RPN Integrated Post Test IV (A):
1. The PN is teaching a breastfeeding client how to care for breast engorgement. Which statement
indicates that the client has not understood the information?
a. ―I’ll use massage to soften my breast‖
b. ―I will use warm packs or take warm shower to ease my breast engorgement‖ – this is an
appropriate way of treating breast engorgement
c. ―If the baby only feeds on one side, I will express milk on the other side‖ – this is correct
d. ―If my breasts are uncomfortable, I will limit the time I breast the baby‖
Answer: A – breast engorgement is treated with warm compresses and emptying the breast if the mother is planning to breastfeed while cold compresses application if the mother is planning to breastfeed; breast binder or well-fitting bra are additional treatment for both breast and not breastfeeding mothers
th2. On the 10 post partum day, a breastfeeding primiparous client is diagnosed with mastitis. The PN
teaches her about self-care for this condition. Which statement indicates that the client understands
a. ―I should continue to breastfeed unless it becomes too painful‖—breastfeeding will help
open milk ducts which help decreased the swelling in mastitis
b. ―I should stop breastfeeding for several days‖ – the mother is allowed to breastfeed
c. ―I shouldn’t breast feed as long as I am on antibiotics‖ – the mother is allowed to breastfeed
even if taking antibiotics; the infant is well-protected from the antibodies transferred from the
mother during the last trimester of pregnancy and during placental separation
d. ―Mastitis may be associated with breast cancer in later life‖ – this is not correct
3. Which information must be communicated to the mother of a pyloric stenosis newborn:
a. Pyloric stenosis is due to a recessive gene carried by parents – pyloric stenosis is
b. Boys carry the gene and tend to develop the disease – both gender carry the gene; incidence is
higher in boys than girls
c. This disease can be cause by breastfeeding – this is not supported by science
d. Most cause of diarrhea among newborns – pyloric stenosis causes constipation
4. A high school suggests that there is no time to teach proper and safe sex education. How would the
PN promote sex education if high school has no time?
a. Distribute pamphlets to all grades
b. Initiate an after school program session –this will be a better time for students to attend
c. Tell an anonymous website
d. Program teaching to every first year high school class
5. A 72-year old mother, taken cared by her daughter at home, has incontinence episodes. Which of
the following health teachings on promoting skin integrity provided by the PN to the patient’s
daughter is most appropriate?
a. Teach the daughter to wash the patient with soap and water after each urination.—this
prevents skin breakdown
b. Instruct the daughter to wash and apply skin barrier and incontinent pad –skin barrier is not
applied to an intact skin
c. Encourage the daughter to frequently reposition the patient- this prevents skin breadown
d. Teach the daughter to wash, clean, dry, apply skin barrier, pads and reposition the patient.
6. A woman with a boyfriend diagnosed with gonorrhea got pregnant. She was concerned that her
boyfriend’s disease may greatly affect the growing fetus. What would be the best nursing
a. Pelvic inflammatory disease (PID) could predispose to preterm delivery.
b. It will cause abnormality and birth defects.
c. It would affect the pregnancy, you should consult the doctor.—gonorrhea may cause
damage to the growing fetus
d. It is a recurrent disease.
7. On her way to work, the nurse who is sitting at the back of the car, has witnessed a motor
vehicle accident. What would the nurse do?
a. Stop the car and assess the situation. – calling for help and assessment of the situation
would be the right initial intervention
b. Call 911 while attending to the most injured person.
c. Slow down the speed of the car and call 911.
d. Stop the car and attend to clients with head injuries.
8. The PN working in the community is teaching high school students and one of them says, ―Fuck
this‖ and points the pencil at the PN. How would the PN assure her safety? a. Report the student to the principal –the student is under the jurisdiction of the school
b. Reprimand the student
c. Confront the student about his unacceptable behavior
d. Get out of the classroom
9. Gary, with IDDM, was discharged to home, He left his medic alert card in the hospital. He has an
appointment in two weeks at the DM clinic. What should the PN do? a. call and tell him to pick up his card – the patient should be responsible for getting his
b. ask the home care nurse to give his card
c. send it by mail
d. forward the card to the outpatient clinic and instruct to give it to him at his clinic visit
10. At the Long Term Facility, the PN is performing a fall-risk assessment on an elderly client with
history of osteoporosis. The PN should collect related information on: a. Client’s gait and balance – unbalanced gait can be a common cause of fall among
b. The agency’s restraints policy
c. The family psychosocial history
d. The client’s dietary preferences
11. At the accident scene, top priority for the client who sustained blunt chest trauma after a motor
vehicle accident would be:
a. Assess client’s airway -- follow ABC when dealing with emergency
b. Place him in fowler’s position
c. Encourage deep breathing and coughing
d. Splint the chest
12. An obese client comes to the physician’s office for a routine physical examination. The PN
chooses a standard blood pressure cuff to monitor the patient’s BP. If a BP cuff is too small for the
client, BP readings taken with such cuff may do which of the following? a. Fail to show changes in the BP
b. Produce a false-high measurement -- more pressure is applied on the patient’s arm
when the smaller BP cuff is inflated, thus, BP is falsely high
c. Produce a false-low measurement
d. The patient will complain of arm discomfort
13. Which of the following sequence do components of the grieving process occur? a. Denial, acceptance, anger, bargaining, hopelessness, fear
b. Anger, denial, hopelessness, bargaining, acceptance
c. Denial, anger, bargaining, depression, acceptance – this is the correct sequence of the
d. Depression, denial, acceptance, bargaining, anger
14. Dad feels left out when mom is breastfeeding baby. What should PN do?
a. Tell Dad that he can help out in other ways – dad should get involved with the care of
the baby like changing diapers, ect
b. Tell dad that breastfeeding nutrients is important to baby nutrition
c. Tell dad he can bottle feed the baby with breast milk
d. Tell dad that it’s important for mom to bond with the baby
15. The PN is aware that immunization of infants does not begin until 2 months of age because:
a. The neonatal spleen is unable to produce efficient antibodies.
b. Infants under 2 months are rarely exposed to infectious diseases.
c. The immunization would attack the immature infant’s body and produce the disease.
d. Maternal antibodies interfere with the development of active antibodies by the infant.
Answer: D – passive antibodies received from the mother would be diminished by age 8 weeks and would not interfere with the development of active immunity after this time.
16. When teaching an 8-year-old child about insulin injection, what should the PN need to consider?
a. At this stage, children are curious to know how things work –―industry vs. inferiority‖
is the developmental stage of school age children
b. Children of this age believed that things are reversible
c. Education and supervision are key elements of preventing injury
d. Obesity is a risk in this age specially when on insulin