HU NP121 Fundamentals of PN Exam 2 S26

Question 1 of 60

HU NP121 Fundamentals of PN Exam 2 S26. The practical nurse (PN) is auscultating a client’s lung sounds for adventitious sounds. Which sound should the PN recognize as crackles?

• A crowing noise heard during inspiration over the trachea.
• Superficial grating sounds heard during inspiration and expiration.
• Popping, non musical sounds usually heard on inspiration in the lung bases.
• A bubbling sound heard during inspiration and expiration in the central airways.

Question 2 of 60

The practical nurse (PN) observes an older adult client who is sitting in a chair whose lower legs and feet have become increasingly dusky and red in appearance. Which action should the PN implement first?

• A Measure for knee-high compression stockings.
• B Evaluate the client’s distal capillary refill time.
• C Determine if pain occurs when walking.
• D Elevate the client’s legs and reassess.

---

Question 3 of 60

Twenty minutes after applying a heating pad, the client complains that it no longer feels warm enough. Which action should the practical nurse (PN) take first?

• A Remove the heat source because the maximum benefit has already been achieved.
• B Increase the heat intensity until the client can feel the warmth.
• C Explain that body receptors have adapted to the heat after the first minutes.
• D Return the malfunctioning equipment to maintenance for repair.

---

Question 4 of 60

An ambulatory client with an indwelling urinary catheter is requesting to take a shower for the first time. Which is the best intervention for the practical nurse (PN) to implement?

• A Assist the client with a sponge bath in a chair or the bed.
• B Clamp the catheter and assist the client with a tub bath.
• C Keep the catheter intact and assist the client with a shower. HU NP121 Fundamentals of PN Exam 2 S26
• D Encourage the client to do self care and provide personal care products.

---

Question 5 of 60

The practical nurse (PN) prepares to remove a client’s saline lock. Which supplies should the PN gather? Select all that apply.

• A Small gauze pad.
• B Paper tape.
• C Sterile gloves.
• D Exam gloves.
• E Three mL syringe.

---

Question 6 of 60

While caring for a client’s postoperative dressing, the practical nurse (PN) observes a red and swollen wound with a moderate amount of yellow-green drainage which is malodorous. Given there is a possibility of methicillin-resistant Staphylococcus aureus (MRSA), which is the most important action for the PN to take?

• A Initiate contact precautions.
• B Force oral fluids.
• C Reapply a sterile nonadhesive dressing.
• D Start progressive mobilization.

---

Question 7 of 60

The practical nurse (PN) dons clean gloves to change the tubing on a gravity infusing bag of IV fluid. In which order should the PN implement these procedures? (Place the first action on top and the last action on the bottom.)

1. Assess the condition of the IV site.
2. Loosen tape that secures the existing tubing.
3. Clamp the IV catheter and attach the new tubing.
4. Remove existing tubing and spike new tubing into bag.
5. Unclamp the tubing and IV catheter and begin the infusion.

---

Question 8 of 60

Patient Data

The client is a 73-year-old adult female admitted to the hospital after several days of vomiting and diarrhea from suspected food poisoning.

Nurses’ Notes: Peripheral IV (PIV) inserted and IV fluids of D5W infusing at 125 mL/hour. Focused assessment reveals mucous membranes are dry. Poor skin turgor. Capillary refill 5 seconds. Pulse is weak. Client describes status as, “Feeling very weak and brain is fuzzy.”

Laboratory Results:

• Potassium: 3.4 mEq/L (3.4 mmol/L) — Normal: 3.5 to 5 mEq/L (3.5 to 5.1 mmol/L)
• Serum osmolality: 280 mOsm/kg (280 mmol/kg) — Normal: 280 to 295 mOsm/kg (280 to 300 mmol/L)

Actions to Take: Infuse a bolus of IV fluids Potential Conditions:HyponatremiaParameters to Monitor:Electrocardiogram

---

Question 9 of 60

A client who is a vegetarian chooses brown rice for lunch. To ensure sufficient amounts of the essential amino acids, which additional food should the practical nurse (PN) recommend?

• A Raw carrots.
• B Stewed tomatoes.
• C Pinto beans.
• D Steamed broccoli. HU NP121 Fundamentals of PN Exam 2 S26

---

Question 10 of 60

A client with an indwelling urinary catheter receives a prescription to have the catheter removed. In the initial hours after removal, which assessment is most important for the practical nurse (PN) to perform?

• A Serial blood pressures.
• B Costovertebral tenderness.
• C Voiding patterns.
• D Fluid intake.

---

Question 11 of 60

Before removing the nasogastric tube from a postoperative client, which assessment is most important for the practical nurse to complete?

• A Incisional pain.
• B Body temperature.
• C Bowel sounds.
• D Blood pressure.

---

Question 12 of 60

An older adult male client reports to the practical nurse (PN) that his feet are cold. Before covering the client’s feet, which action should the PN take to assess the client’s feet for objective data?

• A Use warm and cold objects to test the client’s sensory perception while the client’s eyes are closed.
• B Place the palms of the hands on the plantar surface of the client’s feet to palpate skin temperature.
• C Ask the client to flex and extend each foot and compare the joint range of motion of the two feet.
• D Apply the backs of the hands to the dorsal foot surfaces to compare the temperature of both feet.

---

Question 13 of 60

The practical nurse (PN) is inserting a nasogastric tube (NGT) in a client who has a small bowel obstruction. Which distance should the nurse use to determine the length of insertion for the NGT?

• A From the end of the client’s nose to earlobe to xiphoid process.
• B Through the nose, the pharynx, and through the cardiac sphincter.
• C From the client’s earlobe to the epigastrium.
• D From the client’s nose to the umbilicus.

---

Question 14 of 60

The practical nurse observes the IV access site of an older adult client who is receiving an oral anticoagulant. The IV is placed on the back of the right hand. Which assessment finding should be reported to the charge nurse?

• A Bruising that covers the right hand.
• B IV flow rate slows with wrist flexion.
• C Right radial pulse volume of 3+.
• D Inelastic skin turgor on the right forearm.

---

Question 15 of 60

While changing a dressing and irrigating a draining wound with sterile sodium chloride solution, which protective equipment should the practical nurse (PN) use?

• A Sterile gloves to remove the old dressing and apply the new dressing and goggles.
• B Clean gloves to remove the old dressing and apply the new dressing and a mask.
• C Clean gloves to remove the dressing, face shield to protect from splashing during irrigation, and new clean gloves to apply the new dressing.
• D Sterile gloves to remove the dressing and sterile gloves to apply the new dressing.

Question 16 of 60

A client who is receiving continuous feedings at 40 mL/hour is to have the feedings increased by 10 mL/hour every 4 hours until 60 mL/hour is reached. After 4 hours, the practical nurse (PN) determines that the client’s residual volume is 40 mL. Which action should the PN implement?

• A Increase the feeding by 10 mL/hour as prescribed.
• B Inform the charge nurse of the residual amount.
• C Continue at the present rate for four more hours.
• D Stop the feeding completely for the next four hours.

---

Question 17 of 60

A client receives a prescription for 0.9% sodium chloride 3 liters to be infused in 24 hours. How many mL/hr should the practical nurse (PN) program the infusion pump? (Enter numerical value only.) HU NP121 Fundamentals of PN Exam 2 S26

• 125

---

Question 18 of 60

The practical nurse (PN) observes an unlicensed assistive personnel (UAP) feeding a client who is at risk for aspiration after experiencing a cerebral vascular accident (CVA). The PN should recognize which action by the UAP indicates a need for additional reinforcement?

• A Allows 30 minutes of rest before feeding.
• B Places food on the unaffected side of the mouth.
• C Raises the head of the bed to 40 degrees.
• D Positions the head with the chin tilted slightly downward.

---

Question 19 of 60

A client reports feeling numbness and tingling in the extremities. Which action should the practical nurse (PN) implement?

• A Evaluate the serum electrolyte levels.
• B Review the client’s temperature in the last 24 hours.
• C Encourage increased oral fluid intake.
• D Ask the client to move all the extremities frequently.

---

Question 20 of 60

A client who has been restricted to nothing by mouth (NPO) during the immediate postoperative period has progressed to a clear liquid diet. Which food selection should the practical nurse (PN) provide as a snack?

• A Cherry flavored gelatin and apple juice.
• B Grapefruit juice and applesauce.
• C Beef bouillon broth and crackers.
• D Orange flavored ice cream and water.

---

Question 21 of 60

When auscultating a client’s lungs, where should the practical nurse (PN) place the stethoscope first?

• A Lung apex.
• B Sternum.
• C Aortic site.
• D Clavicle.

---

Question 22 of 60

The practical nurse (PN) is caring for a group of clients on a postoperative orthopedic unit. Which client is at greatest risk for skin breakdown?

• A A malnourished 25-year-old client with cerebral palsy who is four days postoperative flexor tendon release.
• B A normal weight 50-year-old adult client who is one week postoperative for hip prosthesis placement.
• C An overweight 65-year-old adult client who is three days postoperative for bilateral bunionectomy.
• D An obese 80-year-old adult client who is up to the bathroom one day after a shoulder rotator cuff repair. HU NP121 Fundamentals of PN Exam 2 S26

---

Question 23 of 60

The practical nurse (PN) applies oxygen at 2 liters/minute via nasal cannula to a client with dyspnea. Thirty minutes later the client’s oxygen saturation reading is 98% and the client continues to report feeling short of breath. Which action should the PN take?

• A Decrease to 1 liter/minute.
• B Increase to 3 liters/minute.
• C Discontinue the oxygen.
• D Continue at 2 liters/minute.

---

Question 24 of 60

In performing a focused assessment, the practical nurse (PN) lifts the client’s skin as seen in the photo. Which should the PN do next?

• A Measure the depth of indentation.
• B Assess the degree of skin elasticity.
• C Observe for swelling and inflammation.
• D Record palpated skin temperature.

---

Question 25 of 60

The practical nurse (PN) reinforces the instructions to turn, cough, deep breathe, and perform dorsiflexion and extension foot exercises for a client who is one day postoperative following an abdominal hysterectomy. Which intervention should the PN implement next?

• A Encourage incentive spirometry every hour.
• B Remove antiembolism stockings.
• C Discontinue the indwelling urinary catheter.
• D Provide liberal PO fluids and progress the diet.

---

Question 26 of 60

To determine decreased arterial circulation to the lower extremities, which action should the practical nurse (PN) include when collecting data about a client’s feet and ankles?

• A Measure capillary refill time.
• B Palpate for pitting edema.
• C Observe for plantar flexion.
• D Assess skin elasticity.

---

Question 27 of 60

To promote recovery for a client who is immobile, which intervention is most important for the practical nurse (PN) to implement while giving a bed bath?

• A Leave the water basin and tell the client to complete the bath.
• B Determine what function the client can complete without assistance.
• C Encourage the family to participate in assisting the client with the bath.
• D Have the client sit on the side of the bed during the bath.

---

Question 28 of 60

Patient Data

The client is a 42-year-old female who had a cholecystectomy.

0900: Returned to room from postanesthesia care unit (PACU). Situation-background-assessment-recommendation (SBAR) communication reveals the client has had no urine output during the anesthesia recovery period. Last void was 8 hours ago. Client positioned in bed. Warm blanket applied for comfort. IV fluids infusing. HU NP121 Fundamentals of PN Exam 2 S26

1045: Client requesting pain medication and informs has the urge to void. Wishes to use bedpan. Voided 75 mL.

1130: Client reporting continues to have the urge to void and feels “wet.” Placed on bedpan. Voided 50 mL. Bladder focused assessment. Palpated and feels full. Bladder scanner applied and revealed 600 mL residual urine.

Actions to Take:Request a prescription for straight catheterPotential Conditions:Urinary RetentionParameters to Monitor:Amount of urine output

---

Question 29 of 60

In collecting data about a client’s feet, the practical nurse compresses the skin on the dorsal surface of the foot. Which observation indicates the presence of pitting edema?

• A Tenting of the skin.
• B Pallor at the site.
• C Swollen veins.
• D Tissue indentation.

---

Question 30 of 60

Which intervention is most important for the practical nurse (PN) to implement when applying an ice pack to a client?

• A Give directions to leave the pack in place.
• B Wrap the bag in place for comfort.
• C Fill the ice pack with crushed ice.
• D Secure a protective cover over the bag.

---

Question 31 of 60

The practical nurse (PN) is discontinuing a client’s intravenous (IV) infusion. Which action should the PN take first?

• A Apply pressure with an alcohol pad or 2×2 dressing to the venipuncture site.
• B Remove the needle in the direction of the vessel.
• C Elevate the extremity and apply tape or a band-aid to the venipuncture site.
• D Clamp the tubing and remove the tape from the insertion site.

---

Question 32 of 60

The practical nurse (PN) plans to administer a PRN dose of loperamide via a client’s gastrostomy tube. The prescribed dose is 3 mg. The label on the medication bottle reads, “Loperamide 1 mg/5 mL.” How many mL should the PN administer? (Enter numeric value only.)

• 15

---

Question 33 of 60

The practical nurse (PN) is caring for a client with a continuous gastrostomy tube (GT) feeding using an enteral pump. Which intervention is most important for the PN to implement?

• A Provide thorough oral care frequently throughout the day.
• B Flush the GT with tap water once every shift.
• C Check the client frequently for diarrhea.
• D Elevate the head of the bed while the feeding is running.

---

Question 34 of 60

The practical nurse (PN) is reinforcing postoperative teaching with a client on ways to prevent constipation. Which information should the PN include?

• A Add fat containing foods to diet to lubricate stools for easier passage.
• B Take oxycodone as scheduled to prevent painful bowel movements.
• C Drink 800 to 1,000 milliliters of fluid daily.
• D Ambulate early and as frequently as possible.

---

Question 35 of 60

A client receives a prescription for potassium chloride 20 mEq/100 mL intravenously to be infused over 4 hours. The practical nurse (PN) should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

• 25

---

Question 36 of 60

A client has a prescription for a mechanical soft diet and is eating the cooked cereal served on the breakfast tray. The client requests a serving of scrambled eggs. How should the practical nurse (PN) respond?

• A Offer additional cereal instead of eggs.
• B Ask if the client would also like bacon.
• C Review the client’s intake and output record.
• D Notify the dietary department of the request.

Question 37 of 60

An older adult client with a stage one sacral pressure wound is discharged with instructions for home care. Which information should the practical nurse reinforce with the client?

• A Change positions every 2 hours.
• B Elevate head of bed 30 degrees.
• C Use wet-to-dry dressings daily.
• D Apply lotion to sacrum.

---

Question 38 of 60

The practical nurse (PN) observes that the area around and above a client’s IV insertion site is swollen, cool, and pale. Which action should the PN take?

• A Keep the area covered for warmth.
• B Assess for fluid volume excess.
• C Prepare to remove the IV catheter.
• D Tape the IV catheter more securely.

---

Question 39 of 60

Which intervention should the practical nurse (PN) implement when providing morning care for an ambulatory client with an indwelling urinary catheter?

• A Remove the catheter while the client takes a shower.
• B Keep the catheter intact while assisting the client with a shower.
• C Provide the client with a sponge bath in a chair or the bed.
• D Assist the client with a tub bath with the catheter clamped.

---

Question 40 of 60

The healthcare provider has prescribed a DASH diet for a client. The practical nurse (PN) is reinforcing client teaching. Which meal selection by the client indicates to the PN that the client understands the prescribed diet?

• A Blackened catfish, dirty rice, red beans, and iced tea.
• B Salami sandwich, potato chips, apple, and lemonade.
• C Sushi salmon, steamed soy beans, brown rice, and green tea.
• D Fried chicken, french fries, pickles, and cherry cola.

---

Question 41 of 60

A client has an IV of 0.9% normal saline with 20 mEq of KCl infusing at 50 mL/hour. The client tells the practical nurse (PN) that the IV site is painful. Which action should the PN take first?

• A Apply a warm pack to the painful area.
• B Observe the appearance of the IV site.
• C Notify the charge nurse of the client’s pain.
• D Stop the IV fluid and remove the IV.

---

Question 42 of 60

A client with a malabsorption syndrome has a low serum calcium level. The practical nurse should monitor the client for which problem?

• A Bruising.
• B Pallor. HU NP121 Fundamentals of PN Exam 2 S26
• C Tetany.
• D Jaundice.

---

Question 43 of 60

When removing the dressing covering a one inch (2.54 cm) pressure injury on a client’s heel, the practical nurse (PN) observes straw colored drainage seeping from the wound. Which description of this finding should the PN include in the client’s record?

• A A stage 1 pressure injury draining serosanguineous drainage.
• B A one inch (2.54 cm) pressure injury on heel draining serous fluid.
• C Pressure injury with a small amount of purulent drainage.
• D Pressure injury at bony prominence with exudate noted.

---

Question 44 of 60

The practical nurse (PN) is inserting a urinary catheter when the tip of the catheter reemerges from the insertion site. Which action should the PN take next?

• A Reposition the legs before reinsertion.
• B Obtain a new catheter.
• C Increase the lighting in the room.
• D Clean the catheter with betadine.

---

Question 45 of 60

Immediately after completing the total bed bath and linen change for an unconscious client, the practical nurse (PN) observes that the client was incontinent with a large amount of liquid feces. Which action should the PN implement?

• A Place incontinent pads around the client’s buttocks.
• B Cleanse any soiled skin and change the soiled linens.
• C Spray a skin protectant around the perineal area.
• D Repeat the total bed bath and complete linen change.

---

Question 46 of 60

The practical nurse is caring for a client who is dehydrated. Which action by the PN is the best assessment of the client’s hydration status?

• A Measure the blood pressure.
• B Take the client’s temperature.
• C Count the pulse rate.
• D Obtain the client’s weight.

---

Question 47 of 60

Which client finding by the practical nurse (PN) requires the most immediate action by the PN?

• A A yellowish color of skin and sclera.
• B Dark brown, velvety skin on back of neck.
• C Bright red, small bleeding spot on neck.
• D Bluish color around lips and mouth.

---

Question 48 of 60

Patient Data

The client is a 44-year-old with cerebral palsy who is nonverbal and has severe intellectual developmental disability. He requires total care at home, which is provided by his two sisters, a home health nurse, and an unlicensed home health aide. The client is currently in the hospital for a lower respiratory infection.

Nurses’ Notes: Noted the client’s clothes and sheets are wet. The client voided approximately 75 mL of urine. The client’s sister says that he usually wears adult diapers at home as he is unable to communicate when he needs to void.

Actions to Take:Place an incontinence containment product under the clientPotential Conditions:Functional incontinenceParameters to Monitor:Skin integrity

Question 49 of 60

The practical nurse (PN) is caring for a client who is receiving enteral nutrition via a nasogastric tube with a daily caloric goal of 1800 calories. The prescribed formula contains 200 calories/240 mL. How many mL of the formula should the client receive to meet daily caloric goal? (Enter numerical value only.) HU NP121 Fundamentals of PN Exam 2 S26

• 2160

Question 50 of 60

Which assessment finding indicates to the practical nurse that a Venturi face mask is producing the desired effect?

• A Decreased breath sounds.
• B Decreased cough frequency.
• C Increased oxygen saturation.
• D Increased cough productivity.

Question 51 of 60

During data collection, the client informed the practical nurse (PN) that the last bowel movement was three days ago. Which actions should the practical nurse (PN) take next? (Select all that apply.)

• A Evaluate the client’s dietary intake and eating patterns.
• B Auscultate the abdomen for bowel sounds.
• C Determine the client’s usual bowel patterns.
• D Obtain a prescription for an enema or suppository.
• E Measure and record the abdominal girth.

Question 52 of 60

The practical nurse (PN) assesses a client receiving a hypertonic full strength tube feeding that is infusing continuously at 50 mL/hour. Which finding is most important for the PN to report to the charge nurse?

• A Gastric residual of 50 mL.
• B Soft, rounded abdomen.
• C Dry mucous membranes.
• D Presence of bowel sounds.

Question 53 of 60

The practical nurse (PN) learns that a client’s Braden scale score has changed from 21 to 17. In response to this change, which instruction should the PN provide the unlicensed assistive personnel (UAP) who is assisting with the client’s care?

• A Assist with ambulating the client to the restroom.
• B Keep the head of the client’s bed elevated.
• C Report any change in the client’s blood pressure.
• D Maintain turning and positioning schedule.

Question 54 of 60

A client is receiving oxygen per nasal cannula at 2.5 L/minute and reports dry mucous membranes. Which intervention should the practical nurse (PN) implement?

• A Provide hard candy.
• B Apply lip balm to lips.
• C Reduce the oxygen flow meter to 1.5 L/minute.
• D Add sterile water to the oxygen humidification canister. HU NP121 Fundamentals of PN Exam 2 S26

Question 55 of 60

An oil retention enema is prescribed for a hospitalized client. The practical nurse (PN) should administer the enema solution at which temperature?

• A The temperature should be higher (110° F or 43° C) than the client’s body temperature.
• B The solution temperature should be determined by the client’s comfort level.
• C The solution should approximate the client’s body temperature (98° F or 36° C).
• D The temperature of the enema is unrelated to the enema’s effectiveness.

Question 56 of 60

A client in fluid volume overload is admitted to the hospital for diuresis. Which focused assessment should the practical nurse (PN) perform to evaluate the client’s fluid balance?

• A Turgor.
• B Weight.
• C Lung sounds.
• D Blood pressure.

Question 57 of 60

Which electrolyte should the practical nurse (PN) recognize as having a direct effect on a client’s blood pressure?

• A Magnesium.
• B Potassium.
• C Calcium.
• D Sodium.

Question 58 of 60

When assessing an older adult client, the practical nurse (PN) notices that an area of reddened skin over the sacrum does not blanch when external pressure is applied. Which intervention should the PN implement?

• A Gently cleanse the area and pat dry.
• B Re-position with no direct pressure on the area.
• C Cover the area with a moist gauze dressing.
• D Massage the area to increase blood supply.

Question 59 of 60

A high protein diet is prescribed for an adolescent client who has a diagnosis of anemia. Which lunch is best for the practical nurse (PN) to offer this client?

• A A cheese sandwich, an apple, and carbonated soda.
• B A hot dog, potato chips, and glass of milk.
• C An egg salad sandwich, carbonated soda, and chocolate cake.
• D A tuna sandwich, chips, juice, and ice cream.

Question 60 of 60

The practical nurse (PN) prepares to provide wound care. In which order should the PN implement these steps? (Place the first action on top and the last action on the bottom.)

• 1. Don a pair of procedure gloves.
• 2. Remove old dressing.
• 3. Remove soiled gloves, perform handwashing, and don new procedure gloves.
• 4. Apply prescribed medications to the wound.