Nursing 300 Exam 1 Flashcards


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1

A previously healthy 35 year-old woman is admitted to your medical unit with fever, cough, and body aches for two days. She tests positive for seasonal influenza. What type of precautions would be appropriate?

a) Contact

b) Droplet

c) Airborne

D) Standard Precautions

B

2

You are assisting in the admissions process for a patient being directly admitted to your hospital. A 75 year-old male patient presents with his daughter who tells you he’s had a large draining wound on his hip that’s difficult to keep covered and draining onto his linens. You confirm this and suggest to the nurse the patient be placed into:

a) Contact Precautions

b) Standard Precautions

c) Droplet Precautions

d) Airborne Isolation Precautions

A

3

You are a nurse working in the triage area of the Emergency Department. A patient reports a cough with blood-streaked sputum for almost two months with night sweats and an unintended 20-lb weight loss. You suspect tuberculosis (TB). What type of precautions would be appropriate?

a) Contact

b) Droplet

c) Airborne

d) Contact & Droplet

C

4

A newly admitted patient was found wandering the hallways for the past two nights. The most appropriate nursing interventions to prevent a fall for this patient would include:

A. raise all four side rails when darkness falls.

B. use an electronic bed monitoring device.

C. place the patient in a room close to the nursing station.

D. use a loose-fitting vest-type jacket restraint.

C

5

While caring for a child, you identify that additional safety teaching is needed when a young and inexperienced mother states that:

A. teenagers need to practice safe sex.

B. a 3 year old can safely sit in the front seat of the car.

C. children need to wear safety equipment when bike riding.

D. children need to learn to swim even if they do not have a

pool.

B

6

A nurse floats to a busy surgical unit and administers a wrong medication to a patient. This error can be classified as:

A. a poisoning accident.

B. an equipment-related accident.

C. a procedure-related accident.

D. an accident related to time management.

C

7

Which can be ruled out as a source of a healthcare-associated infection (HAI)?

A. The patient with an IV

B. The nurse inserted urinary catheter

C. The physician performed colonoscopy

D. The wife with a cold

D

8

What is the most important weapon against the spread of infection in the hospital?

A. Antibiotics

B. Isolation

C. Hand washing

D. Sterilization of equipment

C

9

If a client is in respiratory isolation without danger of splash, which is not needed?

A. Hand washing

B. Wearing a mask

C. Wearing protective eye wear

D. Private room

C

10

You are caring for a patient who underwent surgery 48 hours ago.

On physical assessment, you notice that the wound looks red and

swollen. The patient’s WBCs are elevated. You should:

A. start antibiotics

B. notify the provider

C. document the findings and reassess in 2 hours

D. place the patient on isolation precautions

B

11

Which best describes medical asepsis?

A. The purpose of medical asepsis is to eliminate microorganisms.

B. The purpose of medical asepsis is to reduce and prevent the spread of microorganisms

C. Medical asepsis involves sterilization of equipment

D. Contamination occurs whenever something sterile comes into contact with something not sterile

B

12

A patient is admitted to a medical unit for a home-acquire

pressure ulcer. The patient has Alzheimer’s disease and has been

incontinent of urine. The nurse inserts a Foley catheter.

You will identify a link in the infection chain as:

A. restraints.

B. poor hygiene.

C. Foley catheter bag.

D. improper positioning.

C (could be portal of exit or entry)

13

Healthy People 2020:

A. Focuses on health promotion and disease prevention

B. Is illness care focused

C. Mandates system change

D. Applies to adults only

A

14

According to Maslow’s hierarchy of needs, which of these needs would the patient seek to meet first?

A. Self-actualization

B. Self-esteem

C. Shelter

D. Love and belonging

C

15

A client suffers from seasonal allergies. The physician suggests a prescription antihistamine and a series of sensitization injections. The client would prefer using a nettipot, air conditioning with HEPA filtration and evening showers. The client is subscribing to what model of care?

A. Health Belief

B. Health Promotion

C. Holistic Health

D. Maslow’s Basic Human Needs

C

16

After evaluating a patient’s external variables, the nurse concludes that health beliefs and practices can be influenced by:

A. emotional factors.

B. intellectual background.

C. developmental stage.

D. socioeconomic factors.

D

17

A 65 year old, African-American male is seen for treatment of hypertension. He works in a high powered executive position, gave up smoking 15 years ago, drinks sociably on occasion and has a BMI of 34. Identify his risk factors for cardiovascular disease. Which are modifiable which are not?

Modifiable: a high powered executive position, smoking 15 years ago, drinks sociably, BMI of 34.

Non-modifiable:65 year old, African-American, male

18

Upon graduation, a student would like to seek employment in the neonatal intensive care unit at Nationwide Children’s Hospital. This student prefers what level of nursing care?

A. Preventative care and education

B. Acute care, high acuity nursing

C. Rehabilitative services

D. End-of life care

B

19

A senior nursing student in the Community Nursing class participates in a health fair and teaches bike safety to elementary students. What level of prevention is this student practicing?´

A. Primary Prevention

B. Secondary Prevention

C. Tertiary Prevention

D. Preventative medicine

A

20

A nursing student is oriented to the unit’s new blood pressure, thermometer and accu check machines during hospital orientation. This is an example of which QSEN competency?

A. Patient-centered care

B. Safety

C. Teamwork and collaboration

D. Informatics

B

21

You will use the concept of tertiary prevention when instructing a patient to:

A. Get a flu shot every year.

B. Take a blood pressure reading every day.

C. Explore hiring a patient with a known disability.

D. Undergo physical therapy following a cerebrovascular accident.

D

22

All patients on bed rest have a lowered BMR? True or False

False

23

Electrolytes

•Na 135-145,

•K 3.5-5.3

•Cl 97-107

•Mg 1.6-2.6

•BiCarb 22-26 mEq/L

•Ca 8.2-9.6

Normal lab values

24

Alubumin

3.4-4.8 g/dL

25

T. Protein

6-8 g/dL

26

BUN

10-31 mg/dL

27

Creatine

.5-1.2 mg/dL

28

A patient has difficulty breathing while lying flat. What should the nurse’s first action be?

A. Raise the HOB up to 45 degree angle

B. Auscultate for adventitious lung sounds

C. Assess the patency of the patient’s nasal sinuses

D. Assess the extremities for adequate circulating blood volume

A

29

The nurse receives 4 patients in report. Which should she see first?

A. 84 y.o. with pneumonia, RR 28, Sp02 89%

B. 54 y.o. post-surgical patient for fractured arm, BP 160/90, HR 72

C. 63 y.o. with venous ulcers from DM, temp 99.1, HR 84

D. 77 y.o. post-surgical mastectomy patient, RR 22, BP 148/62

A

30

Skin turgor is an assessment of:

A. Skin tensile strength

B. Hydration status

C. Underlying support

D. Tactile pain sensation

B

31

A nurse is caring for a patient who states, “I just want to die.”

For the nurse to comply with this request, the nurse should discuss:

A. living wills.

B. assisted suicide.

C. passive euthanasia.

D. advance directives.

D

32

A student nurse employed as a nursing assistant may perform care:

A. as learned in school.

B. expected of a nurse at that level.

C. identified in the hospital’s job description.

D. requiring technical rather than professional skills.

C

33

A patient you are assisting has fallen in the shower. You must complete an incident report. The purpose of an incident report is to:

A. exchange information among health care members.

B. provide information about patients from one unit to another unit.

C. ensure proper care for the patient.

D. aid in the hospital’s quality improvement program.

D

34

You are about to administer an oral medication and you question the dosage. You should:

A. administer the medication.

B. notify the physician.

C. withhold the medication.

D. document that the dosage appears incorrect.

B

35

Information regarding a patient’s health status may not be released to non–health care team members because:

A. legal and ethical obligations require health care providers to keep information strictly confidential.

B. regulations require health care institutions to document evidence of physical and emotional well-being.

C. reimbursement issues related to patient care and procedures may be of concern.

D.fragmentation of nursing and medical care procedures may be identified.

A

36

The nursing assistant asks you the difference between a wound that heals by primary or secondary intention. You will reply that a wound heals by primary intention when the skin edges:

A. are approximated.

B. migrate across the incision.

C. appear slightly pink.

D. slightly overlap each other.

A

37

A surgical wound requires a Hydrogel dressing. The primary advantage of this type of dressing is that it provides:

A. an absorbent surface to collect wound drainage.

B. decreased incidence of skin maceration.

C. protection from the external environment.

D. moisture needed for wound healing.

D

38

A postoperative patient arrives at an ambulatory care center and states, “I am not feeling good.” Upon assessment, you note an elevated temperature. An indication that the wound is infected would be:

A. it has no odor.

B. a culture is negative.

C. the edges reveal the presence of fluid.

D. it shows purulent drainage coming from the incision site.

D

39

Which is not part of the Braden Scale Assessment tool?

A. Skin integrity

B. Moisture

C. Mobility

D. Sensation

A

40

The nurse is caring for a surgical client who develops a wound infection during hospitalization. How is this type of infection classified?
1. Primary
2. Secondary
3. Superinfection
4. Nosocomial

4

41

A hospitalized client develops an infection at a catheter insertion site. The nurse uses the term iatrogenic when describing this infection. Which rationale explains the Nurse's comment?

A. Poor personal hygiene

B. Inadequate dietary intake is the cause

C. The client's developmental level is the cause

D. A procedure performed at the hospital is the cause

D

42

how would the nurse explain the purpose of standard precautions to the nursing assistant on a surgical unit?

A. Decrease the risk of transmitting unidentified pathogens

B. Used by staff when clients are suspected of having a communicable disease

C. Ensure clients perform hand hygiene practices in a universal way

D. Create categories requiring the client to follow additional precautions

A

43

Which category of isolation would the nurse implement for a client who is positive for Clostridium difficile?

A. Airborne precautions

B. Droplet precautions

C. Contact precautions

D. Protective Environment

C

44

The nurse is reviewing discharge plans with a client who is hospitalized with hepatitis A. The nurse concludes that the client understands preventive measures to reduce the risk of spreading the disease when the client makes which statement?

A. "I should wash my hands frequently."
B. "I should launder my clothes separately."
C. "I should put used tissues in the garbage."
D. "I should wear a mask when leaving the house."

A

45

A nurse is teaching Unlicensed Assistive Personnel (UAP) about ways to prevent the spread of infection. It would be appropriate for the nurse to emphasize that the cycle of the infectious process must be broken, which is accomplished primarily through:

1.Handwashing before and after providing client care.
2.Cleaning all equipment with an approved disinfectant after use.
3.Wearing personal protective equipment (PPE) when providing client care.
4.Using medical and surgical aseptic techniques at all times

1

46

Arrange the order of donning personal protective equipment (PPE) while caring for a client with isolation precautions.

1. Apply the cover gown, pull the sleeves down to the wrists, and tie the gown securely at the neck and waist.

2.Apply either a surgical mask or a respirator around the mouth and the nose.

3. Apply eyewear or goggles snugly around the face and eyes

4. Apply clean gloves within the gown

5. Bring the glove cuffs over the edge of the gown sleeves

47

Arrange in the order the items of personal protective equipment (PPE) removed after seeing a client in droplet precautions.

1. Gloves

2. Face shield

3. Gown

4. Mask

48

The school nurse presented a program for teachers about infection-control and hand-washing techniques. Which evaluation method is the most effective way for nurse to evaluate the teachers' knowledge of hand-washing techniques?

A. Observe the teachers lecture the children about hand hygiene

B. Administer an objectively written final examination to the teachers

c. Have the teachers share their knowledge of hand washing

D. Watch the teachers demonstrate infection-control techniques

D

49

A client with active tuberculosis is walking down the hall to obtain a glass of juice from the kitchen, even after having received education regarding airborne precautions. Which nursing intervention would the nurse implement at this time?

A. Ensure regular visits by staff members to meet the clients needs

B. Explore what airborne precautions mean to the client

C. Report the situation to the infection control nurse immediately

D. Reteach the concepts of airborne precautions to client

B

50

Which action would the nurse take first after learning that sputum cultures for a client with a chronic cough were positive for tuberculosis?

A. Place the client on airborne precautions

B. Notify the client's provider

C. Auscultate the client's breath sounds

D. Notify the public health department

A

51

The nurse changed a dressing on a client's wound with vancomycin-resistant enterococci (VRE). Which step would the nurse take to ensure proper disposal of the soiled dressing?

A. Place the dressing in the bedside trash can

B. PLace the dressing in a red/hazardous materials bag

C. Contact environmental services personnel to pick up the dressing

D. Transport the dressing to the laboratory to be placed in the incinerator

B

52

A nurse caring for a client prioritizes nursing actions on the basis of Maslow's hierarchy of needs. Which activities should the nurse perform to meet the client's safety and security needs?

A. Providing a cold bath to reduce the client's body temperature

B. Positioning the bed in a low position and keeping the side rails up

C. Monitoring vital signs, such as blood pressure to decrease the risk of falls

D. Observing a client who has suicidal tendencies to prevent adverse incidents

E. Collaborating with family members to provide emotional support for the client post-surgery

B, C, D

53

Which should the nurse include when teaching a client with Clostridium difficile about decreasing the risk of transmission to family members?

A. Increase fluid intake

B. A high-fiber diet

C. Soap and water for hand washing

D. Wash hands with an alcohol based sanitizer

C

54

To ensure client and visitor safety during transport of a client with influenza A (H1N1) for a computed tomography, the nurse would take which precautions?

A. Place a surgical mask on the patient

B. Other than the standard precautions, no additional precautions are needed

C. Minimize close physical contact

D. Cover the client's legs with a blanket

A

55

Which strategy is the most effective for preventing the transmission of infection?

A. wearing gloves and a gown

B. Applying a face mask and a gown

C. Applying a face mask and gloves

D. Gloves and hand hygiene

D

56

Identify an example of microorganisms transmitted via indirect contact

A. Kissing

B. Deer tick

C. Dirty hands

D. Contaminated water

C

57

Which criteria would the nurse consider when determining if an infection is a health-care associated infection?

A. originated primarily from an exogenous source

B. is associated with a medication-resistant microorganism

C. Occured in conjunction with treatment for an illness

D. Still has the infection despite completing the prescribed therapy

C

58

Under which type of health care services would the nursing student include subacute care?

1. tertiary care

2. continuing care

3. restorative care

4. secondary acute care

A