Mosby's Comprehensive Review Questions for the Canadian PN Exam
Systemic opioid analgesics, such as morphine sulphate, may be used for maternal pain management. Which statement best describes the nursing considerations for administering systemic opiate analgesics?
1. Systemic opioids are often administered up to the second stage of labour.
2. An opioid antagonist such as naloxone (Narcan) should be administered to the mother to reverse the effects if birth is imminent.
3. An opioid antagonist such as naloxone (Narcan) should be administered to the newborn if signs of central nervous system (CNS) depression are present.
4. Systemic opioids should not be used for postpartum pain management, as these drugs cross into breast milk and may cause CNS depression in the newborn. - How would the action and effect of a drug that is metabolized by the liver be affected in a client with severe cirrhosis of the liver?
1. The rate of the excretion of the drug will increase.
2. The duration of the action of the drug will decrease.
3. The action and effects of the drug on body c4. The action and effects of the drug on the body will be prolonged.ells will be blocked—hence no effect. - 4. The action and effects of the drug on the body will be prolonged.
A nurse educator has revised the hospital's orientation program in anticipation of the hospital orientating many new graduate practical nurses within the next 3 months. The nurse educator decides to use sample client health records to highlight areas of professional practice. He conducts his first education session with the new graduates.
Questions 1-5 refer to this case.
During the documentation session, one of the new practical nurses asks what abbreviations can be used within the client's health record. What abbreviations should the practical nurse use?
1. Abbreviations learned in nursing school
2. Abbreviations that have been approved by the Canadian Nurses Association
3. Abbreviations that have been approved by the hospital
4. Abbreviations that are in common use on specific units within the hospital - 3. Abbreviations that have been approved by the hospital
Which of the following statements is the most accurate information with regard to client consent?
1. Practical nurses are responsible for ensuring that clients sign all consent forms on the
health record. 2. The healthcare provider proposing the procedure requiring written consent is the person who must ensure that written client consent is obtained.
3. Verbal consent for an operative procedure is acceptable, and signed consents are not always necessary.
4. When a client is admitted to the hospital, the client signs a written consent that covers
all treatments. - 2. The healthcare provider proposing the procedure requiring written consent is the person who must ensure that written client consent is obtained.
In the sample client's health record, the new graduate practical nurses discover that a nurse has written "Verbal Order, acetaminophen (Tylenol), 325 mg, PO, prn, for pain." There is no evidence that this was an emergency situation. Which of the following describes best practice in relation to verbal medication orders?
1. Verbal orders are to be avoided, except in an emergency situation.
2. Practical nurses should follow the same practice for verbal orders as for telephone orders.
3. Verbal orders should never be accepted, including in emergency situations.
4. Only registered nurses may receive verbal orders for medications from a physician. - 1. Verbal orders are to be avoided, except in an emergency situation.
The new graduate practical nurses review a variety of orders on the sample health records. Which of the following is a correct medication order?
1. Acetaminophen 325 mg PO for pain
2. Acetaminophen 325-650 mg PO for pain q4-6h prn
3. Acetaminophen 325-650 mg PO for pain as needed
4. Acetaminophen 325 or 650 mg q4-6h prn - 2. Acetaminophen 325-650 mg PO for pain q4-6h prn
(The dose is accurate, the route is identified, the frequency is identified, and the qualifier
is identified).
During the orientation, the nurse educator explains that the hospital uses evidence-
informed practice to guide clinical decision making. Which of the following statements best describes evidence-informed practice?
1. An opportunity to obtain funding from the government
2. An opportunity to transfer research findings into practice
3. A chance for professionals to trial untested research findings
4. A way to promote enhanced assessment skills - 2. An opportunity to transfer research findings into practice
Case 2
A manager of home care nurses has noticed over the past 3 months a lack of clarity about the roles of the team members, poor team morale, increasing negative communication, and team conflict. The manager decides to support her staff by providing an education session. Questions 6-9 refer to this case.
One of the new team members is a nurse practitioner (NP). How should the manager describe the level of education for the NP?
1. A nurse who has specialty certification from the Canadian Nurses Association
2. A nurse who has taken a special interest course in a unique field
3. A nurse who has an undergraduate degree in a discipline other than nursing
4. A nurse educated at the master's level with a specialization in a particular practice area - 4. A nurse educated at the master's level with a specialization in a particular practice area
The manager is preparing the education session for her staff group. Which of the following is true in relation to the teaching and learning process?
1. It is important to use the same approach with all types of learners.
2. It is better to introduce all new knowledge instead of connecting it to previously learned knowledge.
3. Learning occurs best when the individual has an identified need to learn.
4. It is always best to deliver education quickly and at the same time of day. - 3. Learning occurs best when the individual has an identified need to learn.
The manager explains that effective interpersonal communication with clients and team members includes which of the following?
1. The use of "you" statements when interacting with clients and colleagues
2. The use of warmth and genuineness in interactions
3. The use of questions that elicit single-word responses in order to promote efficient communication
4. The use of frequent self-disclosure to ensure that others will share your point of view - 2. The use of warmth and genuineness in interactions
In situations in which a team conflict has arisen, what would be the best statement by the manager to her staff?
1. "We should put aside our differences and work together as a team."
2. "I think we should employ a conflict-resolution specialist to help us."
3. "Let's have a discussion about what we can agree is expected team behaviour."
4. "These are the guidelines for team behaviour in this agency." - 3. "Let's have a discussion about what we can agree is expected team behaviour."
Case 3
A practical nurse works in a long-term care facility where many of the residents experience acute agitation. Questions 10-12 refer to this case.
The facility follows a "least-restraint policy." What is the most important consideration with a "least-restraint policy"?
1. That a family conference is organized prior to the implementation of a restraint
2. That all possible alternative interventions have been exhausted before a restraint is implemented
3. That the client has no manifestations of delirium or dementia
4. That the client has signed consent for the application of restraints - 2. That all possible alternative interventions have been exhausted before a restraint is implemented
The practical nurse charts the behaviour of a client. Which of the following statements would be the most appropriate documentation?
1. "The client was agitated today."
2. "The client was confused this morning."
3. "The client was shaking his fist at the practical nurse at 1100 hours."
4. "The client was behaving inappropriately during the evening shift." - 3. "The client was shaking his fist at the practical nurse at 1100 hours."
The practical nurse consults the provincial or territorial standards of nursing practice when contemplating the use of restraints. What is the most important purpose for using standards of nursing practice?
1. Standards will help the practical nurse make decisions about ongoing learning needs.
2. Standards will act as a guide to the practical nurse's clinical decision making.
3. Standards will help the practical nurse in malpractice situations.
4. Standards will guide the practical nurse to be aware of protection of personal health, safety, and welfare. - 2. Standards will act as a guide to the practical nurse's clinical decision making.
Case 4
A practical nurse has immigrated to Canada from Poland. She received her nursing education in Poland and is now studying for the Canadian Practical Nurse Registration Examination (CPNRE). She has discovered many differences in terms and meaning between nursing practice in Canada and nursing practice in Poland.
Questions 13-15 refer to this case.
The practical nurse knows she must be able to articulate the differences and similarities between various nursing organizations. The mandate of nursing regulatory organizations is which of the following?
1. Protection of the public
Systemic opioid analgesics, such as morphine sulphate, may be used for maternal pain management. Which statement best describes the nursing considerations for administering systemic opiate analgesics?
1. Systemic opioids are often administered up to the second stage of labour.
2. An opioid antagonist such as naloxone (Narcan) should be administered to the mother to reverse the effects if birth is imminent.
3. An opioid antagonist such as naloxone (Narcan) should be administered to the newborn if signs of central nervous system (CNS) depression are present.
4. Systemic opioids should not be used for postpartum pain management, as these drugs cross into breast milk and may cause CNS depression in the newborn. - How would the action and effect of a drug that is metabolized by the liver be affected in a client with severe cirrhosis of the liver?
1. The rate of the excretion of the drug will increase.
2. The duration of the action of the drug will decrease.
3. The action and effects of the drug on body c4. The action and effects of the drug on the body will be prolonged.ells will be blocked—hence no effect. - 4. The action and effects of the drug on the body will be prolonged.
A nurse educator has revised the hospital's orientation program in anticipation of the hospital orientating many new graduate practical nurses within the next 3 months. The nurse educator decides to use sample client health records to highlight areas of professional practice. He conducts his first education session with the new graduates.
Questions 1-5 refer to this case.
During the documentation session, one of the new practical nurses asks what abbreviations can be used within the client's health record. What abbreviations should the practical nurse use?
1. Abbreviations learned in nursing school
2. Abbreviations that have been approved by the Canadian Nurses Association
3. Abbreviations that have been approved by the hospital
4. Abbreviations that are in common use on specific units within the hospital - 3. Abbreviations that have been approved by the hospital
Which of the following statements is the most accurate information with regard to client consent?
1. Practical nurses are responsible for ensuring that clients sign all consent forms on the
health record. 2. The healthcare provider proposing the procedure requiring written consent is the person who must ensure that written client consent is obtained.
3. Verbal consent for an operative procedure is acceptable, and signed consents are not always necessary.
4. When a client is admitted to the hospital, the client signs a written consent that covers
all treatments. - 2. The healthcare provider proposing the procedure requiring written consent is the person who must ensure that written client consent is obtained.
In the sample client's health record, the new graduate practical nurses discover that a nurse has written "Verbal Order, acetaminophen (Tylenol), 325 mg, PO, prn, for pain." There is no evidence that this was an emergency situation. Which of the following describes best practice in relation to verbal medication orders?
1. Verbal orders are to be avoided, except in an emergency situation.
2. Practical nurses should follow the same practice for verbal orders as for telephone orders.
3. Verbal orders should never be accepted, including in emergency situations.
4. Only registered nurses may receive verbal orders for medications from a physician. - 1. Verbal orders are to be avoided, except in an emergency situation.
The new graduate practical nurses review a variety of orders on the sample health records. Which of the following is a correct medication order?
1. Acetaminophen 325 mg PO for pain
2. Acetaminophen 325-650 mg PO for pain q4-6h prn
3. Acetaminophen 325-650 mg PO for pain as needed
4. Acetaminophen 325 or 650 mg q4-6h prn - 2. Acetaminophen 325-650 mg PO for pain q4-6h prn
(The dose is accurate, the route is identified, the frequency is identified, and the qualifier
is identified).
During the orientation, the nurse educator explains that the hospital uses evidence-
informed practice to guide clinical decision making. Which of the following statements best describes evidence-informed practice?
1. An opportunity to obtain funding from the government
2. An opportunity to transfer research findings into practice
3. A chance for professionals to trial untested research findings
4. A way to promote enhanced assessment skills - 2. An opportunity to transfer research findings into practice
Case 2
A manager of home care nurses has noticed over the past 3 months a lack of clarity about the roles of the team members, poor team morale, increasing negative communication, and team conflict. The manager decides to support her staff by providing an education session. Questions 6-9 refer to this case.
One of the new team members is a nurse practitioner (NP). How should the manager describe the level of education for the NP?
1. A nurse who has specialty certification from the Canadian Nurses Association
2. A nurse who has taken a special interest course in a unique field
3. A nurse who has an undergraduate degree in a discipline other than nursing
4. A nurse educated at the master's level with a specialization in a particular practice area - 4. A nurse educated at the master's level with a specialization in a particular practice area
The manager is preparing the education session for her staff group. Which of the following is true in relation to the teaching and learning process?
1. It is important to use the same approach with all types of learners.
2. It is better to introduce all new knowledge instead of connecting it to previously learned knowledge.
3. Learning occurs best when the individual has an identified need to learn.
4. It is always best to deliver education quickly and at the same time of day. - 3. Learning occurs best when the individual has an identified need to learn.
The manager explains that effective interpersonal communication with clients and team members includes which of the following?
1. The use of "you" statements when interacting with clients and colleagues
2. The use of warmth and genuineness in interactions
3. The use of questions that elicit single-word responses in order to promote efficient communication
4. The use of frequent self-disclosure to ensure that others will share your point of view - 2. The use of warmth and genuineness in interactions
In situations in which a team conflict has arisen, what would be the best statement by the manager to her staff?
1. "We should put aside our differences and work together as a team."
2. "I think we should employ a conflict-resolution specialist to help us."
3. "Let's have a discussion about what we can agree is expected team behaviour."
4. "These are the guidelines for team behaviour in this agency." - 3. "Let's have a discussion about what we can agree is expected team behaviour."
Case 3
A practical nurse works in a long-term care facility where many of the residents experience acute agitation. Questions 10-12 refer to this case.
The facility follows a "least-restraint policy." What is the most important consideration with a "least-restraint policy"?
1. That a family conference is organized prior to the implementation of a restraint
2. That all possible alternative interventions have been exhausted before a restraint is implemented
3. That the client has no manifestations of delirium or dementia
4. That the client has signed consent for the application of restraints - 2. That all possible alternative interventions have been exhausted before a restraint is implemented
The practical nurse charts the behaviour of a client. Which of the following statements would be the most appropriate documentation?
1. "The client was agitated today."
2. "The client was confused this morning."
3. "The client was shaking his fist at the practical nurse at 1100 hours."
4. "The client was behaving inappropriately during the evening shift." - 3. "The client was shaking his fist at the practical nurse at 1100 hours."
The practical nurse consults the provincial or territorial standards of nursing practice when contemplating the use of restraints. What is the most important purpose for using standards of nursing practice?
1. Standards will help the practical nurse make decisions about ongoing learning needs.
2. Standards will act as a guide to the practical nurse's clinical decision making.
3. Standards will help the practical nurse in malpractice situations.
4. Standards will guide the practical nurse to be aware of protection of personal health, safety, and welfare. - 2. Standards will act as a guide to the practical nurse's clinical decision making.
Case 4
A practical nurse has immigrated to Canada from Poland. She received her nursing education in Poland and is now studying for the Canadian Practical Nurse Registration Examination (CPNRE). She has discovered many differences in terms and meaning between nursing practice in Canada and nursing practice in Poland.
Questions 13-15 refer to this case.
The practical nurse knows she must be able to articulate the differences and similarities between various nursing organizations. The mandate of nursing regulatory organizations is which of the following?
1. Protection of the public
