C. An Asian patient is likely to hide his pain. Nursing responsibilities for Mrs. Mitchell now include: questions I know this will be difficult for you, but your hair will grow back after the completion of chemotheraphy Question 26Which of the following parameters should be checked when assessing respirations? Maintain an erect trunk, Fowler/semi-Fowler Burns Dont worry.. offers some relief but doesnt recognize the patients feelings. 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. - Atelectisis Eupnea is normal respiration quiet, rhythmic, and without effort. oxygen therapy, During a Romberg test, the nurse asks the patient to assume which position? Abdominal cramping with hyperactive, high pitched tinkling bowel sounds can indicate a bowel obstruction. These changes, in turn, increase the work load of the left ventricle. The most common psychogenic disorder among elderly person is: The nurse administers penicillin to a patient with a documented history of allergy to the drug. A patient is kept off food and fluids for 10 hours before surgery. She should notify the physician if the urine output is: 34. ARateBAll of the above CSymmetryDRhythmQuestion 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. bowel, The other nursing actions may be necessary but are not a major priority. School-aged children and adolescents Parkinsons disease is a neurologic disorder caused by lesions in the extrapyramidial system and manifested by tremors, muscle rigidity, hypokinesis, dysphagia, and dysphonia. A patient demonstrating symptoms of drugs or alcohol withdrawal Question 24Which of the following vascular system changes results from aging?AIncreased peripheral resistance of the blood vesselsBAll of the above CDecreased blood flowDIncreased work load of the left ventricleQuestion 24 Explanation: Aging decreases elasticity of the blood vessels, which leads to increased peripheral resistance and decreased blood flow. C. A platelet count evaluates the number of platelets in the circulating blood volume. She is required to bathe only soiled areas of the body since the mortician will wash the entire body. Waiting to consult a physical therapist is unnecessary. The physician is responsible for instructing the patient about the test and for writing the order for the test.Question 43After 1 week of hospitalization, Mr. Gray develops hypokalemia. Riboflavin Fundamentals of Nursing Practice Exam 2 (PM) If not, container tends to be left off and pets or children can get into it. 29. Preoxygenate the patient 1234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950End The attending physician may need information from the nurse to complete the death certificate, but he is responsible for issuing it. Score What is a nurses responsibility concerning Nutrition? PRN - as needed / per requested Keep needle in skin for 10 sec, Clean the vials Question 5To assess the kidney function of a patient with an indwelling urinary (Foley) catheter, the nurse measures his hourly urine output. - Should be kept below the patient for the effect of gravity Question 32The most common deficiency seen in alcoholics is:AThiamineBRiboflavinCPantothenic acid DPyridoxineQuestion 32 Explanation: Chronic alcoholism commonly results in thiamine deficiency and other symptoms of malnutrition. D. All of these positions are appropriate for a rectal examination. Most people get insulin from endogenous means. - Reposition every two hours to reduce the risk of infection never manually recap needles after injection The nurse administers the wrong medication to a patient and the patient vomits. remove protective covering The physician is responsible for instructing the patient about the test and for writing the order for the test.Question 30The most common psychogenic disorder among elderly person is:ASleep disturbances (such as bizarre dreams)BDepressionCDecreased appetite DInability to concentrateQuestion 30 Explanation: Sleep disturbances, inability to concentrate and decreased appetite are symptoms of depression, the most common psychogenic disorder among elderly persons. Thick, tenacious secretions, a dry, hacking cough, orthopnea, and shortness of breath are signs of ineffective airway clearance. The best response would be:AWhy are you crying? Because transplants are done within hours of death, decisions about organ donation must be made as soon as possible. Machines vary from facility to facility, wash hands to stop, think and be vigilant when administering medications, metric system Automated medication dispensing systems in the hospital Eye clear Shiny hair Ridged nails Moist conjunctiva 2. Hold pen with thumb ready to depress Provide information and reassurance, How to Document for Endotracheal Intubation, Size of ET tube (width & length) Battery is the unlawful touching of another person or the carrying out of threatened physical harm. (Choose all that apply) may increase undermining and or tunneling behavioral- anxiety, agitation, consiousness The three elements necessary to establish a nursing malpractice are nursing error (administering penicillin to a patient with a documented allergy to the drug), injury (cerebral damage), and proximal cause (administering the penicillin caused the cerebral damage). Nausea C. Because the pedal pulse cannot be detected in 10% to 20% of the population, its absence is not necessarily a significant finding. The nurse discusses the foods allowed on a 500-mg low sodium diet. - Some drugs can cross the placenta and should not be administered to pregnant women, Therapeutic Effects Question 28A new head nurse on a unit is distressed about the poor staffing on the 11 p.m. to 7 a.m. shift. Question 22The correct sequence for assessing the abdomen is:AAssessment for distention, tenderness, and discoloration around the umbilicus.BTympanic percussion, measurement of abdominal girth, and inspectionCPercussions, palpation, and auscultationDAuscultation, percussion, and palpation Question 22 Explanation: Because percussion and palpation can affect bowel motility and thus bowel sounds, they should follow auscultation in abdominal assessment. Ham, olives, and chicken bouillon contain large amounts of sodium and are contraindicated on a low sodium diet. - Airway obstruction due to swallowing small objects Completely black on CXR indicated a collapsed lung 4. Congratulations - you have completed Fundamentals of Nursing Practice Exam 2 (PM). A 38-year old patients vital signs at 8 a.m. are axillary temperature 99.6 F (37.6 C); pulse rate, 88; respiratory rate, 30. 2) Comprehension - The patient must understand the explanation. Setting priorities What is the first thing the nurse should do after writing down the order? Examples of patients suffering from impaired awareness include all of the following except: Age is also a factor. reduces leakage of medication into subcutaneous tissue The physician orders a platelet count to be performed on Mrs. Smith after breakfast. (more prone to trips & falls throw rugs are a death trap), Other Issues/Risk Factors that are concerns for safety, Lifestyle ** Prescriptions are often being done electronically, Double-Check Question 31If a patients blood pressure is 150/96, his pulse pressure is:A54B150C246D96Question 31 Explanation: The pulse pressure is the difference between the systolic and diastolic blood pressure readings in this case, 54. 44. underuse, Capsules Errors include Ineffective airway clearance related to thick, tenacious secretions. Assisting a patient out of bed with the bed locked in position is the correct nursing practice; therefore, the fracture was not the result of malpractice. Question 17In Maslows hierarchy of physiologic needs, the human need of greatest priority is:AOxygen BEliminationCNutritionDLoveQuestion 17 Explanation: Maslow, who defined a need as a satisfaction whose absence causes illness, considered oxygen to be the most important physiologic need; without it, human life could not exist. Maintain the patient in an orthopneic position as needed 38. During a Romberg test, which evaluates for sensory or cerebellar ataxia, the patient must stand with feet together and arms resting at the sidesfirst with eyes open, then with eyes closed. Also, this page requires javascript. medications absorbed more slowly this route than IM Prone offer tissue to blot runny nose but not blow. A series of coughs throughout exhalations A negative nitrogen balance is present when catabolic states exist. She elevates the head of the bed to the high Fowler position, which decreases his respiratory distress. represents increasing amounts of new blood vessels Amyotrophic lateral sclerosis, a disease marked by progressive degeneration of the neurons, eventually results in atrophy of all the muscles; including those necessary for respiration. Time used Chicken bouillon of O2 being given and does not dry out membranes, 2L is 28% Most of the time it passes through the stomach and dissolves in the intestines Patient's perspectives Ability of the medication to dissolve - Face down Such a patient is unlikely to display emotion, such as crying. -Never use over-the-counter (OTC) drugs or herbal supplements. What should she do? Reporting any changes in patient's status after medication administration, Which task would be most appropriate for the nurse to delegate to the nursing assistive personnel (NAP)? 125 ml in 4 hours Biotransformation occurs when enzymes detoxify, degrade, and remove active chemicals Fundamentals of Nursing Test #2 Flashcards | Quizlet Fundamentals of Nursing Test #2 Term 1 / 97 Patient Medication Dose Route Time Documentation Effect To be educated To refuse Click the card to flip Definition 1 / 97 What are the nine rights medication administration? Hypercapnia, hypoxemia, fever, pregnancy, wound healing 20. Check with the dyspnea scale Protect your own body - Exposure to second hand smoke - Assess ability for patient self medication Discourage them from making a decision until their grief has eased, Tell them the body will not be available for a wake or funeral, Listen to their concerns and answer their questions honestly, Encourage them to sign the consent form right away. The most common deficiency seen in alcoholics is: 32. The nurse is responsible for giving the patient breakfast at the scheduled time. Intracardiac It involves professional misconduct, such as omission or commission of an act that a reasonable and prudent nurse would or would not do. Decreased appetite Enhanced by a wide base of support, What is Good Nursing Coordinated Body Movement, Must overcome an object's weight and be aware of it's center of gravity. 32. Fundamentals Of Nursing Exam 2- Documentation by Roxy0214049 , Sep. 2008 Subjects: 2 documentation exam fundamentals Click to Rate "Hated It" Click to Rate "Didn't Like It" Click to Rate "Liked It" Click to Rate "Really Liked It" Click to Rate "Loved It" Favorite Add to folder Flag Flashcards Memorize Test Games Tweet Related Essays anterieor aspects of thighs Herbal drugs can interact negatively with prescribed meds. Parenteral: Subcut, IV, ID, IM Administer medications following the rights apply prescribed number of inches over paper measuring guide The best response would be: Lethargy Risk for aspiration Parkinsons disease is a neurologic disorder caused by lesions in the extrapyramidial system and manifested by tremors, muscle rigidity, hypokinesis, dysphagia, and dysphonia. I will be back to check on you." Substance abuse SIMS Environmental modifications Questions Not Attempted Encourage the patient to walk in the hall alone 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. B. Screw on needle She elevates the head of the bed to the high Fowler position, which decreases his respiratory distress. Assisting a patient out of bed with the bed locked in position is the correct nursing practice; therefore, the fracture was not the result of malpractice. Question 1Examples of patients suffering from impaired awareness include all of the following except:AA patient who cannot care for himself at homeBA patient demonstrating symptoms of drugs or alcohol withdrawal CA semiconscious or over fatigued patientDA disoriented or confused patientQuestion 1 Explanation: A patient who cannot care for himself at home does not necessarily have impaired awareness; he may simply have some degree of immobility. Regulated by TJC & CMS (centers for medicare/medicaid services) DAccountability is clearest when one nurse is responsible for the overall plan and its implementation.Question 46 Explanation: Studies have shown that patients and nurses both respond well to primary nursing care units. We need to get O to the cells throughout the body!! Question 20The nurses most important legal responsibility after a patients death in a hospital is:ANotifying the coroner or medical examinerBObtaining a consent of an autopsyCLabeling the corpse appropriatelyDEnsuring that the attending physician issues the death certification Question 20 Explanation: The nurse is legally responsible for labeling the corpse when death occurs in the hospital. This information is documented and reported to the physician and the nursing supervisor. 4. ..I didnt get to the bad news yet would be inappropriate at any time. An insulin pump is a small battery-operated device about the size of a small cell phone. Respiratory rate only Femoral Thus, an axillary temperature of 99.6F (37.6C) would be considered abnormal. 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. D. The quality and efficiency of the respiratory process can be determined by appraising the rate, rhythm, depth, ease, sound, and symmetry of respirations. Simple Face Mask Which of the following is an example of nursing malpractice? Why is this patient getting the med? Question 44The four main concepts common to nursing that appear in each of the current conceptual models are: Which of the following statement is incorrect about a patient with dysphagia? Med chemicals bind to proteins to help meds get to where they need to go, Can only occur after the medication reaches the site of action 3. 11. Inform the staff that they must volunteer to rotate Once you are finished, click the button below. Use the formation of water from hydrogen and oxygen to explain the following terms: chemical reaction, reactant, product. Ability to absorb, metabolize, and excrete -Contact the prescriber to inform him/her of the error. 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. B. Current condition You have not finished your quiz. Disorders of Bones, Joints, & Muscles apothecary system Allow a 1 hour rest period between activities Depression typically begins before the onset of old age and usually is caused by psychosocial, genetic, or biochemical factors. The nurse must place a pillow under the decreased persons head and shoulders to prevent blood from settling in the face and discoloring it. 25. 96 A 38-year old patients vital signs at 8 a.m. are axillary temperature 99.6 F (37.6 C); pulse rate, 88; respiratory rate, 30. Pain related to immobilization of affected leg would be an appropriate nursing diagnosis for a patient with a leg fracture. All doneNeed more practice!Keep trying!Not bad!Good work!Perfect! Goals and outcomes Medication Interactions red or pink granulation tissue Insert needle at 90 angle right drug The nurse is responsible for: Aging decreases elasticity of the blood vessels, which leads to increased peripheral resistance and decreased blood flow. The other answers are diseases that can occur in the elderly from physiologic changes. - info medical personnel can look at Amyotrophic lateral sclerosis, a disease marked by progressive degeneration of the neurons, eventually results in atrophy of all the muscles; including those necessary for respiration. Some hospitals have standing orders up to 2L CFeverDSympathetic nervous system stimulationQuestion 45 Explanation: Parasympathetic nervous system stimulation of the heart decreases the heart rate as well as the force of contraction, rate of impulse conduction and blood flow through the coronary vessels. Performing activities of daily living, Body Alignment Ati ene fundamentals physiologic concepts for nursing practice nutrition flashcards quizlet nclex rn practice . Correct dosage Question 13The family of an accident victim who has been declared brain-dead seems amenable to organ donation. In the event that a medication error occurs, the nurse should do the following first: Side rails are a deterrent that prevent a patient from falling out of bed. Notifying the coroner or medical examiner instill prescribed number of drops Kaopectate is an anti diarrheal medication. cleanse site using circular stroke starting with area immediately next to drain and moving away -To cause less inconvenience for prescribers She may be involved in obtaining consent for an autopsy or notifying the coroner or medical examiner of a patients death; however, she is not legally responsible for performing these functions. Question 32Which of the following is an example of nursing malpractice?AThe nurse administers penicillin to a patient with a documented history of allergy to the drug. A125 ml in 4 hours B64 ml in 2 hoursC90 ml in 3 hoursDLess than 30 ml/hourQuestion 19 Explanation: A urine output of less than 30ml/hour indicates hypovolemia or oliguria, which is related to kidney function and inadequate fluid intake. keep needle inserted 10 seconds after injection of medications These include: Caffeine-containing drinks, such as coffee and cola. 45. Which of the following is the most common cause of dementia among elderly persons? Age is also a factor. Please visit using a browser with javascript enabled. What are the most frequent route of exposure to blood-borne disease? - Patient and family education, 1. Question 8In Maslows hierarchy of physiologic needs, the human need of greatest priority is:ANutritionBEliminationCLoveDOxygen Question 8 Explanation: Maslow, who defined a need as a satisfaction whose absence causes illness, considered oxygen to be the most important physiologic need; without it, human life could not exist. All of the following can cause tachycardia except: The resting pulse rate in an adult ranges from 60 to 100 beats/minute, so a rate of 88 is normal. Attempted Questions Correct A complete blood count does not provide immediate results and does not always immediately reflect blood loss. Bed rest and oxygen by Venturi mask at 24% would improve oxygenation of the tissues and cells but must be ordered by a physician. In Sims position, the patient lies on his left side with the left arm behind the body and his right leg flexed. The infant falls off the scale, suffering a skull fracture. Higher level on inspiration and lower level on expiration Discourage the patient from walking in the hall for a few more days Intra articular - into a joint Age is also a factor. Kidneys, - semiprone on right or left side with weight placed on anterior ilium, humerus, & clavicle, Patient safety - 1st priority Respiratory rate Transdermal patches -Change the feeding pump bag and tubing every 24 hours. What factors affect ventilation and O transport? All of the above Caffeine-containing drinks, such as coffee and cola. ASittingBTrendelenburg CStandingDGenupectoralQuestion 18 Explanation: During a Romberg test, which evaluates for sensory or cerebellar ataxia, the patient must stand with feet together and arms resting at the sidesfirst with eyes open, then with eyes closed. Muscle weakness Swallowing - patient may not be able to swollow and patient should sit upright when taking meds Noncompliance Things they like doing but can't Ingestion 31. Question 14Palpating the midclavicular line is the correct technique for assessingARespiratory rateBApical pulse CBaseline vital signsDSystolic blood pressureQuestion 14 Explanation: The apical pulse (the pulse at the apex of the heart) is located on the midclavicular line at the fourth, fifth, or sixth intercostal space. - other places: lungs, kidneys, blood, and intestines Correct Your hair is really pretty offers no consolation or alternatives to the patient. The patient uses her dominant hand to insert the suppository along the posterior wall of the vaginal canal. 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. Nutrition ", What is the goal of computerized physician order entry (CPOE)? Beets AC = before meals The nurse is responsible for giving the patient breakfast at the scheduled time. apply to chest, back, upper arm, or legs. Which of the following is an example of nursing malpractice? maintain privacy Patients feel less anxious and isolated and more secure because they are allowed to participate in planning their own care. - the body requires insulin in order to convert sugar into energy. Question 19To assess the kidney function of a patient with an indwelling urinary (Foley) catheter, the nurse measures his hourly urine output. Urinary analgesics O2 is a drug and must have doctor's orders Any items you have not completed will be marked incorrect. Patients should begin ambulation as soon as possible after surgery to decrease complications and to regain strength and confidence. Nursing diagnosis This information is documented and reported to the physician and the nursing supervisor. - Head of bed elevated, support and align hips and spine High- humidity air and chest physiotherapy help liquefy and mobilize secretions. Nursing responsibilities for Mrs. Mitchell now include: Reporting an APTT above 45 seconds to the physician, Assessing the patient for signs and symptoms of frank and occult bleeding. 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. Active Assist - patient moves joints with help from nurse, Walker - only come in one width. 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: 13. - swayed back, less coordination, budda belly -Rectal hemorrhoids 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 28. as drainage is being emptied out of reservoir, compress the device until bottom and top are in contact, quickly cleanse opening CAn 88-year old incontinent patient with gastric cancer who is confined to his bed at homeDAn alert, chronic arthritic patient treated with steroids and aspirinQuestion 24 Explanation: Pressure ulcers are most likely to develop in patients with impaired mental status, mobility, activity level, nutrition, circulation and bladder or bowel control. List A ham and Swiss cheese sandwich on whole wheat bread depth dependent upon location, over boney prominence it will not be as deep as over areas with abundant subcutaneous tissue, Full thickness Mrs. Lim begins to cry as the nurse discusses hair loss. Decreased cardiac output Demonstrating the signal system and providing an opportunity for a return demonstration ensures that the patient knows how to operate the equipment and encourages him to call for assistance when needed. If loading fails, click here to try again. However, the familys concerns must be addressed before members are asked to sign a consent form. Hint A confused 78-year old patient with congestive heart failure (CHF) who requires assistance to get out of bed. Parasympathetic nervous system stimulation of the heart decreases the heart rate as well as the force of contraction, rate of impulse conduction and blood flow through the coronary vessels. The physician orders a maintenance dose of 5,000 units of subcutaneous heparin (an anticoagulant) daily. Nclex Practice Questions 1 Free Test Bank 2022 Nurseslabs.
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