A client with paranoia is admitted to the mental health unit and immediately goes to the corner of the room and sits quietly without communicating. In approaching the client, what intervention should the practical nurse (PN) implement first?

Explain the daily schedule of unit activities.

Review client rights of hospitalization.

Offer the client an as-needed (PRN) medication.

Describe the functions of the practical nurse (PN).

Answer and Explanation

The Correct Answer is D

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Correct Answer is C

Explanation

When a preoperative client expresses fear and uncertainty about undergoing surgery, the priority action for the practical nurse (PN) is to notify the charge nurse of the client's concerns. This is important because the charge nurse can coordinate appropriate interventions and support for the client, ensuring their emotional well-being and addressing their fears.

A. The injury may require medical attention, as the mother mentioned that the boy is in pain. B. The abrasions on the boy's leg and hand have healed. C. The mother describes what she did after her child got injured. D. The boy lacks coordination when answering the nurse's questions.

Correct Answer is A

Explanation

This is the correct answer, as it reﬂects the nurse's assessment of the injury and the appropriate action to take. The nurse should consider the mother's report of pain as a valid indicator of the severity of the injury, and should not dismiss or minimize it. The nurse should also observe the boy's arm and shoulder for any signs of fracture, dislocation, swelling, bruising, or deformity, and ask him to rate his pain on a scale of 0 to 10. The nurse should then decide whether to refer the boy to a physician or an emergency department for further evaluation and treatment.

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A client with paranoia is admitted to the mental health unit and immediately goes to the corner of the room and sits quietly without communicating. In approaching the client, what intervention should the practical nurse (PN) implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A male preoperative client who has already signed the informed consent for a surgical procedure confides in the practical nurse (PN) that he is really frightened and unsure about undergoing the surgery. Which priority action should the PN take?

Correct Answer is C

Explanation

The mother of a school-aged boy tells the practical nurse (PN) that he fell out of a tree and hurt his arm and shoulder. The mother says the boy is in pain and needs medical help. The nurse should assess the injury and decide the appropriate action to take.

Correct Answer is A

Explanation

The practical nurse (PN) is preparing for shift change. Which task has the highest priority and should be completed first?

The practical nurse (PN) assigns an unlicensed assistive personnel (UAP) to clean the hearing aid of an older adult resident of a long-term care facility. Which instructions should the PN provide to the UAP? (Select all that apply.)

Exhibits here Review H and P and nurse's notes. What other assessment techniques can the nurse use to identify the potential source of the client's new-onset confusion and decreased appetite? Select all that apply.

The practical nurse (PN) is assigning tasks to an unlicensed assistive personnel (UAP) who is giving basic care to a group of residents in a long-term care facility. Which client's task should be completed by a PN, rather than the UAP?

Discussed the DASH diet with the client and gave examples of appropriate portion sizes. Review H and P, nurse's note, and laboratory results. What other nutritional recommendations would be helpful for this client in reducing the risk for type 2 diabetes? Select all that apply.

Ancient is scheduled for a thoracentesis that will be done at the bedside. What should the practical nurse (PN) prepare before the healthcare provider arrives to perform the procedure?