REX PN Canadian practical nurse EXAM A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFIED ANSWERS

NURS EXAM ms




Exam Solution ms




HESI PN Comprehensive Exam 1 Cartes 2026 A+ GRAD
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E ASSURED COMPLETE SOLUTIONS AND VERIFIED ANS
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WERS (82176) ms




QUESTION 1 ms




What action should the PN implement to facilitate speech for a client who has a fenest
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rated tracheostomy tube? ms ms



A. Show the client how to use a tracheostomy plug.
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B. Determine the client's ability to swallow.
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C. Remove the inner cannula.
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D. Give oxygen at 6 L/minute via tracheostomy collar.
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ANSWER

B. Determine the client's ability to swallow. A fenestrated tracheostomy has an opening or hole on t
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he posterior aspect of the outer cannula that allows airflow over the vocal cords and speech in a cli
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ent who is spontaneously breathing. It does not have a cuff, so the client's risk for aspiration should
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be determined.
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QUESTION 2 ms




A client is wearing a continuous 24-
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hour Holter monitor for elevation of heart rhythm disturbances. What info should the
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PN reinforce with this client?
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A. Remove the electrodes to shower or bathe
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B. Keep a diary of activities as long as the monitor is worn.
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C. Exercise as much as possible while the monitor is in place.
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D. Call the assigned number if an episode of irregular heartbeats occurs.
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ANSWER

B. Keep a diary of activities as long as the monitor is worn. Nursing care for a client with a Holter
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monitor includes preparation of the skin, placement of the electrodes and leads, and activities of dail
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y living, so the client should be informed of the importance of keeping an accurate record of activiti
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es and symptoms
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,QUESTION 3 ms




A client with advanced cirrhosis is prescribed lactulose (Cephulac) 30 ml QID. The clie
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nt complains that the medicine is causing diarrhea. Which therapeutic response of the
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medication should the PN provide the client?
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A. Promotes fluid loss.
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B. Prevents constipation.
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C. Excretes ammonia to improve cerebral function.
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D. Reduces the risk for gastrointestinal bleeding.
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ANSWER

C. Excretes ammonia to improve cerebral function. To treat portal-
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systemic encephalopathy, lactulose causes the movement of serum ammonia, which accumulates due
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to hepatic dysfunction in cirrhosis, into the gut and results in diarrhea due to the osmotic movemen
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t of water.
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QUESTION 4 ms




The PN is caring for a client with chronic kidney disease (CKD). What info should the
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PN reinforce about medication management?
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A. Oral iron supplements reverse chronic anemia in CKD.
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B. Calcium supplements are needed to maintain serum levels.
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C. Nonsteroidal antiinflammatories are safe to use for pain.
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D. Antihypertensive drugs should always be used as directed.
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ANSWER

D. Antihypertensive drugs should always be used as directed. Blood pressure control is essential for
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a client with CKD because hypertension and cardiovascular disease occur with the progression of CK
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D.



QUESTION 5 ms




Which information related to a client's history of benign prostatic hypertrophy (BPH)
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should the practical nurse (PN) report to the healthcare provider?
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A. Change in bowel movements.
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B. Persistent lower back pain.
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C. White penile discharge.
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D. Difficulty with urination.
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ANSWER

D. Difficulty with urination. The prostate gland lies below the bladder neck and surrounds the ureth
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ra. An increase in the size of the prostate gland caused by BPH compresses the urethra, resulting in
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difficulty initiating the urinary stream.
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QUESTION 6 ms

, What action should the practical nurse (PN) implement first for a client with a head i
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njury and clear nasal drainage?
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A. Obtain a specimen of the fluid for culture and sensitivity.
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B. Check the nasal drainage with a glucose test strip.
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C. Assess the client's temperature every 2 to 4 hours.
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D. Inspect the nares bilaterally for signs of inflammation.
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ANSWER

B. Check the nasal drainage with a glucose test strip. If the client is exhibiting clear nasal drainage a
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fter a head injury, the first action is to determine if the fluid is cerebrospinal fluid (CSF). Glucose is
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present in CSF. ms ms




QUESTION 7 ms




The practical nurse (PN) is monitoring a client who is admitted in active labor. After r
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eviewing the nursing admission assessment, the PN determines the client's membrane
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s have been ruptured for 36 hours. The PN should monitor the client for which risk fa
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ctor?
A. Excessive bleeding.
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B. Precipitous labor.
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C. Supine hypotension.
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D. Intrauterine infection.
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ANSWER

D. Intrauterine infection. When a client is in active labor with spontaneous rupture of membranes (S
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ROM) longer than 24 hours, microorganisms from the vagina can ascend into the amniotic sac and c
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ause chorioamnionitis and placentitis.
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QUESTION 8 ms




Which finding in a newborn is most important for the practical nurse (PN) to report?
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A. Clinical jaundice evident on the forehead within 24 hours of birth.
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B. Icterus color of blanched skin on the thorax at day 3 after birth.
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C. Serum bilirubin concentrations less than 2 mg/dl in cord blood.
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D. Bilirubin level of 4 mg/dl using a transcutaneous bilirubinometry.
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ANSWER

A. Clinical jaundice evident on the forehead within 24 hours of birth. Jaundice is clinically visible wh
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en bilirubin levels reach 5 to 7 mg/dl and appears in a cephalocaudal manner, first noticed in the h
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ead, and then progresses gradually to the thorax, abdomen, and extremities. Clinical jaundice that is
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evident within 24 hours of birth warrants immediate attention and is pathological. Although addition
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al assessments of physiological jaundice should be made, jaundice in the first 24 hours is life threate
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ning and requires immediate intervention.
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QUESTION 9 ms