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Exam 1 - Nursing 1
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Questions in this quiz (54)
1What will the nurse instruct nursing assistive personnel (NAP) to do when measuring an adult patient's radial pulse?
- APlace the patient in the lateral (side-lying) position before measuring the pulse
- BApply gloves with each patient before measuring the pulse.
- CDocument whether the patient's pulse is bounding or has diminished.
- DPalpate the patient's inner wrist on the thumb side with the fingertips of your two middle fingers.
2Which action would best assess the effect of exercise on a patient's radial pulse measurement?
- AMeasuring the patient's radial pulse before and after exercise.
- BAssessing the patient's radial pulse 30 minutes after exercise.
- CComparing the patient's radial and apical pulses after exercise.
- DComparing the patient's pre-exercise radial and post-exercise apical pulses.
3During the admissions process, the nurse initially assesses the patient's radial pulse primarily for what purpose?
- AAssessment of peripheral blood perfusion
- BEstablishment of a baseline as part of the patient's vital signs
- CAssessment of the patient's cardiovascular disease risk
- DDetermination of oxygen saturation
4Inadequate oxygenation to the body will cause the radial pulse to become:
- ATachycardic
- BBradycardic
- CIrregular
- DBounding
5What is the nurse's priority action if a patient's radial pulse has an irregular rhythm?
- AReassess the pulse for 1 full minute.
- BAssess the patient for a pulse deficit.
- CWait 5 minutes, and then reassess the pulse.
- DReview documentation regarding an irregular rhythm
6A nursing student is taking care of a patient with possible appendicitis and is curious about the best method of diagnosing this disorder. What does the nursing student have to consider in formulating a question using the PICO format (patient, population, or problem; intervention; comparison intervention; outcomes) to determine evidence-based practice?
- AProblem: appendicitis; interventions: ultrasound versus CT scan; outcome: diagnosis of appendicitis
- BProblem: pain; interventions: meperidine versus morphine; outcome: pain free
- CProblem: fever; interventions: cooling measures versus antipyretics; outcome: normal temperature
- DProblem: appendicitis; Interventions: complete blood count versus chemistry panel tests; outcome: painless
7The nurse decides to access a systematic review database to determine evidence-based practice related to the patient’s treatment plan for a diagnosis of otitis media (i.e., ear infection). What database can provide that type of resource?
- ACumulative Index of Nursing and Allied Health Literature (CINAHL)
- BCochrane
- CPubMed
- DMD Consult
8The nurse researcher provides participants with informed consent so that what ethical principle is upheld?
- ARespect for persons
- BBeneficence
- CJustice
- DEthics
9The nurse feels that the results of a recent literature search and analysis about handwashing should be implemented in the entire hospital system. With whom would the nurse be required to collaborate?
- AColleagues caring for patients in her unit
- BColleagues in the community
- CAdministrators at the hospital
- DOthers in her department
10Knowledge gained from research in the 1970s about placing infants on their backs to prevent sudden infant death syndrome was not recommended to parents until the 1990s. This is an example of what barrier to evidence-based practice?
- AProliferation of research
- BImplementation delay
- CInformation needs not being met
- DLack of readily available resources
116. A patient is on the way to the hospital in an ambulance and is asked to participate in a research protocol for a new treatment for myocardial infarction. What is this an example of? (Select all that apply.)
- AStandard practice
- BAn ethical dilemma
- CA violation of informed consent
- DA patient who is in a vulnerable population category
- ECompliance with important ethical issues of justice and autonomy
12Patients are participating in a study to identify genetic disorders. What is a potential concern? (Select all that apply.)
- AViolation of confidentiality if a disorder is revealed
- BPossible adverse consequences related to employment
- CPossible adverse consequences related to reputation
- DPossible adverse consequences to insurability
- EInability to prevent the progression of genetic disorders
13Which entity or document specifically addresses the role of the nurse in research? (Select all that apply.)
- AAmerican Nurses Association standards of practice
- BInstitutional review board
- CHospital Magnet status
- DJoint Commission
- EMD Consult
14Which of the following factors contributes to the nurse having difficulty keeping up with the latest patient care information? (Select all that apply.)
- AImplementation delays
- BProliferation of research
- CVolume of health care literature
- DHours spent in direct patient care
- EThe need to read 3 articles every day of the week
15After reading various research articles and reviews on a subject, the nurse designs a practice change based on the literature. What stage of evidence-based practice is this?
- AMaintaining the change
- BImplementing the change
- CEvaluating and critically appraising
- DSynthesizing the evidence and developing a plan
16The nurse facilitates the use of the intellectual standard of critical thinking of significance by posing which question to determine the patient’s understanding of his or her new diagnosis of type 1 diabetes mellitus on his or her lifestyle?
- A“What information do I need to provide to teach the patient?”
- B“Do you understand how to administer your insulin?”
- C“What are the signs of low blood glucose?”
- D“How will this diagnosis impact your career?”
17In providing care to a newly admitted patient, the nurse’s inferences are more accurate if based upon which of the following?
- AObjective data
- BAssumptions
- CIntuition
- DExperience
183. During the postoperative assessment on a patient, the nurse has a “hunch” that the patient has a postoperative complication based upon
- Aintuition
- Binterpretation
- Cinformation processing
- Dinference
19In using intuition to address a clinical problem, the expert nurse bases his or her approach upon which of the following?
- AJudgment
- BData collection
- CExperiential knowledge
- DLogical deduction
20A new graduate nurse explains a new approach in the positioning of patients with chronic low back pain. The nurse preceptor responds, “That is not the way we do it here.” The preceptor’s response illustrates which error in critical thinking?
- ALack of information
- BErroneous assumptions
- CIllogical thinking
- DBias
21The nurse uses a case study presentation to present an educational offering to the staff on the unit. This strategy improves the staff nurses’ critical thinking through which of the following?
- AReviewing the literature
- BPracticing application of knowledge
- CDiscussing with colleagues
- DRole playing
22In preparing to administer medications to a patient, the nurse notes a medication that she has never administered. If the nurse administers the medication without researching the medication, this represents which error in critical thinking?
- ALack of information
- BIllogical thinking
- CClose-mindedness
- DErroneous assumptions
23The nurse uses critical thinking to interpret data. Which of the following data sources are objective? (Select all that apply.)
- APatient interview
- BLaboratory values
- CBody language
- DX-ray results
- EVital signs
- FBreath sounds
24In preparing for a certification examination, the nurse chooses to develop a concept map to help understand the content. This strategy is based upon which characteristics of concept maps? (Select all that apply.)
- AFacilitates note-taking
- BRequires thinking aloud
- CFosters making correlation between concepts
- DValidates content with an expert
- EOrganizes visual data
25The nurse receives change of shift report on the five assigned patients and reviews prescriptions, treatments, and medications scheduled for the shift. Based on analysis of this information, the nurse chooses which patient to assess first. Which process of critical thinking best describes the nurse’s action?
- AProblem solving
- BDecision making
- CJudgment
- DReasoning
26In approaching a new clinical situation, the nurse uses which question to facilitate precision in critical thinking?
- A“What do I know about this situation?”
- B“What additional details do I need to gather?”
- C“Does the clinical presentation correlate with the diagnosis?”
- D"Are the treatments appropriate for the diagnosis?”
27Which question would be most appropriate for the nurse to ask while evaluating the relevance of patient data?
- ADo these findings make sense?
- BHow can this information be verified?
- CWhat are the most significant factors in the problem?
- DWhat is the relationship of this information to other data?
28The nurse is assigned to develop a plan of care for a patient with a medical diagnosis that is unknown to the nurse. Guided by critical thinking, which action should the nurse take first?
- AAsk the patient to describe the chief complaint
- BRequest that another nurse be assigned to this patient
- CReview data about the medical diagnosis and routine management
- DComplete a physical assessment of the patient
29The nurse obtains a lower-than-normal (88% on room air) pulse oximetry reading on a patient. Which actions by the nurse result from accurately employing the critical-thinking skill of analysis in the nursing process? (Select all that apply. )
- AAssessing the patient for symptoms of hypoxia
- BProviding oxygen according to standing orders
- CElevating the head of the bed, if not contraindicated
- DAllowing the patient to be alone to rest more comfortably
- EDiscussing adaptations needed for daily activities with the patient
30Which of the following actions reflects inductive reasoning?
- AUsing subjective and objective data to confirm a diagnosis
- BAssessing for specific clinical presentations based on a disease process
- CCorrelating elevated blood pressure to pathophysiology
- DValidating an automatic blood pressure cuff reading with a manual measurement
31The nurse is completing an assessment on a patient with sudden onset of abdominal pain. During the assessment, the nurse considers similar presentations and the underlying pathophysiology related to the patient’s clinical manifestations. Which critical-thinking skill should the nurse use first to determine the cause of the patient’s abdominal pain?
- AEvaluation
- BInterpretation
- CReflection
- DInference
32The nurse can facilitate critical thinking through the use of which interpersonal skills? (Select all that apply.)
- ATeamwork
- BIntuition
- CJudgment
- DConflict management
- EAdvocacy
- FReasoning
33In providing care to a patient admitted to rule out human immunodeficiency virus (HIV) infection, wearing gloves during which activity may be an indication of bias?
- ACollecting the patient's medical history
- BAdministering IV medications
- CPerforming oral care
- DCompleting a bed bath
34During the assessment of a patient admitted for a total hip replacement, the nurse asks the patient to explain prior hospital experiences and, more specifically, any operative experiences. These questions reflect the nurse’s use of which intellectual standard of critical thinking?
- AClarity
- BLogic
- CPrecision
- DSignificance
35On initial assessment of a patient, the nurse notices an area of redness over the right trochanter that, when pressed lightly, does not blanch. What does this assessment finding indicate to the nurse?
- AThe presence of an infection in the area
- BThe presence of a stage I pressure ulcer
- CAn allergic reaction to the sheets
- DThe need to apply a cold compress to reduce inflammation
36Four days after abdominal surgery, the patient is getting out of bed and feels something “pop” in his abdominal wound. An increase in amount of drainage from the wound is seen, and further examination shows that the sutured incision is now partially open, with tissue protruding from the wound. What is the nurse’s next action?
- AApply Steri-Strips to close the wound edges.
- BCover the wound with saline-moistened gauze, and notify the physician.
- CAssure the patient that this is common, and document the findings.
- DApply a binder to pull the wound edges together and provide support to the edges.
373. Which features are characteristic of a closed drainage system such as a Jackson-Pratt (JP) drain? (Select all that apply.)
- AWorks by gravity
- BProvides for early discharge
- CUsually is inserted in surgery
- DReduces the amount of antibiotics required
- EAllows for accurate measurement of wound drainage
- FAllows bacteria to migrate up the drain from the surrounding dressing
38Which intervention should be initiated by the nurse caring for a patient with urinary or fecal incontinence?
- AUsing a heat lamp to dry the skin
- BChanging the adult brief every 8 hours
- CCleansing frequently with hot water and a strong soap
- DUsing an incontinence cleanser and a moisture barrier ointment
39Based on knowledge of areas at greatest risk for development of a pressure ulcer in the bedridden patient, the nurse identifies which position to minimize this risk?
- A30-degree side-lying
- BSitting with the head of the bed elevated 75 degrees
- C90-degree side-lying
- DLying supine with the bed flat at all times
40A patient who has suffered a stroke is unable to maintain his position while seated in a chair without sliding down. His physician has ordered him to be up in a chair for part of the day. What does the nurse recognize as the patient’s greatest risk factor for development of pressure ulcers?
- AMoisture from incontinence
- BNutritional deficiencies
- CPressure and shear
- DAging
41A patient has a stage III pressure ulcer on the coccyx. Which food will be most beneficial in improving the healing process?
- AFood high in vitamin D
- BWhole-grain carbohydrates
- CHigh-calorie, high-protein drink
- DFood high in fat and water content
42Which technique is used to collect an aerobic culture specimen from a wound?
- ACollect the specimen immediately after removing the old dressing.
- BApply sterile gloves, then open the culture tube.
- CAlways be sure to culture any necrotic tissue.
- DIrrigate the wound before collecting the culture material.
43Which patient is at highest risk for impaired wound healing?
- AA 22-year-old with a pelvic fracture incurred in a motor vehicle accident
- BA 49-year-old with a history of smoking two packs a day who just had abdominal surgery
- CA 72-year-old with diabetes and cardiovascular disease who had surgical repair of a broken hip
- DA 90-year-old with no chronic health conditions with a small blistered burn on the hand
44Which statement best describes the healing process for a surgical wound that has been closed with the use of sutures?
- AThe edges of the wound are approximated.
- BNew tissue fills the sides and base of the wound.
- CThe proliferate phase is longer with surgical wounds.
- DDebridement aids in the surgical healing process.
45What does a Braden Score of 14 indicate to the nurse?
- AHigh risk for the development of pressure ulcers
- BLow risk for the development of pressure ulcers
- CThe need for a special mattress
- DThe presence of a pressure ulcer
46Which is the most appropriate treatment choice for a wound with a shallow pink wound bed and minimal drainage?
- AUse of an enzymatic debriding agent
- BA moisture retentive dressing such as a hydrocolloid
- CGauze moistened with 0.9% normal saline
- DAn aginate covered with a foam dressing
47What does wound irrigation require?
- AA bulb syringe and 0.9% normal saline
- BPersonal protective equipment including goggles
- CUse of an antiseptic solution such as Betadine
- DTwice daily dressing changes
48What is the most appropriate dressing for a pressure ulcer that is draining a large amount of exudate, extends through the fascia and into the deeper tissues including muscles and bone, and has granulation tissue in the wound bed?
- AAlginate dressing
- BDamp to dry dressing
- CHydrocolloidal dressing
- DGauze dressing reinforced with ABD pads
49A patient who is on bed rest has a stage I pressure ulcer on the sacrum and is recovering from a pelvic injury sustained in a motor vehicle accident. What is the priority nursing diagnosis for this patient?
- AIneffective coping related to pelvic injury
- BRisk for Infection related to open wound site
- CRisk for impaired tissue integrity and pain related to motor vehicle accident
- DImpaired skin Integrity related to pressure, secondary to immobility
50In planning care on the hospital unit, the nurse prioritizes care for assigned patients with regard to skin integrity. Which patient would be the nurse’s highest priority for skin issues?
- AA 50-year-old female with diabetes who has an ulcer on her foot
- BAn 80-year-old man with incontinence due to clostridium difficile
- CA 22-year-old cocaine addict with a compound fracture of the tibia
- DA 75-year-old female with CHF and a history of breast cancer
51Which is the most important strategy in the prevention of wound infections?
- AThe use of sterile dressings at all times
- BA high protein diet with vitamin C supplements
- CThe use of antibiotics in all patients with wounds
- DCareful and consistent hand hygiene
52Which is correct concerning the use of pain medication in the care of a patient with a chronic wound such as a pressure ulcer?
- AIt is rarely needed as chronic wounds are not as painful as acute wounds due to nerve damage.
- BIt should not be used in the elderly as they are at risk for constipation, a side effect of many pain medications.
- CIt should only be considered if the pain score is greater than “5” on a regular basis during dressing changes.
- DIt should be incorporated into the overall treatment plan based on the patient’s reported pain level and assessment of the patient.
53The nurse is planning care for patients on the hospital unit. For which patient will it be most appropriate to use cold therapy?
- AFor any patient who requests a cold compress
- BFor a male patient with a stage I pressure ulcer
- CFor a female patient with a sprained ankle with edema
- DFor stimulating vasodilatation and improved blood flow in an immobile patient
54Which can be delegated to the unlicensed personnel on the nursing unit? (Select all that apply.)
- AMorning care including a bath, linen change, and application of a barrier ointment
- BDressing changes with application of an enzymatic ointment
- CTurning and positioning a patient during dressing changes
- DAssessment of the skin and wounds
- EObtaining a wound culture
- FRemoval of a simple drain
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- Nursing Quiz on Exam 1 - Nursing 1, created by Robinmarie Rivera on 22/01/2017.
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- Robinmarie Rivera
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