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The client is a young male who appears to be 25-30 years old. He was found unconscious on a sidewalk by a jogger who was passing. The jogger called an ambulance, and the EMT's transported the ent to the hospital. The client is arousable but unable to say what his name is or what happened to him. A STAT CT of the head in the emergency room showed no abnormalities, so the client will be admitted to the medical floor for observation and further tests.

The PN reinforces education about seizures to the client and asks him to explain what he understands about his condition.

Which statements indicate understanding?

Select all that apply

"I don't need to go to the hospital if I have another seizure unless it is a very long seizure or if I have several in a row."

"There are really no lifestyle changes that I can do that will affect my risk of having another seizure."

"I may never know why I started having seizures."

"Having a medic alert bracelet might be a good idea, but it is up to me to decide if I want it or not."

"I can stop taking the phenytoin if I go for a while and don't have a seizure."

Answer and Explanation

Correct Answer : A,C,D

A. "I don't need to go to the hospital if I have another seizure unless it is a very long seizure or if I have several in a row." This statement demonstrates an understanding that certain characteristics of seizures, such as prolonged duration or multiple seizures in succession, may require medical attention and evaluation.
C. "I may never know why I started having seizures." This statement acknowledges the possibility that the underlying cause of the seizures may remain unknown. Seizure etiology can vary, and in some cases, the specific cause cannot be determined despite diagnostic tests.
D. "Having a medic alert bracelet might be a good idea, but it is up to me to decide if I want it or not." This statement recognizes the potential benefits of wearing a medic alert bracelet, which can provide crucial information about the client's condition in case of emergencies. It emphasizes the client's autonomy in making the decision, showing an understanding of the role and significance of the bracelet.
The following statement does not indicate understanding:

"There are really no lifestyle changes that I can do that will affect my risk of having another seizure." This statement is incorrect, as there are lifestyle modifications that can help reduce the risk of seizures, such as getting enough sleep, managing stress, avoiding triggers (if known), and taking prescribed medications as directed.
Regarding the statement "I can stop taking the phenytoin if I go for a while and don't have a seizure," it is not included in the given options.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Collecting fingerstick glucose levels is the most important intervention for the PN to implement for a client who is receiving TPN. TPN is a method of feeding that bypasses the gastrointestinal tract and provides all the nutritional needs of the body through a vein. TPN contains a high concentration of glucose, which can cause hyperglycemia or ﬂuctuations in blood sugar levels. Therefore, it is essential to monitor the client's glucose levels frequently and adjust the infusion rate or insulin administration accordingly.

A. Coﬀee ground secretions drainage via nasogastric tube. B. Nasogastric tube suctioning. C. Assessing pain management response. D. Ineﬀective pain management report:

Correct Answer is C

Explanation

This is the correct answer because it is the most important and relevant action that the PN should do for a postoperative patient with a PCA machine. A PCA machine is a computerized device that allows the patient to self-administer a preset dose of pain medication, usually an opioid, by pressing a buton. The PCA machine is attached to an intravenous (IV) line that delivers the medication directly into the bloodstream. The PCA machine can provide eﬀective and individualized pain relief for postoperative patients, as well as increase their sense of control and satisfaction¹².

The PN should assess the pain management response of the postoperative patient with a PCA machine by monitoring their pain level, vital signs, oxygen saturation, sedation level, and side effects. The PN should use a valid and reliable pain scale, such as the numeric rating scale (NRS) or the visual analog scale (VAS), to measure the patient's pain intensity and relief. The PN should also check the settings and functioning of the PCA machine, such as the dose, lockout interval, and limit. The PN should document and report the patient's pain management response and any problems or complications with the PCA machine to the health care provider.

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Naxlex Comprehensive Predictor Exams

Which intervention is most important for the practical nurse (PN) to implement for a client who is receiving total parenteral nutrition (TPN)?

Correct Answer is A

Explanation

Which action should the practical nurse (PNA) prioritize for postoperative patient with a PCA (Patient- Controlled Analgesia) machine?

Correct Answer is C

Explanation

The practical nurse (PN) is reviewing instructions for the use of pilocarpine ophthalmic drops with a client who has glaucoma. The client replies that the drops should be used to anesthetize the eye if eye pain is experienced. What action should the PN implement?

A female client with immune thrombocytopenic purpura (ITP) is transferred to a long term care facility for physical rehabilitation. To prevent injury, which action is most important for the practical nurse to implement?

A college student brings his roommate to the clinic because the roommate has been talking to someone who is not present. The student tells the practical nurse (PN) that his roommate is acting strange. Which question should the PN ask the client next?

The practical nurse (PN) receives shift reports for four newborns in the full-term newborn nursery. Which infant should the PN assess first?

The practical nurse (PN) is caring for a client with psychosis who demonstrates an inability to communicate effectively. Which method should the PN use to interact with the client?

A 15-year-old adolescent male with a mild mental disability is hospitalized for minor surgery and tells the practical nurse (PN), "WOW! You have big breasts." Which response is best for the PN to provide?

The practical nurse (PN) is auscultating a client's lung sounds. Which description should the PN use to document this sound? (Please listen to the audio clip provided). Audio: [Wheezing sound]