Exhibit Figures1. The practical nurse sees this monitor strip on an unresponsive, pulseless adult. Which action is the priority?A. Start high-quality CPR and prepare for defibrillationB. Give atropine 1 mg IV as the first drug because the rate looks irregularC. Call the family to the bedside before touching the client so consent is witnessedD. Silence the alarm and recheck the lead in 10 minutes because artifact is likelyCheck
Exhibit Figures2. The client is pulseless. This strip is confirmed in two leads. Caption: after a few QRS complexes the remainder is a flat asystole line. Which action is correct?A. Defibrillate at 360 J immediately because any flat-looking line is VFB. Start CPR and follow asystole/PEA drug and reversible-cause steps; do not defibrillate asystoleC. Give a fluid bolus only and wait for a pulse check in 5 minutesD. Apply transcutaneous pacing as the first and only intervention — that shortcut delays the indicated nursing actionCheck
Exhibit Figures3. A monitored client is dizzy. This strip is obtained. What should the practical nurse do first?A. Give a scheduled oral beta blocker now to "slow the extra P waves"B. Document "sinus tachycardia with frequent PVCs" and continue hourly roundsC. Stay with the client, obtain vital signs, and notify the provider of complete (third-degree) atrioventricular blockD. Encourage ambulation to the bathroom to raise the heart rate — that shortcut delays the indicated nursing action — that shortcut delays the indicated nursing actionCheck
Exhibit Figures4. This 12-lead tracing is from a client who is talking, with blood pressure 128/74 mm Hg and no chest pain or syncope. Which action is most appropriate?A. Give atropine immediately because any rate under 60 bpm is an emergencyB. Defibrillate because bradycardia can become VF without warningC. Start a dopamine infusion independently without an order — that shortcut delays the indicated nursing actionD. Continue assessment and report the tracing; atropine is not automatic in asymptomatic sinus bradycardiaCheck
Exhibit Figures5. This sacral area is photographed during turning. Persistent maroon-purple discoloration predominates; a small epidermal break may be present, and fat or bone is not exposed. How should the practical nurse document this injury?A. Deep-tissue pressure injury (persistent maroon-purple discoloration)B. Stage 1 because any color change is nonblanchable redness onlyC. Stage 2 because a tiny epidermal break always means partial-thickness injuryD. Stage 4 because the sacrum is a bony prominenceCheck
Exhibit Figures6. The unit uses this CDC donning sequence poster. Which step is last before entering a contact-plus-droplet room?A. Gloves first so the other PPE stays sterileB. Gloves, so they cover the gown cuffsC. Mask last after walking through the doorwayD. Shoe covers only, skipping gloves if hands were just sanitizedCheck
Exhibit Figures7. This sign is on the closed door. The client has suspected pulmonary tuberculosis. Which personal protective equipment is required for the practical nurse who must enter?A. A surgical mask only, because the sign mentions "precautions" in generalB. Gown and gloves only; no mask if the visit is under 2 minutesC. A fit-tested respirator (N95 or equivalent)D. No respirator if the client wears a mask in bedCheck
Exhibit Figures8. Two teaching posters are used at discharge and during fire drill review. Left: gait. Right: extinguisher. A client with a weak right leg is taught cane use. Separately, after RACE rescue and alarm for a small contained basket fire, which pairing is correct?A. Hold the cane on the weak right side so it "guards the bad hip," and squeeze the extinguisher before pulling the pinB. Walk with furniture instead of a cane, and aim the extinguisher at the top of the flamesC. Skip the cane on carpets, and use PASS before moving the client from the fire — that shortcut delays the indicated nursing action — that shortcut delays the indicated nursing actionD. Hold the cane in the stronger (left) hand; if fighting the small fire is allowed, use PASS: Pull, Aim at the base, Squeeze, SweepCheck
Exhibit Figures9. The practical nurse reviews this 12-lead tracing from a client with crushing chest pain. Which action is the priority?A. Stay with the client, apply oxygen if hypoxic as ordered, and notify the provider immediately of ST-elevation infarction patternB. Wait for the next scheduled troponin in 6 hours because enzymes confirm infarction before any callC. Give a routine oral antacid and recheck the tracing tomorrow — that shortcut delays the indicated nursing action — that shortcut delays the indicated nursing actionD. Defibrillate at once because ST elevation means ventricular fibrillationCheck
Exhibit Figures10. This Lead II strip is obtained. The client is unresponsive and pulseless. Caption: small Lead II crop of regular wide-complex tachycardia; treat as pulseless VT given this stem. Which action is correct?A. Give atropine first because the QRS looks wideB. Start CPR and defibrillate for pulseless ventricular tachycardiaC. Obtain a 12-lead while the client remains pulseless before any compressionsD. Cardiovert at 10 J only, then wait 5 minutesCheck