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Comprehensive Predictor Retake Review: Nursing Practice Questions and Answers, Exams of Nursing

The Courtauld Institute of Art, University of London Nursing

A comprehensive review of nursing practice questions and answers, covering various topics related to patient care, medication administration, and nursing procedures. It includes questions and answers on delegation, hypothyroidism, hyperthyroidism, ostomy care, client privacy, informed consent, post-operative care, repositioning, electrical hazards, neutropenia, abdominal exams, newborn bathing, postpartum adjustments, and more. This resource is valuable for nursing students and professionals seeking to enhance their knowledge and prepare for exams or clinical practice.

Typology: Exams

2024/2025

Available from 03/14/2025

NurseTakshif 🇬🇧

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Comprehensive Predictor Retake Review

1. Delegation to Assistive Personal <Ans> ADLs

-Bathing

-Grooming

-Dressing

-Tioleting

-Ambulating

-Feeding (without swallowing precautions)

-Positioning

-Rountine Tasks

-Bed making

-Specimen collection

-I&O

-Vital Signs ( for stable clients )

2. Planning Care for a Client Who Has Hypothyroidism <Ans> Monitor for low

Bp & bradycardia

-Monitor for chest pain & peripheral edema

-Monitor clients weight

-reorient the client if confusion occurs

-provide frequent rest periods to avoid fatigue & decrease myocardial oxygen

demands

-Monitor respiratory status

-encourage client to cough and breathe deeply to prevent pulmonary complications

-low calorie, high fiber diet , & encourage fluids to prevent constipation and promote

Discover Exams of Nursing The Courtauld Institute of Art, University of London

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Comprehensive Predictor Retake Review

Delegation to Assistive Personal ADLs

Bathing
Grooming
Dressing
Tioleting
Ambulating
Feeding (without swallowing precautions)
Positioning
Rountine Tasks
Bed making
Specimen collection
I&O
Vital Signs ( for stable clients )

Planning Care for a Client Who Has Hypothyroidism Monitor for low Bp & bradycardia

Monitor for chest pain & peripheral edema
Monitor clients weight
reorient the client if confusion occurs
provide frequent rest periods to avoid fatigue & decrease myocardial oxygen demands
Monitor respiratory status
encourage client to cough and breathe deeply to prevent pulmonary complications
low calorie, high fiber diet , & encourage fluids to prevent constipation and promote

weight loss

Administer cathartics and stool softeners as needed.(Avoid fiber laxatives, interfere with absorption of levothyroxine)
Provide extra clothing and blankets for clients who have decreased cold intolerance
caution use of electric blankets
Encourage verbalization of feelings and fears about body changes
Reassure client that most physical manifestations are reversible
use caution with CNS depressants (barbiturates or sedatives)

Signs of hypothyroidism Fatigue/ lethargy

irritability
intolerance to cold
constipation
weight gain
pallor
think brittle fingernails
depression & apathy

Signs of hyperthyroidism nervousness/ irritability

muscle weakness
heat intolerance
weight loss
insomnia
irregular menstrual flow
frequent stools and diarrhea
decreased libido
Tremor, hyperkinesia, hyperreflexia
Exophthalmos
blurry vision or changes
bloodshot appearance of eyes
Goiter
Tachycardia, palpitations, dysthymia

Elevated blood pressure
dyspnea

Nursing care for hyperthyroidism minimize clients energy

promote calm environment
monitor mental status
monitor nutritional status
monitor I&O / weight
provide eye protection (patches, eye lubricant, tape to close eyelids)
monitor vital signs and hemodynamic parameters
reduce room temp
provide cool shower/ sponge bath
Report a increased temp of 1*F immediately
Avoid excessive palpation of the thyroid

Medication for hyperthyroidism Methimazole
Reinforcing Teaching About Ostomy Care: stoma should be moist , shinny, and pink. The peristomal area should be intact

use mild soap and water to cleanse the skin, then dry it gently and completely ( moisturizing soaps interfere with adherence of the pouch)
Apply paste if necessary
measure and mark the desired size for the skin barrier
cut the opening 0.15 cm to 0.3 cm ( 1/18 to 1/8) in larger, allowing the stoma to appear through the opening
apply barrier paste to creases

Developing a Improvement Plan for Assistive Personnel performance should reflect the staff member's job and description

staff cannot use public display boards toots clients names and diagnostics
Electronic records are at password protected
Nurses must not disclose clients info to unauthorized individuals or family members who request it by telephone or email unless person is able to give the code
communication regarding clients status should take place in private areas

Obtaining Telephone Prescriptions have a second nurse listen

repeat it back, making sure to include the medication's name ( spell it out) , dosage, time, and route
Question any prescription that seems inappropriate for the client
Make sure the provider signs the prescription in person within a 24hr time frame

Evaluating Client Understanding of Nitroglycerin Storage store tablets in original bottles

store in a cool dark place
store at room temperature
store away from light & moisture

Prioritizing patient care client with an acute problem takes priority over a client who has chronic problem

A client who has an urgent need takes priority over a client who has non urgent need
client who has unstable findings takes priority over a client who has stable findings

Evaluating Understanding of Informed Consent Consent is informed when a provider explains and the client understands:

the reason for the treatment or procedure
how the treatment or procedure will benefit the client
the risk involved with the procedure or treatment

other options to treat the problem, including not treating the problem

Nurse role in Verifying informed consent Witness clients signature on informed consent

ensure the provider gave the client the necessary info
notifying the provider if client has more questions Nurse Documentation for informed consent:
reinforcement of info originally given by the provider
questions the clients had were forwarded to the provider
use of an interpreter if needed

Post op care after thyroidectomy keep the client in a semi- Fowler's position

support head and neck with pillows & avoid neck extension
monitor vital signs every 15 mins then every 30mins
assist with deep breathing exercising every 30 to 60mins
ensure oral and tracheal suction is provided as needed

avoiding sick people
wearing a face mask if they must go out
washing hands well and often
brushing and flossing teeth every day
not using a rectal thermometer
cleaning cuts right after injury, then covering with a bandage
not using razors
avoiding certain foods, including:
unpasteurized dairy foods
raw fruits, vegetables, and nuts
do not give live vaccines
do not give fresh flowers

Performing an Abdominal Exam exam includes observing the shape of abdomen, palpating for masses, and auscultation for vascular masses

have client urinate before exam
have client lie supine with knees slightly bent
note any guarding or splinting of the abdomen
listen and inspect all 4 quadrants
inspect the umbilicus for position, shape, color, inflammation, discharge, and masses
palpate tender areas last
gurgles and tympany are expected sounds

Reinforcing Teaching About Newborn Bathing Bathing can began once newborn's temperature has stabilized to at least 36.5 C (97.7F)

a compete sponge bath should be postponed until thermoregulation occurs stabi- lizes
gloves should be worn until the newborn's first bath to avoid exposure to body secretions
avoid full bathing baby until cord falls off

Reportable Findings for a 6 month old average weight of a 6 month old is 16 pounds

head circumference increases 1cm(0.4 inches) per month
infant should be able to roll from back to front and hold their bottle
posterior fontanel closes 6-8 weeks
heart rate should be between 100-160 bpm
blood pressure should be: systolic 75- Diastolic 50-

Postpartum Adjustments allow verbalization of feelings

check emotional status

prior to sex the diaphragm is inserted vaginally over the cervix with spermicidal jelly or cream that is applied to the Cervical side of the dome and around the rim
empty bladder prior to insertion to decrease pressure on urethra
washed with mild soap and warm water after each use

Appropriate Use of Contraception Cervical Cap insert up to 6 hr before sex and should be left in place for at least 6hr after sex, no more than 48 hr at a time

Replace every 2 years and refit after any gynecological surgery, birth, or any major weight fluctuation

Appropriate Use of Contraception Contraceptive Sponge one size fits all

moisten with water prior to insertion in the vagina
should be left in place for 6hr after the last act of intercourse and provides protection for up to 24hr

Contraindications for Oral Contraceptives Thromboembolic (DVT past or present)

stroke or heart attack
hypertension
coronary artery disease
gallbladder disease
cirrhosis or liver tumor
headache with focal neurological findings
diabetes mellitus
breast cancer
pregnancy
lactating
less than 6 weeks postpartum

smoker
over the age of 35

Preventing Dental Caries established dental provider by 1 year of age

flossing and brushing should be done to remove plaque
brushing should occur after meals and at bedtime
nothing to eat or drink except water after teeth have been brushed
avoid putting kids to sleep with a bottle filled with juice or milk
consumption of cariogenic foods should be eliminated

Clients at greatest risk for suicide untreated depression

loss of employment/ finances
feelings of isolation/ powerlessness
prior attempts of suicide
change in functional ability
alcohol or substance use disorder

administer bisacodyl to counteract decreased bowel mobility
administer docusate sodium to prevent constipation
lie down if lightheaded or dizziness occurs
change positions slowly
cough at regular intervals to prevent accumulation of secretions in the airway

Identifying Complicated Grief difficult progression through expected stages of grief

work of grief is prolonged
manifestations are more severe and can result in depression or exacerbate a preexisting disorder
suicidal ideation, intense feeling of guilt, and lowered self esteem
somatic complaints persist for an extended period of time

Identifying Defense Mechanisms: Projection: Attributing one's unacceptable feelings or desires to someone else.

Denial: Refusing to recognize or acknowledge real facts or experiences that would lead to anxiety. For example, if someone with substance use disorder doesn't see his problem. Repression: Blocking difficult thoughts from entering into consciousness, such as a trauma survivor shutting out a tragic experience. Regression: Reverting to the behavior or emotions of an earlier developmental stage, which might occur when a person is stressed or anxious. Rationalization: Justifying a mistake or problematic feeling with seemingly logical reasons or explanations. Displacement: Redirecting an emotional reaction from the rightful recipient to an- other person altogether. For example, if a manager screams at an employee, the employee doesn't scream back—but the employee may yell at her partner later that night. Reaction Formation: Behaving or expressing the opposite of one's true feelings. For instance, a man who feels insecure about his masculinity might act overly aggressive. Sublimation: Channeling sexual or unacceptable urges into a productive outlet.

Caring for a client who has psoriasis: no cure treatment is aimed to decrease manifestation of symptoms and decreasing turnover rate of epidermal cells

apply corticosteroids (triamcinolone, betamethasone)
warm and moist occlusive dressings of plastic wrap (gloves, plastic garments,

practice wearing the mask and breathing with it on before use
the cpap is a full face mask unless the nose only mask is used

Caring for a Client who has a hearing Aid use the lowest setting that allows hearing without feedback

to clean the ear mold, use mild soap and water while keeping the hearing aid dry
when the earring aid is not in use for an extended period of time, turn it off and remove the battery to conserve battery power and avoid corrosion of the ear
keep replacement batteries on hand

Providing Ear Irrigation ear irrigation is used to remove buildup ear wax

Sit upright with a towel on the shoulder to capture water that drains from the ear. Some people may also place a basin underneath the ear to catch the water.
Gently pull the ear upward and backward to allow the water to enter the ear more easily. Place the syringe in the ear, inserting it up and toward the back of the ear. This position will help the earwax separate from the ear and drain out of it.
Gently press on the syringe to allow water to enter the ear. If a person feels pain or pressure, they should stop irrigating.
Dry the ear using a towel or by inserting a few drops of rubbing alcohol into the ear.

Teaching About Range of Motion Exericses Hourly while awake Patient should perform

Ankle pump: point the toes toward the head and then away from the head
Foot circles: Rotate the feet in circles at the ankles
Knee Flexion: Flex and extend the legs and the knees

Buck's Traction traction use pulling force to promote and maintain

alignment of the injuries area

Neuro checks should be performed every hour for the first 24hr then every 4hr after that
maintain body alignment and realign client if the clients seems uncomfortable or reports pain
avoid lifting or removing weights
ensure that weights hang freely and are not resting on the floor
if weight accidentally becomes displaced replace the weights
ensure that pulley ropes are free of knots, fraying, loosening, and improper positioning at least every 8 to 12 hours
notify the provider if the client experiences severe pain from muscle spasms unrelieved with medications or repositioning

Reinforcing Teaching about Effleurage: Light, gentle circular stroking of the clients abdomen with the fingertips in rhythm with breathing during contractions

Comprehensive Predictor Retake Review: Nursing Practice Questions and Answers, Exams of Nursing

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Comprehensive Predictor Retake Review