1. A male client with diabetes mellitus calls the clinic to report left calf pain after walking around
the block. Which additional information should the PN report to the healthcare provider?
A) Muscle cramps occur at night when sleeping.
B) Muscles are deconditioned from lack of regular exercise.
C) Shooting pain occurs down the back of one leg when walking.
D) The pain is immediately relieved when he sits down.
.D) The pain is immediately relieved when he sits down. . Atherosclerosis secondary to diabetes
increases risk for peripheral arterial disease, manifested by pain precipitated by walking and
immediately relieved by rest, known as intermittent claudication.
2. The practical nurse (PN) is reviewing preoperative instructions with a male client who is having
surgery today. What question should the PN ask the client to best evaluate his understanding of
the surgery?
A) Do you understand why you are having surgery?
B) Have you undergone this type of surgery in the past?
C) What do you know about the surgery you are having?
D) What symptoms brought you to the hospital for surgery?
.C) What do you know about the surgery you are having? . Open-ended questions are essential to
elicit what the client actually understands about the procedure, whereas closed-ended questions
yield only yes or no responses without revealing true comprehension.
3. Which finding is most important for the practical nurse (PN) to explore further for a client who
had a total abdominal hysterectomy and bilateral oophorectomy yesterday?
A) Right calf is 24 cm and the left calf is 21 cm.
B) No bowel sounds or gurgles auscultated in the abdomen.
C) No urine output 3 hours after the catheter is removed.
D) Dried blood 3 cm in size noted on the abdominal dressing.
.A) Right calf is 24 cm and the left calf is 21 cm. . Unilateral leg swelling is a classic sign of deep
vein thrombosis, a serious postoperative complication due to immobility, dehydration, and vessel
manipulation during major abdominal surgery.
4. Which finding for a client who is 1-day postoperative for a partial thyroidectomy requires
immediate follow-up by the practical nurse (PN)?
A) High pitched expiratory sound.
B) Throat pain rated "9."
,C) Voice is hoarse.
D) Capillary refill is 4 seconds.
.A) High pitched expiratory sound. . Stridor indicates airway obstruction, a life-threatening
postoperative complication after thyroidectomy that requires immediate intervention before
addressing other findings.
5. The practical nurse (PN) is evaluating the self-care of a client who is recovering at home after a
laryngectomy. Which finding indicates to the PN that the client needs additional information?
A) A cool mist humidifier is at the bedside.
B) The salt water solution is dated 3 days ago.
C) A Medic Alert bracelet is on the client's wrist.
D) The client's stoma is covered with a crocheted scarf.
.B) The salt water solution is dated 3 days ago. . Salt water solution must be changed daily to
prevent bacterial growth, so finding a 3-day-old solution indicates the client needs additional
teaching about infection prevention.
6. Which information should the practical nurse (PN) offer a female client who is at risk for
recurrent urinary tract infection (UTI)? (Select all that apply.)
A) Use vinegar solution douche regularly.
B) Avoid wearing tight-fitting jeans.
C) Limit caffeine and alcohol.
D) Void before and after intercourse.
E) Wipe the perineum from front to back.
.B) Avoid wearing tight-fitting jeans. C) Limit caffeine and alcohol. D) Void before and after
intercourse. E) Wipe the perineum from front to back. . These measures reduce UTI risk by
preventing bacterial growth and irritation, while douching disrupts normal flora and increases
infection risk.
7. The practical nurse is caring for a client who is admitted with signs of possible acute brain attack
(stroke) three hours ago. The client's blood pressure is 170/96, regular radial pulse 76
beats/minute, respirations are nonlabored at 11 breaths/minute, and a SpO2 of 99%. What action
is most important for the PN to implement?
A) Call healthcare provider for antihypertensive.
B) Assess the client for Brudzinski's sign.
C) Continue to monitor client's blood pressure.
D) Monitor client's IV fluid intake and urine output.
.C) Continue to monitor client's blood pressure. . Continuous blood pressure monitoring is essential
to determine eligibility for reperfusion therapy; antihypertensives are only indicated if systolic is
180-230 or diastolic is 105-140.
,8. A client with cholelithiasis is admitted with jaundice due to obstruction of the common bile
duct. Which finding is most important for the practical nurse to report to the healthcare provider?
A) Pain radiating to the right shoulder.
B) Clay-colored stool.
C) Hard, rigid abdomen.
D) Vomiting bile-stained emesis.
.C) Hard, rigid abdomen. . A hard, rigid abdomen indicates gallbladder distention and possible
perforation from bile accumulation, requiring immediate reporting to prevent life-threatening
complications.
9. Which findings should the practical nurse identify in a client with anemia due to a vitamin B12
deficiency? (Select all that apply)
A) Gradual weight gain.
B) Smooth, beefy-red oral cavity.
C) Macrocytic red blood cells (RBC).
D) Paresthesia of hands and feet.
E) Leukopenia.
.B) Smooth, beefy-red oral cavity. D) Paresthesia of hands and feet. . Vitamin B12 deficiency
causes glossitis with a smooth, beefy-red tongue and neurologic symptoms like paresthesia, while
weight loss not gain and bone marrow suppression findings are not characteristic.
10. An older client with presbyopia receives a prescription for corrective lenses. Which
information should the practical nurse provide that explains the expected results of the corrective
lenses?
A) Helps to sharpen distance vision.
B) Improves both near and distance vision.
C) Corrects vision for reading and close work.
D) Assists with bilateral accommodation.
.C) Corrects vision for reading and close work. . Age-related lens elasticity loss makes close vision
blurry, and corrective lenses specifically improve visual acuity for reading and close work, not
distance vision.
11. A client with epilepsy is having bilateral rhythmic jerking movements of all extremities. After
calling for help, which action should the practical nurse (PN) do next? (Arrange the interventions
from first to last.)
1. Maintain the client's airway.
2. Observe the client for incontinence.
3. Apply pads to the bedside rails.
4. Avoid stimulation during post-ictal phase.
, .1. Maintain the client's airway. 2. Apply pads to the bedside rails. 3. Observe the client for
incontinence. 4. Avoid stimulation during post-ictal phase. . Airway maintenance is the priority
during a tonic-clonic seizure, followed by injury protection, observation of behaviors, and minimal
stimulation during the post-ictal phase to prevent subsequent seizures.
12. A male client is having an intraocular pressure (IOP) measurement using a tonometer for the
first time. The client is fearful that the test hurts and may damage his vision. Which explanation
should the practical nurse provide?
A) Eyedrops will be prescribed for abnormal IOP readings.
B) A topical anesthetic will be used on the eye surface.
C) The test is quick and does not cause injury or blindness.
D) Reassure the client that the procedure does not hurt.
.B) A topical anesthetic will be used on the eye surface. . Topical ophthalmic anesthetic eliminates
pain sensation during tonometry, providing specific information about comfort measures rather
than vague reassurance.
13. An older female client with osteoporosis asks the practical nurse (PN) to explain why she is
now 2 inches shorter than when she was younger. What information is best for the practical nurse
(PN) to provide?
A) Loss of calcium in the bones causes the change.
B) Bones get shorter with age due to wear and tear.
C) Less fluid in each of the disks between the vertebrae occurs with degeneration.
D) It is a combination of wear and tear and calcium loss that causes the change.
.D) It is a combination of wear and tear and calcium loss that causes the change. . Height loss
results from intervertebral disk changes, erosion, and osteoporosis, combining wear-and-tear
theory with calcium loss for the most comprehensive explanation.
14. An older client who has had a cataract in the right eye for several years tells the practical nurse
(PN), "Now I have lost the sight in my right eye because I waited too long for treatment." What
information should the PN provide?
A) Prompt treatment can save the sight in both of eyes.
B) Nothing can be done once sight is lost in the affected eye.
C) Surgery can restore vision with corrective lens implants or glasses.
D) Explain that surgery cannot provide optimal results immediately.
.C) Surgery can restore vision with corrective lens implants or glasses. . Cataract removal restores
vision with corrective lenses based on refractive error and retinal integrity, directly addressing the
client's fear about permanent sight loss.
15. A client with major burns is receiving cimetidine (Tagamet). Which finding should the practical
nurse (PN) obtain to best evaluate the effectiveness of the medication?
the block. Which additional information should the PN report to the healthcare provider?
A) Muscle cramps occur at night when sleeping.
B) Muscles are deconditioned from lack of regular exercise.
C) Shooting pain occurs down the back of one leg when walking.
D) The pain is immediately relieved when he sits down.
.D) The pain is immediately relieved when he sits down. . Atherosclerosis secondary to diabetes
increases risk for peripheral arterial disease, manifested by pain precipitated by walking and
immediately relieved by rest, known as intermittent claudication.
2. The practical nurse (PN) is reviewing preoperative instructions with a male client who is having
surgery today. What question should the PN ask the client to best evaluate his understanding of
the surgery?
A) Do you understand why you are having surgery?
B) Have you undergone this type of surgery in the past?
C) What do you know about the surgery you are having?
D) What symptoms brought you to the hospital for surgery?
.C) What do you know about the surgery you are having? . Open-ended questions are essential to
elicit what the client actually understands about the procedure, whereas closed-ended questions
yield only yes or no responses without revealing true comprehension.
3. Which finding is most important for the practical nurse (PN) to explore further for a client who
had a total abdominal hysterectomy and bilateral oophorectomy yesterday?
A) Right calf is 24 cm and the left calf is 21 cm.
B) No bowel sounds or gurgles auscultated in the abdomen.
C) No urine output 3 hours after the catheter is removed.
D) Dried blood 3 cm in size noted on the abdominal dressing.
.A) Right calf is 24 cm and the left calf is 21 cm. . Unilateral leg swelling is a classic sign of deep
vein thrombosis, a serious postoperative complication due to immobility, dehydration, and vessel
manipulation during major abdominal surgery.
4. Which finding for a client who is 1-day postoperative for a partial thyroidectomy requires
immediate follow-up by the practical nurse (PN)?
A) High pitched expiratory sound.
B) Throat pain rated "9."
,C) Voice is hoarse.
D) Capillary refill is 4 seconds.
.A) High pitched expiratory sound. . Stridor indicates airway obstruction, a life-threatening
postoperative complication after thyroidectomy that requires immediate intervention before
addressing other findings.
5. The practical nurse (PN) is evaluating the self-care of a client who is recovering at home after a
laryngectomy. Which finding indicates to the PN that the client needs additional information?
A) A cool mist humidifier is at the bedside.
B) The salt water solution is dated 3 days ago.
C) A Medic Alert bracelet is on the client's wrist.
D) The client's stoma is covered with a crocheted scarf.
.B) The salt water solution is dated 3 days ago. . Salt water solution must be changed daily to
prevent bacterial growth, so finding a 3-day-old solution indicates the client needs additional
teaching about infection prevention.
6. Which information should the practical nurse (PN) offer a female client who is at risk for
recurrent urinary tract infection (UTI)? (Select all that apply.)
A) Use vinegar solution douche regularly.
B) Avoid wearing tight-fitting jeans.
C) Limit caffeine and alcohol.
D) Void before and after intercourse.
E) Wipe the perineum from front to back.
.B) Avoid wearing tight-fitting jeans. C) Limit caffeine and alcohol. D) Void before and after
intercourse. E) Wipe the perineum from front to back. . These measures reduce UTI risk by
preventing bacterial growth and irritation, while douching disrupts normal flora and increases
infection risk.
7. The practical nurse is caring for a client who is admitted with signs of possible acute brain attack
(stroke) three hours ago. The client's blood pressure is 170/96, regular radial pulse 76
beats/minute, respirations are nonlabored at 11 breaths/minute, and a SpO2 of 99%. What action
is most important for the PN to implement?
A) Call healthcare provider for antihypertensive.
B) Assess the client for Brudzinski's sign.
C) Continue to monitor client's blood pressure.
D) Monitor client's IV fluid intake and urine output.
.C) Continue to monitor client's blood pressure. . Continuous blood pressure monitoring is essential
to determine eligibility for reperfusion therapy; antihypertensives are only indicated if systolic is
180-230 or diastolic is 105-140.
,8. A client with cholelithiasis is admitted with jaundice due to obstruction of the common bile
duct. Which finding is most important for the practical nurse to report to the healthcare provider?
A) Pain radiating to the right shoulder.
B) Clay-colored stool.
C) Hard, rigid abdomen.
D) Vomiting bile-stained emesis.
.C) Hard, rigid abdomen. . A hard, rigid abdomen indicates gallbladder distention and possible
perforation from bile accumulation, requiring immediate reporting to prevent life-threatening
complications.
9. Which findings should the practical nurse identify in a client with anemia due to a vitamin B12
deficiency? (Select all that apply)
A) Gradual weight gain.
B) Smooth, beefy-red oral cavity.
C) Macrocytic red blood cells (RBC).
D) Paresthesia of hands and feet.
E) Leukopenia.
.B) Smooth, beefy-red oral cavity. D) Paresthesia of hands and feet. . Vitamin B12 deficiency
causes glossitis with a smooth, beefy-red tongue and neurologic symptoms like paresthesia, while
weight loss not gain and bone marrow suppression findings are not characteristic.
10. An older client with presbyopia receives a prescription for corrective lenses. Which
information should the practical nurse provide that explains the expected results of the corrective
lenses?
A) Helps to sharpen distance vision.
B) Improves both near and distance vision.
C) Corrects vision for reading and close work.
D) Assists with bilateral accommodation.
.C) Corrects vision for reading and close work. . Age-related lens elasticity loss makes close vision
blurry, and corrective lenses specifically improve visual acuity for reading and close work, not
distance vision.
11. A client with epilepsy is having bilateral rhythmic jerking movements of all extremities. After
calling for help, which action should the practical nurse (PN) do next? (Arrange the interventions
from first to last.)
1. Maintain the client's airway.
2. Observe the client for incontinence.
3. Apply pads to the bedside rails.
4. Avoid stimulation during post-ictal phase.
, .1. Maintain the client's airway. 2. Apply pads to the bedside rails. 3. Observe the client for
incontinence. 4. Avoid stimulation during post-ictal phase. . Airway maintenance is the priority
during a tonic-clonic seizure, followed by injury protection, observation of behaviors, and minimal
stimulation during the post-ictal phase to prevent subsequent seizures.
12. A male client is having an intraocular pressure (IOP) measurement using a tonometer for the
first time. The client is fearful that the test hurts and may damage his vision. Which explanation
should the practical nurse provide?
A) Eyedrops will be prescribed for abnormal IOP readings.
B) A topical anesthetic will be used on the eye surface.
C) The test is quick and does not cause injury or blindness.
D) Reassure the client that the procedure does not hurt.
.B) A topical anesthetic will be used on the eye surface. . Topical ophthalmic anesthetic eliminates
pain sensation during tonometry, providing specific information about comfort measures rather
than vague reassurance.
13. An older female client with osteoporosis asks the practical nurse (PN) to explain why she is
now 2 inches shorter than when she was younger. What information is best for the practical nurse
(PN) to provide?
A) Loss of calcium in the bones causes the change.
B) Bones get shorter with age due to wear and tear.
C) Less fluid in each of the disks between the vertebrae occurs with degeneration.
D) It is a combination of wear and tear and calcium loss that causes the change.
.D) It is a combination of wear and tear and calcium loss that causes the change. . Height loss
results from intervertebral disk changes, erosion, and osteoporosis, combining wear-and-tear
theory with calcium loss for the most comprehensive explanation.
14. An older client who has had a cataract in the right eye for several years tells the practical nurse
(PN), "Now I have lost the sight in my right eye because I waited too long for treatment." What
information should the PN provide?
A) Prompt treatment can save the sight in both of eyes.
B) Nothing can be done once sight is lost in the affected eye.
C) Surgery can restore vision with corrective lens implants or glasses.
D) Explain that surgery cannot provide optimal results immediately.
.C) Surgery can restore vision with corrective lens implants or glasses. . Cataract removal restores
vision with corrective lenses based on refractive error and retinal integrity, directly addressing the
client's fear about permanent sight loss.
15. A client with major burns is receiving cimetidine (Tagamet). Which finding should the practical
nurse (PN) obtain to best evaluate the effectiveness of the medication?
