ACTUAL EXAM 82 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
|ALREADY GRADED A+
The practical nurse is caring for a 6 year old girl who had surgery
12 hours ago. The child tells the PN that she does not have pain
but a few minutes later, tells her parents that she does. What child
development concept is relevant to this situation?
a) inconsistency in pain reporting suggests that pain not present
b) a child may have pain yet deny its presence to the nurse
c) truthful reporting of pain should occur by this age
d) children use pain experiences to manipulate their parents -
ANSWER-Answer: B
Rationale:
A child may fear receiving an injection for pain or may believe that
pain is a deserved punishment for some misdeed, so the pain is
denied (D) when the nurse asks the child, who then readily admits
having pain to a parent. This behavior should not be interpreted
as (C) but as a valid indication of pain. (A and C) are incorrect
interpretations of this behavior.
A 6 year old who had a tonsillectomy 12 hours ago is complaining
of thirst. What should the practical nurse (PN) offer?
,a) popsicle
,b) lemonade
c) orange juice
d) chocolate milk - ANSWER-Answer: A
Rationale:
Small amounts of clear liquids without red dyes should be offered
to the child. Popsicles (A) are cold and help soothe a dry throat.
Citrus drinks (B and C) are acidic and irritate the operative site in
the posterior oropharynx. Milk (D) thickens oral mucus which
makes swallowing more difficult and causes coughing.
The mother of a male newborn calls the clinic to inquire about the
formation of a yellow crust over her son's circumcision area. What
information should the practical nurse (PN) provide?
a) do not remove the yellow crust from the site
b) stop using petroleum around the head of the penis
c) bring him into the clinic
d) tightly fasten the diaper - ANSWER-Answer: A
Rationale:
Crust formation is part of the healing process and should be
removed (A). (C) is not indicated at this time. The diaper should
, be fastened loosely, not tightly (D) which can place pressure on
the incision site. (B) assists in the healing process and should not
be discontinued.
The mother of a child with croup is having barking, coughing
episodes calls the clinic for assistance. What action should the
practical nurse (PN) recommend that the mother implement first?
a) take the child outside in the cool air
b) bring the child directly to the emergency room
c) sit with the child in bathroom with a hot shower running
d) have the child drink plenty of fluids - ANSWER-Answer: C
Rationale:
Croup (laryngotracheobronchitis) is a viral infection that causes a
"barking" cough and varying degrees of inspiratory stridor, which
often responds to a high humidity environment. Most children can
be managed at home using the stream from a hot shower in a
closed bathroom (C) which often stops laryngeal spasm.
Increasing the child's fluid intake is important (D), but not a priority
at this time.Although exposure to cold air (A) also relieves stridor,
parents should be encouraged to use mist humidifier in the child's
room. (B) is not necessary unless the child is having increasingly
difficulty breathing that may lead to a compromised airway.