Mrs. Worth, 78 years old, is a resident in an apartment complex for older adults. She has an
adult son. Over the past several months, Mrs. Worth has begun to forget days of the week
D) Ask Sara if she would like to talk and otter her support.
and forget to pay her bills. She often wears her night clothing during the day.
Three months later, Mrs. Worth is moved to a special care unit. Her granddaughter Sara visits, This response is empathetic and supportive, acknowledging Sara's feelings and ottering her
but Mrs. Worth does not recognize her. Sara begins to cry. What should the practical nurse the opportunity to express them. It also provides an opening for the practical nurse to otter
do? further assistance or information about Mrs. Worth's condition and how to cope with the
changes it brings. It's important for family members to understand the disease process and
A) Tell Sara that her grandmother likes to talk about living on the farm.
to have their feelings validated, but this should be done in a way that is sensitive to their
B) Tell Sara that this is part of the disease process and is to be expected.
emotional state at the moment.
C) Ask Sara if she would like to walk with her grandmother.
D) Ask Sara if she would like to talk and otter her support.
Mrs. Worth, 78 years old, is a resident in an apartment complex for older adults. She has an
adult son. Over the past several months, Mrs. Worth has begun to forget days of the week
and forget to pay her bills. She often wears her night clothing during the day. B) Assess Mrs. Worth's needs in a calm manner and review the situation for possible triggers.
Mrs. Worth is becoming increasingly agitated by another client. She begins to behave
This response is appropriate because it focuses on understanding and addressing the un-
aggressively. After calling for help, what should the practical nurse do?
derlying cause of Mrs. Worth's agitation and aggressive behavior. It is important to assess
her needs and the situation calmly to identify any triggers that may have caused her reaction.
A) Assess both clients for injury and encourage Mrs. Worth to calm down. This approach is more proactive and therapeutic than immediately resorting to medication or
B) Assess Mrs. Worth's needs in a calm manner and review the situation for possible triggers. restraint, which should be considered only if the situation poses an immediate risk to Mrs.
C) Administer p.r.n. medication and assess both clients for injury. Worth or others and all other de-escalation techniques have been exhausted.
D) Administer p.r.n. medication and obtain an order to restrain Mrs. Worth until she calms
down.
A) Apraxia
Mrs. Worth, 78 years old, is a resident in an apartment complex for older adults. She has an Apraxia is a neurological disorder characterized by an inability to perform purposeful move-
adult son. Over the past several months, Mrs. Worth has begun to forget days of the week ments despite having the physical ability to do so. It is often associated with brain damage
and forget to pay her bills. She often wears her night clothing during the day. or neurodegenerative diseases. In this case, Mrs. Worth's attempt to make phone calls on
While Mrs. Worth's son is visiting his mother, he notices that she is trying to make phone calls her TV remote control could be an example of ideational apraxia, where she has diflculty
on her TV remote control. Which term best describes this? understanding the concept of using objects correctly.
The other terms are less fitting for the described behavior:
B) Akinesia - This refers to an absence of movement, often seen in disorders like Parkinson's
A) Apraxia
disease.
B) Akinesia
C) Aphasia - This is a language disorder that attects a person's ability to communicate, which
C) Aphasia
is not directly related to the described behavior.
D) Aphagia
D) Aphagia - This is a disorder characterized by diflculty swallowing, which is unrelated to the
described behavior.
C) Donepezil (Aricept)
Donepezil (Aricept) is a cholinesterase inhibitor that is commonly used in the treatment of
Mrs. Worth, 78 years old, is a resident in an apartment complex for older adults. She has an Alzheimer's disease. It works by increasing the levels of acetylcholine, a neurotransmitter that
adult son. Over the past several months, Mrs. Worth has begun to forget days of the week is important for memory and learning, in the brain. This can help improve cognitive function
and forget to pay her bills. She often wears her night clothing during the day. and slow the progression of symptoms in some individuals with Alzheimer's disease.
What medication would most likely be ordered for Mrs. Worth's Alzheimer's disease? The other medications listed are used for ditterent purposes:
A) Citalopram (Celexa) - This is an antidepressant of the selective serotonin reuptake inhibitor
A) Citalopram (Celexa) (SSRI) class, used to treat depression and anxiety disorders.
B) Lorazepam (Ativan) B) Lorazepam (Ativan) - This is a benzodiazepine used to treat anxiety, insomnia, and seizures.
C) Donepezil (Aricept) It is not a first-line treatment for Alzheimer's disease.
D) Olanzapine (Zyprexa) D) Olanzapine (Zyprexa) - This is an antipsychotic medication used to treat schizophrenia and
bipolar disorder. It may be used ott-label for agitation in Alzheimer's disease but is not a
primary treatment for the cognitive symptoms of the disease.
,Sammy, 6 years old, has been diagnosed with cystic fibrosis. He is continuing on his daily B) Allow the friend to stay.
regimen for chest physiotherapy and medications. Sammy does not like taking all the med-
ications; it is a daily struggle for his family. Sammy has had several hospital admissions. In this scenario, it is important to consider the emotional and psychological support that
Six months later, Sammy is readmitted to the unit with a respiratory infection. Sammy's mother Sammy needs while he is hospitalized. Allowing a close friend of the family to stay with Sammy
needs to go home, and a close friend of the family will stay with Sammy. How should the can provide him with the comfort and security he needs, especially since his mother needs
practical nurse proceed? to go home. It is also a compassionate approach that acknowledges the family's support
network.
However, it is crucial to ensure that the friend is aware of any specific instructions or guidelines
A) Inform the friend of the unit's visiting hours. related to Sammy's care and that the mother remains the primary decision-maker for Sammy's
B) Allow the friend to stay. medical care. The practical nurse should communicate with the mother to confirm her consent
C) Notify the mother that the friend will be the decision-maker. for the friend to stay and to clarify any roles or responsibilities the friend may have during the
D) Inform Sammy's mother that a family member must remain at the visit.
C) Nutrition less than body requirements related to inability to absorb nutrients.
In the context of failure to thrive in a child with cystic fibrosis (CF), the primary nursing
Sammy, 6 years old, has been diagnosed with cystic fibrosis. He is continuing on his daily diagnosis is likely to be related to nutritional issues. Cystic fibrosis attects the pancreas, leading
regimen for chest physiotherapy and medications. Sammy does not like taking all the med- to inadequate production of digestive enzymes, which are necessary for the absorption of fats
ications; it is a daily struggle for his family. Sammy has had several hospital admissions. and proteins. This can result in malabsorption and poor weight gain, contributing to failure
Sammy has been admitted with failure to thrive. What is the nursing diagnosis of primary to thrive. Therefore, the nursing diagnosis of "Nutrition less than body requirements related
concern? to inability to absorb nutrients" is highly relevant and would be a primary concern.
The other options are also potential concerns for a child with CF but are less directly related
to the specific issue of failure to thrive:
A) Impaired gas exchange related to ventilation-perfusion imbalance
A) Impaired gas exchange related to ventilation-perfusion imbalance - This could be a concern
B) Risk for dehydration related to increased work of breathing
if Sammy had significant respiratory issues, but it is not the primary concern for failure to
C) Nutrition less than body requirements related to inability to absorb nutrients
thrive.
D) Anxiety related to dyspnea
B) Risk for dehydration related to increased work of breathing - This is a potential concern,
especially during respiratory infections, but it is not the primary concern for failure to thrive.
D) Anxiety related to dyspnea - This could be a concern if Sammy were experiencing significant
respiratory distress, but it is not the primary concern for failure to thrive.
D) Decrease in large bulky stools
In cystic fibrosis (CF), the production of pancreatic enzymes is often impaired, leading to
Sammy, 6 years old, has been diagnosed with cystic fibrosis. He is continuing on his daily diflculty in digesting fats and proteins. This can result in malabsorption and the production
regimen for chest physiotherapy and medications. Sammy does not like taking all the med- of large, bulky stools due to the presence of undigested fat. When pancreatic enzymes are
ications; it is a daily struggle for his family. Sammy has had several hospital admissions. administered with meals and snacks, they help to break down fats, making them more easily
Sammy is given pancreatic enzymes with meals and snacks. What should the practical nurse absorbable. As a result, the stools are likely to become smaller and less bulky because more
expect? of the fat is being digested and absorbed.
The other options are less directly related to the administration of pancreatic enzymes:
A) Increase in potassium levels - Pancreatic enzymes are not typically associated with changes
A) Increase in potassium levels in potassium levels.
B) Decrease in vitamin A, D, E and K levels B) Decrease in vitamin A, D, E, and K levels - While fat-soluble vitamins (A, D, E, and K) may be
C) Increase in urinary output poorly absorbed in untreated CF due to fat malabsorption, the administration of pancreatic
D) Decrease in large bulky stools enzymes should improve their absorption, potentially leading to increased levels rather than
a decrease.
C) Increase in urinary output - Pancreatic enzymes are not directly related to changes in urinary
output.
B) Aiding drainage of secretions.
Chest physiotherapy is a crucial component of the treatment for cystic fibrosis (CF) because it
, helps to clear thick mucus from the lungs. In CF, the mucus is abnormally thick and sticky, which
Sammy, 6 years old, has been diagnosed with cystic fibrosis. He is continuing on his daily can lead to blockages in the airways, increased risk of infections, and respiratory diflculties.
regimen for chest physiotherapy and medications. Sammy does not like taking all the med- The primary goal of chest physiotherapy is to aid in the drainage of these secretions, thereby
ications; it is a daily struggle for his family. Sammy has had several hospital admissions. reducing the risk of infections and improving lung function.
What is the primary goal when performing chest physiotherapy with Sammy? The other options are less directly related to the primary goal of chest physiotherapy:
A) Thinning secretions of the alveoli - While thinning secretions can be part of the overall
treatment strategy, the primary goal is to mobilize and remove the thick mucus from the
A) Thinning secretions of the alveoli airways.
B) Aiding drainage of secretions C) Preventing respiratory acidosis - This is a potential benefit of ettective chest physiotherapy,
C) Preventing respiratory acidosis as it can help maintain good lung function and gas exchange, but it is not the primary goal.
D) Keeping mucous plugs out of digestive tract D) Keeping mucous plugs out of the digestive tract - This is not a goal of chest physiotherapy;
mucous plugs are a concern in the respiratory tract, not the digestive tract.
B) Provide a teaching plan for Sammy's mother.
When preparing for Sammy's discharge, it is crucial to ensure that his mother is well-informed
Sammy, 6 years old, has been diagnosed with cystic fibrosis. He is continuing on his daily about his care needs, including medication management, chest physiotherapy, and dietary
regimen for chest physiotherapy and medications. Sammy does not like taking all the med- requirements. A teaching plan tailored to the family's needs can help reinforce the instructions
ications; it is a daily struggle for his family. Sammy has had several hospital admissions. and provide a structured way for the mother to learn and ask questions. This approach is more
Two weeks later, Sammy is ready for discharge. How should the practical nurse initially prepare likely to ensure that the mother feels confident and prepared to care for Sammy at home.
for his discharge? The other options are less comprehensive or interactive:
A) Ask Sammy's mother to help during care - While involving the mother in Sammy's care is
A) Ask Sammy's mother to help during care. important, it is more ettective to provide a structured teaching plan.
B) Provide a teaching plan for Sammy's mother. C) Give Sammy's mother a pamphlet to read - A pamphlet can be a useful supplementary
C) Give Sammy's mother a pamphlet to read. resource, but it may not be suflcient on its own to address all the mother's questions and
D) Provide a movie for Sammy's mother to watch. concerns.
D) Provide a movie for Sammy's mother to watch - A movie might not be the most ettective
educational tool compared to a tailored teaching plan.
C) The cardiac cycle consists of the systole and diastole phases.
The cardiac cycle is the sequence of events that occurs when the heart beats, and it primarily
consists of two main phases: systole and diastole. Systole is the contraction phase when the
Mr. Yellowtail, 58 years old, has cardiomyopathy and is admitted with manifestations of heart pumps blood out to the body and lungs, while diastole is the relaxation phase when the
congestive heart failure (CHF). He is awaiting a heart transplant. He is accompanied by heart fills with blood. Understanding these phases is essential for assessing and managing
During Mr. Yellowtail's assessment, what knowledge should the practical nurse have? patients with heart conditions like cardiomyopathy and congestive heart failure.
The other statements are less relevant to the overall understanding of the cardiac cycle:
A) S2 is best heard over the apex area. A) S2 is best heard over the apex area - This is true, but it is more specific to auscultation
B) S1 is best heard over the aortic and pulmonic area. techniques rather than the general understanding of the cardiac cycle.
C) The cardiac cycle consists of the systole and diastole phases. B) S1 is best heard over the aortic and pulmonic area - This is also true, but it is more specific
D) There are four phases to the cardiac cycle including systole and diastole. to auscultation techniques.
D) There are four phases to the cardiac cycle including systole and diastole - While there are
indeed four phases (atrial systole, ventricular systole, atrial diastole, and ventricular diastole),
the most fundamental understanding involves the two main phases: systole and diastole.
D) Verify the physician's order before preparing the medication.
Mr. Yellowtail, 58 years old, has cardiomyopathy and is admitted with manifestations of The first step in administering any new medication, especially one as potent as Furosemide
congestive heart failure (CHF). He is awaiting a heart transplant. He is accompanied by (Lasix), which is a loop diuretic used to treat fluid retention in conditions such as congestive
The practical nurse is preparing Mr. Yellowtail's morning medication. Furosemide (Lasix) is a heart failure, is to verify the physician's order. This is a critical safety measure to ensure that
new order in the medication administration record (MAR) and has been written as: the medication, dose, and frequency are correct and appropriate for the patient. Verifying
Lasix 80 mg p.o. daily. What should the practical nurse do first? the order helps prevent medication errors and ensures that the patient receives the correct
treatment.
After verifying the order, the practical nurse should:
, Prepare the medication according to hospital policy.
Administer the medication following the rights of medication administration.
Document the administration as required.
The other options are important but should follow the verification of the physician's order:
A) Verify the order on the MAR with another practical nurse. A) Verify the order on the MAR with another practical nurse - This is a good practice for
B) Administer the medication according to the rights of medication administration. double-checking, but it should be done after verifying the physician's order.
C) Prepare the medication and document according to hospital policy. B) Administer the medication according to the rights of medication administration - This
D) Verify the physician's order before preparing the medication. should be done after verifying the order and preparing the medication.
C) Prepare the medication and document according to hospital policy - This should be done
after verifying the order.
C) Assess her knowledge of her husband's health problem.
When Mrs. Yellowtail expresses a misunderstanding about her husband's need for a heart
Mr. Yellowtail, 58 years old, has cardiomyopathy and is admitted with manifestations of transplant, the most appropriate initial action for the practical nurse is to assess her knowledge
congestive heart failure (CHF). He is awaiting a heart transplant. He is accompanied by of her husband's health problem. This will help determine the extent of her misunderstanding
Mrs. Yellowtail arrives at the hospital and tells the practical nurse that she is happy that her and guide the nurse in providing accurate information and education about her husband's
husband does not need a heart transplant and he can come home. What should the practical condition and treatment plan. It is important to ensure that Mrs. Yellowtail has a clear
nurse do? understanding of her husband's health status to support her in providing appropriate care
and making informed decisions.
The other options are less directly focused on addressing the immediate misunderstanding:
A) Refer her to the heart and stroke association.
A) Refer her to the heart and stroke association - While this could be a useful resource
B) Remind her that her husband will need a heart transplant.
for additional support and information, it is not the first step in addressing the immediate
C) Assess her knowledge of her husband's health problem.
misunderstanding.
D) Encourage her to support her husband during hospitalization.
B) Remind her that her husband will need a heart transplant - This is a direct correction, but
it does not address the underlying need for education and understanding.
D) Encourage her to support her husband during hospitalization - This is important, but it
does not address the misunderstanding about the need for a heart transplant.
A) Implement a teaching plan and adapt as needed.
When providing health teaching to Mr. Yellowtail and his wife, the practical nurse should
implement a teaching plan that is tailored to their specific needs and adapt it as necessary
Mr. Yellowtail, 58 years old, has cardiomyopathy and is admitted with manifestations of based on their responses and understanding. This approach ensures that the teaching is
congestive heart failure (CHF). He is awaiting a heart transplant. He is accompanied by relevant, ettective, and can be adjusted to meet the couple's learning needs and preferences.
The practical nurse is aware that health teaching needs to be provided for Mr. Yellowtail and It is important to be flexible and responsive to their questions and concerns.
his wife. What should the practical nurse do? The other options are less comprehensive or flexible:
B) Provide written material related to Mr. Yellowtail's condition - While written materials can
A) Implement a teaching plan and adapt as needed.
be helpful, they should be part of a broader teaching plan that includes verbal explanations,
B) Provide written material related to Mr. Yellowtail's condition.
demonstrations, and opportunities for questions and practice.
C) Develop a teaching plan and avoid changing it.
C) Develop a teaching plan and avoid changing it - A teaching plan should be adaptable to
D) Consult the physician when planning the teaching.
ensure it meets the changing needs and understanding of the patients and their families.
D) Consult the physician when planning the teaching - While consulting the physician for
medical information is important, the practical nurse should take the lead in developing and
implementing the teaching plan based on their expertise in patient education.
D) Decreased potassium level
Mr. Yellowtail, 58 years old, has cardiomyopathy and is admitted with manifestations of Furosemide (Lasix) is a loop diuretic that is commonly used to treat fluid retention in condi-
congestive heart failure (CHF). He is awaiting a heart transplant. He is accompanied by tions such as congestive heart failure (CHF). One of the potential side ettects of furosemide is
Mr. Yellowtail's CHF has worsened. His physician has ordered furosemide (Lasix). What side hypokalemia, or a decreased potassium level in the blood. This can occur because furosemide
increases the excretion of potassium in the urine, along with sodium and water. Monitoring
adult son. Over the past several months, Mrs. Worth has begun to forget days of the week
D) Ask Sara if she would like to talk and otter her support.
and forget to pay her bills. She often wears her night clothing during the day.
Three months later, Mrs. Worth is moved to a special care unit. Her granddaughter Sara visits, This response is empathetic and supportive, acknowledging Sara's feelings and ottering her
but Mrs. Worth does not recognize her. Sara begins to cry. What should the practical nurse the opportunity to express them. It also provides an opening for the practical nurse to otter
do? further assistance or information about Mrs. Worth's condition and how to cope with the
changes it brings. It's important for family members to understand the disease process and
A) Tell Sara that her grandmother likes to talk about living on the farm.
to have their feelings validated, but this should be done in a way that is sensitive to their
B) Tell Sara that this is part of the disease process and is to be expected.
emotional state at the moment.
C) Ask Sara if she would like to walk with her grandmother.
D) Ask Sara if she would like to talk and otter her support.
Mrs. Worth, 78 years old, is a resident in an apartment complex for older adults. She has an
adult son. Over the past several months, Mrs. Worth has begun to forget days of the week
and forget to pay her bills. She often wears her night clothing during the day. B) Assess Mrs. Worth's needs in a calm manner and review the situation for possible triggers.
Mrs. Worth is becoming increasingly agitated by another client. She begins to behave
This response is appropriate because it focuses on understanding and addressing the un-
aggressively. After calling for help, what should the practical nurse do?
derlying cause of Mrs. Worth's agitation and aggressive behavior. It is important to assess
her needs and the situation calmly to identify any triggers that may have caused her reaction.
A) Assess both clients for injury and encourage Mrs. Worth to calm down. This approach is more proactive and therapeutic than immediately resorting to medication or
B) Assess Mrs. Worth's needs in a calm manner and review the situation for possible triggers. restraint, which should be considered only if the situation poses an immediate risk to Mrs.
C) Administer p.r.n. medication and assess both clients for injury. Worth or others and all other de-escalation techniques have been exhausted.
D) Administer p.r.n. medication and obtain an order to restrain Mrs. Worth until she calms
down.
A) Apraxia
Mrs. Worth, 78 years old, is a resident in an apartment complex for older adults. She has an Apraxia is a neurological disorder characterized by an inability to perform purposeful move-
adult son. Over the past several months, Mrs. Worth has begun to forget days of the week ments despite having the physical ability to do so. It is often associated with brain damage
and forget to pay her bills. She often wears her night clothing during the day. or neurodegenerative diseases. In this case, Mrs. Worth's attempt to make phone calls on
While Mrs. Worth's son is visiting his mother, he notices that she is trying to make phone calls her TV remote control could be an example of ideational apraxia, where she has diflculty
on her TV remote control. Which term best describes this? understanding the concept of using objects correctly.
The other terms are less fitting for the described behavior:
B) Akinesia - This refers to an absence of movement, often seen in disorders like Parkinson's
A) Apraxia
disease.
B) Akinesia
C) Aphasia - This is a language disorder that attects a person's ability to communicate, which
C) Aphasia
is not directly related to the described behavior.
D) Aphagia
D) Aphagia - This is a disorder characterized by diflculty swallowing, which is unrelated to the
described behavior.
C) Donepezil (Aricept)
Donepezil (Aricept) is a cholinesterase inhibitor that is commonly used in the treatment of
Mrs. Worth, 78 years old, is a resident in an apartment complex for older adults. She has an Alzheimer's disease. It works by increasing the levels of acetylcholine, a neurotransmitter that
adult son. Over the past several months, Mrs. Worth has begun to forget days of the week is important for memory and learning, in the brain. This can help improve cognitive function
and forget to pay her bills. She often wears her night clothing during the day. and slow the progression of symptoms in some individuals with Alzheimer's disease.
What medication would most likely be ordered for Mrs. Worth's Alzheimer's disease? The other medications listed are used for ditterent purposes:
A) Citalopram (Celexa) - This is an antidepressant of the selective serotonin reuptake inhibitor
A) Citalopram (Celexa) (SSRI) class, used to treat depression and anxiety disorders.
B) Lorazepam (Ativan) B) Lorazepam (Ativan) - This is a benzodiazepine used to treat anxiety, insomnia, and seizures.
C) Donepezil (Aricept) It is not a first-line treatment for Alzheimer's disease.
D) Olanzapine (Zyprexa) D) Olanzapine (Zyprexa) - This is an antipsychotic medication used to treat schizophrenia and
bipolar disorder. It may be used ott-label for agitation in Alzheimer's disease but is not a
primary treatment for the cognitive symptoms of the disease.
,Sammy, 6 years old, has been diagnosed with cystic fibrosis. He is continuing on his daily B) Allow the friend to stay.
regimen for chest physiotherapy and medications. Sammy does not like taking all the med-
ications; it is a daily struggle for his family. Sammy has had several hospital admissions. In this scenario, it is important to consider the emotional and psychological support that
Six months later, Sammy is readmitted to the unit with a respiratory infection. Sammy's mother Sammy needs while he is hospitalized. Allowing a close friend of the family to stay with Sammy
needs to go home, and a close friend of the family will stay with Sammy. How should the can provide him with the comfort and security he needs, especially since his mother needs
practical nurse proceed? to go home. It is also a compassionate approach that acknowledges the family's support
network.
However, it is crucial to ensure that the friend is aware of any specific instructions or guidelines
A) Inform the friend of the unit's visiting hours. related to Sammy's care and that the mother remains the primary decision-maker for Sammy's
B) Allow the friend to stay. medical care. The practical nurse should communicate with the mother to confirm her consent
C) Notify the mother that the friend will be the decision-maker. for the friend to stay and to clarify any roles or responsibilities the friend may have during the
D) Inform Sammy's mother that a family member must remain at the visit.
C) Nutrition less than body requirements related to inability to absorb nutrients.
In the context of failure to thrive in a child with cystic fibrosis (CF), the primary nursing
Sammy, 6 years old, has been diagnosed with cystic fibrosis. He is continuing on his daily diagnosis is likely to be related to nutritional issues. Cystic fibrosis attects the pancreas, leading
regimen for chest physiotherapy and medications. Sammy does not like taking all the med- to inadequate production of digestive enzymes, which are necessary for the absorption of fats
ications; it is a daily struggle for his family. Sammy has had several hospital admissions. and proteins. This can result in malabsorption and poor weight gain, contributing to failure
Sammy has been admitted with failure to thrive. What is the nursing diagnosis of primary to thrive. Therefore, the nursing diagnosis of "Nutrition less than body requirements related
concern? to inability to absorb nutrients" is highly relevant and would be a primary concern.
The other options are also potential concerns for a child with CF but are less directly related
to the specific issue of failure to thrive:
A) Impaired gas exchange related to ventilation-perfusion imbalance
A) Impaired gas exchange related to ventilation-perfusion imbalance - This could be a concern
B) Risk for dehydration related to increased work of breathing
if Sammy had significant respiratory issues, but it is not the primary concern for failure to
C) Nutrition less than body requirements related to inability to absorb nutrients
thrive.
D) Anxiety related to dyspnea
B) Risk for dehydration related to increased work of breathing - This is a potential concern,
especially during respiratory infections, but it is not the primary concern for failure to thrive.
D) Anxiety related to dyspnea - This could be a concern if Sammy were experiencing significant
respiratory distress, but it is not the primary concern for failure to thrive.
D) Decrease in large bulky stools
In cystic fibrosis (CF), the production of pancreatic enzymes is often impaired, leading to
Sammy, 6 years old, has been diagnosed with cystic fibrosis. He is continuing on his daily diflculty in digesting fats and proteins. This can result in malabsorption and the production
regimen for chest physiotherapy and medications. Sammy does not like taking all the med- of large, bulky stools due to the presence of undigested fat. When pancreatic enzymes are
ications; it is a daily struggle for his family. Sammy has had several hospital admissions. administered with meals and snacks, they help to break down fats, making them more easily
Sammy is given pancreatic enzymes with meals and snacks. What should the practical nurse absorbable. As a result, the stools are likely to become smaller and less bulky because more
expect? of the fat is being digested and absorbed.
The other options are less directly related to the administration of pancreatic enzymes:
A) Increase in potassium levels - Pancreatic enzymes are not typically associated with changes
A) Increase in potassium levels in potassium levels.
B) Decrease in vitamin A, D, E and K levels B) Decrease in vitamin A, D, E, and K levels - While fat-soluble vitamins (A, D, E, and K) may be
C) Increase in urinary output poorly absorbed in untreated CF due to fat malabsorption, the administration of pancreatic
D) Decrease in large bulky stools enzymes should improve their absorption, potentially leading to increased levels rather than
a decrease.
C) Increase in urinary output - Pancreatic enzymes are not directly related to changes in urinary
output.
B) Aiding drainage of secretions.
Chest physiotherapy is a crucial component of the treatment for cystic fibrosis (CF) because it
, helps to clear thick mucus from the lungs. In CF, the mucus is abnormally thick and sticky, which
Sammy, 6 years old, has been diagnosed with cystic fibrosis. He is continuing on his daily can lead to blockages in the airways, increased risk of infections, and respiratory diflculties.
regimen for chest physiotherapy and medications. Sammy does not like taking all the med- The primary goal of chest physiotherapy is to aid in the drainage of these secretions, thereby
ications; it is a daily struggle for his family. Sammy has had several hospital admissions. reducing the risk of infections and improving lung function.
What is the primary goal when performing chest physiotherapy with Sammy? The other options are less directly related to the primary goal of chest physiotherapy:
A) Thinning secretions of the alveoli - While thinning secretions can be part of the overall
treatment strategy, the primary goal is to mobilize and remove the thick mucus from the
A) Thinning secretions of the alveoli airways.
B) Aiding drainage of secretions C) Preventing respiratory acidosis - This is a potential benefit of ettective chest physiotherapy,
C) Preventing respiratory acidosis as it can help maintain good lung function and gas exchange, but it is not the primary goal.
D) Keeping mucous plugs out of digestive tract D) Keeping mucous plugs out of the digestive tract - This is not a goal of chest physiotherapy;
mucous plugs are a concern in the respiratory tract, not the digestive tract.
B) Provide a teaching plan for Sammy's mother.
When preparing for Sammy's discharge, it is crucial to ensure that his mother is well-informed
Sammy, 6 years old, has been diagnosed with cystic fibrosis. He is continuing on his daily about his care needs, including medication management, chest physiotherapy, and dietary
regimen for chest physiotherapy and medications. Sammy does not like taking all the med- requirements. A teaching plan tailored to the family's needs can help reinforce the instructions
ications; it is a daily struggle for his family. Sammy has had several hospital admissions. and provide a structured way for the mother to learn and ask questions. This approach is more
Two weeks later, Sammy is ready for discharge. How should the practical nurse initially prepare likely to ensure that the mother feels confident and prepared to care for Sammy at home.
for his discharge? The other options are less comprehensive or interactive:
A) Ask Sammy's mother to help during care - While involving the mother in Sammy's care is
A) Ask Sammy's mother to help during care. important, it is more ettective to provide a structured teaching plan.
B) Provide a teaching plan for Sammy's mother. C) Give Sammy's mother a pamphlet to read - A pamphlet can be a useful supplementary
C) Give Sammy's mother a pamphlet to read. resource, but it may not be suflcient on its own to address all the mother's questions and
D) Provide a movie for Sammy's mother to watch. concerns.
D) Provide a movie for Sammy's mother to watch - A movie might not be the most ettective
educational tool compared to a tailored teaching plan.
C) The cardiac cycle consists of the systole and diastole phases.
The cardiac cycle is the sequence of events that occurs when the heart beats, and it primarily
consists of two main phases: systole and diastole. Systole is the contraction phase when the
Mr. Yellowtail, 58 years old, has cardiomyopathy and is admitted with manifestations of heart pumps blood out to the body and lungs, while diastole is the relaxation phase when the
congestive heart failure (CHF). He is awaiting a heart transplant. He is accompanied by heart fills with blood. Understanding these phases is essential for assessing and managing
During Mr. Yellowtail's assessment, what knowledge should the practical nurse have? patients with heart conditions like cardiomyopathy and congestive heart failure.
The other statements are less relevant to the overall understanding of the cardiac cycle:
A) S2 is best heard over the apex area. A) S2 is best heard over the apex area - This is true, but it is more specific to auscultation
B) S1 is best heard over the aortic and pulmonic area. techniques rather than the general understanding of the cardiac cycle.
C) The cardiac cycle consists of the systole and diastole phases. B) S1 is best heard over the aortic and pulmonic area - This is also true, but it is more specific
D) There are four phases to the cardiac cycle including systole and diastole. to auscultation techniques.
D) There are four phases to the cardiac cycle including systole and diastole - While there are
indeed four phases (atrial systole, ventricular systole, atrial diastole, and ventricular diastole),
the most fundamental understanding involves the two main phases: systole and diastole.
D) Verify the physician's order before preparing the medication.
Mr. Yellowtail, 58 years old, has cardiomyopathy and is admitted with manifestations of The first step in administering any new medication, especially one as potent as Furosemide
congestive heart failure (CHF). He is awaiting a heart transplant. He is accompanied by (Lasix), which is a loop diuretic used to treat fluid retention in conditions such as congestive
The practical nurse is preparing Mr. Yellowtail's morning medication. Furosemide (Lasix) is a heart failure, is to verify the physician's order. This is a critical safety measure to ensure that
new order in the medication administration record (MAR) and has been written as: the medication, dose, and frequency are correct and appropriate for the patient. Verifying
Lasix 80 mg p.o. daily. What should the practical nurse do first? the order helps prevent medication errors and ensures that the patient receives the correct
treatment.
After verifying the order, the practical nurse should:
, Prepare the medication according to hospital policy.
Administer the medication following the rights of medication administration.
Document the administration as required.
The other options are important but should follow the verification of the physician's order:
A) Verify the order on the MAR with another practical nurse. A) Verify the order on the MAR with another practical nurse - This is a good practice for
B) Administer the medication according to the rights of medication administration. double-checking, but it should be done after verifying the physician's order.
C) Prepare the medication and document according to hospital policy. B) Administer the medication according to the rights of medication administration - This
D) Verify the physician's order before preparing the medication. should be done after verifying the order and preparing the medication.
C) Prepare the medication and document according to hospital policy - This should be done
after verifying the order.
C) Assess her knowledge of her husband's health problem.
When Mrs. Yellowtail expresses a misunderstanding about her husband's need for a heart
Mr. Yellowtail, 58 years old, has cardiomyopathy and is admitted with manifestations of transplant, the most appropriate initial action for the practical nurse is to assess her knowledge
congestive heart failure (CHF). He is awaiting a heart transplant. He is accompanied by of her husband's health problem. This will help determine the extent of her misunderstanding
Mrs. Yellowtail arrives at the hospital and tells the practical nurse that she is happy that her and guide the nurse in providing accurate information and education about her husband's
husband does not need a heart transplant and he can come home. What should the practical condition and treatment plan. It is important to ensure that Mrs. Yellowtail has a clear
nurse do? understanding of her husband's health status to support her in providing appropriate care
and making informed decisions.
The other options are less directly focused on addressing the immediate misunderstanding:
A) Refer her to the heart and stroke association.
A) Refer her to the heart and stroke association - While this could be a useful resource
B) Remind her that her husband will need a heart transplant.
for additional support and information, it is not the first step in addressing the immediate
C) Assess her knowledge of her husband's health problem.
misunderstanding.
D) Encourage her to support her husband during hospitalization.
B) Remind her that her husband will need a heart transplant - This is a direct correction, but
it does not address the underlying need for education and understanding.
D) Encourage her to support her husband during hospitalization - This is important, but it
does not address the misunderstanding about the need for a heart transplant.
A) Implement a teaching plan and adapt as needed.
When providing health teaching to Mr. Yellowtail and his wife, the practical nurse should
implement a teaching plan that is tailored to their specific needs and adapt it as necessary
Mr. Yellowtail, 58 years old, has cardiomyopathy and is admitted with manifestations of based on their responses and understanding. This approach ensures that the teaching is
congestive heart failure (CHF). He is awaiting a heart transplant. He is accompanied by relevant, ettective, and can be adjusted to meet the couple's learning needs and preferences.
The practical nurse is aware that health teaching needs to be provided for Mr. Yellowtail and It is important to be flexible and responsive to their questions and concerns.
his wife. What should the practical nurse do? The other options are less comprehensive or flexible:
B) Provide written material related to Mr. Yellowtail's condition - While written materials can
A) Implement a teaching plan and adapt as needed.
be helpful, they should be part of a broader teaching plan that includes verbal explanations,
B) Provide written material related to Mr. Yellowtail's condition.
demonstrations, and opportunities for questions and practice.
C) Develop a teaching plan and avoid changing it.
C) Develop a teaching plan and avoid changing it - A teaching plan should be adaptable to
D) Consult the physician when planning the teaching.
ensure it meets the changing needs and understanding of the patients and their families.
D) Consult the physician when planning the teaching - While consulting the physician for
medical information is important, the practical nurse should take the lead in developing and
implementing the teaching plan based on their expertise in patient education.
D) Decreased potassium level
Mr. Yellowtail, 58 years old, has cardiomyopathy and is admitted with manifestations of Furosemide (Lasix) is a loop diuretic that is commonly used to treat fluid retention in condi-
congestive heart failure (CHF). He is awaiting a heart transplant. He is accompanied by tions such as congestive heart failure (CHF). One of the potential side ettects of furosemide is
Mr. Yellowtail's CHF has worsened. His physician has ordered furosemide (Lasix). What side hypokalemia, or a decreased potassium level in the blood. This can occur because furosemide
increases the excretion of potassium in the urine, along with sodium and water. Monitoring
