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REX-PN 4 exam with verified solutions
1. During the working phase of therapy, the client begins to arrive late
for appointments because of traffic and her busy schedule. What would
the prac- tical nurse interpret this behaviour as?: Resistance;
conscious or unconscious introduction of actions that sabotage the
caring relationship
2. A practical nurse creates a professional development plan as part of
her annual performance review. Which of the following would be most appropriate plan to facilitate the practical nurse's development?:
Attend continuing educa- tion courses related to primary client care
responsibilities
3. A 10-year-old boy is admitted to a hospital for evaluation for a
kidney transplant. A practical nurse learns that the client received hemodialysis for 2 years due to stage 5 kidney disease. The nurse knows that the illness can interfere with this client's achievement of
which of the following?: Industry
4. Industry: Is the fourth stage of Erik Erikson's theory of
psychosocial develop- ment.
Occurs during childhood between the ages of approximately six to twelve
5. What is most important aspect of hand washing?: Friction
6. Which of the following would the nurse educator state is the goal
of ther- apeutic communication?: Obtaining information, developing
trust, and showing caring
7. When assessing if a procedural risk to a client is justified, the
ethical principle underlying the dilemma is known as::
Nonmaleficence
8. Nonmaleficence: Is the principle of
creating no harm. It refers to preventing or
minimizing harm to an individual.
9. A 24-year-old female client has been advised to stop smoking. Which
of the following statements by the nurse is considered therapeutic?: "I
can offer you some information outlining multiple ways to stop smoking.
10. Nursing staff members are sitting in the lounge taking their morning
break. An unregulated care provider (UCP) tells the group that he thinks that the unit secretary has acquired immunodeficiency syndrome (AIDS). The UCP proceeds to tell the nursing staff that the
13. A physician has written the following order for pain relief for a client
"meperidine (morphine), 10 mg, oral, q3-4h, prn." How should the practical nurse
action this request?: Contact the physician for clarification of the drug
14. What is the primary reason why practical nurses should be involved in social
justice issues?: Social-economic and political issues have an impact on health
15. The neighbour tells the practical nurse that she received outstanding nursing care
from one of her colleagues during her labour and childbirth. What is the best way for the
practical nurse to recognize his nursing colleague's professional efforts?: Share the
feedback with the nursing colleague
16. A registered nurse is paired with a practical nurse for a night shift. Which of the
following client should be assigned to the practical nurse?: A 39-year-old male client
who is an unstable diabetic requiring a blood glucose level check
17. A new graduate nurse asks her mentor and practical nurse of 10 years, which of
the following situations would be considered a medication error. The mentor answer correctly if she states all of them would be considered a medication error, except::
Questioning an incorrect order
18. Which of the following interventions is not likely to facilitate effective
communication between a dying client and family?: The nurse makes decision for the
client and family to relieve them of unnecessary demands
19. A practical nurse working in a physician's office observes a physician sneeze into
his hand as he is walking from one examination room to another. He does not wash his hands before entering the examination room to see his next client. What is the nurse's
first priority?: Tell the physician to wash his hands
20. A 82-year-old male has a Mantoux skin test at a physician's office. The practical
nurse reading the test obtains a result of 7 mm induration. What should be the next
action by the practical nurse?: Refer him to a physician Because it becomes the
physician's responsible to further interpret the results and decide on a diagnosis.
21. A practical nurse works in a hospital in Vancouver when suddenly she hears
bombs go off in the distance. During a disaster where mass hysteria could occur,
which of the following states of clients should be taken care of first?: Panic
22. A practical nurse is working in a nursing unit with only electronic medical records.
The room are semi-private, with two clients to a room, and equipped with a computer for
each client. Which of the following actions by the nurse is the most appropriate?: Log-
off the computer before leaving the client's room
23. A nursing manager asks one of the practical nurses to be a preceptor for a new
staff member. Which of the following statements by the practical nurse
assessment for Vicky's immediate postoperative period?: Hemorrhage The throat is a
vascular area- and it can occur quickly
29. A client in the thoracic unit pulls out his right chest tube. What is the immediate
action by the practical nurse?: Place an occlusive dressing over the puncture site
30. An 80-year-old male develops manifestations of an infection. Which of the following
abnormal findings indicates that the client has an infection?: Leuko- cytosis
31. A 45-year-old male client with a diagnosis of alcohol abuse appears untidy and
disorganized. The best plan to gain the client's involvement in personal care would
include:: Assisting him in bathing and dressing by giving him clear, simple directions
32. A practical nurse is creating a plan of care for a 65-year-old male client who was
experiencing anxiety after being let go of his job of over 30 years. The client is now verbalizing concerns regarding the ability to meet financial
obligations and role expectations. What is the priority nursing problem for this client?: Lack
of ability to cope effectively
33. A note in a client's medical record indicates a specific drug is taken through enteral
administration. Which of the following is an example of enteral administration?: Oral
34. Enteral administration: Involves the esophagus, stomach, and small and large
intestines.
35. Parenteral administration: 'Passes' the stomach; goes straight to bloodstream
36. As a practical nurse working in a child and youth mental health clinic, you will likely
assess for common anxiety disorders in young children. Which of the following is most
common?: Separation anxiety
37. A 95-year-old female is admitted to an acute care hospital from a long-term care
facility. Shortly after arrival, the practical nurse documents the Braden Scale score on
her chart. What is the main purpose of the Braden Scale?: To identify clients at risk for
pressure injury early
38. A 42-year-old client has been treated with cortisone preparations for an extended
period of time. Why do individuals with this treatment have an in- creased risk of
developing infections?: Cortisone suppresses the body's normal immune response
High levels of cortisol promote protein breakdown in the body and reduces cell-me- diated
responses, lowering the two factors in immune response
39. A practical nurse is reinforcing instructions for a client taking clopidogrel 75 mg PO
daily. Which statement by the client indicates understanding of the reinforced
43. A practical nurse examines a client who complains of abdominal pain. The practical
nurse discovers the client's symptoms include left lower quadrant abdominal pain, nausea and loss of appetite. These signs and symptoms are most likely consistent
with:: Diverticulitis
44. To prevent pulmonary complications after surgery, clients should be in- structed
to perform which of the following?: Diaphragmatic breathing
45. A 27-year-old female who is 22 weeks pregnant presents with a severe
generalized headache that started when she got out of bed in the morning. When standing upright, the pain is much worse that she has to lie down in the waiting room. She complains of mild nausea and slightly decreased hearing but no other symptoms. The exam is normal. What is the best test for diagnosis?:
Radionuclide cisternography
46. Radionuclide cisternography: A medical imaging study which involves inject- ing a
radionuclide by lumbar puncture (spinal tap) into a client's cerebral spinal fluid (CSF)
If there is abnormal CSF flow within the brain and spinal canal can be altered by
hydrocephalus.
47. A 9-year-old child has received high doses of antibodies. His mother asks the
practical nurse to explain the term "ototoxicity." The practical nurse is aware that ototoxicity describes a potential consequence of medications having an adverse effect
on:: The organs of hearing
48. A 31-year-old pregnant female has hepatitis B report reads "HBsAg = positive".
Which of the following correctly describes the client's hepatitis B status?: Infected
49. What is the most consistent laboratory finding with a client that has been
diagnosed with chronic respiratory alkalosis?: Elevated arterial blood pH, low PaCO‚
50. Chronic respiratory alkalosis: An acid-base disturbance
Characterized by a primary and sustained decrease in arterial carbon dioxide tension
(PaO‚) and an elevated arterial blood pH.
51. Chronic respiratory alkalosis causes:: Alveolar hyperventilation due to syn- cope or
dizziness.
52. Larry loses a major client with his financial planning firm and on his way home that
same day, his car gets a flat tire. Later that evening, he finds fault with his wife and two
children at home. What defence mechanism is Larry expressing?: Displacement
53. A nurse is performing a neurological assessment on a client who elicits a positive
Romberg's sign. Which observation does the nurse makes this
59. A client with chronic pulmonary dysfunction is placed on a corticosteroid
medication to reduce mucosal edema and inflammation. What is the most common
cardiovascular side effect of corticosteroids?: Hypertension
Will increase blood pressure secondary to the sodium and water retention properties of it,
hence, long-term use must be closely monitored.
60. A practical nurse uses postural drainage on a 67-year-old female client with cystic
fibrosis. Which of the following is mostappropriate position for the client when treating
the superior segments of the lower lobes?: Prone with two pillows under the hips
61. A 82-year-old male is being treated for depression with a tricyclic antide- pressant
(TCA). He should be observed carefully for:: Orthostatic hypotension and urinary
retention
62. Side effects of lithium: Diarrhea and electrolyte imbalances
63. Side effects of older antipsychotics,: Photosensitivity, skin, and rashes
64. A 24-year-old female delivered a healthy 3,400 g (7.5 lbs.) boy yesterday. The
practical nurse plans to perform a health assessment with the client and
her baby. Which of the following should the practical nurse be aware of when examining
the infant?: Abdominal breathing observation
65. A 53-year-old male has an amputation on his right leg. The afternoon following
surgery, the practical nurse finds the client lying in bed crying. What is the most
appropriate documentation for this event?: "Lying in bed, crying"
66. Librium: An anxiolytic that is not usually administered to children under five
years old.
67. Lithium: Is used for treating bipolar disorder
68. Phenobarbital: An anti-epileptic drug
69. Aside from treating depression, some antidepressants are also known to be
effective in treating individuals with:: Eating disorders
70. A practical nurse is providing an inservice to the community focusing on
preventing the incidence of hepatitis in children. Which type of hepatitis could a child
contract from a contaminated diaper changing table?: Hepatitis A
71. The mode of transmission of hepatitis A in children: Ingestion of fecally
contaminated water and exposure to contaminated changing tables.
72. A mother brings in her 5-year-old boy to the emergency department be- cause of
asthma related issues. The triage of practical nurses assess the young boy and notices he has tachypnea, wheezing and diminished air entry. The boy begins to shake when the initial treatment of salbutamol is adminis- tered by inhalation. What should the
practical nurse do?: Reassure the client that the side effect of the salbutamol
76. Which of the following is an example of primary prevention?: Remaining out of
direct sunlight when working outdoors during the summer
77. For maternal pain management, systemic opioid analgesics (such as mor- phine
sulphate) can be used. Which statement best describes the nursing considerations for
administering systemic opiate analgesics?: An opioid an- tagonist such as naloxone
should be administered to the newborn if signs of CNS depression are present
78. A client is admitted who reports severe pain in the left lower quadrant of the
abdomen. Which of the following actions would be used to assist with pain relief?:
Positioning the client for comfort using pillows
79. A practical nurse is caring for a 72-year-old female client with bipolar disorder.
Which of the following behaviours by the client indicates a maniac episode is
subsiding?: The client sits and talks with other clients at mealtimes
80. A practical nurse is planning a teaching session with a group of children regarding
nutrition. What must the practical nurse initially assess prior to the teaching session?:
What are the development levels of the children
To understand the level of comprehension
81. A 77-year-old female is experiencing a loss of peripheral vision. Which of the
following eye condition is this likely caused by?: Glaucoma; "tunnel visson"
82. A 31-year-old female is in active labour and is 6 cm dilated. Continuous electronic
fetal heart rate monitoring reveals a baseline heart rate of 110 bpm with a variability of
16-18 bpm. She has a history of chronic hypertension. Based on these findings, what is
this most indicative of?: Fetal well-being
83. A nurse caring for a client who has been receiving intravenous (IV) diuret- ics
suspects that the client is experiencing a fluid volume deficit. Which as- sessment
finding would the nurse note in a client with this condition?: Weight loss and poor skin
turgor
84. A practical nurse has received an assignment for the day shift. She makes her initial
rounds of her assigned clients. Which client should the nurse plan to care for first?: A
client with a white blood cell count of 13,000 mm³ (14 x 10 *9/L) and a temperature of
39°C
85. A home care nurse plans care for a child in a leg cast for treatment of a fractured
right ankle. The nurse diagnosis skin integrity and risk for impaired on the care plan.
Which of the following actions by the nurse is best?: Teaching the child how to perform
isometric exercises of the right leg
86. Parents of a newborn with Down syndrome is ask by the practical nurse what to
expect when they take their infant home. What potential problems might the nurse
discuss with the parents?: Possible difficulty with feedings; d/t larger tongues, poor
muscle control, and coordination
A temperature of 40°C is abnormal without a corresponding increase in pulse and
respiratory rate, the thermometer may be defective.
92. A physician requests the practical nurse to insert a peripherally inserted central
catheter (PICC) line at the bedside of a 45-year-old male client. Which of the following
should be the priority assessment after the insertion?: Hem- orrhage at the insertion
site
93. A 32-year-old mother of a 5-month old baby girl, ask the nurse if her baby will be
able to pull herself to a standing position. What should the practical nurse tell the
mother?: "Your baby will probably stand by holding onto a table at 9 months"
94. A 29-year-old male experienced a cerebrovascular accident (CVA) resulting from a
ruptured aneurysm with a subarachnoid hemorrhage. Although he shows signs of improvement, his wife has been informed that he has apraxia as a result of the CVA. The wife asks the practical nurse to tell her what apraxia means. How should the practical
nurse reply?: Apraxia is the inability to use objects properly
