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Final Review
Final Review
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1
A major concern in healthcare is poor compliance with hand hygiene select reasons this occurs....
Understaffing
Nurses do not value the importance
Apathy
Availability of sinks / hand disinfectant
Lack of time
If the Physicians are not performing, it is not important for this patient
2
Drug administration is more rapid from the subcutaneous (SQ) route than the intramuscular (IM) route
True
False
3
A patient with cirrhosis of the liver has hepatic impairment. This will require what changes to meds. (Select all)
Increased frequency of monitoring of patient for adverse effects
An increased dosage of medications
A change in the timing of medication administration
Giving all medications by Intravenous
Giving all medications by intramuscular injection
A reduction in the dosage of the drugs
4
What is clinical judgement when applied to a client? (select all that apply)
Consideration the client's medication regimen and evaluation
Execution of the nursing curricula in clinical environment
Assessing pt cues, prioritizing and generating solutions & eval. outcomes
Consideration of the client's condition
Consideration of the nurses educational and skill acquisition
Consideration of the client's family dynamics
5
Select all assessments the nurse should make of a patient's hair
History or presence of disease/therapy that may affect hair (chemotherapy)
Length of patient's hair and how quickly it grows
Inspect for dandruff, pediculosis, alopecia, secretions or lesions
Amount of hair spray to maintain a style
6
Select all the functions of the skin.
Sensation
Formation of Vitamin D
Blood flow throughout the body
Oxygenation
Protection
Temperature regulation
7
What factors affect drug absorption?
Lower concentration to obtain effect
Route of drug solubility
Route of administration
Patient's age, sex, disease process, physical activity and level of stress
Larger drug molecules are absorbed quicker
The rate of dissolution
8
The Controlled Substances Act categorizes drugs Schedule I thru V. Schedule V are the most tightly controlled
False
True
9
The nursing diagnosis step is critical to the other phases of the nursing process.
True
False
10
Nursing research is an objective and subjective process of analyzing phenomena of importance to nursing
False
True
11
Ch. 2 Select the definitions / criteria for clinical judgement...
the application of knowledge
Analyzing a client's needs
Evalutating outcomes
Thinking about thinking
UEnsuring thinking is unbiased
Prioritizing nursing actions
12
What are the signs and symptoms of a fracture? (select all that apply)
Swellng of the surrounding tissue
Swelling only at the fracture site
Loss of function
Tenderness at the site
Diminished function
Deformity of the area
13
The IOM states core competencies a nurse must possess to deliver safe effective nursing care (select all that apply)
Follow all physician orders as outlined
Work collaboratively in nursing teams independent of other hospital teams
Employ evidence-based practice
Provide client-centered care
Provide goal-directed, client- centered care
Apply quality improvement
14
Select all the factors that increase a client's risk for infection.....
Chronic allergies and exposure to allergens
Chronic diseases
Very young children and older adults
Compromised immune system
Dry, intact skin
Smoking, substance abuse and multiple sex partners
15
What are the most common poisonous agents ingested by children? Select all that apply
Medications
Household cleaners
Alcohol
Indoor house plants
Dog food
Carbonated drinks
16
In a punitive culture, errors are reduced because Health Care Providers are afraid of losing their jobs
True
False
17
Some procedures require both standard precautions and sterile technique
True
False
18
What is the universal sign of choking?
Jumping up and down
Waving arms frantically overhead
Grasping one's neck with both hands
Hands over mouth
19
What instructions should you give a paitent who is taking sublingual medication? (select all that apply)
Rinse mouth with water after administration
Hold it under your tongue until it completely dissolves
Measure the dosage with the calibrated cup at eye level
Should not chew or swallow it whole
20
_________ is a structured communication technique that improves communication between healthcare providers
Shift / transfer of care handoff
SBAR - Situation, Background, Assessment and Recommendation
Warm Handoff - Report with patient's input
The 4 P's: Patient, Progress, Precautions and Plan
21
Select all the measures that could help strengthen nursing classification as a profession....
Enact uniform continuing education requirements
Educate the public about the true nature of nursing practice
Standardize the educational requirements for entry into practice
Continue nursing as an hourly wage with employer deciding work conditions
22
Data a nurse collects with her visual senses are.... (select all that apply)
Patient's general appearance
Bowel sounds
Skin color
Pulse rate and rhythm
Body odor
Patient's equipment and monitor readings
23
Select all the measures that decrease the likelihood of infections....
Immunizations
Adequate/appropriate rest and physical activity
Good personal hygiene
Constant high stress
Short, clean fingernails
Obesity
24
Select the effects of immobility on the GI system.....
Increased appetite
Extreme result is paralytic ileus
Slowed digestion
Accelerates peristalsis
25
The tongue and teeth begin the digestion process.
True
False
26
The pharmacokinetic processes are.... (select all that apply)
Excretion
Distribution
Primary effects
Interaction with target cell
Metabolism
Absorption
27
There are never any economic or living environmental factors that impact one's bathing frequency.
True
False
28
Supination is turning upward and pronation is turning downward.
True
False
29
Before delivering drugs by the enteral route, the nurse should evaluate which of the following.
Last location of the injection site
Ability of the patient to lie supine
Compatibility of the drug with intravenous fluids
Ability of the patient to swallow
30
What are the rights of medication administration - select all that apply
Right medication
Right absorption
Right patient
Right time
Right MAR
Right dose
31
What are the typical causes of hospital fires? (select all that apply)
Anesthesia Causes
Pharmaceutical compounding
Electrical issues
Cigarett smoking
32
Select all the measures to teach a client in the community to help avoid infection....
Insist others wear masks
Avoid excess hand sanitizer as is very drying to skin causing small cracks
Frequently shake others hands and then clean when get home
Carry and use hand sanitizer anytime you touch any surfaces or people
Avoid/eliminate contact with others with fever or illness symptoms
Wash hands frequently and avoid touching surfaces in public bathrooms
33
ADAMS MEDS: What is a prototype drug and how does it differ from other drugs in the same class?
Prototype is an understood drug model that drugs in class are compared
Prototype drug addresses a drug's mechanism of action
Prototype drug is based on the way it works on the molecular level
Prototype is the classification based on intended effect
34
Select all the health promotion activities....
Getting adequate rest and nutrition
Encouraging frequent handwashing
Thoroughly washing glasses, utensils and dishes with hot soapy water
Getting additional rest
Increasing fluids and taking medications as prescribed
Activities that foster the highest state of well-being
35
What measures should a nurse take to reduce back injuries? Select all that apply...
Raise the bed to proper work height
Work out and increase your personal strength
Consistently use assistive devices when moving patients
Refuse to lift a patient
Seek assistance from only really strong staff
Follow proper body mechanics when moving patients
36
CH. 19 What is the purpose of the physical assessment? Select all that apply
Screen for new and monitor current client condition
Support nursing care and development of nursing diagnosis
Obtain baseline data about the patient
Assist physician with diagnosing patient
37
A 79 year old patient is fearful of exercise. What would you teach your patient to overcome the barriers? Select all
Begin at a normal pace and gradually increase intensity
Do not waste your time on warming up or stretching.
Make it a social activity and exercise with others
Take frequent rest periods as needed
38
Eyes should be cleansed from the outer canthus to the inner corner (towards the nasolacrimal duct).
True
False
39
What part of a sterile field are considered unsterile?
The sterile gloves after donning
The sterile field that is in constant visualization
The one inch margin around the edges of the field
Any area that becomes wet
40
Ch. 21 What are some important developmental considerations when providing safe care to a preschool child? Select all...
Monitor child - they need constant supervision esp. fire, poisoning
Ensure they lay prone when putting to bed
Monitor for choking hazards as they put everything in their mouth
Supervision of outside play esp. streets and play equip.
Keep cords wound up or put away, electrical outlets covered with safety cap
Water Safety - Prevention drowning
41
Which medications would not be administered through a nasogastric tube? (select all that apply)
Liquid IV medications
Liquid IM medications
Finely crushed tablets
Sustained release tablets
Enteric coated tablets
Liquid oral medications
42
The are four phases of approval for drugs; phases progress from cellular/animal testing through to pt's with the disease
True
False
43
Select all the disadvantages of computerized and standardized are plan......
Loss of nurse creativity
Miss unique needs of patient
Time Savings
Miss meeting NANDA criteria
44
Select all the possible reservoirs of infection.....
Chlorinated swimming pool
Animals
Diapers
Disinfected/sterilized surgical instruments
Raw sewage
Human body
45
Many "never events" can be prevented by good nursing care.
True
False
46
Select all the main concepts of the full spectrum model of nursing
Theoretical knowledge
Nursing expectations
Thinking
Caring
Context (client situation)
Doing
47
Select all that will impact an uninsured person's health status....
More likely to seek medical treatment
Less likely to receive necessary post hospitalization care and follow up
Easier access to health screening services
Less likely to seek medical treatment
48
When someone is choking the first thing you should do is position the patient and perform the Heimlich manuever
False
True
49
Select all appropriate bed positioning devices in the hospital setting.
Gait belt
Restraints
Pillows
Trapeze
50
Patient safety system approach stresses humans make mistakes thus key to safety is creating systems that prevent errors
True
False
51
What is the main cause of injuries during the adolescent period? Select all that apply.
Risk taking behaviors d/t feeling indestructible leading to injury
Motor vehicle accidents
Stress and abuse r/t work
Sports and recreational injuries
52
Ch. 3 Choose the statement that is secondary data and objective data .....
The nurse tells the patient that she is anemic
A client's health record that the breast exam was normal
A client tells the nurse that she experiences severe cramping with menses
The client reports daily weights have remained consistent within one pound
53
What is the role of the nurse in medication administration (select all that apply)
Ensure medications are administered and delivered in safe manner
Ensure the patient understands the use and administration of meds
Infor patient, even if disagree, in hospital have to take prescribed meds
Ensure healthcare provider orders are accurate
54
Sources of noise pollution (select all that apply)
Whistling neighbor
Garbage trucks/ construction vehicles
Barking dog
Children playground noise
Jet planes
Road traffic
55
The aging process can result in sensory loss or physiological changes leading to weakness and gait instability.
False
True
56
Select all the components of nurse caring.....
Being with
Clinical aptitude
Doing for
Sharing past nursing experiences
Enabling
Knowing (understanding their perspective)
57
Where is the best site to visualize jaundice?
Nail beds and skin color
Patient's feet
Sclera of the eyes
Oral mucous membranes
58
Cyanosis is.....(select all that apply)
Extreme Edema causing the skin to leak fluid
Poor circulation or inadequate oxygenation
Purple-colored spots and patches that occur on the skin
Bluish color of the skin
59
Select all the nail changes that occur with aging.
Nails become extremely brittle
Nail beds turn bluish
Nails become thickened
Nails become ridged
60
Select all the factors that can cause dry mouth
Heavy cigarette smoking
Mouth breathing
Heavy alcohol consumption
Excess salt intake
Certain medications
Poor oral hygiene
61
What is critical thinking?
Process of formal education structured for nursing practice
Nursing informal education through socialization and clinical experience
Collection and analyzing information, with careful consideration for action
The nurse moves from abstract principles to clinical practice experience
62
Drugs are classified by their teratogenic risk and Category A is safest and Category X are the most dangerous to fetus
False
True
63
What are the precautions to take when evaluating the carotid arteries?
Routinely palpate the carotids once establish baseline
Always check bilaterally the carotids for equal strength and rhythm
Never massage the artery as you palpate
Never palpate both carotid arteries at the same time
64
Normal flora is nonpathogenic microorganisms that help control growth of pathogenic microorganisms.
True
False
65
CH. 29 The four components of body mechanicsh are... (select all that apply)
Muscle strength
Spinal cord adaptability
Body alignment
Coordination
Joint mobility
Balance
66
Ch. 20 What is a pathogen? (select all that apply)
Bacteria
Indigestion
Viruses
Fungi
Topical Vitiligo
Allergens
67
Reasons for non-adherence to a medication regimen include: (select all)
Medication is having a therapeutic effect
No symptoms of disease
Excellent cognitive ability
Inability to afford the medication
Forgetfulness
Visual and motor deficits
68
The nurse reads that a drug has a 'narrow therapeutic index' this means that the drug has what properties?
Has a narrow segment of the population whom the drug will work as desired
It has a narrow range of effectiveness it may not give the desired response
Has a narrow range of conditions/diseases that it will be expected to treat
Has narrow safety margin- small increases may produce adverse/toxic effect
69
The Professional Nurse is responsible for making assessments.
True
False
70
Select all the guidelines for good body alignment......
Squat to lift heavy objects from the floor
Push, slide or pull heavy objects instead of lifting when possible
Minimize twisting
Stand in good alignment with a wide base of support
When reaching below the hips, always bend from the waist
When lifting / moving heavy objects hold them away from the body
71
Select all the links in the chain of infection....
Mode of transmission
Daily bathing of patient
Portal of exit and portal of entry
Good hand hygiene
Reservoir
Infectious agent
72
Healthy nails are usually clean, smooth and convexly curved.
True
False
73
Dr. Jean Watson's nursing theory is improving the environment to enable patients to heal themselves.
False
True
74
What is the rationale for the administration of a loading dose of a drug?
It results in lower dosages being required to achieve therapeutic effects
It decreases the number of doses that must be given
It decreases the risk of drug toxicity
It more rapidly builds plasma drug levels to a plateau level
75
Ch. 1 What factors make it difficult to define nursing?
The complexity of the nursing role
Rapid changes in the nursing role
Changes in the beliefs and expectations of the nursing role
Nursing's ability to customize their practice and develop personal policies
The continual changing architectural design of hospitals
Changing nature of healthcare
76
Select all the factors that make microbes favor the human body as a reservoir of infection.....
Microbes that thrive in typical levels of human electrolytes
Microbes that thrive in unusually dry spaces
Microbes that thrive in a pH of around 7.4
Microbes that thrive in cooler temperatures than the human body
Microbes that thrive at the same temperature as humans
Microbes that thrive in high salinity
77
Primary effects of medications are unintended and non-therapeutic effects
True
False
78
Select all the types of nursing diagnoses.....
Syndrome
Wellness
Deviation from norm
Unknown outcome
Risk of / for potential
Actual
79
The keys to minimizing radiation exposure are limiting time, distance and proper shielding.
True
False
80
A clinical pathway guideline provides better support for an intervention than an agency's critical pathway.
False
True
81
Immobility decreases the workload on the heart.
False
True
82
Select all the advanced practice clinical roles for the registered nurse.
Certified Registered Nurse Anesthetists (CRNA)
Scrub Technologist First Assistant (CSTFA)
Clinical Nurse Specialists (CNS)
Physician Assistant
Nurse Practitioner (NP)
Certified RN IV
83
What are the components of a pain assessment?
Aggravating and alleviating factors
Measures that provide pain relief
Pain intensity
Pain location and quality
84
Select all the aspects that define clinical reasoning....
The application of knowledge, information from various sources
Recognizing the need for more information
Reliance on past clinical experiences in decision making
Process of synthesizing knowledge and information from numerous sources
85
Select the correct statement in regard to chemical, generic and trade names of drugs.
A drug has just one trade name but several generic and chemical names
A drug has only one chemical and generic name but several trade names
A drug has just one generic but several chemical and trade names
A drug has just one chemical but several generic and trade names
86
Select all factors that are part of the Morse Fall Assessment
Patient with IV or heparin lock
One medical diagnosis
Patient uses ambulation aids
Person has a history of falling
Patient with altered mental status
Change in BP from hypertension to within normal limits
87
What specific measures would you discuss with a 9 month-old's mother to prevent choking... select all that apply
Do not give child hard candy, popcorn, grapes, marshmallows or nuts
Ensure plastic bags are stored out of reach of children
Only feed child finger foods
Inspect toys for small removable parts
88
What is the most common hernia occurring in male clients?
Lumbar disc herniation
Femoral hernia
Inguinal hernia
Hiatal hernia
89
Ch. 4 Mechanistic nursing is ....... select all that apply
Meeting the needs of the whole person
Properly administering all patient medications
Caring processes and interventions
Getting the nursing tasks done
90
Select the original levels of Maslow's basic human needs.....
Self-actualization
Ongoing education and cerebral stimulation
Caring and comfort when ill
Physiological
Safety and security
Love and belonging
91
Theoretical nursing requires an understanding of the how and why of correctly performing nursing skills.
False
True
92
Skin is the body's primary defense mechanisms to prevent entry of pathogens into the body.
True
False
93
Ch. 22 Select all the benefits of personal hygiene
Improves self-esteem
Provides comfort
contributes to physical and psychological well-being
Enables the nurse to smell any potential infection or diseases
Aids the skin in regulating temperature
Aids with elimination (bowels and urinary)
94
The physical skills are performed in order of inspection, palpation, percussion, auscultation except abdominal assess.
False
True
95
A major cause of injury from motor vehicle accident is from the airbag when child is riding in the front seat
False
True
96
Select all emerging infections of special concern in healthcare....
Airborne infections
Emerging new infections that have the potential to become epidemics
Easily identifiable bacterial infections
Re-emerging polio
Viruses
Chicken pox
97
The four essential concepts in nursing theory are (select all)...
Person
Environment
Health
Nurse
Physician collaboration
Holistic care