The nurse explains to a patient that a cough: 37. Shaving the site on the day before surgery Feedings VS. 13. A clinical nurse specialist is a nurse who has: Completed a masters degree in the prescribed clinical area and is a registered professional nurse. Soap or detergent to promote emulsification Therefore, used needles should never be recapped; instead they should be inserted in a specially designed puncture resistant, labeled container. So, after removing gloves and washing hands, the nurse should untie the back of the gown; slowly move backward away from the gown, holding the inside of the gown and keeping the edges off the floor; turn and fold the gown inside out; discard it in a contaminated linen container; then wash her hands again. The mid-deltoid injection site is seldom used for I.M. Rubbing the injection site is contraindicated because it may cause the medication to extravasate into the skin.Question 14An infected patient has chills and begins shivering. 24. Discuss the significance of carbohydrates. injections because it:ACan be used only when the patient is lying downBBruises too easilyCCan accommodate only 1 ml or less of medicationDDoes not readily parenteral medication Question 15 Explanation: The mid-deltoid injection site can accommodate only 1 ml or less of medication because of its size and location (on the deltoid muscle of the arm, close to the brachial artery and radial nerve).Question 16The physician orders an IV solution of dextrose 5% in water at 100ml/hour. - decreased O2 capacity (anemia) Which of the following conditions may require fluid restriction? Eating, drinking and medications are allowed because the X-ray is of the chest, not the abdominal region. Thus, a count of 25,000/mm3 indicates leukocytosis.Question 26Which of the following nursing interventions is considered the most effective form or universal precautions?ADiscard all used uncapped needles and syringes in an impenetrable protective containerBFollow enteric precautions CWear gloves when administering IM injectionsDCap all used needles before removing them from their syringesQuestion 26 Explanation: According to the Centers for Disease Control (CDC), blood-to-blood contact occurs most commonly when a health care worker attempts to cap a used needle. Colostomy irrigation seconds 10,000/mm insertion site.Question 19When transferring a patient from a bed to a chair, the nurse should use which muscles to avoid back injury?ABack musclesBLeg musclesCAbdominal musclesDUpper arm muscles Question 19 Explanation: The leg muscles are the strongest muscles in the body and should bear the greatest stress when lifting. A 22G, 1 needle is usually used for adult I.M. - pain When transferring a patient from a bed to a chair, the nurse should use which muscles to avoid back injury? 25G 42. - promotes cardiovascualr health though controlling portions, eating a varied diet, and watching sodium intake Presence of cardiac enzymes D. A clinical nurse specialist must have completed a masters degree in a clinical specialty and be a registered professional nurse. The best way of determining whether a patient has learned to instill ear medication properly is for the nurse to: Ask the patient to demonstrate the procedure, Ask the patient if he/she has used ear drops before, Demonstrate the procedure to the patient and encourage to ask questions, Have the patient repeat the nurses instructions using her own words. - secure the tube to the patient's nose or cheek and to their gown The American Nurses Association identifies requirements for certification and offers examinations for certification in many areas of nursing., such as medical surgical nursing. The reaction can range from a rash or hives to anaphylactic shock. -. injections, which are typically administered in the vastus lateralis or ventrogluteal site.Question 13All of the following nursing interventions are correct when using the Z-track method of drug injection except:AUse a needle thats a least 1 longBAspirate for blood before injectionCPrepare the injection site with alcoholDRub the site vigorously after the injection to promote absorption Question 13 Explanation: The Z-track method is an I.M. - may be auscultated in clients with asthma and COPD. - fad diets/risk of eating disorders injection is to:ALocate the upper aspect of the upper outer quadrant of the buttock about 5 to 8 cm below the iliac crestBPalpate a 1 circular area anterior to the umbilicusCDivide the area between the greater femoral trochanter and the lateral femoral condyle into thirds, and select the middle third on the anterior of the thigh DPalpate the lower edge of the acromion process and the midpoint lateral aspect of the armQuestion 22 Explanation: The vastus lateralis, a long, thick muscle that extends the full length of the thigh, is viewed by many clinicians as the site of choice for I.M. A 22G, 1 needle is usually used for adult I.M. Applying a topical antiseptic to the skin on the evening before surgery 39. The urinary system is normally free of microorganisms except at the urinary meatus. injections, which are typically administered in the vastus lateralis or ventrogluteal site. The best nursing intervention is to: In an infected patient, shivering results from the bodys attempt to increase heat production and the production of neutrophils and phagocytotic action through increased skeletal muscle tension and contractions. 7,000/mm In the operating room, the nurse and physician are required to wear sterile gowns, gloves, masks, hair covers, and shoe covers for all invasive procedures. Respiratory isolation, like strict isolation, requires that the door to the door patients room remain closed. Urticaria C. The edges of a sterile field are considered contaminated. - hypovolemia (dehydration and hemorrhage) All of the following are common signs and symptoms of phlebitis except: A red streak exiting the IV insertion site, Edema and warmth at the IV insertion site, Pain or discomfort at the IV insertion site. She must successfully complete the licensing examination to become a registered professional nurse. UPDATED ACTUAL EXAM MATERIALUpdated questions with answers.Actual exam questions and answers for self-study.Our app is a source of accurate exam questions and answers to help you pass your exam easily and quickly! Touching the outside wrapper of sterilized material without sterile gloves, Using sterile forceps, rather than sterile gloves, to handle a sterile item, Placing a sterile object on the edge of the sterile field, Pouring out a small amount of solution (15 to 30 ml) before pouring the solution into a sterile container. 13 gtt/minute Heart-Healthy Diet: 28. - decreased LOC; coma List Describe the structure and function of the cardiopulmonary system. Use these nursing practice questions as an alternative to Quizlet or ATI. Thus, a count of 25,000/mm3 indicates leukocytosis. Manage Settings Planning - hallucinations 34. ; beets turn stool red. They are pharmaceutically manufactured in these forms for valid reasons, and altering them destroys their purpose. It also is used to evaluate the patients potential for bleeding; however, this is not its primary purpose. Use a needle thats a least 1 long Results Pureed Diet: Strictisolation requires the use of clean gloves, masks, gowns and equipment to prevent the transmission of highly communicable diseases by contact or by airborne routes. Total Questions on Quiz Any oral medications All of the following measures are recommended to prevent pressure ulcers except: which behaviors are the nurses Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew - personal habits - odorless In which step of the nursing process would the nurse ask a patient if the medication she administered relieved his pain? Shaving the site of the intended surgery might cause breaks in the skin, thereby increasing the risk of infection; however, if indicated, shaving, should be done immediately before surgery, not the day before. - stomach pH is normally <3.5 Palpate the lower edge of the acromion process and the midpoint lateral aspect of the arm Which of the following procedures always requires surgical asepsis? Clay colored stools indicate: A graduate of an associate degree program is not a clinical nurse specialist: however, she is prepared to provide bed side nursing with a high degree of knowledge and skill. Urine Culture: 2. is administered to a collection of individuals who have in common one or more personal or enviromental characteristics. Average Cardiac Output (CO) = 5-8 L/min All of the following are appropriate nursing interventions except:AAssess a vital signs every 15 minutes for 2 hoursBOrder a hemoglobin and hematocrit count 1 hour after the arteriography CCheck the pressure dressing for sanguineous drainageDAssess femoral, popliteal, and pedal pulses every 15 minutes for 2 hoursQuestion 47 Explanation: A hemoglobin and hematocrit count would be ordered by the physician if bleeding were suspected. - NG tubes can be used to feed an individual who can't get nutrition by mouth - perform every 3 days or when the ostomy appliance is leaking or accidentally However, research has shown that massage only increases the likelihood of cellular ischemia and necrosis to the area. 15 cards. Which of the following blood tests should be performed before a blood transfusion? Irrigate the patient with 1% Neosporin solution three times a daily Evaluation: How would you evaluate if your interventions have worked? Developmental Factors: BBeen certified by the National League for NursingCReceived credentials from the Philippine Nurses AssociationDGraduated from an associate degree program and is a registered professional nurseQuestion 44 Explanation: A clinical nurse specialist must have completed a masters degree in a clinical specialty and be a registered professional nurse. - patients unable to tolerate large volumes of fluid benefit most from this type of enema, which is by design low volume The appropriate needle gauge for intradermal injection is: Because an intradermal injection does not penetrate deeply into the skin, a small-bore 25G needle is recommended. - dyspnea Discuss interventions for symptom management in patients at the end of life. 22. - restlessness 4,500/mm Any procedure that involves entering this system must use surgically aseptic measures to maintain a bacteria-free state. - gently wash body, gently close eyelids Causes: All of the following are appropriate nursing interventions except:AAssess femoral, popliteal, and pedal pulses every 15 minutes for 2 hoursBCheck the pressure dressing for sanguineous drainageCOrder a hemoglobin and hematocrit count 1 hour after the arteriography DAssess a vital signs every 15 minutes for 2 hoursQuestion 49 Explanation: A hemoglobin and hematocrit count would be ordered by the physician if bleeding were suspected. TOP: Communication and Documentation MSC: Management of Care A red streak exiting the IV insertion site The following data may be collected but it is not linked to your identity: Privacy practices may vary based on, for example, the features you use or your age. 34. The equivalent dose in milligrams is: Which element in the circular chain of infection can be eliminated by preserving skin integrity? injection technique in which the patients skin is pulled in such a way that the needle track is sealed off after the injection. 1) Infants-School Age: Tolerance to a drug means that the patient experiences a decreasing physiologic response to repeated administration of the drug in the same dosage. - perform dressing changes per agency policy. Please visit using a browser with javascript enabled. Early in the morning - decrease in nutrient demand Idiosyncrasy is an individuals unique hypersensitivity to a drug, food, or other substance; it appears to be genetically determined. - place clean gown or clothes and cover with clean sheet White potatoes C. Respiratory isolation, like strict isolation, requires that the door to the door patients room remain closed. Questions Not Attempted How do you interpret a urinalysis (S.G, protein, glucose, nitrates, ketones). 4. - diabetic ketoacidosis In which step of the nursing process would the nurse ask a patient if the medication she administered relieved his pain? - once urine reaches the bladder, it begins to fill and stretch based on the amount of urine present Although applying corn starch to the rash may relieve discomfort, it is not the nurses top priority in such a potentially life-threatening situation.Question 10Which of the following types of medications can be administered via gastrostomy tube?AEnteric-coated tablets that are thoroughly dissolved in waterBAny oral medicationsCCapsules whole contents are dissolve in waterDMost tablets designed for oral use, except for extended-duration compounds Question 10 Explanation: Capsules, enteric-coated tablets, and most extended duration or sustained release products should not be dissolved for use in a gastrostomy tube. solutions or medications), mechanical irritants (the needle or catheter used during venipuncture or cannulation), or a localized allergic reaction to the needle or catheter. A postoperative patient who has undergone orthopedic surgery If you leave this page, your progress will be lost. Durable Power of Attorney: gives another person the authority to make medical decisions, must be a family member. - perform every 3 days or when the ostomy appliance is leaking or accidentally Nursing . - effectively communicate All of the following are good sources of vitamin A except: The main sources of vitamin A are yellow and green vegetables (such as carrots, sweet potatoes, squash, spinach, collard greens, broccoli, and cabbage) and yellow fruits (such as apricots, and cantaloupe). - the volume of infused saline stimulates peristalsis - restricts the client from eating or drinking anything until the diet is advanced Continue with Recommended Cookies, Fundamentals of Nursing 100 Questions Practice Exam F1A, Anna Curran. The equivalent dose in milligrams is:A0.6 mgB10 mgC600 mg D60 mgQuestion 31 Explanation: gr 10 x 60mg/gr 1 = 600 mgQuestion 32A patient with no known allergies is to receive penicillin every 6 hours. Hypoventilation: shallow breathing with a lower than expected respiratory rate -trauma Identify the clinical outcomes as a result of hypoventilation. Compare and contrast the different types of enemas (water, hypertonic, saline, soapsud). Analysis Initial vasoconstriction may cause skin to feel cold to the touch. Anorexia is another symptom of hypokalemia. 30 seconds Describe and differentiate between urine collection methods (clean catch vs. indwelling catheter). 26. Immobility impairs bladder elimination, resulting in such disorders as. - as the patient's death comes closer, the hospice team provides intensive support to the patient and family Dysphagia means difficulty swallowing. EXAMPLES: broth, gelatin, water, tea, fruit juices, sports drunks There are 50 questions to complete. The ELISA test is used to: The most appropriate nursing action would be to:AWithhold the moderation and notify the physicianBAdminister the medication and notify the physicianCAdminister the medication with an antihistamineDApply corn starch soaks to the rash - maintain skin integrity around stoma - patients accepted into hospice usually have less than 6-12 months to live Discard all used uncapped needles and syringes in an impenetrable protective container The normal count ranges from 150,000 to 350,000/mm3. Phlebitis, the inflammation of a vein, can be caused by chemical irritants (I.V. Hemolysis occurs more rapidly in ABO incompatibilities than in Rh incompatibilities. S & S: injection. Which of the following procedures always requires surgical asepsis? Soapsud Enema: Once you are finished, click the button below. - intended to decrease strain on the digestive system while keeping the body hydrated 2) Adolescents: solutions or medications), mechanical irritants (the needle or catheter used during venipuncture or cannulation), or a localized allergic reaction to the needle or catheter. The physician usually orders supplemental potassium to prevent hypokalemia in patients receiving diuretics. - transport oxygen in their hemoglobin Therefore, used needles should never be recapped; instead they should be inserted in a specially designed puncture resistant, labeled container. An 18G, 1 needle is usually used for I.M. 48. - diet for individuals with kidney disease that limits intake of sodium, potassium, and phosphorous - remove medical devices attached to patient 0.6 mg A topical antiseptic would not remove microorganisms and would be beneficial only after proper cleaning and rinsing. Which of the following blood tests should be performed before a blood transfusion? 10. - surgery and anesthesia Because of this, limiting the patients intake of oral and I.V. The two blood vessels most commonly used for TPN infusion are the: 46. A signed consent is not required because a chest X-ray is not an invasive examination. - consists of easily digestible foods that do not leave undigested residue in the intestinal tract - poor meal choices 6. Question Text Ask the patient if he/she has used ear drops before A 20G needle is usually used for I.M. Differentiate between wheezing, crackles, and rhonchi. Demonstrate the procedure to the patient and encourage to ask questions A patient has returned to his room after femoral arteriography. Interventions: - weakness insertion site. These symptoms probably indicate that the patient is experiencing: 18. - therapeutic diets, Describe what is included in each step of the nursing process for clients with impaired nutrition (dysphagia, malnutrition, etc.). Signs and symptoms of phlebitis include pain or discomfort, edema and heat at the I.V. Hypokalemia - bowel incontinence Any inflammation or obstruction that impairs bile flow will affect the stool pigment, yielding light, clay-colored stool. Any procedure that involves entering this system must use surgically aseptic measures to maintain a bacteria-free state. 30. The equivalent dose in milligrams is: 28. Chest pain and urticaria may be symptoms of impending anaphylaxis. Turning on the patients room ventilator It also is used to evaluate the patients potential for bleeding; however, this is not its primary purpose. Before a blood transfusion is performed, the blood of the donor and recipient must be checked for compatibility. - widespread availability of unhealthy/fast food The American Nurses Association identifies requirements for certification and offers examinations for certification in many areas of nursing., such as medical surgical nursing. Coughing, a protective response that clears the respiratory tract of irritants, usually is involuntary; however it can be voluntary, as when a patient is taught to perform coughing exercises. A topical antiseptic would not remove microorganisms and would be beneficial only after proper cleaning and rinsing. - constipation A signed consent is not required Hot water may lead to skin irritation or burns.Question 21When removing a contaminated gown, the nurse should be careful that the first thing she touches is the:AInside of the gown BWaist tie and neck tie at the back of the gownCCuffs of the gownDWaist tie in front of the gownQuestion 21 Explanation: The back of the gown is considered clean, the front is contaminated. Because of the danger of anaphylactic shock, he nurse should withhold the drug and notify the physician, who may choose to substitute another drug. Which of the following is a sign or symptom of a hemolytic reaction to blood transfusion? The best nursing intervention is to:AApply iced alcohol spongesBProvide increased cool liquidsCProvide additional bedclothesDProvide increased ventilation Question 14 Explanation: In an infected patient, shivering results from the bodys attempt to increase heat production and the production of neutrophils and phagocytotic action through increased skeletal muscle tension and contractions. Discuss the basic components of "My Plate". In this reaction, antibodies in the recipients plasma combine rapidly with donor RBCs; the cells are hemolyzed in either circulatory or reticuloendothelial system. - avoid processed foods and fast food When administering the medication, the nurse observes a fine rash on the patients skin. Chest Tubes: A. Differentiate between water and fat soluble vitamins. 19. All of the following statement are true about donning sterile gloves except: 11. Upper GI bleeding results in black or tarry stool. Impending constipation However, research has shown that massage only increases the likelihood of cellular ischemia and necrosis to the area.Question 47Thrombophlebitis typically develops in patients with which of the following conditions?AChronic Obstructive Pulmonary Disease (COPD) BAcute pulsus paradoxusCIncreases partial thromboplastin timeDAn impaired or traumatized blood vessel wallQuestion 47 Explanation: The factors, known as Virchows triad, collectively predispose a patient to thromboplebitis; impaired venous return to the heart, blood hypercoagulability, and injury to a blood vessel wall. Pain Management: 1,2, and 3 Terms in this set (61) Florence nightingale is also known as? Terminal disinfection is the disinfection of all contaminated supplies and equipment after a patient has been discharged to prepare them for reuse by another patient. Attempted Questions Correct 12. Urinary catheterization Potential for bleeding D. In the evaluation step of the nursing process, the nurse must decide whether the patient has achieved the expected outcome that was identified in the planning phase. The middle third of the muscle is recommended as the injection site. - may feel clammy/damp injection is to: Palpate the lower edge of the acromion process and the midpoint lateral aspect of the arm, Palpate a 1 circular area anterior to the umbilicus, Divide the area between the greater femoral trochanter and the lateral femoral condyle into thirds, and select the middle third on the anterior of the thigh, Locate the upper aspect of the upper outer quadrant of the buttock about 5 to 8 cm below the iliac crest. 3) In the acute care hospital setting, insert urinary catheters using aseptic technique and sterile equipment Attempted Questions Wrong injections in children, typically in the vastus lateralis. - maintain secure, airtight dressing (vaseline dressing with dry gauze taped over top) Good luck! Why are these interventions effective? Synergism - substance abuse Leg muscles - patients can receive palliative care while also pursuing curative treatment options. All of the following are appropriate nursing interventions except: - physical activity A postoperative patient who has undergone orthopedic surgery, A patient receiving broad-spectrum antibiotics. The physician usually orders supplemental potassium to prevent hypokalemia in patients receiving diuretics. An infected patient has chills and begins shivering. A. Leukopenia is a decreased number of leukocytes (white blood cells), which are important in resisting infection. Differentiate between hospice and palliative care. - from the kidneys, urine is transported to the bladder by the ureters Cap all used needles before removing them from their syringes, Discard all used uncapped needles and syringes in an impenetrable protective container, Wear gloves when administering IM injections. 21. The reaction can range from a rash or hives to anaphylactic shock. Return Time allowed Question Text Can be used only when the patient is lying down After routine patient contact, hand washing for 30 seconds effectively minimizes the risk of pathogen transmission. 33, 34, 35, 36, 37, Adaptive Processes Exam 1 Medications and Lab, Julie S Snyder, Linda Lilley, Shelly Collins. Which of the following statements about chest X-ray is false? A graduate of an associate degree program is not a clinical nurse specialist: however, she is prepared to provide bed side nursing with a high degree of knowledge and skill. You got 50 minutes to finish the exam .Good luck! Exam Mode Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam. The nurse does not need to wear gloves for respiratoryisolation, but good hand washing is important for all types of isolation.Question 38Which of the following is a sign or symptom of a hemolytic reaction to blood transfusion?AChest painBHemoglobinuriaCDistended neck veins DUrticariaQuestion 38 Explanation: Hemoglobinuria, the abnormal presence of hemoglobin in the urine, indicates a hemolytic reaction (incompatibility of the donors and recipients blood). - evaluates overall appearance for color, clarity, and odor A. 25. Many medications and foods will discolor stool for example, drugs containing iron turn stool black. Decompression: The physician orders an IV solution of dextrose 5% in water at 100ml/hour. 14. Time used For more information, see the developers privacy policy. - should be restricted to no more than a few days due to limited calorie and nutrients it offers Thus, a count of 25,000/mm3 indicates leukocytosis. This procedure seals medication deep into the muscle, thereby minimizing skin staining and irritation. 11. - pregnancy Insertion: Animal sources include liver, kidneys, cream, butter, and egg yolks. Tolerance to a drug means that the patient experiences a decreasing physiologic response to repeated administration of the drug in the same dosage. Tub bathing might transfer organisms to another body site rather than rinse them away. If loading fails, click here to try again. Attempts to cool the body result in further shivering, increased metabloism, and thus increased heat production. This leads to bladder distention and urine stagnation, which provide an excellent medium for bacterial growth leading to infection. Yawning and hiccupping do not prevent microorganisms from entering or leaving the body.
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