Case 1 Mrs. C, 80 years old, is admitted to day surgery for the extraction of cataract in her left

 Case 1 Mrs. C, 80 years old, is admitted to day surgery for the extraction of cataract in her left eye. 1. A practical nurse who has just started a shift has been assigned to Mrs. C. What should the practical nurse do to most accurately identify this client?Refer to the name on the bed.Ask a co-worker to identify Mrs. CCheck the client’s name on her armband.Say Mrs. C’s name and wait for a response.2. Which of the following communication techniques should the practical nurse use to facilitate Mrs. C’s understanding of her postoperative care?Speak loudly so that Mrs. C can hear and ask her if she understands.Stand by Mrs. C’s left side, speak in a clear and concise manner, and ask her if she has any questions.Provide Mrs. C with an instructional video on cataract surgery.Stand in front of Mrs. C, speak in a clear and concise manner, and ask her if she has any questions.3.  Mrs. C has just returned from the recovery room. She is disoriented and restless. What should the practical nurse do to best promote Mrs. C’s safety?Keep Mrs. C’s bed in the lowest position with the side rails up.Turn on the light above Mrs. C’s bed to facilitate her vision.Keep all of Mrs. C’s on her bedside table.Ensure that Mrs. C’s walker remains close to her bed.4. Mrs. C is seen at the eye clinic the next day. The practical nurse removes the dressing as ordered and observes increased redness and swelling around the left eye. What should the practical nurse do next?Report the findings immediately.Cleanse Mrs. C’s eye and re-patch.Chart the findings in the nurse’s notes.Instruct Mrs. C to apply ice to her eye when she gets home.5. Mrs. C falls when walking down the hall at the eye clinic. After assessing Mrs. C and helping her off the floor, which of the following actions should the practical nurse take with regard to documentation and safety?Help her to a chair, report the fall, and complete an incident report.Once she is in a chair, fill out and incident report, and document the fall in the nurse’s notes.Ask another staff member to assist her to a chair, and fill out and incident report.Assist her to a chair and immediately document the fall in the nurse’s notes.END OF CASE Case 2Mr. Little, a 19-year-old client, confides in the practical nurse that he is experiencing pain and itching in the genital area. His tests confirm a diagnosis of Herpes Simplex Virus Type 2.6. Which one of the following questions would be most appropriate for the practical nurse to ask Mr. Little initially during data collection?”Were you upset when you found out about your diagnosis?””Did you know that herpes is transmitted sexuality?””How have you prevented transmission since your diagnosis?””What do you understand regarding your diagnosis?”7. Which one of the following actions would be most appropriate for the practical nurse to take in order to encourage Mr. Little to discuss his feelings? Stay with Mr. Little until he is willing to share his feelings.Explain that it is normal to feel embarrassed.Be accepting of Mr. Little’s reaction to his diagnosis.Encourage Mr. Little to discuss his sexual relationships.8. Which one of action is most important for the practical nurse to follow when assessing Mr. Little’s genital area?Wear disposable gloves.Wear a mask if genital areas are openWear a clean gownWear sterile latex gloves9. What is the primary reason for the practical nurse to practice medical asepsis when caring for Ken?To protect the hospitalTo protect Mr. LittleTo protect the practical nurseTo protect other clients10. Which one of the following statements is most likely to encourage Mr. Little to take responsibility for his own behaviors?”You should wear loose fitting pajamas.””Avoid intercourse while your lesions are open.””Let’s review this list of recommended practices you should consider following.””You need to stay on bedrest for a couple of days.”END OF CASE     Case 3Mrs. Lillian Goldstone, 78 years old, has been admitted with a diagnosis of varicose veins. Her lower extremities are edematous.11. What should the practical nurse do initially to assist Mrs. Goldstone to move up in bed?Elevate the head of the bed prior to assisting her.Raise the bed to a working height prior to assisting her.Ask her to extend her knees during the move.Ask her to push with her feet during the move.12. What should the practical nurse do to assist Mrs. Goldstone with her personal hygiene?Wash the lower extremities from distal to proximal areas.Rub the feet dry to promote circulation.Do pericare washing from front to back.Apply powder to keep the skin dry.13. When discharged, Mrs. Goldstone will be staying with her daughter, Catherine. Which one of the following actions by the practical nurse would be most appropriate when explaining to Catherine how to care for her mother?Instruct Catherine to apply a hot water bottle to her mother’s affected leg.Teach Catherine to encourage her mother to wear prescribed anti-embolic stockings.Suggest that Catherine assist her mother in performing ROM exercises.Recommend that Catherine encourage her mother to remain on bedrest.14. Mrs. Goldstone asks why her feet are swollen. Which one of the following responses by the practical nurse would be most appropriate?”Why do you think your feet are swollen?””Hanging your feet over the side of the bed may have made them swell.””The circulation from your feet is slowed down, causing the swelling.””You have a condition called varicose veins.”15. Which one of the following physician’s orders for Mrs. Goldstone should the practical nurse clarify prior to implementing care?Maintain accurate intake and output.Initiate an exercise program today.Maintain complete bedrest.Remove antiembolic stocking h.s.16. Mrs. Goldstone has progressed to activity as tolerated. On her third hospital day, she reports pain in her right calf. On examination, the area feels warm to touch. What should the practical nurse do first?Massage Mrs. Goldstone’s leg gently to relieve the pain.Report Mrs. Goldstone’s manifestations to the physician immediately.Return Mrs. Goldstone to bed, and report the observations.Assess and report Mrs. Goldstone’s blood pressure and pulse. END OF CASECase 4Bill Brown is a young boy with history of repeated bouts of tonsillitis. To prevent possible heart problem and/or kidney damage, complications of bacterial tonsillitis, the physician decided to remove Bills tonsils. He will undergo tonsillectomy.17. Which one of the following assessments indicates the presence of a postoperative complication of a tonsillectomy?Sore throatMild earacheFrequent swallowingDysphagia18. What information should the practical nurse include in the preoperative teaching regarding Bill’s return to the unit after regaining consciousness?He will need to begin deep breathing and coughing exercises.He will have to clear his throat forcibly.He will remain quietly in the supine position.He will have the head of the bed elevated. 19. Following surgery, Bill returns to the unit conscious and alert. What should the practical nurse do first? Assess Bill’s throat.Offer Bill some crushed ice.Check Bill’s vital signsAsk the medication nurse for an analgesic for Bill.20. What should the practical nurse use when handling Bill’s oral secretions?Sterile glovesClean glovesMask and gownMask and gloves 21. Bill is now allowed to drink cold fluids. Which one of the following fluids should the practical nurse offer him?Orange juiceMilkWaterGinger ale 22. Bill is being discharged from the surgical unit. Which one of the following discharge instructions should the practical nurse reinforce?Start soft foods in 1 week.Begin antiseptic gargles 4 times a day.Avoid vigorous clearing of throat.Report mouth odour. END OF CASECase 5Mrs. Martha Abbott, a 72-year-old married client, has left hemiplegia from a recent cerebrovascular accident.  23. How can the practical nurse best encourage Mrs. Abbott to participate in her bath? Allow her enough time to do what she can.Ask her to wash only her face and hands.Praise her only when she completes her bath.Have her use her affected arm to wash. 24. Which one of the following measures by the practical nurse will help Mrs. Abbott in maintaining regular bowel elimination? Encourage a high-fibre diet.Provide 1,000 ml of fluids per day.Offer low-residue foods.Encourage toileting prior to meals. 25. Mrs. Abbott is now able to ambulate using a walker. How should the practical nurse help Mrs. Abbott to ambulate safely? Keep the walker close to the body at all times.Move the walker and the unaffected leg forward together.Lean into the walker keeping the elbows bent.Move the walker forward and then the affected leg. 26. Mrs. Abbott can bear weight on her unaffected leg. Where should the practical nurse place the wheelchair to best assist Mrs. Abbott to transfer safely from bed to wheelchair? 1)         Parallel to bed on her unaffected side2)         Parallel to bed on her affected side3)         With the seat of the wheelchair facing the bed4)         At the head of the bed with the armrests removed 27. A rectal suppository has been ordered for Mrs. Abbott’s constipation. Which one of the following techniques is important when administering the rectal suppository? 1)         Place the suppository past the internal sphincter and against the rectal wall.2)         Insert the suppository directly into soft-formed stool.3)         Place the suppository between the external and internal sphincters.4)         Position client in right lateral or right Sims’ position. END OF CASE   Case 6 Mr. Jacques Martin, 55 years old, is admitted to the unit following a total right hip replacement. The practical nurse notices a 10 cm light red oozing on the dressing. A drain with vacuum suction is located in Mr. Martin’s wound. 28. What must the practical nurse do first? 1)         Immediately report the obvious signs of hemorrhage to the unit nurse.2)         Check to see if there are any sign of bleeding under the right hip.3)         Apply a pressure bandage to the operative site.4)         Assess blood flow by noting the colour of the nail bed on the right foot. 29. Which one of the following methods is effective for preventing infection in Mr. Martin’s surgical site? 1)         Clamp the drain when Mr. Martin washes at the sink.2)         Change the vacuum suction (e.g. Hemovac) each time it is full.3)         Assess the drainage characteristics once a day.4)         Ensure that the connection between the vacuum suction (e.g. Hemovac) and the tubing is intact. 30. On the third post-op day, Mr. Martin’s wife informs the practical nurse that she has placed the trochanter roll on the side of her husband’s right leg. She says that the leg does not appear straight when he is lying on his back. Which measure would help to prevent improper positioning of Mr. Martin’s leg? 1)         Suggest that Mrs. Martin remind her husband to keep his leg adducted.2)         Suggest to Mrs. Martin that she elevate her husband’s leg on a pillow.3)         Demonstrate the use of a trochanter roll to Mrs. Martin.4)         Inform Mrs. Martin that the trochanter roll should be positioned only by the practical nurse. 31. Mr. Martin is now able to weight bear without walking aids. He tells the practical nurse that he would feel safer if he could use a walker for a few days. Which one of the following comments would promote Mr. Martin’s autonomy? 1)         “I have no objection to you using the walker for a few days.”2)         “The physician’s order is very clear. He doesn’t want you to use a walker.”3)         “How about if I walk with you until you feel safe without the walker.”4)         “I suggest that you walk in the corridor a few times to strengthen your right leg muscles.” END OF CASE  Health Science Science Nursing NURSING 123 Share QuestionEmailCopy link Comments (0)

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