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PNLE: Fundamentals in Nursing Exam 3 (PM)
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Question 1
The best way to instill eye drops is to:
A
Drop the medication into the inner canthus regardless of eye position
B
Instruct the patient to lock upward, and drop the medication into the center of the lower lid
C
Instruct the patient to look ahead, and drop the medication into the center of the lower lid
D
Drop the medication into the center of the canthus regardless of eye position
Question 1 Explanation:
Having the patient look upward reduces blinking and protects the cornea. Instilling drops in the center of the lower lid promotes absorption because the drops are less likely to run into the nasolacrimal duct or out of the eye.
Question 2
A male patient is to be discharged with a prescription for an analgesic that is a controlled substance. During discharge teaching, the nurse should explain that the patient must fill this prescription how soon after the date on which it was written?
A
Within 3 months
B
Within 1 month
C
Within 6 months
D
Within 12 months
Question 2 Explanation:
In most cases, an outpatient must fill a prescription for a controlled substance within 6 months of the date on which the prescription was written.
Question 3
The nurse in charge measures a patient’s temperature at 102 degrees F. what is the equivalent Centigrade temperature?
A
39 degrees C
B
38.9 degrees C
C
40.1 degrees C
D
47 degrees C
Question 3 Explanation:
To convert Fahrenheit degrees to centigrade, use this formula: C degrees = (F degrees – 32) x 5/9 C degrees = (102 – 32) 5/9 + 70 x 5/9 38.9 degrees C
Question 4
All of the following parts of the syringe are sterile except the:
A
Barrel tip
B
Barrel
C
Inside of the plunger
D
Needle tip
Question 4 Explanation:
All syringes have three parts: a tip, which connects the needle to the syringe; a barrel, the outer part on which the measurement scales are printed; and a plunger, which fits inside the barrel to expel the medication. The external part of the barrel and the plunger and (flange) must be handled during the preparation and administration of the injection. However, the inside and trip of the barrel, the inside (shaft) of the plunger, and the needle tip must remain sterile until after the injection.
Question 5
A female patient exhibits signs of heightened anxiety. Which response by the nurse is most likely to reduce the patient’s anxiety?
A
“Let’s talk about what’s bothering you.”
B
“Read this manual and then ask me any questions you may have.”
C
“Why don’t you listen to the radio?”
D
“Everything will be fine. Don’t worry.”
Question 5 Explanation:
Anxiety may result from feeling of helplessness, isolation, or insecurity. This response helps reduce anxiety by encouraging the patient to express feelings. The nurse should be supportive and develop goals together with the patient to give the patient some control over an anxiety-inducing situation. Because the other options ignore the patient’s feeling and block communication, they would not reduce anxiety.
Question 6
A patient is in the bathroom when the nurse enters to give a prescribed medication. What should the nurse in charge do?
A
Return shortly to the patient’s room and remain there until the patient takes the medication
B
Wait for the patient to return to bed, and then leave the medication at the bedside
C
Tell the patient to be sure to take the medication. And then leave it at the bedside
D
Leave the medication at the patient’s bedside
Question 6 Explanation:
The nurse should return shortly to the patient’s room and remain there until the patient takes the medication to verify that it was taken as directed. The nurse should never leave medication at the patient’s bedside unless specifically requested to do so.
Question 7
A female patient with a terminal illness is in denial. Indicators of denial include:
A
Numbness
B
Stoicism
C
Shock dismay
D
Preparatory grief
Question 7 Explanation:
Shock and dismay are early signs of denial-the first stage of grief. The other options are associated with depression—a later stage of grief.
Question 8
When examining a patient with abdominal pain the nurse in charge should assess:
A
The symptomatic quadrant first
B
Any quadrant first
C
The symptomatic quadrant either second or third
D
The symptomatic quadrant last
Question 8 Explanation:
The nurse should systematically assess all areas of the abdomen, if time and the patient’s condition permit, concluding with the symptomatic area. Otherwise, the nurse may elicit pain in the symptomatic area, causing the muscles in other areas to tighten. This would interfere with further assessment.
Question 9
To evaluate a patient for hypoxia, the physician is most likely to order which laboratory test?
A
Red blood cell count
B
Sputum culture
C
Arterial blood gas (ABG) analysis
D
Total hemoglobin
Question 9 Explanation:
All of these test help evaluate a patient with respiratory problems. However, ABG analysis is the only test evaluates gas exchange in the lungs, providing information about patient’s oxygenation status.
Question 10
A patient receiving an anticoagulant should be assessed for signs of:
A
Hypertension
B
An elevated hemoglobin count
C
Hypotension
D
An increased number of erythrocytes
Question 10 Explanation:
A major side effect of anticoagulant therapy is bleeding, which can be identified by hypotension (a systolic blood pressure under 100 mm Hg). Anticoagulants do not result in the other three conditions.
Question 11
Which human element considered by the nurse in charge during assessment can affect drug administration?
A
The patient’s socioeconomic status
B
The patient’s cognitive abilities
C
The patient’s occupational hazards
D
The patient’s ability to recover
Question 11 Explanation:
The nurse must consider the patient’s cognitive abilities to understand drug instructions. If not, the nurse must find a family member or significant other to take on the responsibility of administering medications in the home setting. The patient’s ability to recover, occupational hazards, and socioeconomic status do not affect drug administration.
Question 12
Nurse Brenda is teaching a patient about a newly prescribed drug. What could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications?
A
Sensory deficits
B
Decreased plasma drug levels
C
Lack of family support
D
History of Tourette syndrome
Question 12 Explanation:
Sensory deficits could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications. Decreased plasma drug levels do not alter the patient’s knowledge about the drug. A lack of family support may affect compliance, not knowledge retention. Toilette syndrome is unrelated to knowledge retention.
Question 13
When administering drug therapy to a male geriatric patient, the nurse must stay especially alert for adverse effects. Which factor makes geriatric patients to adverse drug effects?
A
Increased amount of neurons
B
Aging-related physiological changes
C
Faster drug clearance
D
Enhanced blood flow to the GI tract
Question 13 Explanation:
Aging-related physiological changes account for the increased frequency of adverse drug reactions in geriatric patients. Renal and hepatic changes cause drugs to clear more slowly in these patients. With increasing age, neurons are lost and blood flow to the GI tract decreases.
Question 14
The nurse in charge is transferring a patient from the bed to a chair. Which action does the nurse take during this patient transfer?
A
Places the chair facing away from the bed
B
Helps the patient dangle the legs
C
Stands behind the patient
D
Position the head of the bed flat
Question 14 Explanation:
After placing the patient in high Fowler’s position and moving the patient to the side of the bed, the nurse helps the patient sit on the edge of the bed and dangle the legs; the nurse then faces the patient and places the chair next to and facing the head of the bed.
Question 15
Which of the following planes divides the body longitudinally into anterior and posterior regions?
A
Midsagittal plane
B
Transverse plane
C
Sagittal plane
D
Frontal plane
Question 15 Explanation:
Frontal or coronal plane runs longitudinally at a right angle to a sagittal plane dividing the body in anterior and posterior regions. A sagittal plane runs longitudinally dividing the body into right and left regions; if exactly midline, it is called a midsagittal plane. A transverse plane runs horizontally at a right angle to the vertical axis, dividing the structure into superior and inferior regions.
Question 16
Before administering the evening dose of a prescribed medication, the nurse on the evening shift finds an unlabeled, filled syringe in the patient’s medication drawer. What should the nurse in charge do?
A
Obtain a label for the syringe from the pharmacy
B
Discard the syringe to avoid a medication error
C
Use the syringe because it looks like it contains the same medication the nurse was prepared to give
D
Call the day nurse to verify the contents of the syringe
Question 16 Explanation:
As a safety precaution, the nurse should discard an unlabeled syringe that contains medication. The other options are considered unsafe because they promote error.
Question 17
The nurse is assessing a postoperative adult patient. Which of the following should the nurse document as subjective data?
A
Laboratory test result
B
Patient’s description of pain
C
Electrocardiographic (ECG) waveforms
D
Vital signs
Question 17 Explanation:
Subjective data come directly from the patient and usually are recorded as direct quotations that reflect the patient’s opinions or feelings about a situation. Vital signs, laboratory test result, and ECG waveforms are examples of objective data.
Question 18
The nurse uses a stethoscope to auscultate a male patient’s chest. Which statement about a stethoscope with a bell and diaphragm is true?
A
The diaphragm detects high-pitched sounds best
B
The diaphragm detects low-pitched sounds best
C
The bell detects high-pitched sounds best
D
The bell detects thrills best
Question 18 Explanation:
The diaphragm of a stethoscope detects high-pitched sound best; the bell detects low pitched sounds best. Palpation detects thrills best.
Question 19
A female patient is being discharged after cataract surgery. After providing medication teaching, the nurse asks the patient to repeat the instructions. The nurse is performing which professional role?
A
Caregiver
B
Manager
C
Patient advocate
D
Educator
Question 19 Explanation:
When teaching a patient about medications before discharge, the nurse is acting as an educator. The nurse acts as a manager when performing such activities as scheduling and making patient care assignments. The nurse performs the care giving role when providing direct care, including bathing patients and administering medications and prescribed treatments. The nurse acts as a patient advocate when making the patient’s wishes known to the doctor.
Question 20
The physician orders heparin, 7,500 units, to be administered subcutaneously every 6 hours. The vial reads 10,000 units per millilitre. The nurse should anticipate giving how much heparin for each dose?
A
1 ¼ ml
B
½ ml
C
¼ ml
D
¾ ml
Question 20 Explanation:
The nurse solves the problem as follows: 10,000 units/7,500 units = 1 ml/X 10,000 X = 7,500 X= 7,500/10,000 or ¾ ml
Question 21
A scrub nurse in the operating room has which responsibility?
A
Positioning the patient
B
Handling surgical instruments to the surgeon
C
Assisting with gowning and gloving
D
Applying surgical drapes
Question 21 Explanation:
The scrub nurse assist the surgeon by providing appropriate surgical instruments and supplies, maintaining strict surgical asepsis and, with the circulating nurse, accounting for all gauze, sponges, needles, and instruments. The circulating nurse assists the surgeon and scrub nurse, positions the patient, applies appropriate equipment and surgical drapes, assists with gowning and gloving, and provides the surgeon and scrub nurse with supplies.
Question 22
A female patient who speaks a little English has emergency gallbladder surgery, during discharge preparation, which nursing action would best help this patient understand wound care instruction?
A
Demonstrating the procedure and having the patient return the demonstration
B
Asking frequently if the patient understands the instruction
C
Asking an interpreter to replay the instructions to the patient.
D
Writing out the instructions and having a family member read them to the patient
Question 22 Explanation:
Demonstrating by the nurse with a return demonstration by the patient ensures that the patient can perform wound care correctly. Patients may claim to understand discharge instruction when they do not. An interpreter of family member may communicate verbal or written instructions inaccurately.
Question 23
A male patient has a soft wrist-safety device. Which assessment finding should the nurse consider abnormal?
A
Pink nail beds
B
Cool, pale fingers
C
A palpable ulnar pulse
D
A palpable radial pulse
Question 23 Explanation:
A safety device on the wrist may impair circulation and restrict blood supply to body tissues. Therefore, the nurse should assess the patient for signs of impaired circulation, such as cool, pale fingers. A palpable radial or lunar pulse and pink nail beds are normal findings.
Question 24
When explaining the initiation of I.V. therapy to a 2-year-old child, the nurse should:
A
Inform the child that the needle will be in place for 10 days
B
Tell the child, “This treatment is for your own good”
C
Ask the child, “Do you want me to start the I.V. now?”
D
Give simple directions shortly before the I.V. therapy is to start
Question 24 Explanation:
Because a 2-year-old child has limited understanding, the nurse should give simple directions and explanations of what will occur shortly before the procedure. She should try to avoid frightening the child with the explanation and allow the child to make simple choices, such as choosing the I.V. insertion site, if possible. However, she shouldn’t ask the child if he wants the therapy, because the answer may be “No!” Telling the child that the treatment is for his own good is ineffective because a 2-year-old perceives pain as a negative sensation and cannot understand that a painful procedure can have position results. Telling the child how long the therapy will last is ineffective because the 2-year-old doesn’t have a good understanding of time.
Question 25
The difference between an 18G needle and a 25G needle is the needle’s:
A
Length
B
Thickness
C
Bevel angle
D
Sharpness
Question 25 Explanation:
Gauge is a measure of the needle’s thickness: The higher the number the thinner the shaft. Therefore, an 18G needle is considerably thicker than a 25G needle.
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PNLE: Fundamentals in Nursing Exam 3 (EM)
Choose the letter of the correct answer. You got 25 minutes to finish the exam .Good luck!
Start
Congratulations - you have completed PNLE: Fundamentals in Nursing Exam 3 (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
When explaining the initiation of I.V. therapy to a 2-year-old child, the nurse should:
A
Ask the child, “Do you want me to start the I.V. now?”
B
Give simple directions shortly before the I.V. therapy is to start
C
Tell the child, “This treatment is for your own good”
D
Inform the child that the needle will be in place for 10 days
Question 1 Explanation:
Because a 2-year-old child has limited understanding, the nurse should give simple directions and explanations of what will occur shortly before the procedure. She should try to avoid frightening the child with the explanation and allow the child to make simple choices, such as choosing the I.V. insertion site, if possible. However, she shouldn’t ask the child if he wants the therapy, because the answer may be “No!” Telling the child that the treatment is for his own good is ineffective because a 2-year-old perceives pain as a negative sensation and cannot understand that a painful procedure can have position results. Telling the child how long the therapy will last is ineffective because the 2-year-old doesn’t have a good understanding of time.
Question 2
The nurse uses a stethoscope to auscultate a male patient’s chest. Which statement about a stethoscope with a bell and diaphragm is true?
A
The bell detects thrills best
B
The diaphragm detects low-pitched sounds best
C
The bell detects high-pitched sounds best
D
The diaphragm detects high-pitched sounds best
Question 2 Explanation:
The diaphragm of a stethoscope detects high-pitched sound best; the bell detects low pitched sounds best. Palpation detects thrills best.
Question 3
A male patient is to be discharged with a prescription for an analgesic that is a controlled substance. During discharge teaching, the nurse should explain that the patient must fill this prescription how soon after the date on which it was written?
A
Within 6 months
B
Within 1 month
C
Within 3 months
D
Within 12 months
Question 3 Explanation:
In most cases, an outpatient must fill a prescription for a controlled substance within 6 months of the date on which the prescription was written.
Question 4
The nurse is assessing a postoperative adult patient. Which of the following should the nurse document as subjective data?
A
Vital signs
B
Electrocardiographic (ECG) waveforms
C
Laboratory test result
D
Patient’s description of pain
Question 4 Explanation:
Subjective data come directly from the patient and usually are recorded as direct quotations that reflect the patient’s opinions or feelings about a situation. Vital signs, laboratory test result, and ECG waveforms are examples of objective data.
Question 5
The best way to instill eye drops is to:
A
Instruct the patient to lock upward, and drop the medication into the center of the lower lid
B
Drop the medication into the inner canthus regardless of eye position
C
Instruct the patient to look ahead, and drop the medication into the center of the lower lid
D
Drop the medication into the center of the canthus regardless of eye position
Question 5 Explanation:
Having the patient look upward reduces blinking and protects the cornea. Instilling drops in the center of the lower lid promotes absorption because the drops are less likely to run into the nasolacrimal duct or out of the eye.
Question 6
Which human element considered by the nurse in charge during assessment can affect drug administration?
A
The patient’s cognitive abilities
B
The patient’s occupational hazards
C
The patient’s socioeconomic status
D
The patient’s ability to recover
Question 6 Explanation:
The nurse must consider the patient’s cognitive abilities to understand drug instructions. If not, the nurse must find a family member or significant other to take on the responsibility of administering medications in the home setting. The patient’s ability to recover, occupational hazards, and socioeconomic status do not affect drug administration.
Question 7
A scrub nurse in the operating room has which responsibility?
A
Handling surgical instruments to the surgeon
B
Applying surgical drapes
C
Assisting with gowning and gloving
D
Positioning the patient
Question 7 Explanation:
The scrub nurse assist the surgeon by providing appropriate surgical instruments and supplies, maintaining strict surgical asepsis and, with the circulating nurse, accounting for all gauze, sponges, needles, and instruments. The circulating nurse assists the surgeon and scrub nurse, positions the patient, applies appropriate equipment and surgical drapes, assists with gowning and gloving, and provides the surgeon and scrub nurse with supplies.
Question 8
A female patient who speaks a little English has emergency gallbladder surgery, during discharge preparation, which nursing action would best help this patient understand wound care instruction?
A
Writing out the instructions and having a family member read them to the patient
B
Asking frequently if the patient understands the instruction
C
Demonstrating the procedure and having the patient return the demonstration
D
Asking an interpreter to replay the instructions to the patient.
Question 8 Explanation:
Demonstrating by the nurse with a return demonstration by the patient ensures that the patient can perform wound care correctly. Patients may claim to understand discharge instruction when they do not. An interpreter of family member may communicate verbal or written instructions inaccurately.
Question 9
When administering drug therapy to a male geriatric patient, the nurse must stay especially alert for adverse effects. Which factor makes geriatric patients to adverse drug effects?
A
Aging-related physiological changes
B
Faster drug clearance
C
Increased amount of neurons
D
Enhanced blood flow to the GI tract
Question 9 Explanation:
Aging-related physiological changes account for the increased frequency of adverse drug reactions in geriatric patients. Renal and hepatic changes cause drugs to clear more slowly in these patients. With increasing age, neurons are lost and blood flow to the GI tract decreases.
Question 10
A female patient with a terminal illness is in denial. Indicators of denial include:
A
Preparatory grief
B
Shock dismay
C
Numbness
D
Stoicism
Question 10 Explanation:
Shock and dismay are early signs of denial-the first stage of grief. The other options are associated with depression—a later stage of grief.
Question 11
A patient is in the bathroom when the nurse enters to give a prescribed medication. What should the nurse in charge do?
A
Tell the patient to be sure to take the medication. And then leave it at the bedside
B
Return shortly to the patient’s room and remain there until the patient takes the medication
C
Wait for the patient to return to bed, and then leave the medication at the bedside
D
Leave the medication at the patient’s bedside
Question 11 Explanation:
The nurse should return shortly to the patient’s room and remain there until the patient takes the medication to verify that it was taken as directed. The nurse should never leave medication at the patient’s bedside unless specifically requested to do so.
Question 12
Which of the following planes divides the body longitudinally into anterior and posterior regions?
A
Frontal plane
B
Sagittal plane
C
Transverse plane
D
Midsagittal plane
Question 12 Explanation:
Frontal or coronal plane runs longitudinally at a right angle to a sagittal plane dividing the body in anterior and posterior regions. A sagittal plane runs longitudinally dividing the body into right and left regions; if exactly midline, it is called a midsagittal plane. A transverse plane runs horizontally at a right angle to the vertical axis, dividing the structure into superior and inferior regions.
Question 13
The nurse in charge measures a patient’s temperature at 102 degrees F. what is the equivalent Centigrade temperature?
A
47 degrees C
B
38.9 degrees C
C
39 degrees C
D
40.1 degrees C
Question 13 Explanation:
To convert Fahrenheit degrees to centigrade, use this formula: C degrees = (F degrees – 32) x 5/9 C degrees = (102 – 32) 5/9 + 70 x 5/9 38.9 degrees C
Question 14
To evaluate a patient for hypoxia, the physician is most likely to order which laboratory test?
A
Sputum culture
B
Total hemoglobin
C
Red blood cell count
D
Arterial blood gas (ABG) analysis
Question 14 Explanation:
All of these test help evaluate a patient with respiratory problems. However, ABG analysis is the only test evaluates gas exchange in the lungs, providing information about patient’s oxygenation status.
Question 15
All of the following parts of the syringe are sterile except the:
A
Inside of the plunger
B
Needle tip
C
Barrel tip
D
Barrel
Question 15 Explanation:
All syringes have three parts: a tip, which connects the needle to the syringe; a barrel, the outer part on which the measurement scales are printed; and a plunger, which fits inside the barrel to expel the medication. The external part of the barrel and the plunger and (flange) must be handled during the preparation and administration of the injection. However, the inside and trip of the barrel, the inside (shaft) of the plunger, and the needle tip must remain sterile until after the injection.
Question 16
Before administering the evening dose of a prescribed medication, the nurse on the evening shift finds an unlabeled, filled syringe in the patient’s medication drawer. What should the nurse in charge do?
A
Obtain a label for the syringe from the pharmacy
B
Use the syringe because it looks like it contains the same medication the nurse was prepared to give
C
Call the day nurse to verify the contents of the syringe
D
Discard the syringe to avoid a medication error
Question 16 Explanation:
As a safety precaution, the nurse should discard an unlabeled syringe that contains medication. The other options are considered unsafe because they promote error.
Question 17
The nurse in charge is transferring a patient from the bed to a chair. Which action does the nurse take during this patient transfer?
A
Helps the patient dangle the legs
B
Places the chair facing away from the bed
C
Position the head of the bed flat
D
Stands behind the patient
Question 17 Explanation:
After placing the patient in high Fowler’s position and moving the patient to the side of the bed, the nurse helps the patient sit on the edge of the bed and dangle the legs; the nurse then faces the patient and places the chair next to and facing the head of the bed.
Question 18
A female patient exhibits signs of heightened anxiety. Which response by the nurse is most likely to reduce the patient’s anxiety?
A
“Let’s talk about what’s bothering you.”
B
“Why don’t you listen to the radio?”
C
“Everything will be fine. Don’t worry.”
D
“Read this manual and then ask me any questions you may have.”
Question 18 Explanation:
Anxiety may result from feeling of helplessness, isolation, or insecurity. This response helps reduce anxiety by encouraging the patient to express feelings. The nurse should be supportive and develop goals together with the patient to give the patient some control over an anxiety-inducing situation. Because the other options ignore the patient’s feeling and block communication, they would not reduce anxiety.
Question 19
A female patient is being discharged after cataract surgery. After providing medication teaching, the nurse asks the patient to repeat the instructions. The nurse is performing which professional role?
A
Caregiver
B
Educator
C
Manager
D
Patient advocate
Question 19 Explanation:
When teaching a patient about medications before discharge, the nurse is acting as an educator. The nurse acts as a manager when performing such activities as scheduling and making patient care assignments. The nurse performs the care giving role when providing direct care, including bathing patients and administering medications and prescribed treatments. The nurse acts as a patient advocate when making the patient’s wishes known to the doctor.
Question 20
A patient receiving an anticoagulant should be assessed for signs of:
A
An elevated hemoglobin count
B
Hypertension
C
Hypotension
D
An increased number of erythrocytes
Question 20 Explanation:
A major side effect of anticoagulant therapy is bleeding, which can be identified by hypotension (a systolic blood pressure under 100 mm Hg). Anticoagulants do not result in the other three conditions.
Question 21
When examining a patient with abdominal pain the nurse in charge should assess:
A
The symptomatic quadrant last
B
Any quadrant first
C
The symptomatic quadrant first
D
The symptomatic quadrant either second or third
Question 21 Explanation:
The nurse should systematically assess all areas of the abdomen, if time and the patient’s condition permit, concluding with the symptomatic area. Otherwise, the nurse may elicit pain in the symptomatic area, causing the muscles in other areas to tighten. This would interfere with further assessment.
Question 22
A male patient has a soft wrist-safety device. Which assessment finding should the nurse consider abnormal?
A
A palpable radial pulse
B
Pink nail beds
C
A palpable ulnar pulse
D
Cool, pale fingers
Question 22 Explanation:
A safety device on the wrist may impair circulation and restrict blood supply to body tissues. Therefore, the nurse should assess the patient for signs of impaired circulation, such as cool, pale fingers. A palpable radial or lunar pulse and pink nail beds are normal findings.
Question 23
The physician orders heparin, 7,500 units, to be administered subcutaneously every 6 hours. The vial reads 10,000 units per millilitre. The nurse should anticipate giving how much heparin for each dose?
A
¾ ml
B
½ ml
C
¼ ml
D
1 ¼ ml
Question 23 Explanation:
The nurse solves the problem as follows: 10,000 units/7,500 units = 1 ml/X 10,000 X = 7,500 X= 7,500/10,000 or ¾ ml
Question 24
The difference between an 18G needle and a 25G needle is the needle’s:
A
Thickness
B
Sharpness
C
Bevel angle
D
Length
Question 24 Explanation:
Gauge is a measure of the needle’s thickness: The higher the number the thinner the shaft. Therefore, an 18G needle is considerably thicker than a 25G needle.
Question 25
Nurse Brenda is teaching a patient about a newly prescribed drug. What could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications?
A
Decreased plasma drug levels
B
History of Tourette syndrome
C
Lack of family support
D
Sensory deficits
Question 25 Explanation:
Sensory deficits could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications. Decreased plasma drug levels do not alter the patient’s knowledge about the drug. A lack of family support may affect compliance, not knowledge retention. Toilette syndrome is unrelated to knowledge retention.
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1. Nurse Brenda is teaching a patient about a newly prescribed drug. What could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications?
Decreased plasma drug levels
Sensory deficits
Lack of family support
History of Tourette syndrome
2. When examining a patient with abdominal pain the nurse in charge should assess:
Any quadrant first
The symptomatic quadrant first
The symptomatic quadrant last
The symptomatic quadrant either second or third
3. The nurse is assessing a postoperative adult patient. Which of the following should the nurse document as subjective data?
Vital signs
Laboratory test result
Patient’s description of pain
Electrocardiographic (ECG) waveforms
4. A male patient has a soft wrist-safety device. Which assessment finding should the nurse consider abnormal?
A palpable radial pulse
A palpable ulnar pulse
Cool, pale fingers
Pink nail beds
5. Which of the following planes divides the body longitudinally into anterior and posterior regions?
Frontal plane
Sagittal plane
Midsagittal plane
Transverse plane
6. A female patient with a terminal illness is in denial. Indicators of denial include:
Shock dismay
Numbness
Stoicism
Preparatory grief
7. The nurse in charge is transferring a patient from the bed to a chair. Which action does the nurse take during this patient transfer?
Position the head of the bed flat
Helps the patient dangle the legs
Stands behind the patient
Places the chair facing away from the bed
8. A female patient who speaks a little English has emergency gallbladder surgery, during discharge preparation, which nursing action would best help this patient understand wound care instruction?
Asking frequently if the patient understands the instruction
Asking an interpreter to replay the instructions to the patient.
Writing out the instructions and having a family member read them to the patient
Demonstrating the procedure and having the patient return the demonstration
9. Before administering the evening dose of a prescribed medication, the nurse on the evening shift finds an unlabeled, filled syringe in the patient’s medication drawer. What should the nurse in charge do?
Discard the syringe to avoid a medication error
Obtain a label for the syringe from the pharmacy
Use the syringe because it looks like it contains the same medication the nurse was prepared to give
Call the day nurse to verify the contents of the syringe
10. When administering drug therapy to a male geriatric patient, the nurse must stay especially alert for adverse effects. Which factor makes geriatric patients to adverse drug effects?
Faster drug clearance
Aging-related physiological changes
Increased amount of neurons
Enhanced blood flow to the GI tract
11. A female patient is being discharged after cataract surgery. After providing medication teaching, the nurse asks the patient to repeat the instructions. The nurse is performing which professional role?
Manager
Educator
Caregiver
Patient advocate
12. A female patient exhibits signs of heightened anxiety. Which response by the nurse is most likely to reduce the patient’s anxiety?
“Everything will be fine. Don’t worry.”
“Read this manual and then ask me any questions you may have.”
“Why don’t you listen to the radio?”
“Let’s talk about what’s bothering you.”
13. A scrub nurse in the operating room has which responsibility?
Positioning the patient
Assisting with gowning and gloving
Handling surgical instruments to the surgeon
Applying surgical drapes
14. A patient is in the bathroom when the nurse enters to give a prescribed medication. What should the nurse in charge do?
Leave the medication at the patient’s bedside
Tell the patient to be sure to take the medication. And then leave it at the bedside
Return shortly to the patient’s room and remain there until the patient takes the medication
Wait for the patient to return to bed, and then leave the medication at the bedside
15. The physician orders heparin, 7,500 units, to be administered subcutaneously every 6 hours. The vial reads 10,000 units per millilitre. The nurse should anticipate giving how much heparin for each dose?
¼ ml
½ ml
¾ ml
1 ¼ ml
16. The nurse in charge measures a patient’s temperature at 102 degrees F. what is the equivalent Centigrade temperature?
39 degrees C
47 degrees C
38.9 degrees C
40.1 degrees C
17. To evaluate a patient for hypoxia, the physician is most likely to order which laboratory test?
Red blood cell count
Sputum culture
Total hemoglobin
Arterial blood gas (ABG) analysis
18. The nurse uses a stethoscope to auscultate a male patient’s chest. Which statement about a stethoscope with a bell and diaphragm is true?
The bell detects high-pitched sounds best
The diaphragm detects high-pitched sounds best
The bell detects thrills best
The diaphragm detects low-pitched sounds best
19. A male patient is to be discharged with a prescription for an analgesic that is a controlled substance. During discharge teaching, the nurse should explain that the patient must fill this prescription how soon after the date on which it was written?
Within 1 month
Within 3 months
Within 6 months
Within 12 months
20. Which human element considered by the nurse in charge during assessment can affect drug administration?
The patient’s ability to recover
The patient’s occupational hazards
The patient’s socioeconomic status
The patient’s cognitive abilities
21. When explaining the initiation of I.V. therapy to a 2-year-old child, the nurse should:
Ask the child, “Do you want me to start the I.V. now?”
Give simple directions shortly before the I.V. therapy is to start
Tell the child, “This treatment is for your own good”
Inform the child that the needle will be in place for 10 days
22. All of the following parts of the syringe are sterile except the:
Barrel
Inside of the plunger
Needle tip
Barrel tip
23. The best way to instill eye drops is to:
Instruct the patient to lock upward, and drop the medication into the center of the lower lid
Instruct the patient to look ahead, and drop the medication into the center of the lower lid
Drop the medication into the inner canthus regardless of eye position
Drop the medication into the center of the canthus regardless of eye position
24. The difference between an 18G needle and a 25G needle is the needle’s:
Length
Bevel angle
Thickness
Sharpness
25. A patient receiving an anticoagulant should be assessed for signs of:
Hypotension
Hypertension
An elevated hemoglobin count
An increased number of erythrocytes
Answers and Rationales
(B) Sensory deficits. Sensory deficits could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications. Decreased plasma drug levels do not alter the patient’s knowledge about the drug. A lack of family support may affect compliance, not knowledge retention. Toilette syndrome is unrelated to knowledge retention.
(C) The symptomatic quadrant last. The nurse should systematically assess all areas of the abdomen, if time and the patient’s condition permit, concluding with the symptomatic area. Otherwise, the nurse may elicit pain in the symptomatic area, causing the muscles in other areas to tighten. This would interfere with further assessment.
(C) Patient’s description of pain. Subjective data come directly from the patient and usually are recorded as direct quotations that reflect the patient’s opinions or feelings about a situation. Vital signs, laboratory test result, and ECG waveforms are examples of objective data.
(C) Cool, pale fingers. A safety device on the wrist may impair circulation and restrict blood supply to body tissues. Therefore, the nurse should assess the patient for signs of impaired circulation, such as cool, pale fingers. A palpable radial or lunar pulse and pink nail beds are normal findings.
(A) Frontal plane. Frontal or coronal plane runs longitudinally at a right angle to a sagittal plane dividing the body in anterior and posterior regions. A sagittal plane runs longitudinally dividing the body into right and left regions; if exactly midline, it is called a midsagittal plane. A transverse plane runs horizontally at a right angle to the vertical axis, dividing the structure into superior and inferior regions.
(A) Shock dismay. Shock and dismay are early signs of denial-the first stage of grief. The other options are associated with depression—a later stage of grief.
(B) Helps the patient dangle the legs. After placing the patient in high Fowler’s position and moving the patient to the side of the bed, the nurse helps the patient sit on the edge of the bed and dangle the legs; the nurse then faces the patient and places the chair next to and facing the head of the bed.
(D) Demonstrating the procedure and having the patient return the demonstration. Demonstrating by the nurse with a return demonstration by the patient ensures that the patient can perform wound care correctly. Patients may claim to understand discharge instruction when they do not. An interpreter of family member may communicate verbal or written instructions inaccurately.
(A) Discard the syringe to avoid a medication error. As a safety precaution, the nurse should discard an unlabeled syringe that contains medication. The other options are considered unsafe because they promote error.
(B) Aging-related physiological changes. Aging-related physiological changes account for the increased frequency of adverse drug reactions in geriatric patients. Renal and hepatic changes cause drugs to clear more slowly in these patients. With increasing age, neurons are lost and blood flow to the GI tract decreases.
(B) Educator. When teaching a patient about medications before discharge, the nurse is acting as an educator. The nurse acts as a manager when performing such activities as scheduling and making patient care assignments. The nurse performs the care giving role when providing direct care, including bathing patients and administering medications and prescribed treatments. The nurse acts as a patient advocate when making the patient’s wishes known to the doctor.
(D) “Let’s talk about what’s bothering you.” Anxiety may result from feeling of helplessness, isolation, or insecurity. This response helps reduce anxiety by encouraging the patient to express feelings. The nurse should be supportive and develop goals together with the patient to give the patient some control over an anxiety-inducing situation. Because the other options ignore the patient’s feeling and block communication, they would not reduce anxiety.
(C) Handling surgical instruments to the surgeon. The scrub nurse assist the surgeon by providing appropriate surgical instruments and supplies, maintaining strict surgical asepsis and, with the circulating nurse, accounting for all gauze, sponges, needles, and instruments. The circulating nurse assists the surgeon and scrub nurse, positions the patient, applies appropriate equipment and surgical drapes, assists with gowning and gloving, and provides the surgeon and scrub nurse with supplies.
(C) Return shortly to the patient’s room and remain there until the patient takes the medication. The nurse should return shortly to the patient’s room and remain there until the patient takes the medication to verify that it was taken as directed. The nurse should never leave medication at the patient’s bedside unless specifically requested to do so.
(C) ¾ ml. The nurse solves the problem as follows: 10,000 units/7,500 units = 1 ml/X 10,000 X = 7,500 X= 7,500/10,000 or ¾ ml
(C) 38.9 degrees C. To convert Fahrenheit degrees to centigrade, use this formula: C degrees = (F degrees – 32) x 5/9 C degrees = (102 – 32) 5/9 + 70 x 5/9 38.9 degrees C
(D) Arterial blood gas (ABG) analysis. All of these test help evaluate a patient with respiratory problems. However, ABG analysis is the only test evaluates gas exchange in the lungs, providing information about patient’s oxygenation status.
(B) The diaphragm detects high-pitched sounds best. The diaphragm of a stethoscope detects high-pitched sound best; the bell detects low pitched sounds best. Palpation detects thrills best.
(C) Within 6 months. In most cases, an outpatient must fill a prescription for a controlled substance within 6 months of the date on which the prescription was written.
(D) The patient’s cognitive abilities. The nurse must consider the patient’s cognitive abilities to understand drug instructions. If not, the nurse must find a family member or significant other to take on the responsibility of administering medications in the home setting. The patient’s ability to recover, occupational hazards, and socioeconomic status do not affect drug administration.
(B) Give simple directions shortly before the I.V. therapy is to start. Because a 2-year-old child has limited understanding, the nurse should give simple directions and explanations of what will occur shortly before the procedure. She should try to avoid frightening the child with the explanation and allow the child to make simple choices, such as choosing the I.V. insertion site, if possible. However, she shouldn’t ask the child if he wants the therapy, because the answer may be “No!” Telling the child that the treatment is for his own good is ineffective because a 2-year-old perceives pain as a negative sensation and cannot understand that a painful procedure can have position results. Telling the child how long the therapy will last is ineffective because the 2-year-old doesn’t have a good understanding of time.
(A) Barrel. All syringes have three parts: a tip, which connects the needle to the syringe; a barrel, the outer part on which the measurement scales are printed; and a plunger, which fits inside the barrel to expel the medication. The external part of the barrel and the plunger and (flange) must be handled during the preparation and administration of the injection. However, the inside and trip of the barrel, the inside (shaft) of the plunger, and the needle tip must remain sterile until after the injection.
(A) Instruct the patient to lock upward, and drop the medication into the center of the lower lid. Having the patient look upward reduces blinking and protects the cornea. Instilling drops in the center of the lower lid promotes absorption because the drops are less likely to run into the nasolacrimal duct or out of the eye.
(C) Thickness. Gauge is a measure of the needle’s thickness: The higher the number the thinner the shaft. Therefore, an 18G needle is considerably thicker than a 25G needle.
(A) Hypotension. A major side effect of anticoagulant therapy is bleeding, which can be identified by hypotension (a systolic blood pressure under 100 mm Hg). Anticoagulants do not result in the other three conditions.