Canadian Practical Nurse Registration Examination (CPNRE) 3rd EDITION EXAM ANSWER KEYMrs. Campbell, 73 years old, is diagnosed with right breast cancer and admitted to the medical unit. She is now undergoing radiation therapy on her right breast. 1. The health care team has established a goal to maintain skin integrity at the radiation site. Which of the following actions would meet this goal when bathing Mrs. Campbell? a. Antiseptic soap is too harsh on the fragile skin. b. Gentle wash with water will assist with maintaining skin integrity. Mild or gentle soaps (dove or ivory) can be used. c. Contraindicated on irradiated area. d. Contraindicated on irradiated area 2. Which nursing intervention is appropriate for the practical nurse to do following Mrs. Campbell’s right mastectomy? a. Only the right arm must be elevated to decrease edema and promote drainage. b. Safe to obtain BP from left arm; this does not jeopardize client safety. c. Unsafe; this can restrict circulation and increase the risk of injury and infection to arm. d. Hourly exercise may be too frequent. Right arm requires regular exercise. 3. The treatment plan for Mrs. Campbell includes a slow-release dermal analgesic (Fentanyl) patch. Which of the following actions is most appropriate for the practical nurse to take? a. The client can shower if she wishes since the patch is waterproof and left on for 72 hours. b. It should be a different site to prevent potential skin irritation. Site should be washed when removing old patch. c. The patch should not be trimmed or cut since this changes the medication. d. Securing correctly ensures patch efficiency and durability. Pressing other than around the edges may cause immediate release of medication and potential patch malfunction. 4. Mrs. Campbell has a right mastectomy. The practical nurse has just assessed Mrs. Campbell after receiving her from the recovery room. She is moaning and restless. Which of the following goals should be the first priority? a. Pain must be relieved before dressing (skin), education (teaching) or anxiety can be dealt with. b. Not a priority when the client is in pain. c. Pain is the priority. d. Pain is the priority. 5. A personal care aide is assisting Mrs. Campbell with her morning care. The practical nurse arrives to give Mrs. Campbell her morning medication and observes that Mrs. Campbell is wearing a tight polyester shirt. What should the practical nurse do? a. This may be offensive to the personal care aide. b. No direction provided to the personal care aide. c. Offers an explanation, providing an understanding, motivational, courtesy to the health care aide out of the client’s presence. d. No explanation provided to the personal care aide. CASE 2 Sally, 17 years old, has come to the clinic with symptoms of gonorrhea. 6. Tom is the practical nurse working with Sally. What should Tom consider prior to completing a health history with Sally? a. Past history is not much of a concern as sexual history. b. Sally’s parents do not have to be present. c. Revealing information about one’s sexuality is usually difficult, especially with a member of the opposite sex.
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