pulse of 54/min, nausea, and yellow-tinted vision, along with a digoxin level above the stated reference range and potassium of 3.1 mEq/L; withholding the dose and promptly reporting these findings follows medication-safety procedures. Documenting the pulse and symptoms and clarifying whether the symptoms are new provide useful data for the registered nurse and prescriber. Giving digoxin based only on a pulse threshold ignores the concerning symptoms and laboratory findings. The practical nurse should not independently instruct the client to discontinue a long-term medication after discharge.

3. 3.In a long-term care facility, which task is appropriate for the practical nurse to assign to an experienced unlicensed assistive personnel (UAP)?

   • A.Assess a resident who reports new shortness of breath
   • B.Obtain and record the morning weight of a stable resident with heart failure
   • C.Teach a resident with a new colostomy how to empty the pouch
   • D.Evaluate whether a newly prescribed pain medication relieved a resident's pain

   Rationale: Obtaining and recording a routine weight for a stable resident is a predictable task that can be performed by a trained UAP, with the practical nurse reviewing and reporting significant changes. Evaluating a medication's effect requires nursing judgment and is not an appropriate UAP task. Teaching a new skill and assessing new shortness of breath also require nursing judgment and intervention. The practical nurse remains responsible for communicating abnormal findings and following facility policy.

4. 4.The parent of a 4-year-old being discharged after an asthma exacerbation says, "We have no way to get to the follow-up appointment, and we ran out of the controller inhaler last week." Which response by the practical nurse is best?

   • A.Notify the registered nurse and help connect the family with the case manager or appropriate community resources before discharge.
   • B.Tell the parent that the clinic will provide transportation and a replacement inhaler.
   • C.Explain that the parent should use the rescue inhaler daily until the next appointment.
   • D.Recommend delaying the follow-up appointment until transportation is available.

   Answer and rationale are in the full material.

5. 5.A primigravida at 32 weeks says, "I signed the consent form, but I still do not understand why the provider recommends induction." Which action should the practical nurse take?

   • A.Witness the signature and continue preparing the client for the procedure.
   • B.Explain the risks and benefits of induction so the client can make an informed decision.
   • C.Pause the preparation and notify the registered nurse or provider that the client has unanswered questions.
   • D.Tell the client that signing the form means the decision cannot be changed.

   Answer and rationale are in the full material.