Mrs. Mitchell has been given a copy of her diet. Question 9Studies have shown that about 40% of patients fall out of bed despite the use of side rails; this has led to which of the following conclusions?ASide rails are ineffectiveBSide rails are a reminder to a patient not to get out of bed CSide rails are a deterrent that prevent a patient from falling out of bed.DSide rails should not be usedQuestion 9 Explanation: Since about 40% of patients fall out of bed despite the use of side rails, side rails cannot be said to prevent falls; however, they do serve as a reminder that the patient should not get out of bed. The attending physician may need information from the nurse to complete the death certificate, but he is responsible for issuing it. Altered neurovascular status to extremities (cyanosis, pallor, coldness of skin, tingling, pain, numbness) Which findings should be reported?ATemperature onlyBRespiratory rate onlyCPulse rate and temperatureDTemperature and respiratory rate Question 35 Explanation: Under normal conditions, a healthy adult breathes in a smooth uninterrupted pattern 12 to 20 times a minute. APerson, nursing, environment, medicineBPerson, environment, health, nursing CPerson, health, nursing, support systemsDPerson, health, psychology, nursingQuestion 44 Explanation: The focus concepts that have been accepted by all theorists as the focus of nursing practice from the time of Florence Nightingale include the person receiving nursing care, his environment, his health on the health illness continuum, and the nursing actions necessary to meet his needs. physical techniques and Increased work load of the left ventricle With that being said, critical thinking is the backbone of the nursing world. EXPOSED BONE, TENDON, OR MUSCLE The nurse administers the wrong medication to a patient and the patient vomits. Fever, exercise, and sympathetic stimulation all increase the heart rate.Question 46The four main concepts common to nursing that appear in each of the current conceptual models are: All patients receiving anticoagulant therapy must be observed for signs and symptoms of frank and occult bleeding (including hemorrhage, hypotension, tachycardia, tachypnea, restlessness, pallor, cold and clammy skin, thirst and confusion); blood pressure should be measured every 4 hours and the patient should be instructed to report promptly any bleeding that occurs with tooth brushing, bowel movements, urination or heavy prolonged menstruation. Follow the medication administration rights potential for injury of axillary, radial, brachial, and ulnar nerves and brachial artery 1234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950End In this case, the supervisor is the resource person to approach. adapter (tip) designed to fit the hub of a needle or needless device A patient about to undergo abdominal inspection is best placed in which of the following positions? - Wrong medication, route, and time - Airway patency (stridor), Diagnostic Test that may indicate poor oxygenation, ECG - what is heart doing? Which of the following is the most significant symptom of his disorder? I didnt get to the bad news yet Keep it simple Defines the scope of nurses' professional functions and responsibilities. All four side rails up is considered a restraint Attempted Questions Wrong Although a new head nurse should initially spend time observing the unit for its strengths and weakness, she should take action if a problem threatens patient safety. Beets and urinary analgesics, such as pyridium, can color urine red. Additional Vitamin C is needed in growth periods, such as infancy and childhood, and during pregnancy to supply demands for fetal growth and maternal tissues. 5. Written communication that does the same is considered libel. must be derided to allow for healing Question 24Which of the following patients is at greatest risk for developing pressure ulcers?AAn apathetic 63-year old COPD patient receiving nasal oxygen via cannulaBA confused 78-year old patient with congestive heart failure (CHF) who requires assistance to get out of bed. do not rub or massage into skin - Drops, teaspoons, tablespoons, cups, pints, quarts Question 3The most common psychogenic disorder among elderly person is:ADecreased appetite BInability to concentrateCDepressionDSleep disturbances (such as bizarre dreams)Question 3 Explanation: Sleep disturbances, inability to concentrate and decreased appetite are symptoms of depression, the most common psychogenic disorder among elderly persons. It involves professional misconduct, such as omission or commission of an act that a reasonable and prudent nurse would or would not do. C. A patient with dysphagia (difficulty swallowing) requires assistance with feeding. - Concentrations in units of mass per units of volume, Conversions within one system Thus, an axillary temperature of 99.6F (37.6C) would be considered abnormal. Choose the letter of the correct answer. A client has been admitted to a nursing home, and the nurse completes an assessment. Protect your own body Kaopectate is an anti diarrheal medication. 20. D. The quality and efficiency of the respiratory process can be determined by appraising the rate, rhythm, depth, ease, sound, and symmetry of respirations. ** Prescriptions are often being done electronically, Double-Check Pre-attached needle Pantothenic acid Sitting Question Details B. According to this theory, other physiologic needs (including food, water, elimination, shelter, rest and sleep, activity and temperature regulation) must be met before proceeding to the next hierarchical levels on psychosocial needs. sharpest - nervous system disease, Genupectoral Question 7The most common injury among elderly persons is:AHip fracture BAtheroscleotic changes in the blood vesselsCIncreased incidence of gallbladder diseaseDUrinary Tract InfectionQuestion 7 Explanation: Hip fracture, the most common injury among elderly persons, usually results from osteoporosis. 11. A. Changes in vital signs may be cause by factors other than blood loss. Consuit a physical therapist before allowing the patient to ambulate. aqueous solution Immobility, diaphoresis, and avoidance of deep breathing or coughing, Decreased blood pressure and heart rate and shallow respirations. An increased partial pressure of carbon dioxide in arterial blood (PACO2) would not initially result in cardiac arrest. Accountability is clearest when one nurse is responsible for the overall plan and its implementation. A complete blood count does not provide immediate results and does not always immediately reflect blood loss. Person, health, nursing, support systems aerosol The nurse documents this breathing as: Lethargy Side rails are a deterrent that prevent a patient from falling out of bed. behavioral- anxiety, agitation, consiousness Question 42The nurse observes that Mr. Adams begins to have increased difficulty breathing. 34. Temperature and respiratory rate Maternal and Child Health Nursing (NCLEX Exams), Medical and Surgical Nursing (NCLEX Exams), Pharmacology and Drug Calculation (NCLEX Exams), NCLEX Practice Exam for Blood Transfusion, The patient will find pureed or soft foods, such as custards, easier to swallow than water, Fowlers or semi Fowlers position reduces the risk of aspiration during swallowing. Exam Mode Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam. Adverse Effects Multiple sclerosis, a progressive, degenerative disease involving demyelination of the nerve fibers, usually begins in young adulthood and is marked by periods of remission and exacerbation. If you withhold a medication what do you do? Text Mode Text version of the exam C. The nurse is legally responsible for labeling the corpse when death occurs in the hospital. 16. She is required to bathe only soiled areas of the body since the mortician will wash the entire body. The other answers are incorrect interpretations of the statistical data. Bed rest and oxygen by Venturi mask at 24% would improve oxygenation of the tissues and cells but must be ordered by a physician. * Try to strategically plan how far walking by having a chair available nearby. Questions Not Attempted patient education, Locked cabinet The nurse must place a pillow under the decreased persons head and shoulders to prevent blood from settling in the face and discoloring it. Inadequate tissue oxygenation at the cellular level Infants and children Unit 4: The Roles Of Nurses In Different Health Care System I health educate the patients and families on ways to maintain a healthy lifestyles and how to prevent diseases. Also, this page requires javascript. - other places: lungs, kidneys, blood, and intestines Illness 1. Depression typically begins before the onset of old age and usually is caused by psychosocial, genetic, or biochemical factors Question 31Which of the following nursing interventions promotes patient safety?ADemonstrate the signal system to the patientBAsses the patients ability to ambulate and transfer from a bed to a chairCCheck to see that the patient is wearing his identification bandD All of the above Which nursing action has the highest priority for a patient receiving medication via a nasogastric feeding tube? A. Question 19A patient is kept off food and fluids for 10 hours before surgery. In an abdominal surgery patient, these might include immobility, diaphoresis, and avoidance of deep breathing or coughing, as well as increased heart rate, shallow respirations (stemming from pain upon moving the diaphragm and respiratory muscles), and guarding or rigidity of the abdominal wall. Tachypnea is rapid respiration characterized by quick, shallow breaths. Its only temporaryBYour hair is really prettyCWhy are you crying? Atheroscleotic changes in the blood vessels In the horizontal recumbent position, the patient lies on his back with legs extended and hips rotated outward. Things they like doing but can't Current condition 26. ice to site before injection Start - Clot in blood vessel and narrow blood vessels can impede circulation Tympanic percussion, measurement of abdominal girth, and inspection are methods of assessing the abdomen. Tracheal Examples of patients suffering from impaired awareness include all of the following except: 44. Other symptoms include diminished memory, apathy, disinterest in appearance, withdrawal, and irritability. Right dose Question 34For a rectal examination, the patient can be directed to assume which of the following positions?AHorizontal recumbentBAll of the above CSimsDGenupecterolQuestion 34 Explanation: All of these positions are appropriate for a rectal examination. Abdominal girth is unrelated to blood loss. Question 18Which of the following is an example of nursing malpractice?AThe nurse assists a patient out of bed with the bed locked in position; the patient slips and fractures his right humerus.BThe nurse administers the wrong medication to a patient and the patient vomits. 3. never manually recap needles after injection Congratulations - you have completed Fundamentals of Nursing Practice Exam 2 (EM). Question 4All of the following can cause tachycardia except:AParasympathetic nervous system stimulation Question Details 1) Completeness (Disclosure) - tell patient everything regarding a treatment decision. Pain related to immobilization of affected leg would be an appropriate nursing diagnosis for a patient with a leg fracture. Ability to absorb, metabolize, and excrete If patient asks the nurse her opinion about a particular physicians and the nurse replies that the physician is incompetent, the nurse could be held liable for: Oral communication that injures an individuals reputation is considered slander. What is a nurses responsibility concerning Temperature? aka, NPH Symmetry 6. The other answers are diseases that can occur in the elderly from physiologic changes. Helps balance. Question 48A prescribed amount of oxygen s needed for a patient with COPD to prevent:AInhibition of the respiratory hypoxic stimulus BCirculatory overload due to hypervolemiaCRespiratory excitementDCardiac arrest related to increased partial pressure of carbon dioxide in arterial blood (PaCO2)Question 48 Explanation: Delivery of more than 2 liters of oxygen per minute to a patient with chronic obstructive pulmonary disease (COPD), who is usually in a state of compensated respiratory acidosis (retaining carbon dioxide (CO2)), can inhibit the hypoxic stimulus for respiration. Risk for infection Swallowing - patient may not be able to swollow and patient should sit upright when taking meds Put air into the cloudy vial first Assuming that a semitrailer behaves as a square cylinder, find the force exerted if a wind of 20km/h20 \mathrm{~km} / \mathrm{h}20km/h strikes it broadside. Question 10High-pitched gurgles head over the right lower quadrant are:AA sign of increased bowel motilityBA sign of abdominal cramping CA sign of decreased bowel motilityDNormal bowel soundsQuestion 10 Explanation: Hyperactive sounds indicate increased bowel motility; two or three sounds per minute indicate decreased bowel motility. Checking the patients identification band verifies the patients identity and prevents identification mistakes in drug administration. The brain-dead patients family needs support and reassurance in making a decision about organ donation. - muscle-skeletal changes occur Question 25Before rigor mortis occurs, the nurse is responsible for:AAllowing the body to relax normally BPlacing one pillow under the bodys head and shouldersCProviding a complete bath and dressing changeDRemoving the bodys clothing and wrapping the body in a shroudQuestion 25 Explanation: The nurse must place a pillow under the decreased persons head and shoulders to prevent blood from settling in the face and discoloring it. What is a nurses responsibility concerning oxygen? Rate Ineffective airway clearance related to dry, hacking cough is incorrect because the cough is not the reason for the ineffective airway clearance. Time used Explain the procedure to the client- allow them as much control and involvement as possible. Administering an incorrect medication is a nursing error; however, if such action resulted in a serious illness or chronic problem, the nurse could be sued for malpractice. A patient is kept off food and fluids for 10 hours before surgery. Set your dose Which of the following is the most common cause of dementia among elderly persons? - Work with the families so that care is followed The patient inserts the suppository 10 cm (4 inches) into the vaginal canal. Elevate the head of the bed Applying a hot water bottle or heating pad to a patient without a physicians order does not include the three required components. 42. The other nursing actions may be necessary but are not a major priority.Question 50The most common injury among elderly persons is:AHip fracture BUrinary Tract InfectionCIncreased incidence of gallbladder diseaseDAtheroscleotic changes in the blood vesselsQuestion 50 Explanation: Hip fracture, the most common injury among elderly persons, usually results from osteoporosis. Consequently, the nurse must observe for objective signs. Critical thinking is not a solo occurrence; it is something that allows you to grow and mature every time it occurs. Mitchell has been given a copy of her diet. always draw up medication with a filter needle, plastic or glass container with rubber seal, insert 5-15 degrees Inability to concentrate When a patient in the terminal stages of lung cancer begins to exhibit loss of consciousness, a major nursing priority is to: - Grams to milligrams (or vice versa) However, the familys concerns must be addressed before members are asked to sign a consent form. List Some of the pumps monitors your blood glucose level. 4. Tighten abdominal muscles and tuck in the pelvis enteric coated 20. Any items you have not completed will be marked incorrect. Body surface area CO transport, CNS sends signal to chest wall to control rate, depth, and rhythm, Carbon dioxide and hydrogen ions affect rate and depth of ventilation, Dissolved in plasma, carbamino compounds, bicarbonate use only for small volumes, toxic effects, idiosyncratic reactions, allergic reactions, tolerance and dependence, and interactions, wound dressing type- ulcer can be visualized, wound dressing that maintains moist environment, promotes healing and protects would by absorption, wound dressing: sheet or tube, keeps wound moist to aid in healing. Air or blood is trapped in the pleural space; Deep breath in, hold for 2 seconds, as you exhale then cough-cough-cough Patients should begin ambulation as soon as possible after surgery to decrease complications and to regain strength and confidence. seconds - Ex: "upon discharge, patient will be able to maintain air on own" Be vigilant During a Romberg test, the nurse asks the patient to assume which position? Before rigor mortis occurs, the nurse is responsible for: Placing one pillow under the bodys head and shoulders, Providing a complete bath and dressing change, Removing the bodys clothing and wrapping the body in a shroud. remove protective covering She elevates the head of the bed to the high Fowler position, which decreases his respiratory distress. Crutches - 3 fingertips below the armpit and arms should be at an angle with the hand grip. Please visit using a browser with javascript enabled. You can program different amounts of insulin for different times of the day and night. What is causing the quick breathing Which of the following statement is incorrect about a patient with dysphagia? eratic use, The pulse pressure is the difference between the systolic and diastolic blood pressure readings in this case, 54. extremes of weight Delivery of more than 2 liters of oxygen per minute to a patient with chronic obstructive pulmonary disease (COPD), who is usually in a state of compensated respiratory acidosis (retaining carbon dioxide (CO2)), can inhibit the hypoxic stimulus for respiration. Fundamentals of Nursing Practice Exam 2 (PM) In the Trendelenburg position, the head of the bed is tilted downward to 30 to 40 degrees so that the upper body is lower than the legs. - Cardiac arrest 150 Influenza and pneumococcal vaccine - Hemothorax C. Orthopnea is difficulty of breathing except in the upright position. These include: Patients should begin ambulation as soon as possible after surgery to decrease complications and to regain strength and confidence. Presenting symptoms of hypokalemia ( a serum potassium level below 3.5 mEq/liter) include muscle weakness, chronic fatigue, and cardiac dysrhythmias. Cardiac catheterization - A decimal system organized into units of 10 You have completed Amyotrophic lateral sclerosis (Lou Gerhigs disease) A platelet count evaluates the number of platelets in the circulating blood volume. Bones, joints, ligaments, tendons, cartilage, Physiology & Regulation of Movement Which of the following nursing interventions has the greatest potential for improving this situation?AContinue administering oxygen by high humidity face maskBPerform chest physiotheraphy on a regular schedule CEncourage the patient to increase her fluid intake to 200 ml every 2 hoursDPlace a humidifier in the patients room.Question 25 Explanation: Adequate hydration thins and loosens pulmonary secretions and also helps to replace fluids lost from elevated temperature, diaphoresis, dehydration and dyspnea. Which of the following is an example of nursing malpractice? 33. Mrs. Mitchell has been given a copy of her diet. The nurse applies a hot water bottle or a heating pad to the abdomen of a patient with abdominal cramping. Administration of Meds: Correct administration Nursing Process: IMPLEMENTATION for patients with low oxygenation, Health Promotion: 37. 21. C. A hospitalized surgical patient leaving his room for the first time fears rejection and others staring at him, so he should not walk alone. Which of the following nursing interventions would be appropriate?AEncourage the patient to walk in the hall aloneBAccompany the patient for his walk.CConsult a physical therapist before allowing the patient to ambulate DDiscourage the patient from walking in the hall for a few more daysQuestion 17 Explanation: A hospitalized surgical patient leaving his room for the first time fears rejection and others staring at him, so he should not walk alone. UNSTAGEABLE UNTIL SLOUGH/ESCHAR IS REMOVED Sensory impairments ATI Quiz Fundamentals 1 Flashcards Quizlet ATI Nursing Fundamentals Practice 1 Flashcard reviewer University Gurnick Academy Course Vocational Nursing 120 (Sean220, VN 320) 94 Documents Academic year:2022/2023 Uploaded byAlec Afanes Helpful? 96 Inhibition of the respiratory hypoxic stimulus 31. Checking the patients identification band verifies the patients identity and prevents identification mistakes in drug administration. The nurse documents this breathing as:ATachypneaBEupncaCOrthopneaDHyperventilation Question 41 Explanation: Orthopnea is difficulty of breathing except in the upright position. Ineffective individual coping related to COPD is wrong because the etiology for a nursing diagnosis should not be a medical diagnosis (COPD) and because no data indicate that the patient is coping ineffectively. How to minimize discomfort with injections? In this example, the standard of care was breached; a 3-month-old infant should never be left unattended on a scale. Question 22A patient has exacerbation of chronic obstructive pulmonary disease (COPD) manifested by shortness of breath; orthopnea: thick, tenacious secretions; and a dry hacking cough. instill drops holding dropper 1/2 inch above ear canal Side Effects The four main concepts common to nursing that appear in each of the current conceptual models are: The focus concepts that have been accepted by all theorists as the focus of nursing practice from the time of Florence Nightingale include the person receiving nursing care, his environment, his health on the health illness continuum, and the nursing actions necessary to meet his needs. Groups Studies have shown that about 40% of patients fall out of bed despite the use of side rails; this has led to which of the following conclusions? apply prescribed number of inches over paper measuring guide - Vibration can I get a witness, caplet Fundamentals of Nursing University Keiser University Fundamentals of Nursing Add to My Courses Documents (326) Questions Students (625) Book related documents Kozier and Erb's Fundamentals of Nursing Volume 1-3 Barbara Kozier; Glenora Erb; Audrey Berman; Shirlee Snyder; Tracy Levett-jones Lecture notes Date Rating year Ratings Show 8 more documents 4. Anticipate the health provider's needs Autolytic debridement, protective, prevents wound dehydration, absorbs small to moderate drainage, Localized skin intact, non-blanchable and reddened. Please visit using a browser with javascript enabled. 10. To reduce the risk of polypharmacy, how should the nurse advise the older patient regarding medications? to have access to drug information It involves professional misconduct, such as omission or commission of an act that a reasonable and prudent nurse would or would not do. Adverse reactions to stop, think and be vigilant when administering medications, metric system AWriting the order for this testBAll of the above CInstructing the patient about this diagnostic testDGiving the patient breakfastQuestion 42 Explanation: A platelet count evaluates the number of platelets in the circulating blood volume. I know this will be difficult for you, but your hair will grow back after the completion of chemotheraphy What are the 3 muscle signs for IM injections? Which of the following vascular system changes results from aging? Effect of rubbing or resistance when a moving body meets a surface when turning, Physiology & Regulation of Movement B. Mashed potatoes and broiled chicken are low in natural sodium chloride. 3. Sitting An apathetic 63-year old COPD patient receiving nasal oxygen via cannula The nurse is responsible for: Type I diabetes Nurse safety - 2nd priority She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process and help nursing students pass the NCLEX exams. - Analgesic (pain) The most common psychogenic disorder among elderly person is: 46. There are 50 questions to complete. The force that occurs in a direction to oppose movement. troche Writing the order for this test The normal activated partial thromboplastin time is 16 to 25 seconds and the normal prothrombin time is 12 to 15 seconds; these levels must remain within two to two and one half the normal levels. The nurse documents this breathing as: 3. Moisture retentive dressings. During the procedure, the client begins to cough and has difficulty breathing. 24. Clear insulin is the short acting insulin, Remove cap A sign of abdominal cramping Ensure that client has taken medications before leaving the room 1234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950End Keep needle in skin for 10 sec, Clean the vials Which finding might lead the nurse to suspect a nutritional alteration? repeat this process using a new swab each time and moving the same circular stroke away from the drain site, place collection container or measuring device on bed b/w you and patient base of ulcer covered by slough and/or eschar in the wound bed these are annoying, but not usually harmful, these are unwanted effects that are more harmful to the body, can be minor all the way up to life threatening, some drugs can interact and cause physical changes ARhythmBRateCAll of the above DSymmetryQuestion 26 Explanation: The quality and efficiency of the respiratory process can be determined by appraising the rate, rhythm, depth, ease, sound, and symmetry of respirations. Person, environment, health, nursing Assessment for distention, tenderness, and discoloration around the umbilicus. Nasal Sprays - Extra doses or failing to administer Your score is Explain in detailed medical terms
