National Council Licensure Examination for Practical Nurses Free Sample Questions

The priority action is to hold the digoxin and notify the RN. The client's potassium level of 3.1 mEq/L indicates hypokalemia. Furosemide is a loop diuretic that excretes potassium, which is the likely cause. Hypokalemia significantly increases the risk of digoxin toxicity, even with a therapeutic digoxin level. Administering the digoxin could lead to life-threatening arrhythmias.

The primary purpose of the bowel preparation solution is to induce diarrhea to completely cleanse the colon of all fecal matter. This is essential for the physician to have a clear and unobstructed view of the entire mucosal lining of the colon during the colonoscopy, allowing for accurate detection of polyps or other abnormalities.

Adolescents are highly focused on peer groups and social activities. Providing practical strategies for managing their diabetes in these settings is critical for adherence and psychosocial well-being.

Hypoglycemia is an acute, life-threatening complication of insulin therapy. The adolescent must be able to recognize the symptoms and know how to treat it immediately for their safety.

Adolescents have variable schedules, activity levels, and eating habits. Teaching them the basic principles of matching insulin to their lifestyle empowers them to manage their blood glucose effectively and safely.

While all other actions are important parts of the admission process, the first priority is to ensure the resident's end-of-life wishes are respected. This involves verifying the DNR order, communicating this status to all staff (e.g., via the chart, wristband, room signage as per policy), and ensuring it is correctly entered into the facility's records. A delay in this critical step could lead to unwanted and invasive procedures in an emergency.

This response is the most therapeutic. It validates the client's feelings (fear) without validating the hallucination itself. It gently presents reality ("I don't hear any voices") and then opens the door for communication and offers the nurse's presence for support. This approach helps build trust and reduces the client's anxiety.

The client is showing clear signs of opioid-induced respiratory depression, a medical emergency. The absolute priority is to address the client's breathing and level of consciousness. Attempting to arouse the client (e.g., sternal rub) can stimulate the respiratory drive. While other actions like stopping the PCA and calling for help are also critical, the first, immediate action is to stimulate the client to breathe.

The child is in severe respiratory distress, indicative of status asthmaticus. The immediate priority is to open the airways. While notifying the RN/provider and applying oxygen are essential, administering a fast-acting bronchodilator via nebulizer is the most direct and crucial intervention to relieve bronchospasm and improve air exchange. This can be done concurrently while calling for help and applying oxygen.

The hemoglobin A1c of 9.2% indicates prolonged, poor glycemic control. Hyperglycemia impairs leukocyte function, reduces collagen synthesis, and compromises peripheral circulation, all of which are critical for wound healing. While neuropathy (lack of pain) and infection (drainage) are related problems, the underlying hyperglycemia is the most significant systemic factor preventing the wound from healing properly.

The daughter is expressing distress and fear. The most appropriate initial response is therapeutic: acknowledge her feelings, validate her concern, and open a conversation. This empathetic approach builds trust and allows the LPN to gather more information about the family's understanding and goals of care, which can then be communicated to the RN and the interdisciplinary team for a comprehensive discussion about feeding options and end-of-life care.

This statement is true. The 30-degree lateral position avoids direct pressure on the trochanter (hip bone), sacrum, and ischium, which are common sites for pressure injury development. The 90-degree side-lying position places intense, direct pressure on the trochanter, significantly increasing the risk of tissue damage.