The practical nurse (PN) is caring for a newborn whose mother has poorly controlled type 1 diabetes mellitus and observes the newborn is grunting with mild sternal retractions. The PN should recognize the newborn is exhibiting signs of which condition?

Hypothyroidism.

Patent ductus arteriosus.

Hyperinsulinemia.

Ventral septal defect.

Answer and Explanation

The Correct Answer is B

The practical nurse (PN) should recognize that a newborn whose mother has poorly controlled type 1 diabetes mellitus and is exhibiting grunting with mild sternal retractions is exhibiting signs of patent ductus arteriosus. Patent ductus arteriosus is a condition in which the ductus arteriosus, a blood vessel that connects the pulmonary artery to the aorta, fails to close after birth. This can result in abnormal blood ﬂow between the aorta and pulmonary artery, leading to respiratory distress.

Hypothyroidism (Option A) and hyperinsulinemia (Option C) are conditions that can occur in newborns, but they do not typically present with grunting and sternal retractions.

Ventral septal defect (Option D) is a congenital heart defect that can cause respiratory distress, but it is not specifically associated with maternal diabetes.

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Correct Answer is A

Explanation

If the practical nurse (PN) is caring for a client who delivered 6 hours ago and assessment findings reveal a boggy uterus that is displaced above and to the right of the umbilicus, the PN should encourage the client to void. A full bladder can displace the uterus and prevent it from contracting properly, leading to a boggy uterus. Encouraging the client to void can help empty the bladder and allow the uterus to contract and return to its normal position. The other actions listed may also be appropriate in some situations, but encouraging voiding is the most appropriate action in this situation.

A. "Are you planning to obey the voices?" B. "When did these voices begin?" C. "Have you taken any hallucinogens?" D. "Do you believe the voices are real?"

Correct Answer is A

Explanation

The practical nurse (PN) should ask the client if he is planning to obey the voices, as this will help determine the client's risk for harming himself or others. The PN should also ask about the onset and duration of the symptoms and any factors that may have triggered them, such as drug use or recent stressors. Additionally, the PN should assess the client's perception of the voices, as some individuals may recognize them as a symptom of a mental illness, while others may believe them to be real. It is important for the PN to remain non-judgmental and supportive during the assessment, while prioritizing the client's safety.

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The practical nurse (PN) is caring for a newborn whose mother has poorly controlled type 1 diabetes mellitus and observes the newborn is grunting with mild sternal retractions. The PN should recognize the newborn is exhibiting signs of which condition?

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is caring for a client who delivered 6 hours ago. Assessment findings reveal a boggy uterus that is displaced above and to the right of the umbilicus. Which action should the PN take?

Correct Answer is A

Explanation

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?

Correct Answer is A

Explanation

A mother calls the clinic to report that her child has just swallowed "poison" and is vomiting. In preparing to instruct the mother about the necessary action to take, which substance should the practical nurse (PN) consider to be the least traumatic to the esophagus when the child vomits?

The practical nurse (PN) is planning care for a child with heart failure. Which intervention should the PN give the greatest priority?

A male client with paranoia has been admitted to the mental health unit, and upon arrival, he 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?

The practical nurse (PN) is contributing to the plan of care for a toddler with failure to thrive due to inadequate caloric intake. Which observation should the PN monitor to best help develop interventions?

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?

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?

The practical nurse (PN) is caring for a postpartum client who delivered 5 hours ago and has saturated a perineal pad with a few clots within 15 minutes. Which action is most important for the PN to implement?