Case Information
CASE 1
Mrs. Jackson, 58 years old, has been admitted to a four-bed room on a medical unit with a diagnosis of
pneumonia.
QUESTIONS 1 to 5 refer to this case
1. The physician's orders for Mrs. Jackson include sputum specimen for C&S and acid-fast bacilli
(AFB). What is the correct method for the client to collect the sputum specimen?
1. Rinse mouth with mouthwash and collect the specimen p.c. breakfast.
2. Collect the specimen in a sterile container at h.s. after deep breathing and coughing.
3. Collect the specimen a.c. breakfast after rinsing mouth with water.
4. Rinse mouth with water and collect at hs.
2. Mrs. Jackson's sputum specimen has come back positive for AFB, and a diagnosis of tuberculosis
has been made. Which nursing intervention is correct?
1. Move Mrs. Jackson to a private room using reverse isolation.
2. Use enteric isolation precautions when providing care for Mrs. Jackson.
3. Use disposable dishes and equipment in Mrs. Jackson's room.
4. Move Mrs. Jackson to a private room with negative air flow.
3. Mrs. Jackson has to go to the radiology department for a chest x-ray. What should the practical
nurse do?
1. Have Mrs. Jackson wear a mask while out of her room.
2. Suggest that a portable x-ray be brought to Mrs. Jackson's room.
3. Advise the x-ray department and advise all staff to wear a mask.
4. Wear a mask and gloves while transporting Mrs. Jackson.
4. Which action represents appropriate risk management interventions for tuberculosis?
1. Teaching Mrs. Jackson about the medications she is taking for tuberculosis
2. Monitoring the clients exposed to tuberculosis for signs and symptoms of the disease
3. Offering to request a lab test for tuberculosis for those clients exposed
4. Placing clients exposed to tuberculosis on droplet precautions until lab results return
5. Mrs. Jackson can expect which therapeutic regime for tuberculosis?
1. A chest x-ray, a cough suppressant, and an antibiotic
2. Follow-up sputum specimens, physiotherapy, and a series of chest x-rays
3. A series of chest x-rays, several antibiotics, and follow-up sputum specimens
, 4. Follow-up sputum specimens, chest physiotherapy, and bronchodilator medications
Case Information
CASE 2
Ms. Saunders, 23 years old, has been admitted with a diagnosis of anorexia nervosa. She has participated
in the development of her care plan. QUESTIONS 6 to 11 refer to this case.
6. Ms. Saunders states, "Everyone is overreacting to my condition and I would do much better with
treatment at home." This statement by Ms. Saunders reflects which one of the following?
1. Acceptance of her condition
2. Fear of her condition
3. Denial of her condition
4. Understanding of her condition
7. Which one of the following examples from Ms. Saunders' chart uses appropriate abbreviations?
1. "Sympt. of anorexia presented"
2. "Enc. client to discuss feelings"
3. "Stated goal is wt. gain of 4 kg"
4. "Discussed wgt loss"
8. What aspect of Ms. Saunders' care should take priority for the practical nurse?
1. Building a trusting relationship with her
2. Reviewing the care plan with her
3. Discussing her nutrition with the dietitian
4. Assisting her to identify coping skills
9. Ms. Saunders has lost 1 kg in the past week. Which one of the following responses by the
practical nurse would best help Ms. Saunders meet her nutritional needs?
1. "Eating may speed up your discharge."
2. "Let's review your goals from your care plan."
3. "Would you like to see the dietitian?"
4. "Shall we take it one day at a time?"
10. The practical nurse notices Ms. Saunders hiding food under her dinner tray and comments on
it. Ms. Saunders says, "Quit telling me to eat!" Which one of the following responses should the
practical nurse make?
1. "Ms. Saunders, you need to review your nutritional goals."
2. "You should try to eat all the food on your tray."
, 3. "You have an eating disorder and we want to help you with it."
4. "I want you to tell me why you are here."
11. The practical nurse finds Ms. Saunders crying and pacing in her room. Which one of the
following entries is acceptable for the practical nurse to record in Ms. Saunders' chart?
1. "Found Ms. Saunders crying and pacing."
2. "Observed crying and pacing in her room."
3. "Entered her room, Ms. Saunders is upset."
4. "Crying and agitated. "
Case Information
CASE 3
Mr. Antonio, 45 years old, is admitted to the palliative care unit with pancreatic cancer. His wife and two
teenage children accompany him. He states that he has abdominal pain. He is jaundiced and has ascites.
The physician has told them that Mr. Antonio will live only a few more weeks.
QUESTIONS 12 to 15 refer to this case.
12. Mr. Antonio requests a vegetarian diet. The physician has ordered a regular diet with
supplements. How should the practical nurse proceed?
1. Advise Mr. Antonio to discuss his dietary request with the physician.
2. Suggest that Mrs. Antonio bring vegetarian meals from home.
3. Inform Mr. Antonio that protein is required for his disease process.
4. Notify the dietitian of Mr. Antonio's need for a change in the meal plan.
13. Mrs. Antonio asks how she and her children will know that her husband's death is getting
closer. How should the practical nurse respond?
1. "You will hear the death rattle right before he dies."
2. "His breathing may slow with longer periods between breaths."
3. "There is really no way of knowing when it will happen."
4. "The nursing staff will give you enough time to call the family."
14. Mrs. Antonio calls the practical nurse to the bedside because her husband is taking his last
breaths. Mrs. Antonio starts to cry and tremble. How should the practical nurse respond?
1. Reassure Mrs. Antonio that her husband is no longer suffering.
2. Inform Mrs. Antonio that pastoral care will be contacted to comfort her family.
3. Stand quietly at the bedside with Mrs. Antonio and her children.
4. Ask her if there is anyone else that she would like the nursing staff to call.
CASE 1
Mrs. Jackson, 58 years old, has been admitted to a four-bed room on a medical unit with a diagnosis of
pneumonia.
QUESTIONS 1 to 5 refer to this case
1. The physician's orders for Mrs. Jackson include sputum specimen for C&S and acid-fast bacilli
(AFB). What is the correct method for the client to collect the sputum specimen?
1. Rinse mouth with mouthwash and collect the specimen p.c. breakfast.
2. Collect the specimen in a sterile container at h.s. after deep breathing and coughing.
3. Collect the specimen a.c. breakfast after rinsing mouth with water.
4. Rinse mouth with water and collect at hs.
2. Mrs. Jackson's sputum specimen has come back positive for AFB, and a diagnosis of tuberculosis
has been made. Which nursing intervention is correct?
1. Move Mrs. Jackson to a private room using reverse isolation.
2. Use enteric isolation precautions when providing care for Mrs. Jackson.
3. Use disposable dishes and equipment in Mrs. Jackson's room.
4. Move Mrs. Jackson to a private room with negative air flow.
3. Mrs. Jackson has to go to the radiology department for a chest x-ray. What should the practical
nurse do?
1. Have Mrs. Jackson wear a mask while out of her room.
2. Suggest that a portable x-ray be brought to Mrs. Jackson's room.
3. Advise the x-ray department and advise all staff to wear a mask.
4. Wear a mask and gloves while transporting Mrs. Jackson.
4. Which action represents appropriate risk management interventions for tuberculosis?
1. Teaching Mrs. Jackson about the medications she is taking for tuberculosis
2. Monitoring the clients exposed to tuberculosis for signs and symptoms of the disease
3. Offering to request a lab test for tuberculosis for those clients exposed
4. Placing clients exposed to tuberculosis on droplet precautions until lab results return
5. Mrs. Jackson can expect which therapeutic regime for tuberculosis?
1. A chest x-ray, a cough suppressant, and an antibiotic
2. Follow-up sputum specimens, physiotherapy, and a series of chest x-rays
3. A series of chest x-rays, several antibiotics, and follow-up sputum specimens
, 4. Follow-up sputum specimens, chest physiotherapy, and bronchodilator medications
Case Information
CASE 2
Ms. Saunders, 23 years old, has been admitted with a diagnosis of anorexia nervosa. She has participated
in the development of her care plan. QUESTIONS 6 to 11 refer to this case.
6. Ms. Saunders states, "Everyone is overreacting to my condition and I would do much better with
treatment at home." This statement by Ms. Saunders reflects which one of the following?
1. Acceptance of her condition
2. Fear of her condition
3. Denial of her condition
4. Understanding of her condition
7. Which one of the following examples from Ms. Saunders' chart uses appropriate abbreviations?
1. "Sympt. of anorexia presented"
2. "Enc. client to discuss feelings"
3. "Stated goal is wt. gain of 4 kg"
4. "Discussed wgt loss"
8. What aspect of Ms. Saunders' care should take priority for the practical nurse?
1. Building a trusting relationship with her
2. Reviewing the care plan with her
3. Discussing her nutrition with the dietitian
4. Assisting her to identify coping skills
9. Ms. Saunders has lost 1 kg in the past week. Which one of the following responses by the
practical nurse would best help Ms. Saunders meet her nutritional needs?
1. "Eating may speed up your discharge."
2. "Let's review your goals from your care plan."
3. "Would you like to see the dietitian?"
4. "Shall we take it one day at a time?"
10. The practical nurse notices Ms. Saunders hiding food under her dinner tray and comments on
it. Ms. Saunders says, "Quit telling me to eat!" Which one of the following responses should the
practical nurse make?
1. "Ms. Saunders, you need to review your nutritional goals."
2. "You should try to eat all the food on your tray."
, 3. "You have an eating disorder and we want to help you with it."
4. "I want you to tell me why you are here."
11. The practical nurse finds Ms. Saunders crying and pacing in her room. Which one of the
following entries is acceptable for the practical nurse to record in Ms. Saunders' chart?
1. "Found Ms. Saunders crying and pacing."
2. "Observed crying and pacing in her room."
3. "Entered her room, Ms. Saunders is upset."
4. "Crying and agitated. "
Case Information
CASE 3
Mr. Antonio, 45 years old, is admitted to the palliative care unit with pancreatic cancer. His wife and two
teenage children accompany him. He states that he has abdominal pain. He is jaundiced and has ascites.
The physician has told them that Mr. Antonio will live only a few more weeks.
QUESTIONS 12 to 15 refer to this case.
12. Mr. Antonio requests a vegetarian diet. The physician has ordered a regular diet with
supplements. How should the practical nurse proceed?
1. Advise Mr. Antonio to discuss his dietary request with the physician.
2. Suggest that Mrs. Antonio bring vegetarian meals from home.
3. Inform Mr. Antonio that protein is required for his disease process.
4. Notify the dietitian of Mr. Antonio's need for a change in the meal plan.
13. Mrs. Antonio asks how she and her children will know that her husband's death is getting
closer. How should the practical nurse respond?
1. "You will hear the death rattle right before he dies."
2. "His breathing may slow with longer periods between breaths."
3. "There is really no way of knowing when it will happen."
4. "The nursing staff will give you enough time to call the family."
14. Mrs. Antonio calls the practical nurse to the bedside because her husband is taking his last
breaths. Mrs. Antonio starts to cry and tremble. How should the practical nurse respond?
1. Reassure Mrs. Antonio that her husband is no longer suffering.
2. Inform Mrs. Antonio that pastoral care will be contacted to comfort her family.
3. Stand quietly at the bedside with Mrs. Antonio and her children.
4. Ask her if there is anyone else that she would like the nursing staff to call.
