Final Fundamentals Review

Which position would be comfortable for the pt and provide best access for the nurse to insert a rectal suppository?

Which home health patient would be the best candidate for a telehealth program?

Which pt typifies the demographic changes of the population in the 21st century and requires increased need for care

Which behavior most strongly suggests that the patient has a future time orientation?

Which nursing action reflects Florence Nightingale’s vision of how to improve patient care?

Which patient needs to get both pneumococcal and influenza vaccines?

Using Maslow’s hierarchy of needs, the nurse gives priority to which problem?

The LVN is told by MD to start blood on a pt,the policy says that LVN can monitor but RNs must initiate. What should do?

A pt has been sleeping in a recliner for the past month cuz “It is easier to fall asleep". What nurse likely suspect?

Pt occasionally sighs during the morning assessment. What is the clinical significance of occasional sighing?

The UAP just reported patients’ vital signs to the nurse. For which patient is an increased pulse an expected finding?

The student has test anxiety. Uses guided imagery to help reduce anxiety just before each test. What is desired outcome?

The nurse delegates denture care to the UAP. What instructions should the nurse give to the UAP about the dentures?

A woman reports episodes of nausea/vomiting, headache, and irritability. Appears shallow breathing and shaky. What 1st?

The pt takes anticoagulant cuz of AFIB and uses ginseng cuz he heard it can prevent DMII. What is most important data?

A pt is yelling at the UAP. As the nurse enters the room, the pt throws the food tray. What should the nurse do 1st?

The LVN is reading the documentation that was done by a new RN. There are many spelling mistakes. What should LVN do?

A pt is diagnosed with asthma. On the care plan, "use inhaler PRN for asthma attacks". How does the nurse implement?

The pt has a bone infection in the lower leg. Which pt ed brochure is the nurse most likely to prepare for the patient?

An older patient has “tenting” over the sternum. Based on this information, what is most important to monitor/assess?

The pt begins to cough and gag with NG tube insertion. The nurse tells pt to breathe, but still coughs. What do 1st?

Which patient action is the best demonstration of a functional outcome?

The nurse reports pt received hypodermoclysis. Which assessment most likely to perform to evaluate efficacy of therapy?

Following a stroke, a pt has difficulty swallowing and risk for aspiration. Which member of health care team consult?

The pt says, “I am going to tell you a secret. I am going to end it all by going for a long swim in the ocean.” What do?

To address the signs and symptoms of the inflammatory phase, which action would the nurse perform?

The nursing student has the opportunity to perform urinary catheterization. What should the student do first?

Taking pt’s history pt makes references to her aunt’s health and events years ago. Which therapeutic comm. w/ pt?

Under what circumstance would the nurse advise the parents to contact the provider about their 1-year-old infant?

The nurse is trying to interview a patient who is very hard of hearing. What strategy should the nurse try first?

The nurse needs to assess a patient who had a head injury. Which neurologic assessment would the nurse perform first?

What is included in the preparation for tracheostomy care in the acute care environment?

The nurse is evaluating the eye care that has been delegated to a new staff member. Which action is appropriate?

Which patient will require serial neurovascular assessments on bilateral extremities?

A pt with Alzheimer’s is transferred from a SNF to hospital for possible sepsis/mental status. Which ? most important?

What is an example of a person who requires assistance with instrumental activities of daily living?

Which nursing intervention demonstrates the application of the gate control theory of pain?

A new nurse writes PERRLA in the pt’s chart. When the preceptor asks her to describe, she is unable. What should do 1st?

The older adult is having trouble reading the labels on his medication bottles. What is the best strategy nurse suggest?

The pt requires suctioning of pulmonary secretions. What is the most accurate problem statement for this pt’s condition?

The nurse is assessing the vision of an older adult patient. Which finding is NOT associated with the aging process?

Which assessment finding of the integumentary system is the most important to report to the provider or dermatologist?

Based on the nurse knowledge of health disorders found among Native American ancestry, which ? most likely to ask?

A nursing student is preparing to do a sterile dressing change. Which action requires correction and instruction?

The nurse gets report that the pt has PAD that affects his lower extremities. What would the nurse expect to find?

A HHA has been assigned to assist a pt with a bath several times a week. Which instruction is appropriate to give HHA?

An older adult pt has been wandering around halls during the late evening hours. The pt hx of falls. What is best?

The pt will be immobilized for an extended period. Which will the nurse use to prevent respiratory complications?

A pt comes to the nurse and demands to have his chart cuz he is leaving and wants care elsewhere. What is best response?

In which case is the nurse most likely to be charged with malpractice?

The nurse has identified six relevant nrsg dx that would apply to the pt’s care. Which nrsg action is most important?

The pt has a midline abdominal incision. With the purpose of reducing a reservoir of infection, what would the nurse do?

The student decides to say hello to a patient. While talking, the pt becomes unresponsive. What should they do 1st?

The family of older adult is having financial issues related to end of life care. Which team member most helpful?

What is an early sign that warrants additional assessment of respiratory status?

What is the purpose of a resident assessment instrument?

A pt reports taking high doses of vitamins. Which vitamin has the greatest risk for toxicity related to high dosage?

A pt requires wound care and IV antibiotics due to an infection of a surgical wound. Which type of care will be best?

The surgeon tells pt risk of blood loss in surgery, the pt is a Jehovah’s Witness and refuses sign consent. Best action?

When caring for a patient with tuberculosis who is on airborne precautions, what should the nurse routinely use?

Nurse writing in black pen on the hardcopy nurse's notes. Realizes writing in wrong chart. What is the best action?

Which patient is most likely to need cues and reminders to accomplish activities of daily living?

The nurse notices a reddened area on the patient’s sacrum. What should the nurse do first?

The nurse has inserted the urinary catheter, attempts to inflate the balloon, pt expresses discomfort. What should do?

Which patient needs to be placed into contact precautions?

The nurse notes that the patient has kyphosis. Which symptom is cause for the greatest concern because of the kyphosis?

The patient has a cast on the left lower leg. Which assessment is performed to prevent compartment syndrome?

One of the major problems of hospitals of the early 19th century has been addressed by which measure in contemporary HC?

Nurse helping pt with a spinal cord injury move into a wheelchair. What do 1st to prevent postural hypotension?

The nurse assisting the patient to transfer from the bed to the chair. Which action shows proper use of body mechanics?

Which patient problem would be considered a collaborative problem?

The nurse is admitting a new patient to the diagnostic and surgical center. What should the nurse do first?

What is the best rationale for drawing at least two blood cultures from two different sites?

After abd surgery, a pt is at risk for wound stress related to coughing. What equipment need to teach about splinting?

Which nursing intervention would help the patient/family to meet the hospice goals?

The provider tells the nurse that the patient has pruritus. Which objective finding is the nurse most likely to observe?

Which laboratory blood test is more likely to require written informed consent?

A patient is interested in adding antioxidants to the diet. What is the best advice?

Pt having a MI, provider orders morphine to relieve pain. Which harmful effect of unrelieved pain is greatest concern?

The nurse is most likely to question the prescription for an enteral feeding tube for which patient?

Which tasks related to admitting a new patient can be delegated to the UAP?

The pt returned 3 hours ago after having surgery, the dressing is now saturated with red, watery drainage. What 1st?