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1. Mrs. Sloane is to receive olive oil in both ears at night for cerumen impaction.
What intervention should the practical nurse perform?
1. Application of a small cotton ball at the meatus after instillation of the ear drops
2. Removal of coarse ear hairs
3. Referral to an ear, nose, and throat (ENT) physician
4. Evacuation of the cerumen using a cotton-tipped swab - Correct Answer: 1.
Application of a small cotton ball at the meatus after instillation of the ear drops
2. The practical nurse is aware that in the older age group, neurological
assessment is important. Which of the following results of Mrs. Sloane's
neurological assessments would be of most concern to the practical nurse?
1. Mrs. Sloane is not sure which day of the week it is today.
2. Mrs. Sloane's Mini-Mental State Examination has declined from 27 last year to
25 today.
3. Mrs. Sloane states that she often misplaces her hearing aid.
4. Mrs. Sloane believes she presently lives in her former home, which she left 2
years ago. - Correct Answer: 4. Mrs. Sloane believes she presently lives in her
former home, which she left 2 years ago.
,3. Ms. Perlstein delivered a healthy 3 200-g boy yesterday. The practical nurse
plans to perform a health assessment with Ms. Perlstein and the baby.
Questions 8-13 refer to this case.
4. When the practical nurse enters the room, baby Perlstein is asleep. What
assessment should the practical nurse first perform?
1. Respirations
2. Apical heart rate
3. Temperature
4. General appearance - Correct Answer: 4. General appearance
5. Which of the following should the practical nurse be aware of when examining
baby Perlstein?
1. The baby should be completely naked for the entire examination.
2. The parents should not be present as they may be distressed by the
examination.
3. She should use a soft, crooning voice.
4. The examination is best done just before feeding. - Correct Answer: 3. She
should use a soft, crooning voice.
6. Which of the following would be part of a normal respiratory assessment for
neonate Perlstein?
1. Observation of abdominal breathing
2. Obtaining a respiratory rate of 70 breaths per minute
,3. Noting a breathing pattern that is regular, with an even rate
4. Assessing that the baby is primarily mouth-breathing rather than nose-
breathing - Correct Answer: 1. Observation of abdominal breathing
7. The practical nurse measures the head circumference of baby Perlstein. Why is
this a component of a neonatal examination?
1. The circumference indicates the degree of moulding resulting from the birth
process.
2. It is part of the Apgar score.
3. Variations from normal may indicate a genetic abnormality or increased
intracranial pressure.
4. Abnormalities in fontanelles are more accurately assessed. - Correct
Answer: 3. Variations from normal may indicate a genetic abnormality or
increased intracranial pressure.
8. How would the practical nurse best confirm a patent rectum and anus in baby
Perlstein?
1. Confirm that the passage of meconium took place within 24-48 hours after
birth.
2. Stroke the anus and note a quick contraction of the sphincter.
3. Introduce a rectal thermometer or cotton-tipped swab into the anus.
4. Gently insert a gloved well-lubricated fifth finger into the rectum. - Correct
Answer: 1. Confirm that the passage of meconium took place within 24-48 hours
after birth.
, 9. How would the practical nurse elicit the Moro reflex from baby Perlstein?
1. Stroke the bottom of his feet.
2. Hold him on his back and allow his head and trunk to drop back a short
distance.
3. Perform a sharp handclap beside his ear.
4. Hold him vertically, allowing one foot to touch a surface. - Correct Answer:
2. Hold him on his back and allow his head and trunk to drop back a short
distance.
Case 3
A registered practical nurse working in the community provides health care to
students at a secondary school as part of his job.
Questions 14-20 refer to this case.
How should the practical nurse approach health assessments and teaching with
adolescents?
1. Involve the parents, as they will be able to reinforce health teaching with their
teenagers.
2. Maintain a professional and strict attitude, as adolescents will respond
positively to authority.
3. Provide factual information about how students can manage specific problems
they identify.