Nursing Home Care and Procedures, Exams of Advanced Education

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Nursing Fundamentals Final Exam

You enter a residents room and the resident has a new onset bedsore. You feel you need to document this in the medical record but also have a discussion with the nurse. Where would you opt to have this discussion? a. In the patients room b. In the hallway with the family c. In private d. At the local bar - C To prevent shampoo from getting into your residents eyes, you should: a. Use a hand held nozzle b. Use dry shampoo c. Rinse the hair throughly d. Use a washcloth to cover the eyes - D Bath water temperature should be at what temperature: a. 110- 115 degrees F b. 110- 120 degrees F c. 105 degrees F d. 105- 109 degrees F - A The word ACUTE when used to define illness means: a. an illness for which there is no reasonable expectation of recovery b. an ongoing illness for which there is no cure

c. a sudden onset to an illness d. an illness that is gradual - C In your role as a nursing assistant, you are able to: a. You can take verbal orders over the phone from doctors b. Give medications c. Insert a foley in the patients vagina or penis d. Report changes in the residents condition to the nurse - D An assisted living facility provides all of the following except: a. Housing b. Personal care c. Social activities d. 24 hour skilled nursing care - D Those persons who provide basic nursing care under the supervision of a registered nurse or a licensed practical nurse are: a. Licensed practical nurse b. Case managers c. Assistive personnel d. The "health care team" - C A federal insurance plan providing benefits for older persons and some younger persons with disabilities is called: a. Medicaid

b. Medicare c. Blue Cross/ Blue Shield d. Coventry - B Which nursing care pattern focuses on tasks and jobs? a. Functional nursing b. Team nursing c. Primary nursing d. Care management - A You promote quality of life by: a. Delegating tasks to your coworkers b. Making sure you bring your resident chocolate and Starbucks c. Doing everything for the patient, they don't need to lift a finger d. Speaking to individuals in a respectful manner - D Your patient has left sided weakness, how do you put on their shirt? a. Clients choice b. Right sleeve c. Left sleeve d. Both sleeve together - C Exercises that move each muscle and joint care called? a. Rotation b. Adduction

c. Range of Motion d. Abduction - C Your patient's roommate has just died, how can you BEST help the client with the loss? a. Discourage individual activity b. Encourage the client talk c. Convince the client its no big loss. The roommate was a complainer d. Leave the client alone - B You go to check on Mrs. Jones, she is very agitated. Your task is to give her a bed bath, When you walk in the room, she tells you "Get out of here. I do not want a bed bath". What should you do? a. Speak loudly because maybe Mrs. Jones didn't hear or understand you. b. Run c. Tell the client they have no choice, shut up and lets get cleaned up d. Talk calmly, slowly, reassure the client. Do not force them. Report the refusal to the nurse. - D Padding side rails on a bed serves a purpose. The purpose is: a. Restrain the patient b. Have somewhere to put the call button c. Keep the client warm d. Protect your client from possible injury - D Which of the following stages of dying is usually the final stage for the client? a. Anger b. Acceptance

c. Bargaining d. Depression - B Which is more correct measure of urinary output? a. 30 oz b. 300ml or cc c. 2 cups d. 1 gallon - B The role of the ombudsman is: a. Work with the nursing home to protect the clients rights b. Control the nursing home budget c. Prepare classes that nurses aides take to learn hygiene d. Run a group of nursing homes - A The BEST time to prepare for a disaster is: a. During your lunch b. When everyone has gone to bed c. During a tornado or hurricane d. Before it happens - D Which temperature is considered MOST accurate? a. Oral b. Axillary (A) c. Temporal

d. Rectal (R) - D The beginning sign of a pressure sore is: a. Coolness b. Discoloration c. Swelling d. Numbness - B What Act did Congress pass in 1987, to protect the quality of life, health and safety of nursing home residents? a. MedicareAct of 1987 b. Patients Bill of Rights c. EMTALA d. Omnibus Budget Reconciliation Act - D Your resident is wealthy. He offers you a "little gift" in the form of cash for providing expert care. You should: a. Accept and say nothing b. Accept like a tip and share it with your coworkers c. Refuse graciously d. Look to see if anyone is listening or watching - C Retirement usually results in: a. Physical changes from aging b. Financial security

c. Less Free Time d. Typically a lower income - d After urinating, the resident is assisted to: a. Wash their hands b. Get back in bed c. GIven something to drink d. Put in a diaper - A What can happen is constipation is not relieved? a. Enema b. Diarrhea c. Incontinence d. Fecal Impaction - D When removing soiled linens, you must wear: a. A gown b. Face Mask c. Eye Protection d. Gloves - D Information that you can see, hear, feel or smell is called: a. Assessment b. Observation c. Objective data

d. Subjective data - D A resident continues to ask you the same question over and over again each time you come into the room. You should: a. Tell the person you are tired of answering the same question b. Yell at the resident c. Report the behavior d. Be patient - D Before leaving on for lunch, you need to: a. Use the bathroom and wash your hands b. Turn off the computer c. Call home and check on your children d. Tell the nurse - D The most common cause of COPD/emphysema is: a. Pollution b. Family History c. Asthma d. Smoking - D When you assist a person to ambulate/walk, what should would do first: a. Apply braces to the legs b. Get crutches, cane or walker c. Apply a gait belt

d. Get the patients glasses - C Before putting your patients feet on the floor for ambulation, you want to ensure: a. They wear whatever they want b. Slippers c. Cowboy boots d. Non skid footwear - D You are asked to collect a sputum specimen from your resident by the nurse. it is easier: a. After an activity b. After a meal c. Before a meal d. Upon awakening in the morning - D An older persons ability to sense pain is: a. Decreased b. Increased c. The same as every other adult d. the same as a baby - A When transferring a resident to a wheelchair: a. The brakes must be locked b. Hold the handgrips c. Put your foot on the back of the wheels to hold in place d. Stand on the footplates - A

Your resident is "comatose" you should assume: a. They can hear b. They can see c. They can touch d. They can speak - A Your resident has a history of a stroke with residual weakness, you are asked to ambulate them. You should: a. Assist on weak side b. Assist on strong side c. Put them in a wheelchair d. Stand in front of them like you are a walker - A What is the term for a device used to take the place of a missing body part? a. Pronation b. External rotation c. Amputation d. Prosthesis - D True of False Accidents or errors in giving care should be reported to the nurse at the end of the shift. - False True or False

A married couple is admitted to a nursing facility. They should be assigned to separate rooms. - False Laws that deal with relationships between people are called? a. Criminal lwas b. Torts c. Responsibilities d. Civil laws - D The nurse tells you to perform a procedure. Which is not true? a. The nurse must be available to answer questions and supervise b. Do whatever the nurse tells you to do c. The procedure must be in your job description d. Your state must allow nursing assistants to perform the procedure - B To residents share a room. One family wants to take pictures of the two residents together. A persons picture taken without permission is called: a. Assault b. Malpractice c. Negligence d. Invasion of Privacy - D An official record of persons who have completed a Nursing Assistant training and competency evaluation programs. a. OBRA b. Civil law

c. Protected nursing assistants records d. Nursing Assistant Registry - D True or False You can never refuse to perform a delegated task. - False True or False Nursing Assistants supervise other Nursing Assistants - False A rule of conduct made by the government body is called: a. A law b. Libel c. Tort d. Informed Consent - A Spreading rumors or talking about the private matters of others is: a. Harassment b. Gossip c. Loads of fun d. Confidentiality - B Looking at things from another's point of view is called: a. Politeness b. Work ethic

c. Empathy d. Courtesy - C True or False Always use medical terms when you talk to the patient or resident. - False True or False Everyone who works at an agency as the right to read the patient.residents records - False True or False Medical diagnosis and the nursing diagnosis are always the same - False True or False Reporting and recording are done before you give the patient care - False True or False The nursing progress never ends - True True or False Conflict in the workplace can impact the quality of the care provided. - True It is 4:00pm. In a 24- hour clock, how do you record time?

a. 2400 b. c. d.0004 - C During which step of the nursing process is care provided? a. Assessment b. Evaluation c. Implementation d. Planning - C True or False A flowsheet is only used by RNS and used to record frequent measurements or observations. - True Large rings are dangerous because: a. They can fall off and can be lost b. They can scratch the resident c. They can damage equipment d. patients can pull them off your finger - B The goal of the healthcare team is to: a. Carry out the MDs orders b. Develop plans of care for residents c. Provide quality care d. Complain about the workload - C

True or False Listen and use silence when dealing with an angry person - True True or False Inappropriate sexual behaviors by the resident are always on purpose - False True or False Everyone likes to be touched - False True or False Giving your opinion, positive or negative, promotes effective communication - True True or False Residents do not feel safe if you tell them what you are doing - False Direct Questions are used to: a. show the person you care about them b. make sure you understand what was said c. focus on specific information d. allow the person time to think - C Communication that uses written/spoken word is:

a. nonverbal b. focusing c. body language d. verbal communication - D What does not promote effective listening? a. sitting back in the chair with your arms crossed b. making eye contact c. facing the person d. asking appropriate questions - A The type of bone that bears weight of the body is called: a. long bone b. flat bone c. irregular bone d. short bone - A The largest art of the brain and the center of thought and intelligence is: a. midbrain b. brainstem c. cerebellum d. cerebellum - D Where does digestion begin?

a. stomach b. esophagus c. mouth d. intestines - C You must check the MSDS a. before using a hazardous substance b. after cleaning up a leak or spill c. at the beginning of the shift d. at the end of the shift - A True or False If you call the resident by name and the respond. You know it is them. - False True or False Restraints are safe and are always used to prevent falls - False True or False The most serious risk of restraint use is death - True True or False Restraints can increase a person's confusion or agitation - True The following statements are about restraint use. Which is false?

a. the least restrictive method is used b. restraints require a doctors order c. restraints can cause serious harm d. restraints are used to discipline a person who is uncooperative with care - D A microbe that is harmful and causes infection is called: a. reservoir b.pathogen c. a non- pathogen d. host - B The process of becoming "unclean" is called: a. asepsis b. disinfection c. contamination d. immunity - C Mrs. Cooper is on isolation precautions. Which is false? a. say hello from the doorway every 15 minutes b. spend as little time as you can in her room c. provide her with hobby materials d. treat her with respect, kindness and dignity - B You are doing a dressing change on a resident. You notice that the dressing has a red/yellow body fluid on it. The dressing is called:

a. Gross b. Biohazards waste c. Bloody pus d. use droplet precautions - B True or False When transferring a patient, the weak side moves first - True True or False Proper positioning prevents pressure ulcers and contractures - True True or False The bed should be placed in low with the call bell in reach when providing patient care. - False Your resident is in back lying position. This is called: a. prone b. supine c. High Fowlers d. dorsal recumbent position - B When logrolling a resident, you must: a. make sure the bed is in Fowlers position b. make sure the bed is in the lowest position

c. make sure that both bed rails are up d. turn the person as a unit, in alignment, with one motion - D The spread of cancer to other body parts is called: a. gangrene b. Benign tumor c. metastasis d. malignant tumor - C You come into a room and find a patient having a seizure. You should: a. leave and find help b. remove any object the patient may hit c. restrain the patient's movements d. raise the foot of the bed - B What are the most obvious indications of hearing impairment? a. resident speaks loudly b. resident leans forward to hear c. resident turns or cups their better ear toward the speaker - D The apical pulse is located? Choose One. a. in the neck b. at the wrist c. in the second finger d. below the left nipple - D

Blood vessels that carry blow away from the heart are called: a. arteries b. veins c. venulee d. capillaries - A Which of following medical problems frequently develop in residents with diabetes? a. kidney failure b. stroke c. decreased vision d. all of the above - D You walk into check on your resident. They are in the bed, sweaty, seem really "out of sorts", and clutching their chest. You suspect: a. Stroke b. Heart attack c. TIA d. COPD - B Which of the following changes in the skin growth should be reported immediately to the nurse. a. change in color b.bleeding c. change in size d. all of the above - D

Difficulty swallowing may be associated with: a. Congestive Heart Failure b. Parkinson's Disease c. Stroke d. Multiple Sclerosis - C When taking an oral temperature with a glass thermometer. The thermometer must be left in place: a. 15 seconds b. 3 minutes c. 45 seconds d. 8 minutes - B Which of the following is an important function of the skin: a. prevents pressure on the subcutaneous tissue b. provides support to the internal organs c. first line defense against infection d. all of the above - D Which of the following vital signs should you report to the nurse immediately. a. 37.1, 78, 16, 118/64 b. 36.9 (r), 90, 20, 138/70 c. 36.4 (a), 158, 22, 90/46 d. 36.6, 100, 16, 120/88 - C

The call bell or signal light should ALWAYS be: a. on the bedrail b. attached to the pillow c. within the patients reach d. on the arm of the chair - C When performing perineal care, you should clean the: a. labia b. urethra to the anal area c. anal area to the urethra d. buttocks to the urethra - B You are giving mouth care to an unconscious resident. You must be especially careful to prevent the resident from: a. Talking during the procedure b. Biting down on the toothbrush c. Eating the toothpaste d. Aspirating fluid - D. An uncircumcised male resident needs perineal care. Which of the following statements is true? a. the foreskin should be retracted. After cleaning, the foreskin is returned to its natural position. b. you should perform the procedures as if the resident were circumcised c. the labia are separated Downward strokes from front to back are used the area d. there is no difference - A

When changing an unsterile dressing, the nurse aide should wash hands: a. before the procedure b. after the procedure c. before and after the procedure d. before, after the removal of the soiled dressing, and after the procedure - D A safety device used to transfer a dependent resident from the bed to chair is called: a. posey vest b. hand roll c. transfer/gait belt d. foot board - C When making an occupied bed, the nursing assistant should: a. raise the side rail on the unattended side b. lower both side rails before changing the bed c. help the client to sit in a chair while the bed is made d. put the dirty sheets on the floor - A What is the besy way to promote the resident independence in bathing a resident who has had a stroke? a. Limit the client to washing her hands b. Leave the client alone and assume the client will do as much as she can c. Encourage the client to do as much as possible and assist as needed d. Give the client a complete bed bath only if requested - C

You enter a patients room and the resident states they are in pain. What should you do? a. ignore the clients statements b. tell the clients to suck it up the pain will go away c. report it to the nurse d. tell the client they will feel better if they just get out the bed - C Men often times have difficulty urinating because: a. kidneys atrophy b. bladder increases in size c. prostate gland enlarges d. urethra loses tone - C Development is a. an involuntary movement b. a skill that must be completed c. changes in mental, emotional, and social function d. the physical changes that can be measured and that occur in steady, orderly manner - C You go to check on a resident and the gown is soiled. The next action should be: a. clean the patient and put the soiled gown back on b. leave the patient dirty and change the gown c. clean the patient and put on a clean gown d. walk out of the room - C Mr. Kline is bedbound. How often should reposition him?