A client who is in active labor is admitted with her cervix dilated to 3 cm with 50% eﬀacement and the presenting part at 0 station. An hour later, she tells the practical nurse (PN) that she wants to go to the bathroom to empty her bladder. The nurse examines the client again and determines her vaginal exam is unchanged.

Which action should the PN implement?

Review the fetal heart rate pattern.

Assist the client up to the bathroom.

Check perineum for changes in "show" or discharge.

Obtain a straight catheter kit to empty her bladder.

Answer and Explanation

The Correct Answer is B

If the client in active labor expresses a desire to empty her bladder and her vaginal exam is unchanged, the practical nurse (PN) should assist her up to the bathroom. An empty bladder can help facilitate labor progress.

Reviewing the fetal heart rate pattern (A) is important, but it is not the most appropriate action in response to the client's request to empty her bladder. Checking the perineum for changes in "show" or discharge (C) is also important, but it is not the most appropriate action in this situation. Obtaining a straight catheter kit to empty the client's bladder (D) may be necessary if she is unable to empty her bladder on her own, but assisting her up to the bathroom should be attempted first.

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Correct Answer is A

Explanation

The first action the PN should take is to check the client's serum human chorionic gonadotropin (hCG) level. This hormone is produced by the placenta and can provide important information about the viability of the pregnancy.

Option B, verifying the date of the last menstrual cycle, can provide useful information about the gestational age of the pregnancy but is not the first priority.

Option C, repeating a urine pregnancy test, can confirm the presence of a pregnancy but does not provide information about its viability.

Option D, inquiring about the last occurrence of intercourse, is not relevant to addressing the client's immediate concern of vaginal bleeding.

A. 50% of the parents reported that their children are aware of bicycle safety. B. The number of students wearing bicycle helmets increased by 10%. C. The number of students riding bicycles to school increased by 25%. D. 80% of the parents identified the need for an annual bicycle safety program.

Correct Answer is B

Explanation

The best indicator to the practical nurse (PN) that the community bicycle safety education program was eﬀective is that the number of students wearing bicycle helmets increased by 10%. Wearing a helmet while riding a bicycle is an important safety measure that can help prevent head injuries in the event of an accident. An increase in the number of students wearing helmets indicates that the program was successful in promoting this safety behavior. The other findings listed may also provide useful information about the eﬀectiveness of the program, but the increase in helmet use is the most direct and measurable indicator of success.

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Naxlex Comprehensive Predictor Exams

A client at 8-weeks gestation presents to the office with a report of vaginal bleeding for the last 12 hours without cramping. Which action should the practical nurse (PN) take?

Correct Answer is A

Explanation

Correct Answer is B

Explanation

The healthcare provider informs an 18-year-old male client that he has Hodgkin's disease. When the practical nurse (PN) enters the room, the client shouts, "Get out of here! I don't want to see anyone! I just want to die!" Which initial response should the PN make?

A child with cerebral palsy (CP) is taking baclofen, a relaxant. Which assessment finding indicates to the practical nurse (PN) that the drug is eﬀective?

A client at the mental health center reports difficulty concentrating at work, feeling very tired during the day, and sleeping 4 to 5 hours at night. To further assess for depression, which question is most important for the practical nurse (PN) to ask?

An older client is admitted to the psychiatric unit for assessment of a recent onset of dementia. The practical nurse (PN) notes that in the evening this client often becomes restless, confused, and agitated. Which intervention should the PN implement?

The practical nurse (PN) is assigned to assist in the care of a laboring client at 42-weeks gestation. While providing perineal care, the PN observes the umbilical cord protruding from the vagina. Which action should the PN take?

A male college student brings his roommate to the clinic because the roommate has been talking to someone who is not present. The client tells the practical nurse (PN) that the voices are saying, "Kill, kill." Which question should the PN ask the client next?

A 3-week-old infant is admited to the pediatric unit with vomiting and dehydration. The mother describes the infant as having projectile vomiting after eating. She also tells the practical nurse (PN) that the baby is always hungry. Which finding warrants immediate intervention by the PN?