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FUNDAMENTALS OF NURSING FINAL EXAM
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A nurse is caring for a patient in the ICU who is being monitored for a possible cerebral aneurysmfollowing a lost of consciousness in the emergency room. The nurse anticipates preparing the pt for ordered diagnostic tests. This nurse's knowledge of the diagnostic procedures for this condition reflectswhich aspect of nursing?
A. The art of nursingB. The science of nursing C. The caring aspect of nursing D. The holistic approach to nursing - CORRECT ANSWER>> B. The science of nursing
A nurse is formulating a clinical question in PICO format. What does the letterP represent? A. Comparison to another similar treatment B. Clearly defined, focused literature reviewC. Specific identification of the desired outcome D. Explicit descriptions of the population of interest - CORRECT ANSWER>> D. Explicit descriptions ofthe population of interest
Insulin - CORRECT ANSWER>> Removes excess glucose from the blood and stores it as glycogen in theliver.
Which nurse who was influential in the development of nursing in North America is regarded as thefounder of American nursing?
A. Clara Barton B. Lillian WaldC. Lavina Dock D. Florence Nightingale - CORRECT ANSWER>> D. Florence Nightingale The student nurse learns that illnesses are classified as either acute or chronic. Which are examples ofchronic illnesses? Select all that apply.
A. Diabetes mellitus B. Bronchial pneumoniaC. Rheumatoid arthritis D. Cystic fibrosisE. Fractured hip F. Otitis media - CORRECT ANSWER>> A, C, & D World War II had a tremendous effect on the nursing profession. Which development occurred duringthis period?
A. The role of the nurse was broadened B. There was a decreased emphasis on educationC. Nursing was practiced mainly in hospital settings D. There was an overabundance of nurses - CORRECT ANSWER>> A. The role of the nurse wasbroadened
E. Health is more than the absence of illness. F. Illness is the response of a person to a disease. - CORRECT ANSWER>> B, E, & F Method of communication between health care providers about patients (the handoff) - CORRECT ANSWER>> SBAR
When the newborn's head is turned to one side, the arm on that side is extended out - CORRECT ANSWER>> Tonic neck
True or false: Diarrhea is a common concern postpartum - CORRECT ANSWER>> False. Constipation is acommon concern if iron is administered
This is the angle for a subcutaneous injection - CORRECT ANSWER>> 45 degrees A nurse has volunteered to give influenza immunizations at a local clinic. What level of care is the nursedemonstrating?
A. TertiaryB. Secondary C. Primary D. Promotive - CORRECT ANSWER>> C. Primary
The outer most layer of the skin - CORRECT ANSWER>> Epidermis First step in the abdominal assessment - CORRECT ANSWER>> Inspection Obesity BMI - CORRECT ANSWER>> >30 mg/dL When the bottom of the foot is stroked upwards, the newborn's toes flare out - CORRECT ANSWER>>Babinski
Health promotion activities may occur on a primary, secondary, or tertiary level. Which activities areconsidered tertiary health promotion? Select all that apply.
A. A nurse runs an immunization clinic in the inner city. B. A nurse teaches a patient with an amputation how to care for the residual limb.C. A nurse provides range-of-motion exercises for a paralyzed patient. D. A nurse teaches parents of toddlers how to childproof their homes.E. A school nurse provides screening for scoliosis for the students. F. A nurse teaches new parents how to choose and use an infant car seat. - CORRECT ANSWER>> B & C When does menstruation return after birth for non lactating women? - CORRECT ANSWER>> 7-9 weeks Nursing students should not drink this when stressed - CORRECT ANSWER>> Alcohol A nurse administers a dose of an oral medication for hypertension to a patient who immediately vomitsafter swallowing the pill. What would be the appropriate initial action of the nurse in this situation?
A. Readminister the medication and notify the primary care provider. B. Readminister the pill in a liquid form if possible.C. Assess the vomit, looking for the pill. D. Notify the primary care provider. - CORRECT ANSWER>> C. If a patient vomits immediately afterswallowing an oral pill, the nurse should assess the vomit for the pill or fragments of it. The nurse should then notify the primary care provider to see if another dosage should be administered. Identify goals of Healthy People 2020 related to diabetes - CORRECT ANSWER>> -Reduce the diseaseand economic burden of diabetes mellitus and improve the quality of life for at risk persons -Reduce disease risk through healthful diets and achievements and management of healthy bodyweights
pH normal values - CORRECT ANSWER>> 7.35-7. A nurse is administering an oral medication to a patient via a gastric tube. The nurse observes themedication enter the tube, and then the tube becomes clogged. What would be the appropriate initial action of the nurse in this situation? A. Attempt to dislodge the medication with a 10-mL syringe.B. Notify the primary care provider. C. Remove the tube and replace it with another tube. D. Flush the tube with 60 mL of water. - CORRECT ANSWER>> A. If medication becomes clogged in a gastric tube, the nurse should attach a 10-mL syringe on the end of the tube and pull back and lightlyapply pressure to the plunger in a repetitive motion to attempt to dislodge the medication. If the medication does not move through the tube, the nurse should notify the primary care provider, whomay request the tube be replaced.
HCO3 normal values - CORRECT ANSWER>> 22-26 mEq/L When does menstruation return for lactating women? - CORRECT ANSWER>> It's dependent on breastfeeding frequency and duration. Anywhere from 2-18 months.
A nurse is teaching a novice nurse how to provide culturally competent care to patients in a culturallydiverse community health clinic. Although all of the following are important to providing culturally competent nursing care, which one is most basic? A. Learning the predominant language of the communityB. Obtaining significant information about the community C. Treating each patient at the clinic as an individual D. Recognizing the importance of the patient's family - CORRECT ANSWER>> C
A nurse witnesses a street robbery and is assessing a 26-year-old female patient who is the victim. Thepatient has minor scrapes and bruises and tells the nurse, "I've never been so scared in my life." What
other symptoms would the nurse expect to find related to the fight-or-flight response to stress? Selectall that apply.
A. Increased heart rateB. Decreased muscle strength C. Increased mental alertnessD. Increased blood glucose levels E. Decreased cardiac output F. Decreased peristalsis - CORRECT ANSWER>> A, C, D The sympathetic nervous system functions under stress to bring about the fight-or-flight response by increasing the heart rate, increasing musclestrength, increasing cardiac output, increasing blood glucose levels, and increasing mental alertness. Increased peristalsis is brought on by the parasympathetic nervous system under normal conditions andat rest.
Risk factors that we can do something about - CORRECT ANSWER>> Modifiable risk factors Sodium normal values - CORRECT ANSWER>> 135-145 mEq/L Potassium normal values - CORRECT ANSWER>> 3.5-5.0 mEq/L Vaginal discharge that occurs after birth and continues for approximately 4-8 weeks - CORRECT ANSWER>> Lochia
Jean's attorney was careful to explain in her defense that Jean had specialty knowledge, experience, andclinical judgment and had met certain criteria established by a nongovernmental association, as a result of which she was granted recognition in a specified practice area. What is this sort of credential called? A. AccreditationB. Licensure C. Certification D. Board approval - CORRECT ANSWER>> C
A. Projection B. DenialC. Displacement D. Repression - CORRECT ANSWER>> B A patient's health history of breast cancer that runs in the family is what type of risk factor? - CORRECT ANSWER>> Non-modifiable risk factor
Laws affecting nursing practice (Think PHMPG) - CORRECT ANSWER>> -Right of Privacy -HIPAA-Malpractice -Patient's Bill of Rights-Good Samaritan Law
Rubra - CORRECT ANSWER>> Deep red mixture, first 3-4 days A nurse administers the wrong medication to a patient and the patient is harmed. The physician whoordered the medication did not read the documentation that the patient was allergic to the drug. Which statement is true regarding liability for the administration of the wrong medication? A. The nurse is not responsible, because the nurse was merely following the doctor's orders. B. Only the nurse is responsible, because the nurse actually administered the medication.C. Only the physician is responsible, because the physician actually ordered the drug. D. Both the nurse and the physician are responsible for their respective actions. - CORRECT ANSWER>>D. Nurses are legally responsible for carrying out the orders of the physician in charge of a patient unless an order would lead a reasonable person to anticipate injury if it were carried out. If the nurse shouldhave anticipated injury and did not, both the prescribing physician and the administering nurse are responsible for the harms to which they contributed. Phosphate normal values - CORRECT ANSWER>> 2.5-4.5 mg/dL
Normal ionized serum calcium level - CORRECT ANSWER>> 4.5-5.1 mg/dL Base excess or deficit values - CORRECT ANSWER>> -2 to +2 mMol/L A patient tells the nurse that she would like to use a mechanical barrier for birth control. Which methodmight the nurse recommend?
A. DiaphragmB. Oral contraceptive pills C. Depo-Provera D. Evra patch - CORRECT ANSWER>> A The diaphragm is the only barrier method of contraception listed; all the other methods are hormonal. Serum Bicarbonate - CORRECT ANSWER>> 25-29 mEq/L A female patient who is receiving chemotherapy for breast cancer tells the nurse, "The treatment forthis cancer is worse than the disease itself. I'm not going to come for my therapy anymore." The nurse responds by using critical thinking skills to address this patient problem. Which action is the first stepthe nurse would take in this process?
A. The nurse judges whether the patient database is adequate to address the problem. B. The nurse considers whether or not to suggest a counseling session for the patient.C. The nurse reassesses the patient and decides how best to intervene in her care. D. The nurse identifies several options for intervening in the patient's care and critiques the merit of each option. - CORRECT ANSWER>> C. The first step when thinking critically about a situation is to identify the purpose or goal of your thinking. Reassessing the patient helps to discipline thinking bydirecting all thoughts toward the goal. Once the problem is addressed, it is important for the nurse to judge the adequacy of the knowledge, identify potential problems, use helpful resources, and critiquethe decision.
Serosa - CORRECT ANSWER>> 2nd stage, pinkish-brownish discharge, expelled 3-10 days.
-Causes the release of arachidonic acid from cell membrane This is what the body does in response to stressors - CORRECT ANSWER>> Adapt This organ needs 25% of our bld supply and is affected with a decrease in perfusion - CORRECT ANSWER>> Kidneys
A medication order reads: "Hydromorphone, 2 mg IV every 3 to 4 hours PRN pain." The prefilledcartridge is available with a label reading "Hydromorphone 2 mg/1 mL." The cartridge contains 1.2 mL of hydromorphone. Which nursing action is correct? A. Give all the medication in the cartridge because it expanded when it was mixed.B. Call the pharmacy and request the proper dose. C. Refuse to give the medication. D. Dispose of 0.2 mL correctly before administering the drug. - CORRECT ANSWER>> D. Many cartridges are overfilled, and some of the medication needs to be discarded. Always check the volume needed toprovide the correct dose with the volume in the syringe. Giving the excess medication in the cartridge may result in adverse effects for the patient. For this dose, it is not necessary to call the pharmacy orrefuse to give the medication, provided the order is written correctly.
Calling an older adult honey or sweety - CORRECT ANSWER>> Elder speak An act passed in 2002 to protect patient privacy - CORRECT ANSWER>> HIPPA pH: 7. PCO2: 32 HCO3: 36 - CORRECT ANSWER>> Metabolic alkalosis
The organ responsible for long-term acid-base balance - CORRECT ANSWER>> Kidneys The nurse collects objective and subjective data when conducting patient assessments. Which patientconditions are examples of subjective data? Select all that apply.
A. A patient tells the nurse that she is feeling nauseous.B. A patient's ankles are swollen. C. A patient tells the nurse that she is nervous about her test results.D. A patient complains of having a rash on her arm that is itchy. E. A patient rates his pain as a 7 on a scale of 1 to 10. F. A patient vomits after eating supper. - CORRECT ANSWER>> A, C, D, E
Amount of blood that is pumped through the heart each minute - CORRECT ANSWER>> 3.5-8 L/min A patient requires 40 units of NPH insulin and 10 units of regular insulin daily subcutaneously. What isthe correct sequence when mixing insulins?
A. Inject air into the regular insulin vial and withdraw 10 units; then, using the same syringe, inject airinto the NPH vial and withdraw 40 units of NPH insulin. B. Inject air into the NPH insulin vial, being careful not to allow the solution to touch the needle; next,inject air into the regular insulin vial and withdraw 10 units; then, withdraw 40 units of NPH insulin. C. Inject air into the regular insulin vial, being careful not to allow the solution to touch the needle; next,inject air into the NPH insulin vial and withdraw 40 units; then, withdraw 10 units of regular insulin. D. Inject air into the NPH insulin vial and withdraw 40 units; then, using the same syringe, inject air into the regular insulin vial and withdraw 10 units of regular insulin. - CORRECT ANSWER>> B Regular or short-acting insulin should never be contaminated with NPH or any insulin modified with added protein.Placing air in the NPH vial first without allowing the needle to contact the solution ensures that the regular insulin will not be contaminated. The primary source of heat in the body - CORRECT ANSWER>> Metabolism When a nurse enters the patient's room to begin a nursing history, the patient's wife is there. Whatshould the nurse do?
A. Introduce oneself and thank the wife for being present. B. Introduce oneself and ask the wife if she wants to remain.
D. Document the finding. - CORRECT ANSWER>> C. The nurse should first validate the finding if it isunusual, deviates from normal, and is unsupported by other data. Should the initial recording prove to be in error, it would have been premature to notify the charge nurse or the surgeon. The nurse shouldbe sure that all data recorded are accurate, thus all data should be validated before documentation if there are any doubts about accuracy. Closing of these gives off the Lub dub sounds - CORRECT ANSWER>> Heart valves This organ is most sensitive to shifts in potassium - CORRECT ANSWER>> The heart This is how to help clear the airway for an infant - CORRECT ANSWER>> Suction A term used meaning no fever - CORRECT ANSWER>> Afebrile QSEN - CORRECT ANSWER>> Quality & Safety Education for Nurses Goal: To meet the challenge of preparing future nurses who will have the knowledge, skills, andattitudes necessary to continuously improve the quality and safety of the health care systems within which they work. Providing spiritual care is mandated by these - CORRECT ANSWER>> Accrediting bodies What issues are covered by state legislation? - CORRECT ANSWER>> -Scope of practice for LPNs, RNs, &APNs -Nursing educational requirement -Composition and disciplinary authority of the BON Bacteria in the mouth has been linked to these diseases - CORRECT ANSWER>> Diabetes and heartdisease
The resistance to left ventricular ejection - CORRECT ANSWER>> Systemic vascular resistance
What are the issues covered by federal legislation? - CORRECT ANSWER>> -Medicare and medicaidprovisions related to reimbursement for nursing services
The client must be able to do this to use the numeric pain scale - CORRECT ANSWER>> Self-report A perfect Glosclow coma score - CORRECT ANSWER>> 15 A nurse discovers that she made a medication error. What should be the nurse's first response? A. Record the error on the medication sheet.B. Notify the physician regarding course of action. C. Check the patient's condition to note any possible effect of the error. D. Complete an incident report, explaining how the mistake was made. - CORRECT ANSWER>> C
An abnormal process in which any aspect of the person's functioning is altered - CORRECT ANSWER>>Illness
The resistance to the injection of blood - CORRECT ANSWER>> Afterload Difficulty remembering names - CORRECT ANSWER>> Normal aging The #1 way to prevent the spread of infection - CORRECT ANSWER>> Hand hygiene What are the issues covered by the National Council of State Board of Nursing (NCSBN)? - CORRECT ANSWER>> -Delegation -Medication administration-Unprofessional conduct -Licensing
A nurse is following the principles of medical asepsis when performing patient care in a hospital setting.Which nursing action performed by the nurse follows these recommended guidelines?
A. The nurse carries the patients' soiled bed linens close to the body to prevent spreadingmicroorganisms into the air. B. The nurse places soiled bed linens and hospital gowns on the floor when making the bed.C. The nurse moves the patient table away from the nurse's body when wiping it off after a meal. D. The nurse cleans the most soiled items in the patient's bathroom first and follows with the cleaner items. - CORRECT ANSWER>> C. According to the principles of medical asepsis, the nurse should move equipment away from the body when brushing, scrubbing, or dusting articles to prevent contaminatedparticles from settling on the hair, face, or uniform. The nurse should carry soiled items away from the body to prevent them from touching the clothing. The nurse should not put soiled items on the floor, asit is highly contaminated. The nurse should also clean the least soiled areas first and then move to the more soiled ones to prevent having the cleaner areas soiled by the dirtier areas. A common site for infection in the elderly - CORRECT ANSWER>> Urinary tract Hyperventilation could cause this acid-base imbalance - CORRECT ANSWER>> Respiratory alkalosis Insulin resistance occurs in this type of diabetes - CORRECT ANSWER>> Type 1 Diabetes
- A patient who has a large abdominal wound suddenly calls out for help because she feels as thoughsomething is falling out of her incision. Inspection reveals a gaping open wound with tissue bulging outward. In which order should the nurse perform the following interventions? Arrange from first tolast.
A. Notify the physician immediately of the situation. B. Cover the exposed tissue with sterile towels moistened with sterile NSS. C. Place the patient in the low Fowler's position. - CORRECT ANSWER>> C, B, A Dehiscence and evisceration is a postoperative emergency that requires prompt surgical repair. The correct order ofimplementation by the nurse is to place the patient in the low Fowler's position, cover the exposed tissue with sterile towels moistened with sterile NSS, and notify the physician immediately of thesituation.
The transfer of heat from one object to another when they are in direct contact - CORRECT ANSWER>>Conduction
A school nurse is performing an assessment of a student who states: "I'm too tired to keep my head upin class." The student has a low-grade fever. The nurse would interpret these findings as indicating which stage of infection? A. Incubation periodB. Prodromal stage C. Full stage of illness D. Convalescent period - CORRECT ANSWER>> B. During the prodromal stage, the person has vague signs and symptoms, such as fatigue and a low-grade fever. There are no obvious symptoms of infectionduring the incubation period, and they are more specific during the full stage of illness, before disappearing by the convalescent period. What are the purposes of the National Patient Safety Goals (Think ICMAIRW)? - CORRECT ANSWER>> -Improve accuracy of pt identification -Improve effectiveness of communication among caregivers-Improve safety use of meds -Reduce harm associated w/clinical alarm systems-Reduce risk of HAI's -Identify safety risks inherent in hospital's pt population-Prevent wrong site, wrong procedure
Longest of all stages - CORRECT ANSWER>> 1st Stage of Labor Hypoventilation can cause this acid-base imbalance - CORRECT ANSWER>> Respiratory acidosis Insulin is secreted by what cells - CORRECT ANSWER>> Beta cells Absolute absence of insulin in the body - CORRECT ANSWER>> Type 1 Diabetes
