CPNRE qtns

Question 1 of 100

Case InformationCASE 1

Mr. Lamy, 62 years old, is hospitalized with emphysema. He is receiving continuous oxygen therapy by nasal cannula.

QUESTIONS 1 to 5 refer to this case.

Mr. Lamy has just finished his bath when he presents with dyspnea. He sits down, leaning forward slightly. What should the practical nurse do?

1. Increase Mr. Lamy's oxygen flow.

2. Check the oxygen saturation level.

3. Ask Mr. Lamy to take deep breaths.

4. Encourage diaphragmatic breathing. You answered this question correctly.




The next day, the practical nurse teaches Mr. Lamy how to perform breathing exercises for his emphysema. Which one of the following shows that Mr. Lamy has understood the teaching?

1. Mr. Lamy observes his abdominal muscles when inhaling and exhaling.

2. Mr. Lamy counts his respirations while inhaling and exhaling silently.

3. While supine, Mr. Lamy inhales deeply and says the letter "O" on exhalation.

4. While sitting, Mr. Lamy inhales deeply and exhales slowly with

pursed lips. You answered this question correctly.

Question 3 of 100




Which one of the following observations would indicate to the practical nurse the possibility of a respiratory tract infection?

1. Dyspnea and more frequent use of bronchodilators

2. Increasingly laboured respirations with whistling on exhalation

3. Reduced breath sounds and presence of tachypnea

4. A productive cough with purulent secretions

Question 4 of 100




Mrs. Lamy asks for information on emphysema. Which one of the following pieces of information about emphysema is the most important to give Mrs. Lamy?

1. Inform her that Mr. Lamy will have to limit his physical exertion.

2. Encourage her to consult their physician for emphysema screening tests.

3. Explain to her that Mr. Lamy will recover once the drug therapy begins.

4. Let her know that his lung tissue might regenerate if he were to stop smoking.

You answered this question incorrectly.

Question 5 of 100




Mrs. Lamy is Aboriginal. She informs the practical nurse that she and her husband have asked an Aboriginal healer to visit Mr. Lamy. What should the practical nurse do?

1. Inform them it is preferable that only one style of therapy be used at a time.

2. Suggest a meeting between the attending physician and the healer.

3. Discuss with the health care team how to accommodate this visit.

4. Do some reading on traditional Aboriginal beliefs.

END OF CASE 1 You answered this question correctly.

Question 6 of 100


Mr. Robertson, 30 years old, was diagnosed 5 years ago with rapidly progressing multiple sclerosis. He has been married for 8 years and has two children, aged 7 and 5. He has recently been admitted to a long-term care facility because his wife can no longer care for him at home.


What behaviour would indicate to the practical nurse that the disease has progressed beyond its early stages?

1. Choking on solid foods

2. Ataxic gait

3. Report of tingling in extremities

4. Having periodic tremors in extremities You answered this question correctly.

Question 7 of 100




What procedure should the practical nurse implement when using a mechanical sling lift to move Mr. Robertson from his bed to a wheelchair?

1. Instruct him to hold onto the swivel bar during transfer.

2. Position the wheelchair perpendicular to the lift.

3. Place the bed in the lowest position.

4. Ask a coworker to assist in the transfer. You answered this question incorrectly.

Question 8 of 100




Mr. Robertson's two sons visit frequently. Which one of the following responses should the practical nurse give when the 7-year-old son asks what is wrong with his dad?

1. "Your dad has a disease called multiple sclerosis, which is a disease of the nervous system."

2. "Your dad has problems with the way messages are sent from his brain to different parts of his body."

3. "That's a very good question! You should ask your dad."

4. "Can you tell me what your mom or dad have told you about his illness?"

You answered this question correctly.

Question 9 of 100




Which response by the practical nurse would be the most encouraging when Mr. Robertson indicates his desire to be more involved in his care?

1. "Would you like to wash and shave yourself daily?"

2. "We can help you with the goals that you set for yourself."

3. "You can decide how long you would like to stay up in the wheelchair."

4. "I am glad you want to participate in your care."

END OF CASE 2 You answered this question incorrectly.

Question 10 of 100


Sean is an 8-month-old infant who is fed via a gastrostomy tube. He is brought to the hospital with diarrhea and dehydration.


Sean's diarrhea has increased. Which sign exhibited by Sean should the practical nurse report immediately?

1. Depressed fontanel

2. Flushed face

3. Heart rate of 110 beats/min

4. Respiratory rate of 34 breaths/min

Question 11 of 100




What should the practical nurse do to maintain Sean's fluid intake?

1. Administer the ordered electrolyte solution.

2. Give high-glucose juices frequently.

3. Administer larger quantities of the usual tube-feeding solution.

4. Give small amounts of milk at least once every hour. You answered this question correctly.

Question 12 of 100




Sean's rectal temperature is 37.5 ºC. He has also developed an irritated rectal area. Which one of the following should the practical nurse consider when planning Sean's morning bath?

1. A tub bath would soothe his irritated skin.

2. A bed bath should be performed to maintain the gastrostomy tube patency.

3. A tepid sponge bath would decrease his temperature.

4. A bed bath should be performed to maintain medical asepsis.Question 13 of 100




Sean's gastrostomy tube site is leaking gastric contents. What should the practical nurse do to prevent irritation of the skin at the tube site?

1. Apply minimal traction to the tube to prevent leakage.

2. Maintain a central position of the tube in the opening.

3. Protect the surrounding skin from drainage.

4. Cleanse the skin surrounding the tube daily.Question 14 of 100




Sean's mother is unable to visit for long periods, and Sean cries when she is not there. What should the practical nurse do to best communicate care and concern to Sean?

1. Provide Sean with a cuddly teddy bear.

2. Distract Sean with a colourful mobile.

3. Stroke Sean's head and upper back.

4. Ask a volunteer to sit with Sean.Question 15 of 100


Sean is an 8-month-old infant who is fed via a gastrostomy tube. He is brought to

the hospital with diarrhea and dehydration.


Sean is having fewer stools per day, and his hydration status is improving. Which documentation by the practical nurse would best indicate Sean's progress?

1. Two formed yellow stools, mucous membranes moist

2. Less frequent stools, turgor improved over yesterday

3. Stools small and partially formed, mucous membranes intact

4. Three less stools today, skin returns immediately after pinching

END OF CASE 3Question 16 of 100


Mr. Whitney, 53 years old, is admitted to a surgical unit following an open reduction of a fractured right tibia resulting from a motor vehicle crash.


Mr. Whitney is 1 day postoperative and has a right leg cast. What priority postoperative assessments should the practical nurse perform?

1. Pain, level of consciousness, intake and output, peripheral neurovascular status

2. Vital signs, pain, intake and output, chest assessment, bowel sounds

3. Pain, bowel sounds, level of consciousness, vital signs

4. Vital signs, pain, chest assessment, peripheral neurovascular statusQuestion 17 of 100


Mr. Whitney, 53 years old, is admitted to a surgical unit following an open

reduction of a fractured right tibia resulting from a motor vehicle crash.


The practical nurse notes from the preoperative records that Mr. Whitney smokes. He is receiving narcotic analgesia. Which postoperative teaching would be most important?

1. Range-of-motion exercises

2. Incentive spirometry

3. Adequate fluid intake

4. Activities of daily livingQuestion 18 of 100




During care, Mr. Whitney states "I am worried I will become constipated." What is the most appropriate response for the practical nurse to make?

1. "Don't worry. It is unlikely you will become constipated."

2. "We can give you a suppository now if you think you need it."

3. "We have a bowel protocol that will help you stay regular."

4. "Let us know when you are uncomfortable and we can give you a laxative."Question 19 of 100




Mr. Whitney rings the call bell and states, "My leg hurts more than before and feels numb." Upon assessment, the practical nurse notes pallor and coolness of the toes of the right foot. What should the practical nurse do?

1. Elevate the affected extremity on pillows.

2. Encourage range-of-motion exercises of the affected extremity.

3. Make certain the physician is notified of the assessment findings.

4. Administer p.r.n. analgesic as ordered.Question 20 of 100




Mr. Whitney is preparing for discharge. He states, "I don't know how I will manage with my crutches as my home has many stairs." What should the practical nurse do?

1. Give Mr. Whitney written instructions on how to use crutches and allow time for him to practise crutch walking prior to discharge.

2. Provide a video demonstrating the correct technique and suggest he avoid using the stairs for a few days.

3. Reinforce use of crutches, provide written instructions, and have Mr. Whitney demonstrate techniques prior to discharge.

4. Arrange for a physiotherapist to visit Mr. Whitney at home to provide crutch-walking instructions in the home environment.

Question 36 of 100

Mrs. MacDonald, 34 years old, delivered a baby 1 day ago. Which of the following findings would indicate that the client is at risk for hemorrhage?

1. Firm fundus and foul-smelling lochia

2. Soft fundus positioned to the left of the umbilicus

3. Lochia rubra contains small clots

4. Heavy lochia flow when first standing up You answered this question incorrectly. Question 37 of 100

Mrs. Stein, 39 years old, had a hysterectomy yesterday. Her employer has stopped by the unit to visit but finds her sleeping. The employer asks, "Will Mrs. Stein be discharged tomorrow?" How should the practical nurse respond?

1. "If Mrs. Stein is a typical hysterectomy client, she will stay in hospital for at least 2 days."

2. "You should ask Mrs. Stein that question when she wakes up."

3. "I don't think it is appropriate for you to ask that question about Mrs. Stein."

4. "With earlier discharges, Mrs. Stein should go home this evening."


Question 38 of 100

Mr. Napolski, 78 years old, has Type I diabetes mellitus. The practical nurse mistakenly provides him with another client's meal. Which action best indicates that the practical nurse has assumed accountability?

1. Monitors for an adverse reaction.

2. Adjusts Mr. Napolski's diet.

3. Reports the incident.

4. Documents tolerance of the meal.


Question 39 of 100

A client's intravenous therapy is to be discontinued. Which is the most appropriate action for the practical nurse to take to remove his IV?

1. Apply pressure, clamp IV, loosen tape, glove, and remove cannula.

2. Clamp IV, glove, loosen tape over site, remove cannula, and apply pressure with gauze.

3. Loosen tape over site, obtain alcohol swab, glove, remove cannula, and apply pressure.

4. Clamp IV, obtain gauze, loosen tape over site, glove, and remove cannula.


Question 40 of 100

A resident on an Alzheimer unit is periodically verbally and physically aggressive toward other residents and staff. What should the practical nurse, as the case manager, do?

1. Call the resident's family and have a conference about the resident's aggressive behaviour.

2. Encourage frequent rest periods for the resident and provide soothing music.

3. Have the staff observe and document the resident's behaviour over a 1-week period.

4. Contact the resident's physician and obtain an order for a sedative to be given p.r.n.


Question 41 of 100

When giving a medication to a 46-year-old male client by the intramuscular route in the deltoid site, what is the maximum volume that can be administered in one injection?

1. 0.5 ml

2. 1.0 ml

3. 2.5 ml

4. 3.0 ml You answered this question correctly. Question 42 of 100

Which one of the following describes auscultation?

1. Listening to body sounds produced by the heart, lungs, and abdomen using a stethoscope

2. Visually examining body parts using an otoscope and an ophthalmoscope

3. Tapping the body with fingertips to help identify location, size, and density of underlying structures

4. Using touch to assess tenderness, texture, temperature, moisture, and organ location


Question 43 of 100

Mr. Jenkins, 28 years old, is admitted for surgery and is reluctant to take pain medication due to a previous drug addiction. How should the practical nurse address this issue?

1. Administer pain medication as ordered.

2. Discuss potential of addiction with short-term pain management.

3. Encourage use of pain medications.

4. Explain the consequences of unmanaged pain in the healing process.


Question 44 of 100

The practical nurse is preparing medications for clients on a busy gerontological unit. Two clients have wandered into the medication room and a family member is requesting to speak to the practical nurse. What should the practical nurse do?

1. Concentrate carefully on the medication orders.

2. Take the family member and the clients to another room and speak with them.

3. Escort the two clients out of the room and ask the family member to come back later.

4. Ask the two clients to remain quiet while the medications are being prepared.


Question 45 of 100

Mrs. Armstrong, 72 years old, has no family but feels a special bond with the practical nurse. She asks if the practical nurse could visit on days off. How should the practical nurse respond?

1. Agree to occasional visits with Mrs. Armstrong on days off.

2. Explain to Mrs. Armstrong that visits are possible at work but not on days off.

3. Tell Mrs. Armstrong that visiting on days off is not encouraged.

4. Request that the nurse-in-charge discuss the situation with Mrs. Armstrong.


Question 46 of 100

A mechanical lift is needed to transfer an 85-year-old dependent male client. Before using the mechanical lift, which one of the following measures is most important for the practical nurse to consider?

1. Have a second staff member available to assist with the transfer if necessary.

2. Ensure that all the hooks or straps are in place before beginning the lift.

3. Be familiar with the mechanical lift and how it functions.

4. Have the client centred on the lift so there is no risk of injury.

You answered this question incorrectly

Question 47 of 100

Mrs. Jabour is receiving a vasodilator. Which of the following clinical manifestations should the practical nurse report immediately?

1. Orthostatic hypotension

2. Blurred vision

3. Decreased appetite

4. Dry mouth and constipation

You answered this question correctly

Question 48 of 100

Mrs. Kraemer, 67 years old, has chronic obstructive pulmonary disease and is receiving oxygen therapy via nasal cannula. What should the practical nurse do first?

1. Verify the oxygen flow rate is as ordered.

2. Ensure the humidification container has sufficient water.

3. Check the positioning of Mrs. Kraemer's nasal cannula.

4. Observe Mrs. Kraemer's nares for skin or mucous membrane breakdown.


Question 49 of 100

Which action by the practical nurse is the most appropriate before administering digoxin (Lanoxin)?

1. Take the radial pulse for 30 seconds.

2. Take the apical pulse for 1 minute.

3. Check the blood pressure.

4. Check the vital signs. You answered this question incorrectly.

Question 50 of 100

Mr. Roads, 66 years old, has just been informed that he has tested positive for human immunodeficiency virus (HIV). Which one of the following responses by the practical nurse would demonstrate emotional support for Mr. Roads?

1. "Most people with HIV continue to work for many years."

2. "Everyone is at risk to contract this virus."

3. "Would you like me to sit with you for a while?"

4. "Would you like some informative pamphlets to read?" You answered this question correctly.

Question 21 of 100

INDEPENDENT QUESTIONS

QUESTIONS 21 to 100 do not refer to a case.

Mrs. Anderton, 42 years old, is awaiting transfer to another unit. While walking to the washroom, she feels dizzy and faints. After ensuring client safety, which action by the practical nurse is most appropriate?

1. Chart as soon as possible after the incident.

2. Chart incident after completing morning care.

3. Complete incident report at the end of shift.

4. Report the incident to the registered nurse at shift change. You answered this question incorrectly.Question 22 of 100

Mr. Desjarlais, 66 years old, has anemia and congestive heart failure. He is receiving three units of packed cells over 8 hours. Which of the following assessments would indicate a complication related to the rate of transfusion for Mr. Desjarlais?

1. Visible pulsations of the aorta in the lower abdomen

2. Urticaria on lower legs and across anterior chest

3. Generalized fatigue and nausea verbalized

4. Crackles noted on auscultation of lungs You answered this question correctly.Question 23 of 100

While on rounds at the nursing home, a practical nurse observes a colleague reprimand a client. Which nursing intervention must the practical nurse perform?

1. Call the colleague aside and suggest that the client deserves an apology.

2. Report the incident to a supervisor immediately and document.

3. Ask the colleague why the client was reprimanded and document the response.

4. Reassure client and discuss the reprimand incident with the colleague. You answered this question incorrectly. Question 24 of 100

Mary, 12 months old, has been admitted to a pediatric unit with an acute asthma attack. Upon assessment, the practical nurse notes bruises in various stages of healing. What should the practical nurse do next?

1. Inform the nurse-in-charge.

2. Notify child protection services.

3. Discuss in shift report.

4. Talk with a coworker. You answered this question correctly.Question 25 of 100

The practical nurse is caring for a 69-year-old immobile client with a large pressure ulcer on the coccyx. The dressing change is ordered b.i.d. This morning, a small area of the dressing is soaked. What is the best intervention for the practical nurse to take?

1. Request an order for an increase in the frequency of dressing changes.

2. Place incontinence briefs on the client and put extra pads on the bed.

3. Apply plastic tape over the dressing to prevent leaking.

4. Proceed with the dressing change and apply extra gauze. You answered this question correctly.Question 26 of 100

Mrs. Wong, 91 years old, suffered a stroke many years ago and requires a geriatric chair when out of bed. How should the practical nurse position Mrs. Wong in this chair?

1. In lateral position, supported with a pillow against her back

2. In semi-Fowler's position with her affected side supported by pillows

3. In an upright position with pillows under her feet

4. In supine position, with her affected hand positioned with a splint You answered this question correctly. Question 27 of 100

Ms. Toth, 45 years old, had a knee replacement and has one unit of whole blood transfusing. Which finding would indicate an adverse reaction?

1. Chills, fever and flushing of face

2. Hypoxia, tachypnea and tachycardia

3. Dyspnea, tachypnea and chest pain

4. Jaundice, ascites and edema You answered this question correctly. Question 28 of 100

While 73-year-old Mr. Brown is being admitted to his room in the nursing home, he notices his roommate being rushed to the hospital. Mr. Brown asks about the health of his new roommate. How should the practical nurse respond?

1. "You can ask your new roommate about his condition when he returns."

2. "I can appreciate your concern, but I need to complete your admission."

3. "I can see you're worried, but I can't share any client information without permission."

4. "Your roommate has been ill for a long time and had to be admitted to the hospital."


Question 29 of 100

Mr. Branch, 67 years old, is diagnosed with prostate cancer and is worried about his future. He has had a colostomy for many years, has difficulty voiding, and does not sleep well. Which one of the following nursing interventions should be included in his plan of care?

1. Arrange for a private room to help him sleep.

2. Perform a catheterization to measure residual urine.

3. Ask a clergy member to visit so he can verbalize his feelings.

4. Offer him the opportunity to express his concerns further.


Question 30 of 100

Mr. Gosling, 37 years old, was admitted to the medical ward 2 days ago with cellulitis of his left arm. Mr. Gosling has never been in hospital before and is unsure of what to expect. How should the practical nurse involve the staff and Mr. Gosling in planning care?

1. Ask Mr. Gosling how he would like his care performed.

2. Schedule a team conference to include Mr. Gosling.

3. Discuss Mr. Gosling's care in the change of shift report.

4. Develop a care plan using information from Mr. Gosling.


Question 31 of 100

While monitoring a blood transfusion, the practical nurse assesses the vital signs and notes that the client's temperature has gone from 37.2 to 38.5 ºC. The client is experiencing no other symptoms. What is the most appropriate action by the practical nurse to take?

1. Continue monitoring for other symptoms.

2. Notify the team leader to discontinue the transfusion.

3. Notify the physician immediately.

4. Encourage the client to drink extra fluids.


Question 32 of 100

Mr. Grimstead, 78 years old, is admitted to the hospital with pneumonia. He is accompanied by his daughter who cares for him. Mr. Grimstead tells the practical nurse, "I'm not really sick enough to be here. I just have a little cough." How should the practical nurse initially plan his nursing care?

1. Discuss Mr. Grimstead's care with his daughter.

2. Request an interdisciplinary conference to develop the care plan.

3. Involve Mr. Grimstead in determining goals of care.

4. Review the standardized care plan for a client with pneumonia.


Question 33 of 100

David, 4 years old, fell while running with a pair of scissors. After hearing the cries for help, the practical nurse arrives to find David on the floor with the scissors in the left side of his chest with no visible bleeding. What is the most important fact about a puncture wound for the practical nurse to consider at this time?

1. Removal of the scissors could start uncontrolled bleeding.

2. Bleeding from the puncture wound will remove microorganisms.

3. Pressure should be exerted on the wound to control bleeding.

4. Elevating the head will prevent hypovolemic shock.


Question 34 of 100

Mr. Martin, 70 years old, is sitting in an armchair that is too low for him. How should the practical nurse promote Mr. Martin's comfort and correct body alignment?

1. Have him stand, and place a pillow on the seat of the chair.

2. Have him sit forward, and place a pillow behind his back.

3. Make a note on the nursing care plan that his chair is not suitable.

4. Elevate his feet on a footstool.


Question 35 of 100

The practical nurse is about to perform perineal care on Mr. Wall. What should the practical nurse do initially to demonstrate respect for Mr. Wall?

1. Provide privacy for him.

2. Demonstrate competence in performing the procedure.

3. Ask him to perform the procedure.

4. Adhere to the principles of medical asepsis. You answered this question correctly.

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