The practical nurse (PN) is assisting with the plan of care for a client who is experiencing torticollis from a traumatic injury sustained during a football game. The client received a prescription for tramadol. Which intervention should the PN include in the client's plan of care?

Encourage the client to resume normal activities after medication administration.

Observe the client for involuntary movements of the lips and tongue every day.

Perform a daily whisper test of the client's hearing to detect symptoms of ototoxicity.

Implement ongoing assessments for signs of shallow or slow breathing.

Answer and Explanation

The Correct Answer is D

Tramadol is an opioid analgesic that can depress the respiratory system and potentially cause respiratory depression. Therefore, it is crucial for the PN to closely monitor the client's breathing pattern, depth, and rate. Assessing for signs of shallow or slow breathing is important to detect any potential respiratory depression and take appropriate action promptly.
The other options listed are not directly related to the administration of tramadol:

A. Encouraging the client to resume normal activities after medication administration is not an appropriate intervention for a client experiencing torticollis. The focus should be on pain management, rest, and implementing measures to relieve the torticollis.
B. Observing the client for involuntary movements of the lips and tongue every day is not specifically related to tramadol. This intervention is more relevant to monitoring for tardive dyskinesia, a side effect associated with certain antipsychotic medications.
C. Performing a daily whisper test of the client's hearing to detect symptoms of ototoxicity is not necessary with tramadol. Ototoxicity refers to damage to the inner ear, often caused by specific medications, but tramadol is not known to cause ototoxic effects.

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Correct Answer is A

Explanation

- A terminally ill client is a client who has a progressive and incurable disease or condition that is expected to result in death within a short period of time, such as months or weeks. A terminally ill client may require palliative care, which is the care that focuses on relieving pain and suﬀering and improving the quality of life for the client and their family.
- An admission assessment is the process of collecting information about a client's health status, needs, preferences, and goals when they are admitted to a health care facility, such as a hospital, nursing home, or hospice. An admission assessment helps to establish a baseline for the client's condition, plan and implement appropriate interventions, and evaluate the outcomes of care.
- A health care proxy is a legal document that allows a client to appoint another person, such as a family member or a friend, to make health care decisions for them if they become unable to do so themselves. A health care proxy may also include specific instructions or preferences about the type and extent of care that the client wishes to receive or refuse, such as life-sustaining treatments, resuscitation, or organ donation.
- Health care proxy documentation is important information that the practical nurse (PN) should collect during the admission assessment of a terminally ill client to an acute care facility, as it reﬂects the client's autonomy, dignity, and wishes regarding their end-of-life care. It also helps to ensure that the client's healthcare decisions are respected and followed by the healthcare team and the facility.

- Therefore, option A is the correct answer, while options B, C, and D are incorrect.

A. The lab results indicate risk factors for transient ischemic attack (TIA), and neurological vital signs should be monitored. B. The lab results indicate myocardial damage, and the client is at risk for cardiac dysrhythmias. C. The client is at risk for pulmonary embolism, and lifestyle modifications need to be implemented. D. The client is at risk for recurrent long-term angina pain and subsequent myocardial infarction (MI).

Correct Answer is B

Explanation

Elevations in troponin I and CK-MB levels indicate myocardial damage, which can result from insufficient blood supply to the heart muscle due to coronary artery disease. When the heart muscle is damaged, it can lead to abnormal electrical activity and rhythm disturbances, known as cardiac dysrhythmias. These dysrhythmias can be life-threatening and require immediate attention.

Transient ischemic attack (TIA) refers to a temporary interruption of blood flow to the brain, which is not directly related to the elevated troponin I and CK-MB levels. Therefore, monitoring neurological vital signs for TIA is not the most significant risk in this case.

Pulmonary embolism, while it is a serious condition, is not directly indicated by the elevated troponin I and CK-MB levels. Lifestyle modifications may be important for managing coronary artery disease but are not the most significant risk based on the given information.

Recurrent long-term angina pain and subsequent myocardial infarction (MI) may be a concern for the client with coronary artery disease, but the elevated troponin I and CK-MB levels suggest that myocardial damage has already occurred. The focus at this point would be on managing the acute myocardial damage and the risk of cardiac dysrhythmias.

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The practical nurse (PN) is assisting with the plan of care for a client who is experiencing torticollis from a traumatic injury sustained during a football game. The client received a prescription for tramadol. Which intervention should the PN include in the client's plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which information should the practical nurse (PN) collect during the admission assessment of a terminally ill client to an acute care facility?

Correct Answer is A

Explanation

Correct Answer is B

Explanation

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]

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.

An adult female client with type 1 diabetes mellitus is receiving NPH insulin 35 units each morning. Which finding should the practical nurse (PN) document as evidence that the amount of insulin is inadequate?

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 client reports experiencing numbness and tingling in the extremities. Which of the client's serum laboratory values should the practical nurse (PN) prioritize reporting to the healthcare provider?

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.)