An older adult client who resides in a long term care facility has a friend of the opposite sex who often
visits in the evenings. The practical nurse (PN) enters the client's room to administer medications and
finds the couple in bed together. Which action should the PN take?
A. Request that the friend get up and leave.
B. Exit the room and quietly close the door.
C. Report the incident to the family.
D. Ask when the nurse should return. - answerB. Exit the room and quietly close the door.
A female client who is scheduled to be discharged within several hours shows the practical nurse (PN) a
knife on her tray and states that she could use it to cut herself. What intervention is most important for
the PN to implement?
A Inform the healthcare provider who discharged the client.
B Include guidelines for coping in the discharge plan.
C Inform the family of the client's statement.
D Call dietary and ask them to send plastic utensils. - answerA Inform the healthcare provider who
discharged the client.
• A Remind the client that the action of the eye drops is to decrease internal eye pressure.
• B Ask the client to describe the intensity of the eye pain using the numerical pain scale.
• C Document in the chart that the client understands the action and use of the eye drops.
• D Clarify with the client that eye pain in glaucoma is uncommon so drops are rarely needed. - answer
History and Physical
The client is a 2-year-old who fell in a pool. He was retrieved from the pool by a family member but was
not breathing. The family member started cardiopulmonary resuscitation (CPR) and the ambulance
brought him to the hospital.
Review H and P.
, What factors are important in determining level of hypoxemia that the child may have experienced
during the submersion?
Select all that apply.
A The amount of time the child was submerged
B Whether or not anyone witnessed the fall into the pool|
C The weight of the child
D Oxygen concentration of the ambient air
E Temperature of water - answerA The amount of time the child was submerged
E Temperature of water
History and Physical
Nurses' Note
1430
The parents are at the bedside and state that each parent thought the other parent was watching the
child. They are not sure how long he was in the pool or how he might have fallen in. The temperature of
the pool was as cool as the temperature outside, about 64° F (17.8°C).
Review H and P and nurse's note.
What are the first four actions that the practical nurse (PN) should do?
A Look for any open wounds
B Determine if the child's airway is clear
C Call child protective services
D Place a cervical collar on the client
E Start a peripheral intravenous line
F Take the child's pulse - answerB Determine if the child's airway is clear
F Take the child's pulse
D Place a cervical collar on the client
visits in the evenings. The practical nurse (PN) enters the client's room to administer medications and
finds the couple in bed together. Which action should the PN take?
A. Request that the friend get up and leave.
B. Exit the room and quietly close the door.
C. Report the incident to the family.
D. Ask when the nurse should return. - answerB. Exit the room and quietly close the door.
A female client who is scheduled to be discharged within several hours shows the practical nurse (PN) a
knife on her tray and states that she could use it to cut herself. What intervention is most important for
the PN to implement?
A Inform the healthcare provider who discharged the client.
B Include guidelines for coping in the discharge plan.
C Inform the family of the client's statement.
D Call dietary and ask them to send plastic utensils. - answerA Inform the healthcare provider who
discharged the client.
• A Remind the client that the action of the eye drops is to decrease internal eye pressure.
• B Ask the client to describe the intensity of the eye pain using the numerical pain scale.
• C Document in the chart that the client understands the action and use of the eye drops.
• D Clarify with the client that eye pain in glaucoma is uncommon so drops are rarely needed. - answer
History and Physical
The client is a 2-year-old who fell in a pool. He was retrieved from the pool by a family member but was
not breathing. The family member started cardiopulmonary resuscitation (CPR) and the ambulance
brought him to the hospital.
Review H and P.
, What factors are important in determining level of hypoxemia that the child may have experienced
during the submersion?
Select all that apply.
A The amount of time the child was submerged
B Whether or not anyone witnessed the fall into the pool|
C The weight of the child
D Oxygen concentration of the ambient air
E Temperature of water - answerA The amount of time the child was submerged
E Temperature of water
History and Physical
Nurses' Note
1430
The parents are at the bedside and state that each parent thought the other parent was watching the
child. They are not sure how long he was in the pool or how he might have fallen in. The temperature of
the pool was as cool as the temperature outside, about 64° F (17.8°C).
Review H and P and nurse's note.
What are the first four actions that the practical nurse (PN) should do?
A Look for any open wounds
B Determine if the child's airway is clear
C Call child protective services
D Place a cervical collar on the client
E Start a peripheral intravenous line
F Take the child's pulse - answerB Determine if the child's airway is clear
F Take the child's pulse
D Place a cervical collar on the client
