HESI PN Comprehensive Exam 2

HESI PN Comprehensive Exam 2 A newborn with apnea is being discharged from the hospital with home monitoring. What information concerning the infant's care should the practical nurse review with the parents? A. Cardiopulmonary resuscitation (CPR). B. Administration of intravenous antibiotics. C. Reassurance that the infant cannot be electrocuted during monitoring. D. Advise that the infant not be left with caretakers, such as babysitters. Correct answer - A. Cardiopulmonary resuscitation (CPR). Rationale: Apnea of infancy (AOI) engenders great anxiety in parents, and the initiation of home monitoring presents additional emotional stress. When home monitoring is required the parents should receive instructio ns that include cardiopulmonary resuscitation(A). (B) does not indicate Apnea Which protocol regarding standard policies about prescriptions should the practical nurse (PN) question? A. All drug prescriptions should have the date, time, and prescriber's signature. B.Verbal orders are accepted from prescribers and should include signatures. C. Prescribers may write specific times at which the medications are to be given. D. Preoperat ive prescriptions should be resumed after a client returns from surgery Correct answer - D. Preoperative prescriptions should be resumed after a client returns from surgery. Rationale: A standard policy about preoperative medications that preoperative prescriptions are automatically canceled for surgery and should be rewritten, if indicated , in the postoperatively so the (PN) should question (D). (A,B,C) are correct statements. When reviewing the safety precautions regarding newborns, what information should the practical nurse communicate to the parents? A. Position the infant to sleep on the baby's back. B. Use a crib with slats no more than 4 inches apart. C. Propping a bottle can be done when the infant gets older. D. Place the infant a front -facing car seat in the automobile. Correct answer - A. Position the infant to sleep on the baby's back. Rationale: The incident of sudden infant death syndrome (SIDS) decline when infants are positioned on their backs (A), instead of prone for sleeping. Cr ib slats (B) 2.375 inches apart to prevent the baby from slipping. (C) Never prop a babies bottle. (D)Infant who weighs less than 30lbs should be placed in a rear facing car seat. When monitoring a newborn, which observation should the practical nurse rep ort to the healthcare provider? A. Rectal temperature of 37.6° C. B. Axillary temperature of 37.1° C. C. Heart rate of 110 beats per minute. Correct D. Respiration rate of 40 breaths per minute. Correct answer - C. Heart rate of 110 beats per minute Rationale: The normal range for a heart beat for an infant is 120 -160 so a heart rate of 110 should be reported to the healthcare provider. Newborn temperature ranges from 97.7,99.4,36.5,37.5 and normal respiratory rate is 30 -60 After reviewing discharge i nstructions with a male client who has hepatitis C, what statement by the client indicates to the practical nurse that the client understands his disease? A. "I will avoid taking any products with acetaminophen, such as Tylenol." B. "I will eliminate alc ohol consumption until my infection subsides." C. "I should eat a diet rich in dark green leafy vegetables." D. "I understand that my other medications doses need to be increased." Correct answer - A. "I will avoid taking any products with acetaminophen, such as Tylenol." Rationale: Tylenol is metabolized in the liver and should be avoided with clients with liver disease Which action should the practical nurse perform first for a child who is injured on the school grounds and has an obvious mis-alignment of the lower forearm? A. Remove the child's finger rings. B. Assess and document the child's level of pain. C. Evaluate the child's range of motion. D. Place arm in a sling at level of the child's heart. Correct answer - A. Remove the chi ld's finger rings. Rationale: The child is a risk for swelling in the distal areas of the affected arm and hand. Removal of finger rings (A) should be implemented first to remove any potential constriction that may occur after tissue injury or fracture o f the lower arm The practical nurse (PN) is participating in a group interview of an applicant who will work in the clinic as a staff PN. Which question is best to ask the applicant? A. "This position requires working on -call every fourth weekend. Can yo u do that?" B. "Do you have child care arrangements for your children?" C. "Do you have any religious requirements that need scheduling accommodation?" D. "Are you going to be the sole supporter for your family?" Correct answer - A. "This position requi res working on -call every fourth weekend. Can you do that?" Rationale: Job interview questions must be specifically job related (A) A client in a nursing home becomes violent and verbally threatens an unlicensed assistive personnel (UAP). Which is the b est way for the practical nurse (PN) in charge during the shift to handle the staff's reaction to the incident? A. Encourage UAP to deal with it privately to prevent compromising client confidentiality. B. Offer a group discussion session so staff can sh are their thoughts and feelings. C. Invite staff out after hours to help distract them from the disturbing client event. D. Refer the UAP to human resources department for a counseling session with a therapist. Correct answer - B.Offer a group discussion session so staff can share their thoughts and feelings Rationale: A critical incident stress debriefing evolves expression of personal feelings, discussion, and working on unresolved emotional issues to minimize post traumatic stress f or the staff member. A CISD is the best action for the PN in charge to take (B) in conjunction with the guidance and assistance of the nursing supervisor in the facility A group of practical nurses (PNs) who work on a medical -surgical unit believe they are understaffed. Which data should the PNs consider when preparing the justification for additional staff? A. Staffing ratios in other states. B. Client acuity and census. C. Overtime payment and unfilled positions. D. Number and frequency of client c omplaints. Correct answer - B. Client acuity and census. Rationale: When presenting the need for increased staff, the PNs should present the request using staffing guidelines that consider client acuity, number of clients, and length of stay(B). The pra ctical nurse (PN) assigns care of a client who is HIV positive to a newly employed PN who states, I can't take care of that client. How should the PN respond? A. "I don't understand your response. Please explain what you mean." B. "Staff cannot pick and choose assignments based on a client's diagnosis." C. "This client will provide a learning opportunity for you, and I'm here to help." D. "I will give you a different client so you will be more comfortable." Correct answer - A. "I don't understand your r esponse. Please explain what you mean." Rationale: The ethical principle of beneficence guides decisions based on the clients well being or dignity. The PN should first assess the rationale supporting the response (A) which may include an infection such a s a "Cold" that places the immunosuppressed client at risk A client with type 2 diabetes mellitus is admitted to the hospital for an exacerbation of asthma. The practical nurse (PN) administers hydrocortisone (Solu -Cortef) 60 mg PO every 6 hours. What inf ormation should the PN to review the next day? A. Serum potassium. B. Serum glucose. C. Respiratory rate. D. Blood pressure. Correct answer - B. Serum glucose. Rationale: High doses of glucocorticoidsteriods can cause an elevation in the serum glucose level, so the PN should review the clients serum glucose(B) Which information should the practical nurse (PN) provide to an unlicensed assistive personnel (UAP) who is newly assigned to the unit? A. Keep head -of-bed elevated 45 degrees for clients with an infusing enteral pump. B. Determine if pain subsides 20 minutes after a client receives an injection. C. Report signs of infection in urine that collects in a bedside drainage unit. D. Observe how clients are using an incentive spirometer after surgery. Correct answer - A. Keep head -of-bed elevated 45 degrees for clients with an infusing enteral pump. Rationale: Information about the basic care clients such as positioning (A) should be specific to a common intervention or treatment and should focus on task within the scope of the UAP's assignment A woman who is 32 -weeks gestation arrives at the prenatal clinic and reports painless contractions and mucoid vaginal discharge. The fetal heart rate is 150 beats/minutes. What action should the practical nurse (PN) implement first? A. Place in the left lateral recumbent position. B. Ask about recent sexual intercourse. C. Encourage an increase in oral fluid intake. D. Determine when the contractions began.