Basic Nursing Test 2 Chapter Review

  1. The most effective way to break the change of infection is by:



    B.
  2. A patient's surgical wound has become swollen, red, and tender. You note that the patient has a new fever and leukocytosis. Your best immediate intervention is to:



    B.
  3. A patient has an indwelling catheter. You recognize that the catheter represents a risk for urinary tract infection because:



    D.
  4. You have redressed a patient's wound and now plan to administer a medication to the patient. It is important to:



    D.
  5. You need to wear a gown when working with a patient:



    A.
  6. Identify when the nurse should remove gloves and perform hand hygiene. Select all that apply:



    • B.
    • c
    • d
  7. The most likely means of transmitting infection between patients is:



    B.
  8. Your ungloved hands come in contact with the drainage from the patient's wound. To clean your hands you should:



    A.
  9. A patient is placed on contact precautions for an infection with a resistant organism. You notice the patient seems to be depressed and withdrawn. The best intervention is to:



    B.
  10. After coming in contact with a patient on isolation, visitors are encouraged to:



    B.
  11. A 68-year-old woman whose husband died last year walks into the wellness clinic of the assisted living facility. She reports that she feels depressed and tired all the time. She provides you with a list of medications, one of which her health care provider altered in the last 3 weeks, atenolol, a beta-adrenergic blocker. Knowing that beta-adrenergic blockers have the potential to cause hypotension and bradycardia, which vital signs can you delegate to the clinics nursing assistant? Select all that apply.



    • D.
    • c
  12. A patient's blood pressure is 102/58 mm Hg in the right arm. On the patient's last visit, the blood pressure was 142/60 mm Hg in the left arm. What is your priority nursing action?



    A.
  13. A 53-year-old man has just returned from the post-anesthesia care unit (PACU) following a small bowel resection. He has smoked 2 packs per day since he was 18 years old. His admission vital signs obtained by the nursing assistant are heart rat 114 beats per minute, BP 118/72 mm Hg, tympanic temperature 97.8⁰ F, respiratory rate 8 breaths per minute, and SpO2 94% using 3 L of oxygen via nasal cannula. How do you describe his vital signs?



    D.
  14. Thirty minutes after returning from the PACU your patient's pulse oximeter alarms, and you note the SpO2 is 89%. While she was sleeping, the oxygen cannula fell out of her nose. What is your priority nursing action?



    C.
  15. Poor oxygenation of the blood ordinarily will affect the pulse rate and cause it to become:



    D.
  16. You dangle your patient on the side of the bed 6 hours after surgery. The nursing assistant obtains a blood pressure of 92/58 mm Hg while he is sitting. The difference between his postoperative BP of 118/58 mm Hg and the sitting blood pressure is described as:



    B.
  17. You help your patient get out of bed 1 day after surgery for a bowel obstruction. He complains of dizziness and nausea. Your immediate action is to:



    C.
  18. Following surgery, your patient's systolic blood pressure drops 25 mm Hg when you are helping him out of bed. What is the likely cause for the change in blood pressure?



    C.
  19. You have assigned routine vital signs to a new nursing assistant recently hired by your clinical manager. You notice that the nursing assistant's last three patients have had unusually low blood pressures that you have had to reconfirm. What is the most likely reason for the low blood pressures that the nursing assistant is obtaining?



    D.
  20. An experienced nursing assistant complains about the vital signs that a newly hired nursing assistant has been asked to retake a BP that the newly hired nursing assistant has taken 3 times this week. As the RN, what action do you take?



    A.
  21. The nurse conducts a patient assessment on a 72-year-old woman and finds a capillary refill time of 4 seconds, a nail bed angle of 160 degrees, hardened nails, and splint hemorrhages. Which findings are abnormal? Select all that apply.



    • A.
    • d
  22. To correctly palpate the patient's skin for temperature, the nurse uses the:



    C.
  23. The patient's respiratory assessment reveals bilateral high pitched, continuous musical sounds heard loudest upon expiration. The nurse interprets these sounds as:



    D.
  24. While auscultating heart sounds, the nurse documents that S1 is heard best at the apex. This sound (S1) correlates with closure of the:



    A.
  25. To assess the patient's posterior tibial pulse, the nurse palpates:



    D.
  26. To spread the breast tissue evenly over the chest wall during an examination, the nurse asks the patient to lie supine with:



    C.
  27. Assessment of which body system requires you to perform auscultation before palpation?



    A.
  28. The nurse is teaching a patient how to perform a testicular self-examination. The nurse instructs the patient:



    D.
  29. The patient is being assessed for range of joint movement. The nurse asks the patient to move the arm away from the body, evaluating the movement of:



    A.
  30. The nurse asks the patient to smile, frown, and raise and lower the eyebrows; these actions evaluate cranial nerve number:



    D.
Author
MarieRN
ID
171961
Card Set
Basic Nursing Test 2 Chapter Review
Description
Chapters 13-15
Updated