Fundamentals of Nursing Exam Solutions
Course Introduction
Fundamentals of Nursing introduces students to the essential concepts and skills required for entry-level nursing practice. The course covers the foundational principles of patient care, including health assessment, infection control, communication, documentation, and basic clinical procedures. Students learn to apply the nursing process, promote patient safety, and deliver compassionate care to individuals across the lifespan. Through theoretical instruction and practical laboratory experiences, the course prepares students to develop critical thinking, professional ethics, and the foundational competencies needed for success in diverse healthcare settings.
Recommended Textbook
Clinical Nursing Skills and Techniques 9th Edition by Perry FAAN
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44 Chapters
1283 Verified Questions
1283 Flashcards
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Page 2
Chapter 1: Using Evidence in Practice
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) During the application stage of evidence-based practice change,it is important to consider: (Select all that apply. )
A)cost.
B)the need for new equipment.
C)management support.
D)adequate staff.
Answer: A,B,C,D
Q2) When evidence-based practice is used,patient care will be:
A)standardized for all.
B)unhampered by patient culture.
C)variable according to the situation.
D)safe from the hazards of critical thinking.
Answer: C
Q3) A well-developed PICOT question helps the nurse:
A)search for evidence.
B)include all five elements of the sequence.
C)find as many articles as possible in a literature search.
D)accept standard clinical routines.
Answer: A
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Page 3
Chapter 2: Admitting, Transfer, and Discharge
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) An unconscious patient is admitted through the emergency department.How and when is identification of the patient made?
A)Determined only when the patient is able
B)Postponed until family members arrive
C)Given an anonymous name under the "blackout" procedure
D)Determined before treatment is started
Answer: B
Q2) The nurse is providing discharge instruction to an 80-year-old patient and her daughter.The patient lives in a two-story home.When asked if the patient has difficulty climbing stairs,the patient says "No," but the nurse notices a look of surprise on the daughter's face.What should the nurse do in this circumstance?
A)Speak with the daughter separately.
B)Cancel the discharge immediately.
C)Order a visiting nurse consult.
D)Notify the physician.
Answer: A
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Chapter 3: Communication and Collaboration
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) The nurse is starting her first set of morning rounds.As she interacts with the patient,her questions revolve around his reactions to his disease process.She also asks if there is anything that she can do to make him more comfortable.This type of interaction is known as _______________.
Answer: therapeutic communication
Therapeutic communication is an application of the process of communication to promote the well-being of the patient.
Q2) The patient tells the nurse that his mother left him when he was 5 years old.The nurse responds by saying,"You say that your mother left you when you were 5 years old?" This is an example of _______________.
Answer: restating
Restating is a technique whereby the nurse repeats the main thought that the patient has expressed.It indicates that the nurse is listening,and validates,reinforces,or calls attention to something important that has been said.
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Chapter 4: Documentation and Informatics
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) The patient is ready to go home from the hospital.What does the nurse provide to the patient and his family before he leaves the facility?
A)Discharge summary
B)Standardized care plan
C)Patient care summary
D)Flow sheet
Q2) Multidisciplinary care plans that include key interventions and expected outcomes within an established time frame are known as _______________.
Q3) Standardized care plans are effective ways to plan care for the patient.To be most effective,however,the SCP must be _________________.
Q4) Nursing documentation must have which of the following characteristics? (Select all that apply. )
A)Factual
B)Organized
C)Public
D)Complete
Q5) ___________________ provide a format for documenting a patient's health status and progress.
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Chapter 5: Vital Signs
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45 Verified Questions
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Sample Questions
Q1) During his initial screening,the patient's blood pressure was noted to be elevated.Two months after the first assessment,he was noted to have a blood pressure of 150/92 and 166/96 at different times during the visit.It is now a month and a half later,and the nurse is concerned because the patient's initial blood pressure on this visit was 154/94.She is preparing to take a second blood pressure,understanding that another reading in this range could lead to a diagnosis of:
A)hypotension.
B)prehypertension.
C)hypertension.
D)orthostatic hypotension.
Q2) An appropriate method of assessing a patient's respirations is for the nurse to:
A)place the bed flat.
B)remove all supplemental oxygen sources from documentation.
C)explain to the patient that respirations are being assessed.
D)gently place the patient's hand in a relaxed position over the upper abdomen.
Q3) The percent to which hemoglobin is filled with oxygen is known as
Q4) _____________ occurs when the systolic blood pressure falls to 90 mm Hg or below.
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Chapter 6: Health Assessment
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Sample Questions
Q1) Which of the following is an expected outcome for a patient after cardiac assessment?
A)Apical pulse rate equals 58 beats per minute
B)Carotid bruits present
C)PMI palpable at left fifth intercostal space at midclavicular line
D)Jugular veins distended with patient in sitting position
Q2) Increased visibility of oxyhemoglobin caused by dilation or increased blood flow is known as ________________.
Q3) The patient is 3 days post abdominal surgery.The nurse uses her stethoscope to listen for bowel sounds.This assessment technique is known as _________________.
Q4) A nurse is documenting a patient's breath sounds.Crackles are heard as:
A)loud,low-pitched,coarse sounds.
B)high-pitched,musical squeaks.
C)dry,grating sounds on inspiration.
D)high-pitched,fine sounds at the end of inspiration.
Q5) The nurse is providing health education to a group of adolescent females.The topic is "Preventing Skin Cancer." As part of the health promotion education,the nurse recommends that they avoid tanning under direct sun at midday and avoid
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Chapter 7: Specimen Collection
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45 Flashcards
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Sample Questions
Q1) An appropriate technique for the nurse to implement when obtaining throat cultures is to:
A)have the patient lie flat in the bed.
B)do the culture before meals or an hour after meals.
C)avoid touching the swab to any of the inflamed areas.
D)place pressure on the tongue blade along the back of the tongue.
Q2) What should the nurse do after obtaining a sample for an arterial blood gas (ABG)?
A)Maintain pressure over the site for 3 to 5 minutes.
B)Check the artery proximal to or above the puncture site.
C)Place the syringe into a plastic bag,and send it to the lab.
D)Apply a cool compress to hematoma formation at the puncture site.
Q3) When discussing the collection of a clean-voided urine specimen,it is important for the nurse to instruct the patient to:
A)use a clean specimen cup.
B)collect 100 to 150 mL of urine for testing.
C)void some urine first and then collect the sample.
D)wash the perineal area with soap and water immediately before voiding.
Q4) A common test performed on fecal material is the ________ test for fecal occult blood.
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Chapter 8: Diagnostic Procedures
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Sample Questions
Q1) A specialized form of angiography in which a catheter is inserted into the left or right side of the heart via a major peripheral vessel to study pressures within the heart,cardiac volumes,valvular function,and patency of coronary arteries is known as
Q2) _____________________ is often used for diagnostic or surgical procedures that do not require complete anesthesia in acute care,surgical care,and outpatient care settings.
Q3) The nurse is preparing to assist with a bone marrow aspiration on a 3-month-old infant.The nurse may expect that the physician will use which site to perform the aspiration?
A)Sternum
B)Anterior iliac crest
C)Proximal tibia
D)Posterior iliac crest
Q4) Which is the appropriate patient position for a lumbar puncture?
A)Prone
B)Supine
C)Sims'
D)Lateral recumbent
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Chapter 9: Medical Asepsis
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) The patient is presenting to the hospital with a high fever and a productive cough.He says that he hasn't felt right since he returned from visiting Somalia about a month before admission.He also states that he has lost about 20 pounds in the last month and frequently wakes up in the middle of the night sweaty and "clammy." What should the nurse prepare to do?
A)Place the patient on contact isolation.
B)Place the patient in a negative-pressure room.
C)Place the patient on droplet precautions.
D)Use standard precautions only.
Q2) Handwashing with soap and water is:
A)the most effective way to reduce the number of bacteria on the nurse's hands.
B)more effective than alcohol-based products for washing hands.
C)necessary for hand hygiene if hands are visibly soiled.
D)not necessary if the nurse wears artificial nails.
Q3) For patients with which of the following conditions should the nurse implement airborne precautions?
A)Rubella
B)Influenza
C)Tuberculosis
D)Pediculosis
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Chapter 10: Sterile Technique
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) An appropriate principle of surgical asepsis is that:
A)the entirety of a sterile package is sterile once it is opened.
B)all of the draped table,top to bottom,is considered sterile.
C)an object held below the waist is considered contaminated.
D)if the sterile barrier field becomes wet,the dry areas are still sterile.
Q2) _____________ is one practice designed to make and maintain objects and areas free from pathogenic microorganisms.
Q3) Which is the appropriate sequence to use when applying sterile attire?
A)Apply sterile gloves.
B)Secure hair.
C)Don protective eyewear.
D)Apply hair cover.
E)Wash hands.
F)Apply mask.
Q4) A sterile field consists of which of the following? (Select all that apply. )
A)Sterile tray
B)Work surface draped with a sterile towel
C)Table covered by a large sterile drape
D)Patient's bedside table
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Chapter 11: Safe Patient Handling, Transfer, and Positioning
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) The nurse is preparing to reposition the patient.Which of the following is a principle of safe patient transfer and positioning?
A)The wider the base of support,the greater the stability of the nurse.
B)The higher the center of gravity,the greater the stability of the nurse.
C)Facing in the opposite direction of movement prevents twisting.
D)Using either the arms or the legs reduces the risk for back injury.
Q2) To position a patient with hemiplegia in Fowler's position,the nurse should:
A)elevate the head of the bed 15 to 30 degrees.
B)place the patient in the prone position.
C)position a spastic hand with the fingers extended using hand rolls.
D)position the patient's head with slight hyperextension of the neck.
Q3) An appropriate procedure to use when moving a patient up in bed is for the nurse to:
A)raise the head of the bed.
B)start by flexing the patient's knees and hips.
C)place a pillow under the patient's shoulders.
D)instruct the patient to inhale and hold still.
Q4) The patient is immobile and is being placed in the supine position.To reduce extension of the fingers and abduction of the thumb,the nurse places _________________ in the patient's hands.
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Chapter 12: Exercise Mobility
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) When teaching the use of a three-point crutch gait,the nurse should instruct the patient to move:
A)both crutches and the affected leg first,then the stronger leg.
B)the right crutch,left foot,left crutch,and right foot in sequence.
C)the left crutch and right foot,then move the right crutch and left foot.
D)both crutches,then lift and swing the legs forward as far as the crutches.
Q2) An appropriate way for the nurse to measure a patient for crutches is to:
A)have a flexion of 45 degrees at both of the patient's elbows.
B)have a space of two to three fingers between the top of the crutch and the axilla.
C)place the crutch tips 1 foot to each side of the patient's feet,and observe the positioning of the crutches.
D)place the crutch tips 1 foot to the front of the patient's feet,and observe the positioning of the crutches.
Q3) The nurse is concerned that the patient may fall while he is ambulating.To help her maintain control while the patient walks,the nurse may apply a ______________ around the patient's waist.
Q4) The patient is performing range of motion (ROM)exercises independently.These are known as __________ exercises.
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Page 14
Chapter 13: Support Surfaces and Special Beds
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27 Verified Questions
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Sample Questions
Q1) The patient will be going home but still requires an air-fluidized bed.Before discharge,it will be necessary for the company that is leasing the bed to inspect the home for accessibility and ________________.
Q2) The patient requires a support surface to help prevent pressure ulcers.He has a large open wound on his leg that is dressed daily.The nurse must choose which support surface would be most appropriate.What does the nurse realize when comparing the different types of support surfaces?
A)Water mattresses are better for patients with open wounds.
B)Air-surface beds cannot be used if the patient needs CPR.
C)Water mattresses make it hard to regulate patient body temperature.
D)Air mattresses reduce shear and friction.
Q3) The patient is admitted to the hospital.Part of the patient assessment will include: (Select all that apply. )
A)use of an appropriate pressure ulcer risk scale.
B)assessment of the patient's nutritional status.
C)assessment of the patient's mobility status.
D)assessment of the patient's fluid status.
Q4) Use of the low-air-loss bed is contraindicated in patients with ___________________.
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Chapter 14: Patient Safety
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Sample Questions
Q1) An ________________ maintains immobilization of the extremities to protect the patient from accidental removal of a therapeutic device.
Q2) In a long-term care facility,an elderly patient drops his burning cigarette into a trash can and starts a fire.A type _____ fire extinguisher is the most appropriate type of fire extinguisher for the nurse to use in this situation.
A)A
B)B
C)C
D)D
Q3) Upon entering the patient's room,the nurse sees a fire burning in the trash can next to the bed.The nurse removes the patient and reports the fire.What is the nurse's next action?
A)Extinguish the fire.
B)Remove all other patients from the unit.
C)Close all doors of patient rooms.
D)Move the trash can into the bathroom.
Q4) More than ____________ patients are injured in falls in inpatient settings annually in the United States.
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Chapter 15: Disaster Preparedness
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Sample Questions
Q1) Which of the following are goals of the Department of Homeland Security (DHS)? (Select all that apply. )
A)Prevention of terrorist attacks
B)Response to disasters
C)Recovery from disasters
D)Coordination of efforts among agencies
Q2) The patient is admitted to the emergency department with possible smallpox exposure.The patient has never had a smallpox immunization.The nurse prepares to administer a smallpox vaccination,realizing that vaccination:
A)within 3 days of exposure will completely prevent the disease.
B)is effective only if received before exposure.
C)4 to 7 days after exposure will completely prevent the disease.
D)within 3 days will offer only some protection from disease.
Q3) Releasing nuclear energy in an explosive manner as the result of a nuclear chain reaction is known as a ________________.
Q4) __________ is the sorting of individuals by the seriousness of their condition and the likelihood of their survival.
Q5) It is recommended that every household prepares a ____________.
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Chapter 16: Pain Management
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Sample Questions
Q1) The patient is in the hospital undergoing major abdominal surgery.When the patient returns from the recovery room,the nurse expects that he most likely will be receiving pain medication:
A)by mouth.
B)intramuscularly.
C)via the epidural route.
D)intravenously.
Q2) The patient has morphine sulfate ordered for pain every 4 hours "prn." The patient complains of severe pain and usually requests more morphine an hour before it is due.The nurse should: (Select all that apply. )
A)Request a "placebo order" from the physician.
B)Offer the patient medication "around the clock" instead of "prn."
C)Offer the patient massage between medication doses.
D)Offer the patient a nonopioid medication between morphine doses if ordered.
Q3) Drugs administered in the epidural space spread by: (Select all that apply. )
A)diffusion through the dura mater.
B)transport through blood vessels.
C)absorption by fat.
D)absorption through muscle.
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Page 18
Chapter 17: Palliative Care
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Sample Questions
Q1) Nurses provide _______________ that is defined as care of the body after death in a manner consistent with the patient's religious and cultural beliefs.
Q2) Before allowing the family of a deceased patient to view the body,the nurse should:
A)insert the patient's dentures.
B)lower the head of the bed.
C)fold the arms and hands over the chest.
D)leave all of the old dressings and tape in place.
Q3) The nurse is preparing to assist the patient at the end stage of her life.To provide comfort for the patient in response to anticipated symptom development,the nurse plans to:
A)decrease the patient's fluid intake.
B)limit the use of pain medication.
C)provide larger meals with more seasoning.
D)determine patient wishes and select appropriate therapies.
Q4) An _______________ is the surgical dissection of a body after death.
Q5) The irreversible absence of all brain function is termed ______________.
Q6) _______________ grief (symptoms lasting longer than 6 months)occurs when a person experiences significant distress related to the loss.
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Chapter 18: Personal Hygiene and Bed Making
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Sample Questions
Q1) The development of diabetic foot ulcers is dependent on which of the following?
(Select all that apply. )
A)Peripheral neuropathy
B)Tissue ischemia
C)Trauma to the foot
D)Pain in the affected extremity
Q2) When teaching parents how to provide oral care to their child,the nurse instructs them to:
A)give bottles with juice at bedtime.
B)begin dental visits after the child is 8 years old.
C)allow the preschool child to floss his teeth without parental supervision.
D)limit snacks to three or four per day.
Q3) In providing perineal care for a male patient,the nurse realizes that the patient has not been circumcised.The nurse should:
A)retract the foreskin aftercare has been completed.
B)place the patient in prone position.
C)replace the foreskin to its natural position aftercare has been provided.
D)have the patient adduct his legs.
Q4) ________________ is defined as excessive growth of body and facial hair.
Q5) The ____________ is the largest human organ.
Page 20
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Chapter 19: Care of the Eye and Ear
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Sample Questions
Q1) The nurse is preparing to provide eye care for a comatose patient.The nurse realizes that comatose patients do not have natural protective mechanisms to protect the cornea.These protective mechanisms include: (Select all that apply. )
A)blinking.
B)squinting.
C)lubrication.
D)dilation.
Q2) How does the nurse assess that a hearing aid is operating correctly?
A)Speaking very softly behind the patient
B)Covering the patient's unaffected ear and speaking
C)Determining the patient's response to a normal tone of voice
D)Removing the hearing aid and sending it to be checked by an audiologist
Q3) The elderly patient is instructed to store his hearing aid in a(n):
A)cold place.
B)container that keeps out moisture.
C)easy to reach place.
D)a cup of water.
Q4) The substance found in the ear canal that has an antibacterial effect and maintains an acid pH is called ______________.
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Chapter 20: Safe Medication Preparation
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Sample Questions
Q1) The nurse reviews a medication administration record for an anticoagulant that is ordered at 0900 daily.The medication record indicates that the drug was given at the following times over the past 4 days.Which times follow the "right time" of medication administration? (Select all that apply. )
A)0800
B)0830
C)0930
D)1000
Q2) When do most medication errors occur? (Select all that apply. )
A)During hospital admission
B)During transfer from one unit to another
C)During discharge home
D)During discharge to another facility
Q3) Medication safety is always one of the ______________ set by The Joint Commission.
Q4) A patient is prescribed diltiazem tablets,which have an onset of 30 minutes,a peak of 2 to 3 hours,and a duration of 6 to 8 hours.The nurse anticipates that the medication will be prescribed ____________ per day.
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Chapter 21: Administration of Nonparenteral Medications
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Sample Questions
Q1) Handheld devices that deliver inhaled medication in a fine powder to penetrate lung airways are known as ___________.
Q2) A nurse is preparing to administer eardrops to an adult patient.Which action should be taken by the nurse?
A)Warm the medication to room temperature using warm water.
B)Pull the pinna down and back to straighten the ear canal.
C)Apply gentle pressure or massage to the pinna of the ear.
D)Remove cerumen from the inner ear canal with a cotton-tipped applicator.
Q3) The nurse is teaching a patient with asthma about using a metered-dose inhaler to administer albuterol.Which statements should the nurse include in the teaching plan? (Select all that apply. )
A)This medication can produce systemic effects such as tachycardia and tremors.
B)After inhaling the medication,hold your breath for about 10 seconds.
C)After inhaling the medication and holding your breath,exhale slowly through an open mouth.
D)After the last dose,do not rinse your mouth or drink any water for at least 1 hour.
Q4) Handheld devices that disperse medications through an aerosol spray or mist to penetrate lung airways are known as ___________.
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Chapter 22: Administration of Parenteral Medications
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Sample Questions
Q1) The nurse is teaching a patient about continuous subcutaneous infusion with an insulin pump.What should the nurse include in the teaching plan?
A)Rotate the site every 1 to 2 days.
B)Place a gauze dressing over the insertion site.
C)Select an insertion site in the abdomen away from the waistline.
D)Pull the skin laterally before inserting the needle.
Q2) The student nurse is preparing to administer an intravenous (IV)bolus medication through a small-gauge IV catheter.The student notes that there is no blood return on aspiration.Which action by the student should the nursing instructor question?
A)Checking the IV site for redness and swelling
B)Immediately stopping the IV infusion and removing the IV catheter
C)Checking to see if the IV is infusing without difficulty
D)Injecting the IV medication if no signs of infiltration
Q3) A patient with multiple intravenous lines has blood infusing in the right antecubital space,parenteral nutrition infusing through a right subclavian line,and normal saline with potassium infusing in the left forearm.An intravenous medication is ordered stat.The nurse will use the line in the ____________ to administer the medication.
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24
Chapter 23: Oxygen Therapy
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Sample Questions
Q1) In noninvasive ventilation,________________ keeps the terminal airways (alveoli)partially inflated,reducing the risk for atelectasis.
Q2) A patient with a nasal cannula at 5 L/min has skin irritation around the nares and complains of a dry mouth and nose.Which action by the student nurse should be questioned by the nursing instructor?
A)Using humidification
B)Applying petroleum-based gel to the nares
C)Providing frequent oral care
D)Asking the physician for an order for sterile nasal saline
Q3) The ________,also called a Briggs adaptor,connects an oxygen source to an artificial airway such as an endotracheal tube.
Q4) A patient is planning to perform incentive spirometry after abdominal surgery.The nurse should encourage the patient to do which of the following?
A)Get comfortable in a semi-reclined position.
B)Inhale as deeply as possible and then exhale into the incentive spirometry device.
C)Hold the breath for at least 3 seconds before exhaling.
D)Exhale as quickly as possible.
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25
Chapter 24: Performing Chest Physiotherapy
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Sample Questions
Q1) The health care provider orders percussion on a patient to help clear airway secretions.Which action by the nurse is appropriate?
A)Performing percussion over the ribs,while avoiding the clavicles and sternum
B)Administering pain medication before performing the percussion because the vibrations will be painful
C)Performing percussion during exhalation only with the flat part of the palm
D)Creating a rocking motion by slightly leaning on the patient's chest
Q2) ________________ is positioning the patient so that the position of the lung segment to be drained allows gravity to have its greatest effect.
Q3) The nurse receives orders on several patients for chest percussion,vibration,and shaking.The nurse is aware that chest physiotherapy maneuvers are indicated for which patient?
A)18-year-old who sustained thoracic trauma from a motor vehicle accident
B)75-year-old with osteoporosis who is underweight
C)15-year-old with cystic fibrosis
D)20-year-old with a fractured clavicle
Q4) The nurse positions the patient flat on the back with a small pillow under the knees to drain the right and left _____________________.
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Chapter 25: Airway Management
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Sample Questions
Q1) The nurse is evaluating a patient to determine whether the endotracheal tube cuff is properly inflated.Which findings indicate proper inflation? (Select all that apply. )
A)Exhaled tidal volume is 50 mL less than the tidal volume set on the ventilator.
B)Air leak is heard with a stethoscope only at the end of inspiration.
C)The patient is able to vocalize.
D)Gastric contents are noted in airway secretions.
Q2) The nurse is providing nasotracheal suctioning for a 13-year-old patient with secretions in the throat and trachea.Which action by the nurse demonstrates proper technique?
A)Applying sterile petroleum jelly to the distal tip of the suction catheter
B)Applying clean gloves to both hands
C)Inserting the suction catheter 6 to 8 inches during inspiration
D)Suctioning the pharynx first and then the trachea
Q3) A plastic or rubber tube that is inserted through the nares or mouth past the epiglottis and vocal cords to maintain an airway is known as an
Q4) A _______________ is inserted directly into the trachea through a small incision made in the patient's neck.
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Chapter 26: Cardiac Care
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Sample Questions
Q1) The nurse is assessing several patients who have returned from surgery when a 12-lead ECG is ordered for a newly admitted patient.Prioritizing patient needs,the nurse determines that obtaining the 12-lead ECG can be most appropriately delegated to which member of the health care team?
A)Administrative secretary
B)Registered nurse who is covering for lunch breaks
C)Nursing assistive personnel (NAP)who has been specifically trained to obtain the measurement
D)ECG technician from the vascular lab
Q2) When describing the rationale for connecting electrodes to each limb and around the heart,the nurse shares with the patient which appropriate explanation?
A)The leads view a specific portion of the heart's surface to help determine which part has sustained damage.
B)Multiple leads are necessary to provide a three-dimensional view of the heart.
C)The electrodes are necessary to provide a shock to the heart if needed during cardiac conversion.
D)The limb electrodes are required to provide a backup study in the event of artifact.
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Chapter 27: Closed Chest Drainage Systems
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Sample Questions
Q1) The nurse is caring for a patient who has a chest tube connected to a water seal.The patient is not on a ventilator.Which of the following would the nurse consider normal?
A)The fluid level in the water seal rises with inspiration.
B)The fluid level in the water seal falls with inspiration.
C)Constant bubbling occurs in the water seal.
D)The fluid level in the water seal falls with expiration 3 days after insertion.
Q2) The nurse is caring for a patient with a chest tube that was inserted 4 days earlier.She notices that the drainage contains a large amount of pus.What does the presence of the pus indicate?
A)Malignancy
B)Pulmonary infarction
C)Empyema
D)Hemothorax
Q3) What should the nurse do to establish a two-chamber waterless chest tube system?
A)Add sterile water to the suction chamber.
B)Add sterile solution to the water seal.
C)Set the float ball to the correct drainage pressure.
D)Connect directly to the chest tube and add nothing.
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Chapter 28: Emergency Measure for Life Support
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29 Flashcards
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Sample Questions
Q1) The nurse enters the patient's room and finds that the patient is not breathing and has no pulse.The patient does not have a do-not-resuscitate order.What would the nurse's most immediate action be?
A)Call the cardiac/respiratory arrest team.
B)Begin cardiopulmonary resuscitation (CPR).
C)Call a co-worker for help.
D)Get the crash cart.
Q2) A semicircular,minimally flexible,curved piece of hard plastic that is inserted into the mouth so it extends from just outside the lips to the pharynx is known as an
Q3) The nurse is working in the emergency department when an 8-year-old patient is brought in with respiratory distress.The nurse is preparing to insert an oral airway.Which of the following is the appropriate size for this patient?
A)Size 1
B)Size 2
C)Size 3
D)Size 7
Q4) The most common cause of airway obstruction in an unresponsive patient is the
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Chapter 29: Intravenous and Vascular Access Therapy
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44 Flashcards
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Sample Questions
Q1) The patient has intravenous (IV)therapy ordered to infuse at 1000 mL over 10 hours.The infusion set has a calibration of 15 gtt/mL.At which rate does the nurse regulate the infusion?
A)20 gtt/min
B)25 gtt/min
C)30 gtt/min
D)32 gtt/min
Q2) The nurse is assisting the physician during the insertion of a central line into the subclavian vein.How should the nurse cleanse the area?
A)With chlorhexidine in a back and forth scrubbing motion
B)With chlorhexidine followed by alcohol in a back and forth scrubbing motion
C)With alcohol in a circular motion for 5 minutes
D)With antimicrobial solution that must be dabbed dry with a sterile towel
Q3) The nurse is caring for a patient who will be on long-term antibiotic therapy.The patient has had numerous intravenous (IV)catheters in the past,but because the upcoming therapy will be given on a long-term basis,the nurse suggests that a _________________ be inserted.
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Chapter 30: Blood Therapy
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29 Flashcards
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Sample Questions
Q1) The nurse is caring for a patient who is receiving blood while monitoring the patient for potential complications.The nurse knows that a systemic response to administration of a blood product that is incompatible with the blood of the recipient,contains allergens to which the recipient is sensitive or allergic,or is contaminated with pathogens is known as a _________.
Q2) The nurse is administering blood.What should the nurse do to detect a blood reaction as quickly as possible?
A)Remain with the patient during the first 15 minutes.
B)Transfuse the blood at 10 mL/min.
C)Monitor vital signs q 1 hour.
D)Transfuse blood at 50 gtt/min.
Q3) What primary intervention should a nurse who is preparing a blood transfusion perform?
A)Set up the Y tubing.
B)Obtain 0.9% saline.
C)Verify the blood product and the patient.
D)Have the patient void or empty the urine drainage container.
Q4) A transfusion in which the donor is the patient is known as an ______________ transfusion or autotransfusion.
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Chapter 31: Oral Nutrition
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28 Flashcards
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Sample Questions
Q1) The patient is placed on a clear liquid diet after surgery.Which of the following foods may the patient select?
A)Coffee with milk and sugar
B)Gelatin,popsicles,apple juice
C)Water,orange juice,Jell-O
D)Black coffee,popsicles,ice cream
Q2) What is an appropriate technique for the nurse to use to prevent aspiration when assisting a patient with meals?
A)Keep the patient's head back and straight.
B)Offer thin-consistency foods.
C)Provide large amounts of fluids.
D)Have the patient sit up for 30 minutes after eating.
Q3) The patient is on the dysphagia puree stage of the national dysphagia diet.Which of the following foods may the patient select?
A)Mashed potatoes
B)Dry cereals moistened with milk
C)Well-cooked noodles in gravy
D)Well-moistened cereals
Q4) _______________ is useful for monitoring short-term changes in visceral protein.
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Chapter 32: Enteral Nutrition
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23 Flashcards
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Sample Questions
Q1) The nurse is preparing to administer an enteral feeding for the patient.The patient has been on enteral feedings for 2 days.The nurse knows that the most appropriate technique for implementing enteral feeding is:
A)weighing the patient weekly.
B)measuring the gastric residual every hour.
C)changing the formula every 12 hours in an open system.
D)leaving the formula in place in an open system for up to 24 hours.
Q2) The nurse is caring for a patient in a chronic vegetative state with inadequate gastric emptying.The nurse would anticipate finding in a ________ tube placed to assist with this patient's nutritional needs.
Q3) The nurse has just inserted a nasogastric (NG)feeding tube into a patient.What should the nurse do to definitely ascertain that the tube is in the stomach or in the intestine?
A)Test the pH of the contents.
B)Use a carbon dioxide sensor.
C)Lower the head of the bed to 15 degrees.
D)Obtain an order for a chest radiograph.
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Chapter 33: Parenteral Nutrition
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Sample Questions
Q1) The patient has been ordered to receive parenteral nutrition (PN)but will require the nutritional therapy to continue for several months.Which route is most important for the nurse to consider?
A)Second intravenous line
B)Enteral feeding tube
C)Central venous access device (CVAD)
D)Parenteral feeding tube
Q2) A 72-year-old patient is admitted to the hospital with a medical diagnosis of intestinal failure.Which intervention should the nurse include in the plan of care to deliver nutritional needs?
A)Enteral nutrition (EN)
B)Parenteral nutrition (PN)
C)A combination of enteral and parenteral nutrition
D)Oral nutrition
Q3) Which assessment should a nurse expect to see for a patient receiving parenteral nutrition (PN)?
A)Weight gain of 1 to 2 pounds per week
B)Serum calcium level of 10 mEq/L
C)Serum potassium level of 2.8 mEq/L
D)Serum glucose level of more than 200 mg/100 mL
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Chapter 34: Urinary Elimination
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Sample Questions
Q1) The nurse is caring for a patient who has an indwelling urinary catheter.Which intervention is most important to include in this patient's plan of care?
A)Maintaining tension on the tubing
B)Emptying the urinary collection bag every 24 hours
C)Cleaning in a circular motion from the meatus down the catheter
D)Keeping the drainage bag on the bed or attached to the side rails
Q2) When providing care for a patient with a suprapubic catheter who has acquired a urinary tract infection (UTI),which intervention is most important for the nurse to implement?
A)Using clean technique
B)Securing the tube to the inner thigh
C)Cleansing the insertion site in a direction toward the drain
D)Promoting intake of 2200 mL of fluid per day
Q3) __________________ involves the insertion of a urinary catheter directly into the bladder through the lower abdominal wall.Urine drains from the catheter into a urinary drainage bag.
Q4) An ______________ has a separate lumen that is used to inflate a balloon so the catheter remains in the bladder for short- or long-term use.
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Page 36
Chapter 35: Bowel Elimination and Gastric Intubation
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Sample Questions
Q1) The nurse prepares to exercise a digital removal of feces.To detect an untoward effect of this procedure,the nurse should assess the patient history for which condition?
A)Heart disease
B)Abdominal pain
C)Urinary infection
D)Diabetes mellitus
Q2) When evaluating a student nurse's ability to digitally remove feces,the nurse preceptor determined that further teaching is required if the student nurse does which of the following interventions?
A)Provides perianal skin care.
B)Continues the procedure if bleeding starts.
C)Follows the procedure by offering the patient the bedpan.
D)Discontinues the procedure in the presence of bradycardia.
Q3) Infrequent bowel movements (less often than every 3 days),difficulty in evacuating feces,inability to defecate,and hard feces are signs of ________________.
Q4) A bedpan that is designed for patients with body or leg casts or for patients restricted from raising their hips (e.g. ,following total joint replacement)is known as a
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Page 37
Chapter 36: Ostomy Care
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Sample Questions
Q1) The output from a urinary or fecal stoma is called the _______________.
Q2) The nurse is caring for a patient who has an ostomy.The nurse notices that the effluent ranges from a thick liquid to a semi-formed stool.The nurse recognizes that this is indicative of which location?
A)Descending colon
B)Ileal portion of the small-intestine
C)Sigmoid colon
D)Transverse or ascending colon
Q3) An opening that is in the ileal portion of the small-intestine is an ____________.
Q4) The nurse is caring for a patient who had a colostomy placed 5 days earlier.The nurse notes that the stoma is red and moist.Which action should the nurse take?
A)Notify the physician immediately.
B)Apply pressure.
C)Document the condition of the stoma.
D)Change the appliance pouch.
Q5) An ostomy that is created from a portion of the ileum to form a stoma through which urine can exit the body is called a(n)_____________.
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Page 38
Chapter 37: Preoperative and Postoperative Care
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Sample Questions
Q1) Therapies and regimens designed to prevent venous thromboembolism (VTE)include which of the following? (Select all that apply. )
A)Pneumatic compression stockings
B)Venous foot pump
C)Low-molecular-weight heparin
D)Fondaparinux
E)Elspar
Q2) Being overweight or obese increases the risk for many diseases and health conditions,including which of the following? (Select all that apply. )
A)Hypertension
B)Coronary heart disease
C)Sleep apnea
D)Respiratory problems
E)Hypotension
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Chapter 38: Intraoperative Care
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Sample Questions
Q1) The _______________ phase begins when the patient enters the operating room suite and ends with admission to the postanesthesia care unit (PACU).
Q2) Through the use of an antimicrobial agent and sterile brushes or sponges,which of the following occurs? (Select all that apply. )
A)Debris and transient microorganisms are removed from the nails,hands,and forearms.
B)The resident microbial count is reduced to a minimum.
C)The skin is sterilized.
D)Rapid/rebound growth of microorganisms is inhibited.
E)The need to wash between patients is reduced.
Q3) The surgeon is about to finish surgery and requests a sponge count.Who would normally perform this task? (Select all that apply. )
A)Scrub nurse
B)Registered nurse first assistant
C)Circulating nurse
D)Certified registered nurse anesthetist
E)Surgical technician
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Chapter 39: Pressure Injury Prevention and Care
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Sample Questions
Q1) A _______________ is a localized injury to the skin and/or underlying tissue,usually over a bony prominence,as a result of pressure,or pressure in combination with shear and/or friction.
Q2) Patients are at risk for developing pressure ulcers on which areas of the body? (Select all that apply. )
A)Coccyx
B)Nares
C)Ears
D)Genitalia
Q3) Aggressive prevention measures should be implemented for a patient in the general population with a pressure ulcer risk on the Braden Scale of less than or equal to: A)16.
B)18. C)20.
D)24.
Q4) When skin layers adhere to the linens and deeper tissue layer move downward,________ damage occurs.
Q5) The removal of devitalized tissue in a wound is known as ______________.
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Chapter 40: Wound Care and Irrigations
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Q1) The nurse is explaining wound healing to a patient.Which of the following statements explains the healing that occurs during the inflammatory stage of wound healing in a full-thickness wound?
A)A reduction in the size of the wound is noted.
B)The epithelial cells duplicate.
C)Synthesis of collagen occurs at the site.
D)Blood flow to the wound and arrival of white blood cells are increased.
Q2) What is an appropriate technique for the nurse to implement for drainage evacuation?
A)Replace the Hemovac drain fully expanded.
B)Attach the drainage tubing to the patient's gown.
C)Tilt the evacuator of the Hemovac away from the plug.
D)Complete the dressing change before the drainage evacuation.
Q3) What should the nurse do when removing intermittent sutures?
A)Snip both sides of the suture before removing.
B)Snip the suture as close to the knot as possible.
C)Snip the suture as close to the skin as possible.
D)Pull up the knot to apply as much tension as possible.
Q4) ___________ is black,brown,or tan tissue in the wound that should be removed before wound healing can begin.
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Chapter 41: Dressings, Bandages, and Binders
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Sample Questions
Q1) The patient is brought from a construction site to the emergency department with a pipe puncturing his abdomen.The pipe is still in place.The patient is triaged and is scheduled for the operating room.What should the nurse do while waiting for the surgeon?
A)Pull the pipe out in the direction of entry.
B)Push the pipe through to the other side,then out.
C)Leave the pipe in place.
D)Apply direct pressure to the insertion site of the pipe.
Q2) The patient is being sent home from the hospital after a cardiac catheterization.What should the nurse instruct the patient to do first if bleeding should occur at the femoral artery puncture site?
A)Call the physician.
B)Call 9-1-1.
C)Apply pressure to the site.
D)Apply a new bandage.
Q3) A __________ dressing comes in direct contact with the wound bed.
Q4) _______________ dressings are used for wounds that require debridement.
Q5) ___________ healing takes place when tissue is cleanly cut and the margins are reapproximated.
Q6) _____________ dressings cover or hold primary dressings in place.
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Chapter 42: Therapeutic Use of Heat and Cold
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Q1) When applying a hypothermia or hyperthermia blanket,the nurse should:
A)wrap the patient's hands and feet.
B)monitor the patient's axillary temperature every hour.
C)put the patient directly onto the heating or cooling blanket.
D)place the patient onto the blanket and then start the heating or cooling process.
Q2) In addition to monitoring the controls on the hypothermia blanket every 30 minutes,the nurse will need to assess the patient's ____________ every 4 hours.
Q3) Hot applications are used with caution in which of the following conditions? (Select all that apply. )
A)Pregnancy
B)Laminectomy sites
C)Malignancy
D)Spinal cord injury
Q4) For which patient should the nurse consider an application of cold?
A)Menstrual cramping
B)Infected wound
C)Fractured ankle
D)Degenerative joint disease
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Chapter 43: Home Care Safety
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Sample Questions
Q1) The nurse is assessing the home of an elderly patient for safety issues.Which of the following actions would reassure the nurse? (Select all that apply. )
A)Cleaning the stove top
B)Putting a shower chair in the bathroom
C)Installing adequate lighting in all living areas
D)Placing emergency numbers close to the telephone
Q2) Common causes of falls in older patients include which of the following? (Select all that apply. )
A)Gait disturbances
B)Muscle weakness
C)Visual impairments
D)Environmental hazards
Q3) Which of the following is a safety measure that the patient should implement in the home environment?
A)Using fluorescent lighting
B)Wearing extra clothing for padding
C)Obtaining a large fire extinguisher
D)Installing additional towel bars for support in the shower
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Chapter 44: Home Care Teaching
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Q1) In teaching the patient how to take his own blood pressure,which of the following is true?
A)Blood pressure cuffs that are too small will give a falsely low reading.
B)Blood pressure cuffs that are too large will give a falsely high reading.
C)Electronic blood pressure cuffs are just as accurate as other methods.
D)The cuff should be placed directly over the skin and not over clothing.
Q2) What instructions should the nurse provide when teaching the patient and the patient's caregiver how to administer parenteral nutrition (PN)?
A)PN solution should be kept refrigerated until time of administration.
B)Remixing separated mixture components by shaking the bag is common.
C)PN is compatible with most intravenous (IV)medications.
D)Blood glucose monitoring will be necessary.
Q3) Which of the following clinical findings are signs of hyperthermia? (Select all that apply. )
A)Dry,warm,flushed skin
B)Chills and piloerection
C)Uncontrolled shivering
D)Loss of memory
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