A term multigravida, who is receiving oxytocin IV for labor augmentation, is requesting pain medication. Review of the client's record indicates that she was medicated 30 minutes ago with butorphanol 2 mg and promethazine 25 mg IV push. Vaginal examination reveals that the client's cervical dilation is 3 cm, 10% eﬀaced, and at a 0 station. Which action should the practical nurse (PN) implement?

Coach the client to take slow, deep breaths during each contraction.

Report to the nurse that the client needs another dose of butorphanol.

Notify the healthcare provider.

Discontinue the oxytocin infusion.

Answer and Explanation

The Correct Answer is A

In this situation, the practical nurse (PN) should coach the client to take slow, deep breaths during each contraction. The client has already been medicated with butorphanol and promethazine for pain relief and it may not be appropriate to administer another dose at this time. Instead, the PN can provide non- pharmacological pain relief measures such as coaching the client to use breathing techniques to help manage the pain during contractions. The other actions listed may also be appropriate in some situations, but coaching the client to use breathing techniques is the most appropriate action in this situation.

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Correct Answer is D

Explanation

Feeling sad or having a depressed mood is a common symptom of depression. Asking the client if they often feel sad can help the practical nurse (PN) assess for depression.

While recent stresses (A), sleep changes (B), and dietary habits (C) may also be relevant to the client's situation, asking if the client often feels sad is the most important question for the PN to ask in order to further assess for depression.

A. Current administration of analgesics or antianxiety medications. B. History of situational depression related to major life events. C. Previous episodes of frequent falls. D. The client's history of alcohol abuse.

Correct Answer is A

Explanation

The practical nurse (PN) should obtain information about the client's current medications, including any analgesics or antianxiety medications that may be contributing to the confusion. These medications can cause cognitive impairment and confusion, especially in older adults. It is important to assess the client's mental status and identify any potential causes of confusion, as this can indicate a change in the client's condition that requires further evaluation and intervention.

Option B is incorrect as it refers to a history of situational depression, which may not be relevant to the current situation.

Option C is also incorrect as it refers to previous falls, which may not be related to the current confusion.

Option D is incorrect as it refers to the client's history of alcohol abuse, which may be important to know but is not the most relevant information to obtain in this situation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

An older female client is admited to the orthopedic unit following surgical repair of a fractured hip. On the second postoperative day, the client becomes confused and repeatedly asks the practical nurse (PN) where she is. Which information should the PN obtain before reporting to the charge nurse?

Correct Answer is A

Explanation

During morning rounds, a client who is admitted with obsessive-compulsive disorder is in the dayroom repeatedly washing the top of the same table. Which intervention should the practical nurse (PN) implement when approaching the client?

The practical nurse (PN) notes several nutritional goals in a standardized plan of care used in the antepartum clinic. Which client goal takes priority?

Which information is most important for the practical nurse (PN) to relay to the registered nurse (RN) concerning a 24-hour-old infant?

Another person tells the practical nurse (PN) that her 7-year-old child frequently wets the bed at night. Which information should the PN provide?

A patient is admitted to the postpartum unit one hour after a sterile vaginal delivery of a normal neonate weighing 8 pounds 2 ounces (3.7 kg). When the client's fundus becomes boggy and displaced above the umbilicus, which action should the practical nurse (PN) take first?

The practical nurse is evaluating a male client with paranoia. Which behavior can this client be expected to exhibit?

The practical nurse (PN) is caring for a client that has just arrived in the emergency department with 2nd degree thermal burns to the right thigh, lower leg and foot, and reports severe pain in the right leg. Which priority action should the PN take while caring for this patient?