1. A 75-year-old male with mid-stage Alzheimer's is a new admission. What question should the
practical nurse ask a family member to obtain the most relevant information for updating the care
plan?
A. Do you have any help at home?
B. Are your children worried about their father?
C. What help does Mr. Robichaud require each day?
D. How frequently are you able to visit?
Rationale: Asking about specific daily needs directly informs the development of a personalized,
functional care plan, whereas the other options focus on feelings or visitor logistics rather than the
patient's required assistance.
2. A resident’s son asks the practical nurse if he can participate in his father’s daily care. What
should the nurse do?
A. Invite the son to come and play cards with his father.
B. Encourage the son to spend his days off with his father.
C. Reassure the son that the father’s care is being provided by the team.
D. Question son about what part of his father's care he would like to be a part of.
Rationale: Asking the son what he wants to do promotes collaboration, respects the family's
wishes, and identifies specific tasks, unlike general suggestions or dismissive reassurance which do
not support family involvement.
3. A practical nurse witnesses a resident fall and become aggressive when assessed. What should
the PN do?
A. Reassure the resident and request a mechanical lift.
B. Stay with him and ask the nurse-in-charge to contact family.
C. Wait until calm to complete the injury assessment.
D. Call for assistance, reassure the resident and provide necessary care.
Rationale: Calling for help ensures safety for both the nurse and resident, while reassurance
addresses the aggression; waiting delays care and a lift is not the priority over stabilization.
4. A PN notices a new unregulated care provider (UCP) appears uncomfortable helping a resident
at mealtimes. What should the nurse do?
,A. Suggest the UCP share concerns with other employees.
B. Partner the UCP with a more experienced unregulated worker.
C. Invite the UCP to attend information sessions on Alzheimer's.
D. Ask the UCP how she feels about caring for clients with Alzheimer's disease.
Rationale: Directly asking about feelings opens a non-judgmental dialogue to identify the specific
source of discomfort, which is more therapeutic than avoiding the issue or delegating it to others.
5. A 68-year-old post-MI patient with diabetes has a reddened area on his sacrum. What is the
proper documentation?
A. Small reddened area noted over sacrum.
B. Reddened area over sacrum the size of a grape.
C. Reddened area over sacrum 3cm in diameter, skin intact.
D. Skin over sacral area appears reddened.
Rationale: Documenting the exact measurement (3cm) and condition of the skin ("intact")
provides objective, precise, and legal data, unlike subjective terms like "small" or vague
comparisons like "grape."
6. The same patient states an oral hypoglycemic pill doesn't look like his home pill. What should
the PN do?
A. Reassure him it's the correct order from the physician.
B. Reassure him the medication is correct even if it looks different.
C. Re-check the Dr's orders and the home medication history.
D. Re-check the pharmacy label before giving the med.
Rationale: The nurse must verify the order against the patient's known medication history to
prevent a medication error, as pills can look different due to manufacturer changes, not simply
reassure the patient.
7. Preparing to administer a nitroglycerin patch, where is the best place to apply it?
A. Lower leg
B. Upper arm
C. Lumbar area
D. Upper thigh
Rationale: The upper arm or chest are preferred sites for transdermal nitroglycerin because they
are relatively hairless, have good circulation, and allow for proper adhesion and rotation, avoiding
areas with large joints or pressure points.
,8. The patient develops diarrhea, vomiting, and then dyspnea with crackles after IV rate increase.
What should the PN do?
A. Discontinue the IV infusion and notify the physician.
B. Reassess the IV rate and encourage deep breathing.
C. Maintain the IV infusion at 150mL/h and notify the physician.
D. Notify the physician and anticipate a decrease in the IV rate.
Rationale: The symptoms indicate fluid overload (pulmonary edema) due to excessive IV rate; the
nurse should notify the physician expecting an order to decrease the rate, not discontinue the IV
entirely unless ordered.
9. The patient reports chest discomfort, is pale, cool, and clammy. Most appropriate sequence of
interventions?
A. Assess vital signs & blood glucose, then apply oxygen.
B. Apply oxygen, assess vital signs and then assess blood glucose.
C. Assess vital signs, apply oxygen, and then give sublingual nitroglycerin.
D. Apply oxygen, assess vital signs and provide a warm blanket.
Rationale: First, assess to confirm the problem, then apply oxygen for suspected cardiac ischemia
(ABCs), and finally administer the PRN nitroglycerin as ordered for chest discomfort.
10. A 13-year-old with vomiting admits to making herself vomit and asks the PN not to tell her
parents. How should the PN respond?
A. Tell her she is only obliged to report vomiting if it occurs during hospitalization.
B. Remind her that clients have the right to determine what is documented.
C. Explain to the pt that information is shared with the health care team to provide appropriate
care.
D. Reassure her stomach pains will subside if she stops vomiting.
Rationale: The nurse must be honest about the limits of confidentiality, explaining that
information is shared for treatment purposes, while not making promises that cannot be kept
regarding parental notification.
11. The same adolescent’s facecloths are missing from the bathroom. What action should the PN
take?
A. Discuss the lost facecloths, search the room, and document.
B. Ask her where they are and ask her to return them.
C. Ask her where they are and chart suspicion they hide uneaten food.
D. Discuss the issue of lost facecloths with the pt and document appropriate information.
, Rationale: The nurse should directly but therapeutically discuss the observation with the patient to
explore the behavior (e.g., hiding emesis), and document the discussion objectively without
accusations.
12. The patient is concerned about her weight and doesn't feel like eating. What should the nurse
do?
A. Design a balanced diet with the dietitian.
B. Ask her likes/dislikes and obtain daily weight.
C. Include the pt in goal-setting for healthy weight, have her maintain a food and fitness journal,
and obtain & record her weight weekly.
D. Promote healthy lifestyle and stress management.
Rationale: Involving the patient in goal-setting and having her maintain a journal promotes
autonomy and self-awareness, which is more therapeutic for eating disorders than prescriptive
diets or daily weighing.
13. A 75-year-old with TB is on isolation. Which action best indicates the PN knows how to collect
a sputum specimen?
A. Keep the specimen at room temperature.
B. Collect the specimen in a clean, light occlusive container.
C. Instruct the pt to use mouthwash prior to collection.
D. Teach the pt to deep breath and cough prior to expectoration.
Rationale: Deep breathing and coughing helps produce a deep sputum specimen from the lower
respiratory tract rather than saliva, which is essential for accurate TB testing.
14. What is the most crucial health information about TB to provide to this patient?
A. His contacts do not need to worry about contracting TB.
B. He must comply with medication protocol on discharge.
C. He should follow a well-balanced diet.
D. His fluid intake should ensure adequate hydration.
Rationale: Non-adherence to the long TB medication regimen leads to drug resistance and
continued spread of the disease, making compliance the most critical public health and personal
health teaching point.
15. What offers the best protection to the PN when providing direct care to a patient with TB?
A. A mask
B. Sterile gloves
C. A gown
practical nurse ask a family member to obtain the most relevant information for updating the care
plan?
A. Do you have any help at home?
B. Are your children worried about their father?
C. What help does Mr. Robichaud require each day?
D. How frequently are you able to visit?
Rationale: Asking about specific daily needs directly informs the development of a personalized,
functional care plan, whereas the other options focus on feelings or visitor logistics rather than the
patient's required assistance.
2. A resident’s son asks the practical nurse if he can participate in his father’s daily care. What
should the nurse do?
A. Invite the son to come and play cards with his father.
B. Encourage the son to spend his days off with his father.
C. Reassure the son that the father’s care is being provided by the team.
D. Question son about what part of his father's care he would like to be a part of.
Rationale: Asking the son what he wants to do promotes collaboration, respects the family's
wishes, and identifies specific tasks, unlike general suggestions or dismissive reassurance which do
not support family involvement.
3. A practical nurse witnesses a resident fall and become aggressive when assessed. What should
the PN do?
A. Reassure the resident and request a mechanical lift.
B. Stay with him and ask the nurse-in-charge to contact family.
C. Wait until calm to complete the injury assessment.
D. Call for assistance, reassure the resident and provide necessary care.
Rationale: Calling for help ensures safety for both the nurse and resident, while reassurance
addresses the aggression; waiting delays care and a lift is not the priority over stabilization.
4. A PN notices a new unregulated care provider (UCP) appears uncomfortable helping a resident
at mealtimes. What should the nurse do?
,A. Suggest the UCP share concerns with other employees.
B. Partner the UCP with a more experienced unregulated worker.
C. Invite the UCP to attend information sessions on Alzheimer's.
D. Ask the UCP how she feels about caring for clients with Alzheimer's disease.
Rationale: Directly asking about feelings opens a non-judgmental dialogue to identify the specific
source of discomfort, which is more therapeutic than avoiding the issue or delegating it to others.
5. A 68-year-old post-MI patient with diabetes has a reddened area on his sacrum. What is the
proper documentation?
A. Small reddened area noted over sacrum.
B. Reddened area over sacrum the size of a grape.
C. Reddened area over sacrum 3cm in diameter, skin intact.
D. Skin over sacral area appears reddened.
Rationale: Documenting the exact measurement (3cm) and condition of the skin ("intact")
provides objective, precise, and legal data, unlike subjective terms like "small" or vague
comparisons like "grape."
6. The same patient states an oral hypoglycemic pill doesn't look like his home pill. What should
the PN do?
A. Reassure him it's the correct order from the physician.
B. Reassure him the medication is correct even if it looks different.
C. Re-check the Dr's orders and the home medication history.
D. Re-check the pharmacy label before giving the med.
Rationale: The nurse must verify the order against the patient's known medication history to
prevent a medication error, as pills can look different due to manufacturer changes, not simply
reassure the patient.
7. Preparing to administer a nitroglycerin patch, where is the best place to apply it?
A. Lower leg
B. Upper arm
C. Lumbar area
D. Upper thigh
Rationale: The upper arm or chest are preferred sites for transdermal nitroglycerin because they
are relatively hairless, have good circulation, and allow for proper adhesion and rotation, avoiding
areas with large joints or pressure points.
,8. The patient develops diarrhea, vomiting, and then dyspnea with crackles after IV rate increase.
What should the PN do?
A. Discontinue the IV infusion and notify the physician.
B. Reassess the IV rate and encourage deep breathing.
C. Maintain the IV infusion at 150mL/h and notify the physician.
D. Notify the physician and anticipate a decrease in the IV rate.
Rationale: The symptoms indicate fluid overload (pulmonary edema) due to excessive IV rate; the
nurse should notify the physician expecting an order to decrease the rate, not discontinue the IV
entirely unless ordered.
9. The patient reports chest discomfort, is pale, cool, and clammy. Most appropriate sequence of
interventions?
A. Assess vital signs & blood glucose, then apply oxygen.
B. Apply oxygen, assess vital signs and then assess blood glucose.
C. Assess vital signs, apply oxygen, and then give sublingual nitroglycerin.
D. Apply oxygen, assess vital signs and provide a warm blanket.
Rationale: First, assess to confirm the problem, then apply oxygen for suspected cardiac ischemia
(ABCs), and finally administer the PRN nitroglycerin as ordered for chest discomfort.
10. A 13-year-old with vomiting admits to making herself vomit and asks the PN not to tell her
parents. How should the PN respond?
A. Tell her she is only obliged to report vomiting if it occurs during hospitalization.
B. Remind her that clients have the right to determine what is documented.
C. Explain to the pt that information is shared with the health care team to provide appropriate
care.
D. Reassure her stomach pains will subside if she stops vomiting.
Rationale: The nurse must be honest about the limits of confidentiality, explaining that
information is shared for treatment purposes, while not making promises that cannot be kept
regarding parental notification.
11. The same adolescent’s facecloths are missing from the bathroom. What action should the PN
take?
A. Discuss the lost facecloths, search the room, and document.
B. Ask her where they are and ask her to return them.
C. Ask her where they are and chart suspicion they hide uneaten food.
D. Discuss the issue of lost facecloths with the pt and document appropriate information.
, Rationale: The nurse should directly but therapeutically discuss the observation with the patient to
explore the behavior (e.g., hiding emesis), and document the discussion objectively without
accusations.
12. The patient is concerned about her weight and doesn't feel like eating. What should the nurse
do?
A. Design a balanced diet with the dietitian.
B. Ask her likes/dislikes and obtain daily weight.
C. Include the pt in goal-setting for healthy weight, have her maintain a food and fitness journal,
and obtain & record her weight weekly.
D. Promote healthy lifestyle and stress management.
Rationale: Involving the patient in goal-setting and having her maintain a journal promotes
autonomy and self-awareness, which is more therapeutic for eating disorders than prescriptive
diets or daily weighing.
13. A 75-year-old with TB is on isolation. Which action best indicates the PN knows how to collect
a sputum specimen?
A. Keep the specimen at room temperature.
B. Collect the specimen in a clean, light occlusive container.
C. Instruct the pt to use mouthwash prior to collection.
D. Teach the pt to deep breath and cough prior to expectoration.
Rationale: Deep breathing and coughing helps produce a deep sputum specimen from the lower
respiratory tract rather than saliva, which is essential for accurate TB testing.
14. What is the most crucial health information about TB to provide to this patient?
A. His contacts do not need to worry about contracting TB.
B. He must comply with medication protocol on discharge.
C. He should follow a well-balanced diet.
D. His fluid intake should ensure adequate hydration.
Rationale: Non-adherence to the long TB medication regimen leads to drug resistance and
continued spread of the disease, making compliance the most critical public health and personal
health teaching point.
15. What offers the best protection to the PN when providing direct care to a patient with TB?
A. A mask
B. Sterile gloves
C. A gown
