Health Assessment and Clinical Skills
Final Exam Questions
Course Introduction
Health Assessment and Clinical Skills is a foundational course designed to equip students with essential knowledge and hands-on expertise in conducting comprehensive health evaluations. The course covers systematic approaches to patient assessment, including health history taking, physical examination techniques, and the use of diagnostic tools across the lifespan. Emphasis is placed on developing proficiency in inspection, palpation, percussion, auscultation, and effective communication with patients. Through a combination of theoretical instruction and practical laboratory sessions, students learn to identify normal and abnormal findings, formulate clinical judgments, and document assessment outcomes accurately, laying the groundwork for effective and safe clinical practice.
Recommended Textbook
Clinical Nursing Skills and Techniques 9th Edition by Perry FAAN
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Page 2
Chapter 1: Using Evidence in Practice
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Sample Questions
Q1) The nurse has done a literature search and found 25 possible articles on the topic that she is studying.To determine which of those 25 best fit her inquiry,the nurse first should look at:
A)the abstracts.
B)the literature reviews.
C)the "Methods" sections.
D)the narrative sections.
Answer: A
Q2) _________________ is a guide for making accurate,timely,and appropriate clinical decisions.
Answer: Evidence-based practice
Evidence-based practice is a guide for making accurate,timely,and appropriate clinical decisions.
Q3) When a PICOT question is developed,the letter that corresponds with the usual standard of care is:
Answer: C
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Chapter 2: Admitting, Transfer, and Discharge
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Q1) 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
Q2) The patient is scheduled to go home after having coronary angioplasty.What would be the most effective way to provide discharge teaching to this patient?
A)Provide him with information on health care websites.
B)Provide him with written information on what he has to do.
C)Sit and carefully explain what is required before his follow-up.
D)Use a combination of verbal and written information.
Answer: D
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4
Chapter 3: Communication and Collaboration
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Sample Questions
Q1) The patient is admitted to the emergency department for trauma received in a fist fight.He states that he could not control himself.He says that his wife left him for another man.He thinks it was because he was always too tired after working to do things.He says he has to work,and there is nothing he could do to change things.He says that he feels trapped in his job,but he knows nothing else.What was the altercation with the other man probably a manifestation of?
A)Mild anxiety
B)Depression
C)Severe anxiety
D)Moderate anxiety
Answer: B
Q2) In caring for patients of different cultures,it is important for the nurse to: (Select all that apply. )
A)use appropriate linguistic services.
B)display empathy and respect.
C)use accurate health history-taking techniques.
D)use patient-centered communication.
Answer: A,B,C,D
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Chapter 4: Documentation and Informatics
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Sample Questions
Q1) Standardized care plans are effective ways to plan care for the patient.To be most effective,however,the SCP must be _________________.
Q2) Which of the following is the best example of accurate documentation?
A)"Abdominal wound is 5 cm in length without redness,edema,or drainage."
B)"OD to be irrigated qd with NS."
C)"No complaint of abdominal pain this shift."
D)"Patient watching TV entire shift."
Q3) ___________________ provide a format for documenting a patient's health status and progress.
Q4) A preprinted guideline used to care for patients with similar health problems is known as the:
A)acuity record.
B)standardized care plan.
C)patient care summary.
D)flow sheet.
Q5) To limit liability,nursing documentation must clearly indicate that the nurse provided individualized,goal-directed nursing care to a patient based on the _____________________.
Q6) The abbreviation for every day (___)is no longer used.
Page 6
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Chapter 5: Vital Signs
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Q1) The patient is complaining of a severe headache.The nurse takes the patient's blood pressure and finds it to be 240/110.What is the pulse pressure?
A)110
B)240
C)130
D)350
Q2) The patient has an order to be off the floor for 15 minutes every 2 hours to smoke a cigarette.The patient has just returned from his "cigarette break." The nurse is about to take the patient's radial pulse and should:
A)wait about 15 minutes before taking his pulse.
B)use her thumb to detect the pulse and get an accurate count.
C)press hard to detect the pulse and get an accurate count.
D)take his pulse for 15 seconds and multiply by 4.
Q3) An inefficient contraction of the heart that fails to transmit a pulse wave to the peripheral pulse site creates a ____________.
Q4) ___________,a subjective symptom,is also referred to as a vital sign,along with the physiological signs.
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Chapter 6: Health Assessment
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Sample Questions
Q1) The nurse is assessing the patient by grasping a fold of skin on his forearm.She notices that the skin remains suspended for a longer than normal period.What could this indicate?
A)Stage 1 pressure ulcer
B)Increased blood flow to the area
C)Localized vasodilation
D)Dehydration
Q2) When performing an assessment of the cardiovascular system,the nurse evaluates the skin and nails of the patient.Inadequate tissue perfusion is known as
Q3) The patient has been in the ICU following an acute myocardial infarction 3 days earlier.During an initial assessment of the patient,the nurse detects a heart murmur that the patient did not have previously.The nurse should __________________.
Q4) Which of the following is an unexpected finding after a cardiac assessment?
A)A pulse rate of 72 beats per minute
B)Jugular vein pulsation with the patient supine
C)PMI found at the midclavicular line
D)A sustained swishing sound during systole or diastole
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Page 8
Chapter 7: Specimen Collection
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Sample Questions
Q1) _______________ organisms grow in superficial wounds exposed to the air.
Q2) When using a commercially prepared tube to collect a culture,the nurse should:
A)take the swab and mix it in the reagent to check for color changes.
B)place the swab into the culture tube and then add a special reagent to the tube.
C)crush the ampule at the end of the tube and put the tip of the swab into the solution.
D)place the swab into the tube,close it securely,and keep it warm until it is sent to the laboratory.
Q3) Localized inflammation,tenderness,warmth at the wound site,and purulent drainage usually signify _______________.
Q4) When teaching a patient about home testing for occult blood,the nurse instructs the patient that:
A)positive results are indicative of bleeding.
B)poultry and fish should be eaten before testing.
C)testing should be done carefully during the menstrual cycle.
D)two samples should be obtained from the same part of the stool specimen.
Q5) ______________ is often indicated to collect sputum from patients unable to spontaneously produce a sample for laboratory analysis.
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Page 9
Chapter 8: Diagnostic Procedures
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Q1) The nurse is caring for a patient who has just undergone a bronchoscopy and has been in recovery for the last 15 minutes.The nurse should be especially watchful for which of the following? (Select all that apply. )
A)Return of the gag reflex
B)Laryngospasm
C)Respiratory status
D)Facial or neck crepitus
Q2) For an upper gastrointestinal endoscopy,a nurse should:
A)remove the patient's dentures.
B)suction the patient every 5 minutes.
C)place the patient in high-Fowler's position.
D)provide fluids immediately after the test is finished.
Q3) An _______________ permits visualization of the vasculature of an organ and the organ's arterial system.
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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Q1) For an infection to take place,which of the following must be present? (Select all that apply. )
A)Pathogen and reservoir
B)Portals of exit and entry
C)Mode of transmission
D)Susceptible host
Q2) When caring for patients,the nurse understands that the single most important technique to prevent and control the transmission of infection is:
A)hand hygiene.
B)the use of disposable gloves.
C)the use of isolation precautions.
D)sterilization of equipment.
Q3) The patient is admitted with mumps.The nurse knows that she will have to:
A)put the patient in a private room.
B)place the patient on standard precautions.
C)wear a mask when closer than 3 feet to the patient.
D)place the patient on contact precautions.
Q4) OSHA and CDC guidelines require health care workers who care for suspected or confirmed TB patients to wear special ________________.
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Chapter 10: Sterile Technique
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Q1) When performing sterile aseptic procedures,the nurse must create a _____________ in which objects can be handled with minimal risk for contamination.
Q2) Which of the following is an appropriate technique for the nurse to use when performing sterile gloving?
A)Put the glove on the nondominant hand first.
B)Interlock the hands after both gloves are applied.
C)Pull the cuffs down on both gloves after gloving.
D)Grasp the outside cuff of the other glove with the gloved hand.
Q3) A nurse is preparing a sterile field for a dressing change using surgical aseptic technique.The nurse gathers supplies to prepare the sterile field using a packaged drape.Which option correctly describes how the nurse should set up the field?
A)Don sterile gloves before opening the packaged drape.
B)Clean the bottle of irrigation solution with alcohol before placing the bottle on the field.
C)Avoid dropping sterile supplies close to the 1-inch border around the drape.
D)Leave the sterile field unattended to obtain needed supplies.
Q4) _____________ is one practice designed to make and maintain objects and areas free from pathogenic microorganisms.
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12
Chapter 11: Safe Patient Handling, Transfer, and Positioning
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Sample Questions
Q1) To transfer the patient who has normal weight bearing and upper body strength out of bed to a chair,what should the nurse do?
A)Grab the patient under the axilla to lift.
B)Have the patient move forward with the weak side.
C)Have the patient put on shoes with nonskid soles.
D)Place the chair in a position 90 degrees opposite the bed.
Q2) The nurse needs to transfer the patient from the bed to the stretcher.The patient is unable to assist.Of the following,which would be the best technique for transferring the patient?
A)Using three nurses and a slide board
B)Using the three-person lift technique
C)Raising the head 30 degrees
D)Having the patient keep arms to the side
Q3) Body balance is achieved when a wide _____________ exists.
Q4) 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.
Q5) Awareness of posture and changes in equilibrium is known as _______________.
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Chapter 12: Exercise Mobility
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Sample Questions
Q1) The patient had a stroke and is currently immobile.The nurse realizes that increasing mobility is critical because immobility can result in alterations in which of the following?
(Select all that apply. )
A)Cardiovascular function
B)Pulmonary function
C)Skin integrity
D)Elimination
Q2) A person's inability to move about freely is known as _______________.
Q3) An appropriate procedure for the nurse to use when applying an elastic stocking is to:
A)remove the stockings every 24 hours.
B)keep the tops of the stockings rolled down slightly.
C)turn the stocking inside out to apply from the toes up.
D)wash stockings daily and dry in a dryer.
Q4) The patient is performing range of motion (ROM)exercises independently.These are known as __________ exercises.
Q5) 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.
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Chapter 13: Support Surfaces and Special Beds
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Sample Questions
Q1) What is the primary purpose for the use of a support surface?
A)To reduce pressure
B)To promote patient comfort
C)To increase circulation
D)To facilitate patient movement
Q2) It is recommended that the Rotokinetic bed stay in the rotation mode for at least _______ hours a day.
Q3) Factors that contribute to pressure ulcer formation include which of the following?
(Select all that apply. )
A)Friction
B)Shear
C)Turning every 2 hours
D)Malnutrition
E)Impaired mobility
Q4) 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 ________________.
Q5) The major cause of pressure ulcers is ________________.
Q6) A full or double-wide _____________ can accommodate a patient up to 1000 pounds.
Page 15
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Chapter 14: Patient Safety
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Sample Questions
Q1) The patient is an elderly gentleman who is admitted for a medical problem.While doing his admission assessment,the nurse learns that the patient gets up 2 to 3 times a night to use the restroom.The institution has only beds with four side rails.Which of the following is the appropriate rationale for leaving one of the lower side rails down?
A)Falls rarely happen in the inpatient setting.
B)Having all side rails raised increases the occurrence of falling.
C)Side rails have no bearing on whether or not a patient falls.
D)Patient falls rarely result in physical injury.
Q2) As part of an attempt to implement a restraint-free environment,the nurse:
A)provides constant activity for the patient.
B)covers or camouflages tubes and drains.
C)changes caregivers as often as possible.
D)reduces visiting hours and times in therapy.
Q3) To promote patient safety,government standards regarding mechanical and physical restraints state that:
A)alternative measures are to be implemented before restraints are used.
B)the nurse's judgment is all that is required for restraint use.
C)restraints should be used immediately for all patients who may need them.
D)restraints cannot be used except to prevent others from being harmed.
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Page 16
Chapter 15: Disaster Preparedness
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Sample Questions
Q1) How is a disaster best defined?
A)Any event or situation that results in multiple casualties and/or deaths
B)A catastrophic and/or destructive event that disrupts normal functioning
C)An industrial accident and unplanned release of nuclear waste
D)An event that results in human casualties that overwhelm available health care resources
Q2) An _________________ provides a standard approach to managing emergencies in which multiple agencies are involved.
Q3) Why are children particularly vulnerable to environmental toxins? (Select all that apply. )
A)They have stronger immune systems.
B)They take in proportionally larger doses of toxins from food,water,and the air.
C)Their organ systems are less able to remove toxins than adult organ systems.
D)They have a greater number of years of life expectancy.
Q4) The dispersal of radioactive material via a "dirty bomb" or by deliberate contamination of food supplies or water supplies is known as a _________________.
Q5) A patient has been exposed to a toxic chemical.The nurse's first priority is _______________.
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Chapter 16: Pain Management
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Sample Questions
Q1) The application of touch and movement to muscles,tendons,and ligaments without manipulation of the joints is called _________________.
Q2) Catheter migration into the______________ can produce dangerously high medication levels.Only physicians and nurse anesthetists administer drugs in this space.
Q3) Which of the following patient conditions is categorized as a neurobiological disease?
A)Physical dependence
B)Addiction
C)Pseudoaddiction
D)Drug tolerance
Q4) Which of the following statements about evaluating patients in pain is true?
A)The best judge of the existence of pain is the nurse.
B)Visible signs always accompany pain.
C)Patients often are hesitant to report pain.
D)Nonpharmacological interventions are better than pain medications.
Q5) ___________ has an identifiable cause and rapid onset and generally disappears with healing.
Q6) ________________ is a method of preventing pain while reducing overall opioid use.
Page 18
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Chapter 17: Palliative Care
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Sample Questions
Q1) For a patient in the final stages of dying,a nurse expects to:
A)keep the patient's room cool.
B)avoid catheterizing the patient.
C)elevate the head of the bed as tolerated.
D)encourage the patient to eat and drink more.
Q2) When caring for a patient who is an appropriate candidate for organ or tissue donation,the nurse knows that requests for donation are:
A)required by state law.
B)the total responsibility of the survivors.
C)a possible inclusion in the advance directive.
D)made only by the physician.
Q3) After the death of a patient and before other nursing interventions are implemented,the nurse should:
A)place the patient in a supine position and elevate the head of the bed 30 degrees.
B)wait an hour to prepare the patient for viewing.
C)place the patient in a side-lying position to allow drainage.
D)exclude the family while the body is being prepared.
Q4) _____________ helps people live as well as possible through the dying process.
Q5) An _______________ is the surgical dissection of a body after death.
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Chapter 18: Personal Hygiene and Bed Making
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Q1) While giving the patient a bed bath,the nurse notices a reddened area on the patient's coccyx.The nurse should:
A)decrease the temperature of the bath water.
B)massage the reddened area to decrease the redness.
C)apply topical moisturizing agents to the area.
D)ignore the redness because it will return to normal soon.
Q2) What should the nurse do before starting a patient's bed bath?
A)Lower the bed.
B)Offer the bedpan or urinal.
C)Partially undress the patient.
D)Place the head of the bed in high-Fowler's position.
Q3) The patient requires postural drainage 3 times a day.Which of the following bed positions would be most appropriate for this task?
A)Fowler's position
B)Trendelenburg's position
C)Reverse Trendelenburg's position
D)Semi-Fowler's position
Q4) Many foot ulcers are due to repeat trauma over time,often caused by
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Chapter 19: Care of the Eye and Ear
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Q1) 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
Q2) The nurse caring for a comatose patient determines that he is wearing contact lenses.Which of the following nursing interventions will the nurse use when removing the contact lenses?
A)Put on snug,powdered,clean gloves.
B)Ask the patient to look down to expose the lower eyeball.
C)Use the fingernail to slide the lens off of the cornea.
D)Inspect the eye after the lenses have been removed.
Q3) When providing care to a patient who has splashed bleach into his eye,the nurse will:
A)remove the patient's contacts immediately.
B)flush the eye from the outer to the inner canthus.
C)reinsert contacts as soon as irrigation is done.
D)irrigate toward the lower conjunctival sac.
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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Q1) A patient reports a pain level of 7 out of 10 and receives 10 mg of morphine IV.The nurse knows that IV morphine has an onset of 1 to 2 minutes,a peak of 20 minutes,and a duration of 4 to 5 hours.The patient asks when he will start to feel some pain relief.The nurse should respond that relief should begin in _____________.
Q2) A patient is receiving vancomycin IV every 8 hours at 0800,1600,and 2400.A serum peak and trough level is ordered after the third dose,which will be given at 1600.When should the nurse order the trough level?
A)1630
B)1800
C)2330
D)2400
Q3) The patient is to receive 200 mg of a medication.There are 100-mg scored tablets available.The nurse prepares _________ tablets.
Q4) A drug interaction in which the combined effect of drugs is greater than the sum of the effects of each individual agent acting independently is known as a
Q5) Medication safety is always one of the ______________ set by The Joint Commission.
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Chapter 21: Administration of Nonparenteral Medications
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Sample Questions
Q1) The nurse is preparing to administer a medication.Which of the following is the most critical to assess before medication administration?
A)Diet history
B)Allergy history
C)Surgical history
D)Drug tolerance
Q2) The nurse is preparing to administer a pediatric dose of liquid medication to an infant.Which action by the nurse is appropriate?
A)Empty the unit-dose container into a plastic cup.
B)Gently shake the multi-dose bottle before pouring the medication.
C)Draw the medication into a syringe with a needle.
D)Use an oral syringe to measure liquid dosages greater than 25 mL.
Q3) How should the nurse position the patient to administer nose drops to the maxillary sinus?
A)Sitting upright with the head tilted backward toward the side to be treated
B)Supine with a small pillow under the shoulders and the head tilted backward
C)Supine with the head tilted backward and turned to the unaffected side
D)Head tilted back over the edge of the bed and turned toward the side to be treated
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Chapter 22: Administration of Parenteral Medications
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Q1) The nurse is teaching a patient how to mix 5 units of regular insulin and 15 units of NPH insulin in the same syringe.The nurse determines that further instruction is needed if the patient does which of the following?
A)Injects 5 units of air into the regular insulin vial first and withdraws 5 units of regular insulin.
B)Injects 15 units of air into the NPH insulin vial but does not withdraw the medication.
C)Withdraws 5 units of regular insulin before withdrawing 15 units of NPH insulin.
D)Calculates the combined total insulin dose as 20 units after withdrawing the regular insulin from the vial.
Q2) The most frequent route of exposure to bloodborne disease for health care workers is needlestick injury.The nurse recognizes that implementation of _________________ can prevent needlestick injury.
Q3) An experienced nurse recognizes that the dorsogluteal injection site is no longer used for intramuscular injections because of the risk of damaging the
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24
Chapter 23: Oxygen Therapy
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Q1) The nurse is teaching a patient with asthma how to measure peak expiratory flow rate (PEFR).What should be included in the teaching plan? (Select all that apply. )
A)Assume a recumbent position before measuring PEFR.
B)Take a deep breath in,exhale,then place the mouthpiece in the mouth and form a firm seal with the lips.
C)After placing the mouthpiece in the mouth,blow out as hard and as fast as possible through the mouth in only one single breath.
D)Measure PEFR 3 times and record the highest number.
Q2) A patient is admitted to the emergency department following a motor vehicle accident.The patient is unconscious and has a broken jaw,a broken nose,and facial lacerations.The patient's breath sounds are diminished,and the health care provider suspects atelectasis.Frequent suctioning is required to clear the airway.Oxygen saturation levels range from 70% to 75%.The nurse recognizes that this patient most likely will have which type of ventilatory device ordered?
A)Continuous positive airway pressure (CPAP)
B)Bi-level positive airway pressure (BiPAP)
C)Nasal cannula
D)Mechanical ventilation
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Chapter 24: Performing Chest Physiotherapy
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Sample Questions
Q1) A patient has retained secretions in the right and left lower lobe superior bronchi.A nurse is demonstrating to family members how to perform percussion and vibration.Which action by the nurse is appropriate?
A)Positioning the patient in a chair leaning forward on a table
B)Asking the patient to lie flat on the stomach with a pillow under the stomach
C)Assisting the patient to the right side with the arm overhead and the feet elevated
D)Asking the patient to lie on the left side with the head elevated
Q2) A patient who is very frail and thin with osteoporosis has just undergone abdominal surgery.The nurse anticipates that which technique will be used to control respiratory secretions in this patient?
A)Forceful coughing
B)Percussion
C)Vibration
D)Shaking
Q3) To move secretions from small distal airways into larger central airways,the nurse would use ________________ and _______________.
Q4) The _______________ provides positive expiratory pressure (PEP)with oral airway oscillations.
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Chapter 25: Airway Management
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Q1) The nurse is performing nasotracheal suctioning on a patient.The nurse should discontinue the suctioning if which of the following occurs?
A)The patient coughs as the catheter is inserted.
B)The heart rate decreases from 84 beats per minute to 60 beats per minute.
C)An increase in pulse occurs from 74 beats per minute to 94 beats per minute.
D)Oxygen saturation levels decrease from 97% to 94%.
Q2) 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.
Q3) A _______________ is inserted directly into the trachea through a small incision made in the patient's neck.
Q4) 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
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Chapter 26: Cardiac Care
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Q1) The nurse is obtaining a 12-lead ECG on a patient and notices that the ECG cannot be interpreted.Which of the following interventions are appropriate for the nurse to take?
(Select all that apply. )
A)Inspect the electrodes for secure placement.
B)Reposition any wires that move as a result of patient breathing or movement.
C)Reposition electrodes that are in the correct position.
D)Remind the patient to remain still in order to obtain a good tracing.
Q2) The nurse is obtaining a 12-lead ECG on a patient with chest discomfort and interprets the results as a very thick-lined waveform tracing.The nurse troubleshoots this tracing by performing which appropriate intervention?
A)Unplugs the battery-operated equipment in the room one item at a time.
B)Reapplies the electrodes to ensure proper connection with the skin.
C)Adjusts the extremity electrodes on the wrists and ankles.
D)Asks the patient to hold his breath to see if the tracing improves.
Q3) ECG tracings that cannot be interpreted are known as _________________.
Q4) _______________ develops when a person is exposed to an excessive number of alarms.
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Chapter 27: Closed Chest Drainage Systems
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Sample Questions
Q1) The patient has a chest tube for a pneumothorax.Assessment revealed continuous bubbling in the water-seal chamber.The nurse finds no loose connections.After the chest tube near the patient is clamped,the bubbling stops.The nurse's first action should be to:
A)apply pressure to the dressing around the chest tube insertion site.
B)move the clamp farther down the tube and note whether bubbling resumes.
C)replace the entire collection tubing and system.
D)increase suction control until bubbling does not resume when the clamp is removed.
Q2) Which of the following is the correct positioning for a patient after a chest tube has been inserted for a pneumothorax?
A)Supine
B)Side-lying
C)Semi-Fowler's
D)High-Fowler's
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) When applying an automated external defibrillator,the nurse would:
A)connect the cable to the machine,apply the pads,and turn on the power.
B)turn on the power,apply the pads,and connect the cable.
C)turn on the power,connect the cable,and apply the pads.
D)connect the cable,turn on the power,and apply the pads.
Q2) The nurse observes a person collapse and stop breathing.The nurse would establish an airway by:
A)inserting an endotracheal tube.
B)inserting a finger to pull the tongue forward.
C)using the head tilt-chin lift maneuver.
D)using a modified jaw-thrust maneuver.
Q3) What is the nurse's responsibility for the patient after he has been intubated during a code event? (Select all that apply. )
A)Ventilate using a bag-mask device at a rate of 22 breaths per minute.
B)Auscultate the epigastric area.
C)Auscultate both lungs.
D)Call for a chest radiograph.
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) What should the nurse do to decrease the potential for infection related to intravenous (IV)infusion therapy?
A)Use the clean technique for dressing changes.
B)Change the IV tubing every 12 hours.
C)Palpate the insertion site daily through the intact dressing.
D)After cleansing the skin,dab it dry with a sterile gauze pad.
Q2) The nurse needs to specifically prevent air emboli that may result from intravenous (IV)therapy.What should the nurse make sure to do to prevent air emboli?
A)Use a needleless system.
B)Prime the tubing completely.
C)Check for medication compatibility.
D)Select a larger-gauge needle or catheter.
Q3) The nurse is caring for a patient who is receiving intravenous (IV)fluids at a rate of 150 mL per hour.During her assessment,the nurse notes that the patient is having more labored respirations,and that crackles have developed in the patient's lungs.The nurse reduces the IV rate and notifies the physician.She does this while recognizing that the patient is experiencing signs of _______________.
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31
Chapter 30: Blood Therapy
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29 Flashcards
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Sample Questions
Q1) A transfusion in which the donor is the patient is known as an ______________ transfusion or autotransfusion.
Q2) For how long may blood preserved with citrate-phosphate-dextrose (CPD)be stored (unfrozen)before use?
A)21 days
B)35 days
C)42 days
D)3 months
Q3) The patient has been home from the hospital for 10 days.On the last day of his hospitalization,he received 2 units of packed red blood cells (RBCs).This morning,he noticed that his skin had a yellow tint to it and his temperature was elevated.Which reaction might this patient be experiencing?
A)Delayed hemolytic transfusion reaction
B)Acute hemolytic transfusion reaction
C)Nonhemolytic febrile reaction
D)Severe allergic transfusion reaction
Q4) The presence or absence of specific antigens on the surface of red blood cells determines ___________________ in the ABO system.
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Page 32
Chapter 31: Oral Nutrition
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28 Flashcards
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Sample Questions
Q1) Which of the following are signs of iron (Fe²<sup>+</sup>)deficiency? (Select all that apply. )
A)Pale eye membranes
B)Cheilosis (redness/swelling)of the lips
C)Spongy,bleeding gingiva
D)Glossitis
Q2) The nurse is assessing the patient for nutritional status.Which laboratory value may indicate compromised protein status?
A)Serum albumin level of 4.0 g/dL
B)Prealbumin level of 12 g/dL
C)Total lymphocyte count of 1600 cells/mm3
D)Prealbumin level of 35 g/dL
Q3) A nurse's role includes performing ___________________ to assess a patient's risk status for malnutrition,assessing and assisting an adult patient with feeding,and identifying patients at risk for aspiration during oral feeding.
Q4) The nurse recognizes that the patient is exhibiting signs of ______________ when she notices that he has difficulty holding food and fluid in his mouth and experiences difficulty moving it to his esophagus.
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Chapter 32: Enteral Nutrition
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Sample Questions
Q1) The nurse is caring for a patient who is receiving continuous tube feedings.What must the nurse do to care for this patient?
A)Verify tube position every 4 to 6 hours.
B)Obtain a radiograph every 4 to 12 hours.
C)Instill air into the stomach via the tube and listen for bubbles.
D)Do not worry about tube placement because the tube has already been determined to be in the right place.
Q2) Which evaluation indicates that placement of a nasogastric or enteric tube is correct?
A)Nasointestinal aspirate with a pH of less than 6
B)Pleural fluid pH of less than 6
C)Gastric aspirate with a pH of 5 or less after patient fasting
D)Gastric aspirate with a pH of 4 and continuous tube feedings
Q3) An appropriate technique for nasogastric (NG)tube insertion is for the nurse to:
A)position the patient supine.
B)apply oil-based lubricant to the plastic tube.
C)advance the tube while the patient swallows.
D)measure the tube length from the nose to the sternum.
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Chapter 33: Parenteral Nutrition
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Sample Questions
Q1) To detect a common untoward effect of interrupting a parenteral nutrition (PN)infusion,the nurse should assess the patient for development of which symptom?
A)Fever
B)Chest pain
C)Erythema and induration
D)Shaking and dizziness
Q2) 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
Q3) If parenteral nutrition (PN)must be discontinued suddenly,hang __________ in water at the same infusion rate to prevent hypoglycemia.
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Chapter 34: Urinary Elimination
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Sample Questions
Q1) The nurse is caring for a patient who is experiencing inadequate bladder emptying.To determine postvoid residual,which technique is most important for the nurse to implement?
A)Bladder scanner
B)Indwelling catheterization
C)Straight/intermittent catheterization
D)Foley catheterization
Q2) A noninvasive device that is used to provide accurate determination of a patient's bladder volume by first creating an ultrasound image of the patient's bladder and then calculating the urine volume in the bladder is known as a ______________.
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) _________________ is the volume of urine in the bladder after a normal voiding.
Q5) 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.
Q6) The risk for catheter-associated urinary tract infection can be reduced by using ___________ when inserting the catheter.
Page 36
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Chapter 35: Bowel Elimination and Gastric Intubation
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Sample Questions
Q1) When care is provided for a patient with an NG tube in place,which intervention is safest for the nurse to implement?
A)Tape the tube up and around the ear on the side of insertion.
B)Secure the tubing to the bed by the patient's head.
C)Mark the tube where it exits the nose.
D)Change the tubing daily.
Q2) While the nurse is administering an enema with a standard enema bag,which intervention is important to implement?
A)Keeping the solution at room temperature
B)Positioning the patient on the right side
C)Raising the enema bag to 12 inches above the patient
D)Instructing the patient to release the enema solution as soon as possible
Q3) The nurse has been directed to provide an enema for an elderly female patient who has very poor rectal sphincter control.Which position is most appropriate for this patient?
A)Sims' position
B)Dorsal recumbent position on the bedpan
C)Sitting on the toilet
D)Right lateral position
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Chapter 36: Ostomy Care
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19 Flashcards
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Sample Questions
Q1) When providing care for a patient with a colostomy or an ileostomy,the nurse recognizes that which is an expected assessment finding?
A)A moist,reddish-pink stoma
B)A dry,purplish stoma
C)Erythema on the skin around the stoma
D)No drainage noted from the stoma when washed
Q2) The nurse is caring for a patient with an ostomy.The nurse notes that the ostomy is putting out watery effluent.The nurse recognizes that this is indicative of which location?
A)Descending colon
B)Sigmoid colon
C)Ileal portion of the small-intestine
D)Transverse colon
Q3) An opening that is in the ileal portion of the small-intestine is an ____________.
Q4) A ______________ is an opening in the large intestine or colon for elimination of fecal material.
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) Which of the following have been identified as evidence-based guidelines to reduce surgical site infections (SSIs)? (Select all that apply. )
A)Prepping the surgical site with a razor followed by an antiseptic scrub
B)Giving antibiotics immediately after the procedure
C)Maintaining blood glucose levels
D)Maintaining normal body temperatures
E)Maintaining proper positioning
Q2) The nurse understands that postop ileus is a possible postoperative complication.Which assessment provides the nurse with information about this postoperative complication?
A)Auscultating for bowel sounds every 4 hours
B)Checking blood pressure while sitting and standing
C)Observing the patient's performance of leg exercises
D)Palpating the suprapubic region for distention
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Chapter 38: Intraoperative Care
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Sample Questions
Q1) 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.
Q2) While supervising the surgical team,the charge nurse notices that a team member's nails are long and chipped.Which action should the nurse take next?
A)Allow the team member to complete the task.
B)Remove the team member to have the nails cut.
C)Turn the team member in to the RNFA.
D)Ask the team member why the nails are long and chipped.
Q3) The _______________ phase begins when the patient enters the operating room suite and ends with admission to the postanesthesia care unit (PACU).
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Chapter 39: Pressure Injury Prevention and Care
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Sample Questions
Q1) When evaluating a patient,the nurse observes an unexpected outcome of treatment when the surrounding skin of an ulcer becomes macerated.The nurse should:
A)obtain a wound culture.
B)apply pressure-reducing devices.
C)use dressings with increased moisture absorption.
D)monitor the patient for systemic signs and symptoms.
Q2) The nurse is turning a patient when she notices an area with nonblanchable redness over the patient's coccyx.The patient complains of pain at the site,and the site feels cooler than the areas immediately around the site.The nurse recognizes that this patient has developed:
A)a stage I pressure ulcer.
B)a stage II pressure ulcer.
C)an unstageable pressure ulcer.
D)deep tissue injury.
Q3) 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.
Q4) The removal of devitalized tissue in a wound is known as ______________.
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Page 41
Chapter 40: Wound Care and Irrigations
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Sample Questions
Q1) The nurse is educating a patient about his role in wound healing.Which of the following factors,if modified by the patient,can support adequate oxygenation at the tissue level?
A)Age
B)Smoking
C)Underlying cardiopulmonary conditions
D)Hemoglobin
Q2) The nurse is changing a surgical dressing and is cleansing the wound.She knows that:
A)the incision line should be cleansed last.
B)she should start at one end of the incision line and swab the entire length.
C)she should start at the center of the incision line and swab toward one end.
D)she should work in a circular motion around the incision line.
Q3) The _____________ is composed of newly formed collagen,and the nurse can usually feel it along a healing wound.It is usually present directly under the suture line between days 5 and 9.
Q4) ___________ is black,brown,or tan tissue in the wound that should be removed before wound healing can begin.
Q5) ___________ are threads of wire or other materials used to sew body tissues together.
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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) What should the nurse do for a patient with a sudden severe hemorrhage?
A)Go for help.
B)Drape the patient.
C)Apply direct pressure.
D)Put on clean or sterile gloves.
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Chapter 42: Therapeutic Use of Heat and Cold
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Q1) A new staff nurse is assigned to the unit.The charge nurse evaluated that the new staff member knows proper use of the aquathermia pad when the:
A)temperature is set between 95°F and 98°F.
B)water in the reservoir is allowed to run out.
C)pad is covered with a towel or a pillowcase.
D)patient is positioned to lie directly over the pad.
Q2) When the skin is exposed to warm or hot temperatures,which of the following occurs? (Select all that apply. )
A)Vasodilatation
B)Vasoconstriction
C)Perspiration
D)Piloerection
Q3) Advantages of moist heat over dry heat include which of the following manifestations? (Select all that apply. )
A)Reduces drying of skin.
B)Softens wound exudate.
C)Does not cause skin maceration.
D)Penetrates deeply into tissue layers.
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44
Chapter 43: Home Care Safety
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Sample Questions
Q1) A patient with a cognitive deficit becomes agitated and upset about not being able to remember daily activities.How should the nurse respond to this agitation?
A)Tell the patient not to worry about it.
B)Provide an easy-to-follow calendar and reinforce the information.
C)Explain that becoming upset is not going to help the situation.
D)Remind the patient that now is the time to rest and relax.
Q2) Dementia is characterized by a gradual,progressive,irreversible _______ dysfunction.
Q3) When a caregiver is communicating with a patient,which of the following actions may facilitate communication? (Select all that apply. )
A)Face the patient who has a hearing impairment.
B)Avoid eye contact.
C)Use simple words.
D)Be aware of nonverbal gestures.
Q4) ___________ is a generalized impairment of intellectual functioning,with the most common form being Alzheimer's disease.
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Chapter 44: Home Care Teaching
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Sample Questions
Q1) What does the nurse teach the patient and caregiver to do when setting up and changing administration sets for continuous tube feedings to preserve medical asepsis?
A)Add formula to formula already hung to prevent waste.
B)Store unused formula at room temperature to prevent spasm.
C)Hang only enough formula that will be infused in a 4- to 6-hour period.
D)Change the administration set every 48 hours.
Q2) When teaching the patient about performing trach care,which of the following actions is an acceptable technique?
A)Remove the old ties before applying the new.
B)Keep two trach tubes of the same size at the bedside.
C)Place the new trach tie,then remove the old tie.
D)Dispose of all old supplies and replace with new.
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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