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1. The practical nurse (PN) is Answer: A
monitoring a child who is man-
ifesting signs of shock after a Rationale:
motor vehicle collision. Which As shock progresses, perfusion in the microcirculation be-
finding is most important for comes marginal despite compensatory adjustments, and the
the PN to report to the charge signs of decompensated shock become pronounced, such as
nurse? tachycardia and narrowing pulse pressure (A). (The difference
between systolic and diastolic blood pressure), which should
a) narrowing pulse pressure be reported immediately. (B,C, and D) are not as significant as
b) apprehension (A).
c) irritability
d) thirst
2. The mother of a 9 month old Answer: B
male infant is concerned be-
cause he cries whenever she Rationale:
Healthy attachment is manifested by stranger anxiety in late
leaves him with a sitter. What is
the best response for the prac- infancy (B). Pain from teething expressed by the infant's cries
tical nurse (PN) to provide? does not occur only when the mother leaves the infant with
another person (A). The PN should evaluate the infant's devel-
a) "Have you noticed whether opmental needs (C) before suggesting the infant may be ill.
your baby is teething?" An infant who manifests stranger anxiety is best supported by
b) "Crying when you leave him the mother if the infant is left for shorter periods of time, not
in a healthy sign of attach- (D).
ment."
c) "Consider taking the baby to
the doctor because he may be
ill."
d) "You could consider leaving
the infant more often so he can
adjust."
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3. Which preoperative action is Answer: C
most important for the practi-
cal nurse (PN) to implement for Rationale:
a newborn with meningomye- A meningomyelocele provides a direct entry for bacteria into
locele? the central nervous system, leading to meningitis. Measures
that protect the integrity of the meningomyelocele sac and in-
a) document vital signs fection control measures should be implemented to minimize
b) prevent skin breakdown the risk of infection (C). (A,B, and D) should be implemented
c) minimize the risk for infec- but do not have the priority of (C).
tion
d) monitor neurologic func-
tioning
4. The practical nurse is caring Answer: B
for a 6 year old girl who had
surgery 12 hours ago. The Rationale:
child tells the PN that she does A child may fear receiving an injection for pain or may believe
not have pain but a few min- that pain is a deserved punishment for some misdeed, so the
utes later, tells her parents that pain is denied (D) when the nurse asks the child, who then
she does. What child develop- readily admits having pain to a parent. This behavior should
ment concept is relevant to this not be interpreted as (C) but as a valid indication of pain. (A
situation? and C) are incorrect interpretations of this behavior.
a) inconsistency in pain report-
ing suggests that pain not pre-
sent
b) a child may have pain yet
deny its presence to the nurse
c) truthful reporting of pain
should occur by this age
d) children use pain experi-
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ences to manipulate their par-
ents
5. A 6 year old who had a tonsil- Answer: A
lectomy 12 hours ago is com-
plaining of thirst. What should Rationale:
the practical nurse (PN) offer? Small amounts of clear liquids without red dyes should be
offered to the child. Popsicles (A) are cold and help soothe a
a) popsicle dry throat. Citrus drinks (B and C) are acidic and irritate the
b) lemonade operative site in the posterior oropharynx. Milk (D) thickens
c) orange juice oral mucus which makes swallowing more difficult and causes
d) chocolate milk coughing.
6. The mother of a male new- Answer: A
born calls the clinic to inquire
about the formation of a yel- Rationale:
low crust over her son's cir- Crust formation is part of the healing process and should be
cumcision area. What informa- removed (A). (C) is not indicated at this time. The diaper should
tion should the practical nurse be fastened loosely, not tightly (D) which can place pressure on
(PN) provide? the incision site. (B) assists in the healing process and should
not be discontinued.
a) do not remove the yellow
crust from the site
b) stop using petroleum
around the head of the penis
c) bring him into the clinic
d) tightly fasten the diaper
7. The mother of a child with Answer: C
croup is having barking,
coughing episodes calls the Rationale:
clinic for assistance. What Croup (laryngotracheobronchitis) is a viral infection that caus-
action should the practical es a "barking" cough and varying degrees of inspiratory stri-
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1. The practical nurse (PN) is Answer: A
monitoring a child who is man-
ifesting signs of shock after a Rationale:
motor vehicle collision. Which As shock progresses, perfusion in the microcirculation be-
finding is most important for comes marginal despite compensatory adjustments, and the
the PN to report to the charge signs of decompensated shock become pronounced, such as
nurse? tachycardia and narrowing pulse pressure (A). (The difference
between systolic and diastolic blood pressure), which should
a) narrowing pulse pressure be reported immediately. (B,C, and D) are not as significant as
b) apprehension (A).
c) irritability
d) thirst
2. The mother of a 9 month old Answer: B
male infant is concerned be-
cause he cries whenever she Rationale:
Healthy attachment is manifested by stranger anxiety in late
leaves him with a sitter. What is
the best response for the prac- infancy (B). Pain from teething expressed by the infant's cries
tical nurse (PN) to provide? does not occur only when the mother leaves the infant with
another person (A). The PN should evaluate the infant's devel-
a) "Have you noticed whether opmental needs (C) before suggesting the infant may be ill.
your baby is teething?" An infant who manifests stranger anxiety is best supported by
b) "Crying when you leave him the mother if the infant is left for shorter periods of time, not
in a healthy sign of attach- (D).
ment."
c) "Consider taking the baby to
the doctor because he may be
ill."
d) "You could consider leaving
the infant more often so he can
adjust."
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3. Which preoperative action is Answer: C
most important for the practi-
cal nurse (PN) to implement for Rationale:
a newborn with meningomye- A meningomyelocele provides a direct entry for bacteria into
locele? the central nervous system, leading to meningitis. Measures
that protect the integrity of the meningomyelocele sac and in-
a) document vital signs fection control measures should be implemented to minimize
b) prevent skin breakdown the risk of infection (C). (A,B, and D) should be implemented
c) minimize the risk for infec- but do not have the priority of (C).
tion
d) monitor neurologic func-
tioning
4. The practical nurse is caring Answer: B
for a 6 year old girl who had
surgery 12 hours ago. The Rationale:
child tells the PN that she does A child may fear receiving an injection for pain or may believe
not have pain but a few min- that pain is a deserved punishment for some misdeed, so the
utes later, tells her parents that pain is denied (D) when the nurse asks the child, who then
she does. What child develop- readily admits having pain to a parent. This behavior should
ment concept is relevant to this not be interpreted as (C) but as a valid indication of pain. (A
situation? and C) are incorrect interpretations of this behavior.
a) inconsistency in pain report-
ing suggests that pain not pre-
sent
b) a child may have pain yet
deny its presence to the nurse
c) truthful reporting of pain
should occur by this age
d) children use pain experi-
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ences to manipulate their par-
ents
5. A 6 year old who had a tonsil- Answer: A
lectomy 12 hours ago is com-
plaining of thirst. What should Rationale:
the practical nurse (PN) offer? Small amounts of clear liquids without red dyes should be
offered to the child. Popsicles (A) are cold and help soothe a
a) popsicle dry throat. Citrus drinks (B and C) are acidic and irritate the
b) lemonade operative site in the posterior oropharynx. Milk (D) thickens
c) orange juice oral mucus which makes swallowing more difficult and causes
d) chocolate milk coughing.
6. The mother of a male new- Answer: A
born calls the clinic to inquire
about the formation of a yel- Rationale:
low crust over her son's cir- Crust formation is part of the healing process and should be
cumcision area. What informa- removed (A). (C) is not indicated at this time. The diaper should
tion should the practical nurse be fastened loosely, not tightly (D) which can place pressure on
(PN) provide? the incision site. (B) assists in the healing process and should
not be discontinued.
a) do not remove the yellow
crust from the site
b) stop using petroleum
around the head of the penis
c) bring him into the clinic
d) tightly fasten the diaper
7. The mother of a child with Answer: C
croup is having barking,
coughing episodes calls the Rationale:
clinic for assistance. What Croup (laryngotracheobronchitis) is a viral infection that caus-
action should the practical es a "barking" cough and varying degrees of inspiratory stri-
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