Name: Score:
20 Multiple choice questions
Term 1 of 20
Which technique should the practical nurse use to give a Z-track intramuscular (IM) injection?
A. Ensure that no air is present in the syringe.
B. Inject the medication into the dorsal gluteal site.
C. Select a 22-gauge, 1-inch needle for injection.
D. Massage the site for 2 minutes after the injection.
B. The Z-track IM injection technique is used to administer irritating or cutaneous-staining
medications into a large muscle, such as the dorsal gluteal site and is given by moving the
surface skin to one side before puncturing the skin.
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.
C. Daily perineal care BID and PRN should include cleansing of the meatus and catheter
junction with soap and water.
(A, B, and D) do not support the concept of medical asepsis and catheter care.
C. Daily weights are the best indicator of fluid status because a sudden increase or
decrease in weight in 24-hours provides an estimate of fluid volume retention or fluid loss.
Skin turgor (A) is used to measure a client's hydration status
,Term 2 of 20
Which growth and developmental characteristic should the practical nurse (PN) consider when
discussing spirituality with an adolescent client?
A. Has a good concept of a supreme being.
B. Questions religious practices and values.
C. Gives oneself to spiritual tasks.
D. Accepts the meaning of spiritual faith.
B. An adolescent often reconsiders child-like concepts of a spiritual power, and in the
search for an identity may either question practices and values, or may find spiritual power
as the motivation to seek a clearer meaning to life. Older adults, not adolescents, often turn
to important relationships and give themselves to spiritual tasks (C). Adolescents do not
necessarily have a good concept of a supreme being (A) nor fully accept the meaning of
spiritual faith
A. Guilt is expressed as a bereaved person's self-reproach. When a loved one is lost, the
grieving process begins. The recovery through this process can be slow but must be
recognized as a natural part of life. Psychological growth comes with time as the client
moves through the grief process (denial, anger, bargaining, guilt (B), depression (C),
loneliness, bargaining (D), acceptance, and hope), which all clients may not go through.
C. An apical-radial pulse provides the most objective comparison when one nurse obtains
the radial pulse and another nurse simultaneously auscultates the apical pulse. When one
nurse collects both rates, either at the same or separate times (A, B, and D), the data
obtained is less accurate.
D. A descriptive scale, such as a pain scale, is the most accurate measure of the intensity of
pain, which can only be described by the client. A numerical pain scale used before and
after implementing measures to alleviate pain provides a comparison that best determines
the effectiveness of an analgesic. (A, B, and C) are subjective descriptors of the client's pain
that do not indicate the degree of pain relief after a medication is given.
, Term 3 of 20
The practical nurse (PN) is assessing a client with dark skin who is in respiratory distress. Which
client response should the PN evaluate to determine cyanosis in this client?
A. Cyanosis in a client with dark skin is seen only in the sclera.
B. Abnormal skin color changes in a client with dark skin cannot be determined.
C. The lips and mucous membranes of a client with dark skin are dusky in color.
D. Blanching the soles of the feet in a client with dark skin reveals cyanosis.
C. Causes of cyanosis include hypoxemia or decreased cardiac output which provides clues
to respiratory status with changes in skin color and mucous membranes. Cyanosis, a late
sign of hypoxemia, is best observed in the tissue that has superficial capillary supply, such
as mucous membranes, the conjunctivae, lips, palms, and under the tongue, which is readily
visible in dark skin.
B. A client has the right to refuse any medication but should be informed of the therapeutic
value of routine compliance with taking antihypertensive medications (B). Giving
medication subversively to an alert client (A) is a violation of his autonomy and is
unacceptable. (C) is reprimanding. If the client continues to refuse medication after being
informed of its value and risks associated with noncompliance, the refusal and reasons
should be documented
D. A client's religious and cultural preferences should be considered when providing basic
hygiene. (A and C) provide valid rationale for daily hygiene, but the client's religious beliefs
should be considered in the client's choice. Although offering choices (B) addresses client
autonomy, the client's care should be individualized.
D. After confirming a victim with foreign body airway obstruction (FBAO) cannot speak, the
first should be placed between the xiphoid process and umbilicus, and a rapid sequence of
abdominal thrusts should be administered until the FBAO is relieved, not (B and C). If the
victim becomes unresponsive, CPR (A) should be initiated after activating EMS.
20 Multiple choice questions
Term 1 of 20
Which technique should the practical nurse use to give a Z-track intramuscular (IM) injection?
A. Ensure that no air is present in the syringe.
B. Inject the medication into the dorsal gluteal site.
C. Select a 22-gauge, 1-inch needle for injection.
D. Massage the site for 2 minutes after the injection.
B. The Z-track IM injection technique is used to administer irritating or cutaneous-staining
medications into a large muscle, such as the dorsal gluteal site and is given by moving the
surface skin to one side before puncturing the skin.
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.
C. Daily perineal care BID and PRN should include cleansing of the meatus and catheter
junction with soap and water.
(A, B, and D) do not support the concept of medical asepsis and catheter care.
C. Daily weights are the best indicator of fluid status because a sudden increase or
decrease in weight in 24-hours provides an estimate of fluid volume retention or fluid loss.
Skin turgor (A) is used to measure a client's hydration status
,Term 2 of 20
Which growth and developmental characteristic should the practical nurse (PN) consider when
discussing spirituality with an adolescent client?
A. Has a good concept of a supreme being.
B. Questions religious practices and values.
C. Gives oneself to spiritual tasks.
D. Accepts the meaning of spiritual faith.
B. An adolescent often reconsiders child-like concepts of a spiritual power, and in the
search for an identity may either question practices and values, or may find spiritual power
as the motivation to seek a clearer meaning to life. Older adults, not adolescents, often turn
to important relationships and give themselves to spiritual tasks (C). Adolescents do not
necessarily have a good concept of a supreme being (A) nor fully accept the meaning of
spiritual faith
A. Guilt is expressed as a bereaved person's self-reproach. When a loved one is lost, the
grieving process begins. The recovery through this process can be slow but must be
recognized as a natural part of life. Psychological growth comes with time as the client
moves through the grief process (denial, anger, bargaining, guilt (B), depression (C),
loneliness, bargaining (D), acceptance, and hope), which all clients may not go through.
C. An apical-radial pulse provides the most objective comparison when one nurse obtains
the radial pulse and another nurse simultaneously auscultates the apical pulse. When one
nurse collects both rates, either at the same or separate times (A, B, and D), the data
obtained is less accurate.
D. A descriptive scale, such as a pain scale, is the most accurate measure of the intensity of
pain, which can only be described by the client. A numerical pain scale used before and
after implementing measures to alleviate pain provides a comparison that best determines
the effectiveness of an analgesic. (A, B, and C) are subjective descriptors of the client's pain
that do not indicate the degree of pain relief after a medication is given.
, Term 3 of 20
The practical nurse (PN) is assessing a client with dark skin who is in respiratory distress. Which
client response should the PN evaluate to determine cyanosis in this client?
A. Cyanosis in a client with dark skin is seen only in the sclera.
B. Abnormal skin color changes in a client with dark skin cannot be determined.
C. The lips and mucous membranes of a client with dark skin are dusky in color.
D. Blanching the soles of the feet in a client with dark skin reveals cyanosis.
C. Causes of cyanosis include hypoxemia or decreased cardiac output which provides clues
to respiratory status with changes in skin color and mucous membranes. Cyanosis, a late
sign of hypoxemia, is best observed in the tissue that has superficial capillary supply, such
as mucous membranes, the conjunctivae, lips, palms, and under the tongue, which is readily
visible in dark skin.
B. A client has the right to refuse any medication but should be informed of the therapeutic
value of routine compliance with taking antihypertensive medications (B). Giving
medication subversively to an alert client (A) is a violation of his autonomy and is
unacceptable. (C) is reprimanding. If the client continues to refuse medication after being
informed of its value and risks associated with noncompliance, the refusal and reasons
should be documented
D. A client's religious and cultural preferences should be considered when providing basic
hygiene. (A and C) provide valid rationale for daily hygiene, but the client's religious beliefs
should be considered in the client's choice. Although offering choices (B) addresses client
autonomy, the client's care should be individualized.
D. After confirming a victim with foreign body airway obstruction (FBAO) cannot speak, the
first should be placed between the xiphoid process and umbilicus, and a rapid sequence of
abdominal thrusts should be administered until the FBAO is relieved, not (B and C). If the
victim becomes unresponsive, CPR (A) should be initiated after activating EMS.
