TEST BANK FOR LPN TO RN TRANSITIONS4TH EDITION
CLAYWELL. ALL CHAPTERS
1. A client with cancer who has been taking opioid analgesics for two years now
requires increased doses to obtain pain relief. The client expresses fear about
becoming addicted to these drugs. What information should the practical nurse (PN)
provide?
A. Opioid use with cancer does not cause addiction.
B. Addiction is easily reversed if it occurs during pain management.
C. Prescribed opiates for cancer pain relief improve qualify of life.
D. Opioid dosages can be tapered if a client fears addiction. - ANSWER: C. Prescribed
opiates for cancer pain relief improve qualify of life
The goal of pain management for clients with cancer using opiates is to minimize
pain and maintain quality of life
2. A client's indwelling urinary catheter is removed at 9:30 AM. The practical nurse
(PN) assesses the client every two hours for the desire to void. Which documented
assessment requires further intervention by the PN?
A. 1:30 pm: unable to void.
B. 5:30 pm: unable to void.
C. 3:30 pm: unable to void.
D. 11:30 am: unable to void. - ANSWER: B. A client is due to void within 8 hours of
catheter removal, so at 5:30 PM. Longer than 8 hours after removal, catheter
reinsertion may be necessary. If the bladder is not distended, further action may not
be needed
3. Which position is best for the practical nurse to place the client in during
administration of a rectal suppository for constipation?
A. Prone with pillows under the client's abdomen.
B. Supine with the client on a bed pan.
C. Left Sims' position with upper leg flexed.
D. Right-side lying knee-chest position. - ANSWER: C. Left side-lying Sims' position
lessens the likelihood that the suppository or feces will be expelled, exposes the
anus for visualization during insertion, and helps the client to relax the external anal
sphincter
4. The practical nurse (PN) is adding tap water to several medications for
administration via feeding tube. Which preparation should the PN administer
without delay?
A. Reconstituted powder.
B. Timed release capsule.
C. Cherry flavored elixir.
D. Flavorless suspension. - ANSWER: B. Although the gelatin capsule can be opened
to administer the spansule's granules, the PN should not crush or allow the timed-
released granules to dissolve before administering this preparation via feeding tube
since the timed-release function can be compromised.
,What action should the practical nurse (PN) take when drawing medication from an
ampule?
A. Aspirate with a filter needle and syringe.
B. Tap the bottom of the ampule lightly.
C. Snap the neck of ampule towards nurse.
D. Use an alcohol swab to open ampule. - ANSWER: A. An ampule is made of glass
with a constricted neck that is snapped off to allow access to the medication.
Medications are easily withdrawn from the ampule by aspirating the fluid with a
filter needle and syringe. Filter needles are used when withdrawing medication from
a glass ampule to prevent glass particles from being drawn into the syringe with the
medication. Tap the top, not the bottom (B), of the ampule lightly to allow all of the
medication to drop to the bottom. When opening the ampule, the top should be
snapped away from the nurse's face and body (C). An opened alcohol swab wrapped
around the top of the ampule may allow alcohol to leak into the ampule
The practical nurse (PN) is preparing to reconstitute a drug from powder form for IM
administration. Which step should the PN implement first?
A. Verify the drug with the medication administration record.
B. Mix the powder with the solution.
C. Attach the needle to the syringe.
D. Read the label to determine the amount of diluent to use. - ANSWER: A. The Five
Rights of medication administration include the right drug, right dose, right route,
right time, and right client. The first action should be verification of the right drug in
the powder form for reconstitution.
Which action should the practical nurse (PN) implement when administering a
subcutaneous injection to a client who weighs 325 pounds?
A. Produce a bleb at the injection site.
B. Insert the needle at a 15-degree angle.
C. Select a needle with a longer shaft.
D. Rub vigorously for a faster response. - ANSWER: C. To ensure penetration into the
deep layer of subcutaneuos adipose for a client who is obese, the needle length
should be longer than the usual needle (preferably 3/8 to 5/8 inch in length) for
subcutaneous injection.
Which finding indicates to the practical nurse (PN) that an older client who is
receiving intravenous therapy is experiencing fluid overload?
A. Edema in lower extremities.
B. Crackles in the lung fields.
C. Pulse rate of 64 beats/min.
D. Respirations of 16 breaths/min. - ANSWER: B. IV fluid overload in an older client is
likely to cause an increase in the workload of the heart causing a decrease in cardiac
output
, The practical nurse (PN) is checking the surgical dressing for a client who arrived on
the postoperative unit an hour ago. The dressing has an increase in the accumulation
of serosanguinous drainage. What nursing action should the PN take?
A. Reinforce the dressing with clean gauze sponges and tape.
B. Change the surgical dressing immediately to prevent infection.
C. Mark the outlined area of drainage with date, time and initials.
D. Collect a sample of the drainage for a culture and sensitivity - ANSWER: C. The
area of bleeding on the dressing should be outlined, dated, timed and initialed for
furture comparison and evaluation
A male client who is 2 days postoperative for exploratory abdominal surgery is
ambulating in the hall with the practical nurse (PN). The client tells the PN, "I think
something in my incision just let go." Which action should the PN implement first?
A. Notify the healthcare provider.
B. Assist the client to a supine position.
C. Instruct the client to avoid deep breathing.
D. Request an abdominal binder from a coworker. - ANSWER: B. The sensation of the
surgical site letting go is characteristic of wound dehiscence in the early
postoperative period. The client should be placed into a supine position
The practical nurse (PN) is applying a dry, sterile dressing to a client's abdominal
wound. Which allergy should the PN verify with the client?
A. Tape.
B. Antibiotic ointment.
C. Povidone-iodine.
D. Hydrogen peroxide. - ANSWER: A. a dry, sterile dressing includes the use of gauze
and tape . Although a client may be allergic to the other substances used in wound
care, (B, C, and D) are not used for a dry, sterile dressing.
The practical nurse (PN) is changing a postoperative dressing for a client with a
horizontal lower abdominal incision. What method should the PN use to remove the
tape from the dressing?
A. Pull from the left to right across the abdomen.
B. Peel across the abdomen from the right to the left.
C. Start from the top of the incision moving to the bottom.
D. Remove all four sides by moving to the center of the incision. - ANSWER: D. The
tape should be removed by starting all four sides and moving towards the center of
the incision to prevent disruption of the wound.
Which action should the practical nurse (PN) follow when applying an elasticized
bandage to a client's leg?
A. Secure the end with metal clips.
B. Overlap turns of the bandage equally.
C. Adjust the tension as needed.
D. Wrap from the proximal to distal end. - ANSWER: B. The overlapping turns of the
elasticized bandage should be evenly wrapped. Metal clips (A) may release and
CLAYWELL. ALL CHAPTERS
1. A client with cancer who has been taking opioid analgesics for two years now
requires increased doses to obtain pain relief. The client expresses fear about
becoming addicted to these drugs. What information should the practical nurse (PN)
provide?
A. Opioid use with cancer does not cause addiction.
B. Addiction is easily reversed if it occurs during pain management.
C. Prescribed opiates for cancer pain relief improve qualify of life.
D. Opioid dosages can be tapered if a client fears addiction. - ANSWER: C. Prescribed
opiates for cancer pain relief improve qualify of life
The goal of pain management for clients with cancer using opiates is to minimize
pain and maintain quality of life
2. A client's indwelling urinary catheter is removed at 9:30 AM. The practical nurse
(PN) assesses the client every two hours for the desire to void. Which documented
assessment requires further intervention by the PN?
A. 1:30 pm: unable to void.
B. 5:30 pm: unable to void.
C. 3:30 pm: unable to void.
D. 11:30 am: unable to void. - ANSWER: B. A client is due to void within 8 hours of
catheter removal, so at 5:30 PM. Longer than 8 hours after removal, catheter
reinsertion may be necessary. If the bladder is not distended, further action may not
be needed
3. Which position is best for the practical nurse to place the client in during
administration of a rectal suppository for constipation?
A. Prone with pillows under the client's abdomen.
B. Supine with the client on a bed pan.
C. Left Sims' position with upper leg flexed.
D. Right-side lying knee-chest position. - ANSWER: C. Left side-lying Sims' position
lessens the likelihood that the suppository or feces will be expelled, exposes the
anus for visualization during insertion, and helps the client to relax the external anal
sphincter
4. The practical nurse (PN) is adding tap water to several medications for
administration via feeding tube. Which preparation should the PN administer
without delay?
A. Reconstituted powder.
B. Timed release capsule.
C. Cherry flavored elixir.
D. Flavorless suspension. - ANSWER: B. Although the gelatin capsule can be opened
to administer the spansule's granules, the PN should not crush or allow the timed-
released granules to dissolve before administering this preparation via feeding tube
since the timed-release function can be compromised.
,What action should the practical nurse (PN) take when drawing medication from an
ampule?
A. Aspirate with a filter needle and syringe.
B. Tap the bottom of the ampule lightly.
C. Snap the neck of ampule towards nurse.
D. Use an alcohol swab to open ampule. - ANSWER: A. An ampule is made of glass
with a constricted neck that is snapped off to allow access to the medication.
Medications are easily withdrawn from the ampule by aspirating the fluid with a
filter needle and syringe. Filter needles are used when withdrawing medication from
a glass ampule to prevent glass particles from being drawn into the syringe with the
medication. Tap the top, not the bottom (B), of the ampule lightly to allow all of the
medication to drop to the bottom. When opening the ampule, the top should be
snapped away from the nurse's face and body (C). An opened alcohol swab wrapped
around the top of the ampule may allow alcohol to leak into the ampule
The practical nurse (PN) is preparing to reconstitute a drug from powder form for IM
administration. Which step should the PN implement first?
A. Verify the drug with the medication administration record.
B. Mix the powder with the solution.
C. Attach the needle to the syringe.
D. Read the label to determine the amount of diluent to use. - ANSWER: A. The Five
Rights of medication administration include the right drug, right dose, right route,
right time, and right client. The first action should be verification of the right drug in
the powder form for reconstitution.
Which action should the practical nurse (PN) implement when administering a
subcutaneous injection to a client who weighs 325 pounds?
A. Produce a bleb at the injection site.
B. Insert the needle at a 15-degree angle.
C. Select a needle with a longer shaft.
D. Rub vigorously for a faster response. - ANSWER: C. To ensure penetration into the
deep layer of subcutaneuos adipose for a client who is obese, the needle length
should be longer than the usual needle (preferably 3/8 to 5/8 inch in length) for
subcutaneous injection.
Which finding indicates to the practical nurse (PN) that an older client who is
receiving intravenous therapy is experiencing fluid overload?
A. Edema in lower extremities.
B. Crackles in the lung fields.
C. Pulse rate of 64 beats/min.
D. Respirations of 16 breaths/min. - ANSWER: B. IV fluid overload in an older client is
likely to cause an increase in the workload of the heart causing a decrease in cardiac
output
, The practical nurse (PN) is checking the surgical dressing for a client who arrived on
the postoperative unit an hour ago. The dressing has an increase in the accumulation
of serosanguinous drainage. What nursing action should the PN take?
A. Reinforce the dressing with clean gauze sponges and tape.
B. Change the surgical dressing immediately to prevent infection.
C. Mark the outlined area of drainage with date, time and initials.
D. Collect a sample of the drainage for a culture and sensitivity - ANSWER: C. The
area of bleeding on the dressing should be outlined, dated, timed and initialed for
furture comparison and evaluation
A male client who is 2 days postoperative for exploratory abdominal surgery is
ambulating in the hall with the practical nurse (PN). The client tells the PN, "I think
something in my incision just let go." Which action should the PN implement first?
A. Notify the healthcare provider.
B. Assist the client to a supine position.
C. Instruct the client to avoid deep breathing.
D. Request an abdominal binder from a coworker. - ANSWER: B. The sensation of the
surgical site letting go is characteristic of wound dehiscence in the early
postoperative period. The client should be placed into a supine position
The practical nurse (PN) is applying a dry, sterile dressing to a client's abdominal
wound. Which allergy should the PN verify with the client?
A. Tape.
B. Antibiotic ointment.
C. Povidone-iodine.
D. Hydrogen peroxide. - ANSWER: A. a dry, sterile dressing includes the use of gauze
and tape . Although a client may be allergic to the other substances used in wound
care, (B, C, and D) are not used for a dry, sterile dressing.
The practical nurse (PN) is changing a postoperative dressing for a client with a
horizontal lower abdominal incision. What method should the PN use to remove the
tape from the dressing?
A. Pull from the left to right across the abdomen.
B. Peel across the abdomen from the right to the left.
C. Start from the top of the incision moving to the bottom.
D. Remove all four sides by moving to the center of the incision. - ANSWER: D. The
tape should be removed by starting all four sides and moving towards the center of
the incision to prevent disruption of the wound.
Which action should the practical nurse (PN) follow when applying an elasticized
bandage to a client's leg?
A. Secure the end with metal clips.
B. Overlap turns of the bandage equally.
C. Adjust the tension as needed.
D. Wrap from the proximal to distal end. - ANSWER: B. The overlapping turns of the
elasticized bandage should be evenly wrapped. Metal clips (A) may release and
