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Nursing model question paper 4
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1.The patient has a history of terminal cancer but is
being admitted for treatment of a pressure ulcer. The patient’s wife has been
caring for him at home and refuses to discuss admission to a nursing home. The
wife looks extremely tired and is near the point of exhaustion. What could the
nurse suggest?
a. A consult for hospice care
b. Continuing with the plan of care as is
c. That the doctor order the patient into a nursing
home
d. That the wife stay away while the patient is
hospitalized
ANS: A
2. The patient is being admitted to the hospital for
injuries received when a hurricane destroyed her home. She is upset from the
loss of her home and possessions. What type of loss is this considered?
a. Necessary loss
b. Maturational loss
c. Situational loss
d. Perceived loss
ANS: C
3. The nurse recognizes that anticipatory grieving can
be most beneficial for a patient or family because it can:
a. be done in a private setting.
b. be discussed with other individuals.
c. promote separation of the ill patient from the
family.
d. allow time for the process of grief.
ANS: D
4. The nurse is preparing to assist the patient at the
end stage of her life. To provide comfort for the patient in response to
anticipated symptom development, the nurse plans to:
a. decrease the patient’s fluid intake.
b. limit the use of pain medication.
c. provide larger meals with more seasoning.
d. determine patient wishes and select appropriate
therapies.
ANS: D
5. A nurse-initiated or independent activity for
promotion of respiratory function in a terminally ill patient is to:
a. limit PO fluid intake.
b. position the patient in semi-Fowler’s or Fowler’s
position.
c. reduce narcotic analgesic use.
d. administer bronchodilators.
ANS: B
6. When caring for a patient who is an appropriate
candidate for organ or tissue donation, the nurse knows that requests for
donation are:
a. required by state law.
b. the total responsibility of the survivors.
c. a possible inclusion in the advance directive.
d. made only by the physician.
ANS: C
7. The patient is on a ventilator and has a heartbeat
but has been declared “brain dead.” The family has agreed to organ donation.
The nurse realizes that which of the following organ donations would require
that the patient be left on life support?
a. Eyes
b. Bone
c. Kidney
d. Skin
ANS: C
8. An appropriate technique for the nurse to implement
when caring for a patient’s body after death is to:
a. remove the patient’s ID band and put a new gown on
the patient.
b. cover the patient with a sheet and transfer him or
her to the morgue.
c. inquire about particular cultural or spiritual
practices.
d. remove tubes and lines if the patient is to be
autopsied.
ANS: C
9. After the death of a patient and before other
nursing interventions are implemented, the nurse should:
a. place the patient in a supine position and elevate
the head of the bed 30 degrees.
b. wait an hour to prepare the patient for viewing.
c. place the patient in a side-lying position to allow
drainage.
d. exclude the family while the body is being
prepared.
ANS: A
10. Before allowing the family of a deceased patient
to view the body, the nurse should:
a. insert the patient’s dentures.
b. lower the head of the bed.
c. fold the arms and hands over the chest.
d. leave all of the old dressings and tape in place.
ANS: A
11. A new staff member is working with a patient who
is dying. A nurse evaluates that this new employee requires additional teaching
when he or she is observed:
a. limiting the family’s visiting hours.
b. staying with the patient and family as much as
possible.
c. finding a quiet place for family members to gather.
d. asking the family if they would like to help with
preparing the body.
ANS: A
12. The patient was a practicing Hindu when he died.
Knowing this, the nurse realizes that:
a. the body should be covered with a cotton sheet.
b. anointing of the sick is performed even after
death.
c. family members often prefer to wash the body after
death.
d. the body should be buried within 24 hours.
ANS: C
13. For a patient in the final stages of dying, a
nurse expects to:
a. keep the patient’s room cool.
b. avoid catheterizing the patient.
c. elevate the head of the bed as tolerated.
d. encourage the patient to eat and drink more.
ANS: C
14. Hospice care can be provided in which of the
following settings? (Select all that apply.)
a. Home
b. Free-standing hospice facilities
c. Extended care facilities
d. Acute care facilities
Ans: ALL OF THE ABOVE
15. Hospice benefits include which of the following?
(Select all that apply.)
a. Respite for family caregivers
b. Hospitalization for acute symptom management
c. Emotional and psychological support
d. Financial assistance and funeral arrangement
ANS: ABC
16. The World Health Organization (2002) defines
___________ as an “approach that improves the quality of life of individuals
and their families facing life-threatening illness, through the prevention and
relief of suffering by means of early identification and impeccable assessment
and treatment of pain and other physical, psychological, and spiritual
problems.”
Ans: Palliative Care
17. _____________ helps people live as well as
possible through the dying process.
Ans: Hospice
18. ___________________ specify medical interventions
that the patient does not want in certain situations, such as mechanical
ventilation, and are used to communicate the care a patient wants, for example,
pain relief to the fullest extent possible.
Ans: Advanced directives
19. Nurses provide _______________ that is defined as
care of the body after death in a manner consistent with the patient’s
religious and cultural beliefs
Ans: Postmortem care
20. A person experiences an actual _________ when an
object or a person can no longer be felt, heard, or experienced.
Ans: Loss
21. The irreversible absence of all brain function is
termed ______________.
Ans: Brain death
22. An _______________ is the surgical dissection of a
body after death.
Ans: Autopsy
23. The patient was brought into the emergency
department with a cardiac arrest after suffering multiple gunshot wounds. The
patient did not survive even after multiple attempts at resuscitation. The
nurse is preparing the body for transport to the morgue by completing hospital
procedures for __________________.
Ans: Autopsy
24. The nurse is aware that normal flora that does not
cause disease but does prevent disease-causing microorganisms from reproducing
is known as:
a. sebum.
b. the epidermis.
c. resident bacteria.
d. the dermis.
ANS: C
25. In relation to hygiene and the acute care setting,
the nurse knows that which of the following statements is true?
a. The disposable bath is a less desirable form of
bathing than the traditional basin bath.
b. The disposable bath is a more desirable form of
bathing than the traditional basin bath.
c. The disposable bath is more desirable for patients
who can bathe independently.
d. The disposable bath is not an acceptable form of
bathing in the acute care setting.
ANS: B
26. The nurse is caring for a ventilated patient in
the ICU who has just undergone coronary artery bypass. The nurse is concerned
that the patient may be at risk for ventilator-acquired pneumonia (VAP). What
step will she take to minimize this risk?
a. Not provide oral hygiene because this may cause
bacterial contamination of the airway.
b. Be careful not to use chlorhexidine in oral care
because it provides a medium for bacterial growth.
c. Not use chlorhexidine in oral care because it
enhances the rate at which VAP develops.
d. Include the use of a chlorhexidine rinse as part of
oral hygiene to delay the development of VAP.
ANS: D
27. The nurse plans to give the patient a therapeutic
bath. Which of the following is considered therapeutic?
a. Bed bath
b. Sponge bath at the sink
c. Sitz bath
d. Bag bath
ANS: C
28. What should the nurse do before starting a
patient’s bed bath?
a. Lower the bed.
b. Offer the bedpan or urinal.
c. Partially undress the patient.
d. Place the head of the bed in high-Fowler’s
position.
ANS: B
29. The nurse is preparing to provide a complete bed
bath to a patient who has a running IV. She places a bath blanket over the
patient and:
a. removes the gown from the arm with the IV first.
b. removes the gown from the arm without the IV first.
c. removes the gown after the bath to keep the patient
warm.
d. readjusts the IV rate before removing the gown.
ANS: B
30. While washing the patient’s face, the nurse
should:
a. wash the eyes using soap and warm water.
b. wash the eyes from outer canthus to inner canthus.
c. wash the eyes with plain warm water.
d. use the same portion of the washcloth.
ANS: C
31. When bathing a patient, which sequence is the
correct approach to use?
a. Wash the feet after the legs.
b. Wash the eyes after the face.
c. Wash the legs before the abdomen.
d. Wash the back area before the extremities.
ANS: A
32. What should hygienic care of the patient with dry
skin include?
a. Use of moisturizers
b. Use of ultraviolet light
c. Application of antiseptic lotion
d. Lowering of bath water temperature
ANS: A
33. While giving the patient a bed bath, the nurse
notices a reddened area on the patient’s coccyx. The nurse should:
a. decrease the temperature of the bath water.
b. massage the reddened area to decrease the redness.
c. apply topical moisturizing agents to the area.
d. ignore the redness because it will return to normal
soon.
ANS: C
34. The optimal position for a female patient for the
provision of perineal care is:
a. prone.
b. side-lying.
c. high-Fowler’s.
d. dorsal recumbent.
ANS: D
35. While evaluating the hygienic care practices of a
female patient, the nurse recognizes that additional instruction is necessary
if the patient:
a. washes the perineal area from back to front.
b. washes the labia majora before the labia minora.
c. avoids tension on the indwelling catheter.
d. uses separate sections of the washcloth for each
cleansing stroke.
ANS: A
36. In providing perineal care for a male patient, the
nurse realizes that the patient has not been circumcised. The nurse should:
a. retract the foreskin after care has been completed.
b. place the patient in prone position.
c. replace the foreskin to its natural position after
care has been provided.
d. have the patient adduct his legs.
ANS: C
37. The home care nurse is getting ready to help the
patient prepare a tub bath. What should the nurse be sure to do?
a. Instruct the patient to use safety bars.
b. Use the patient’s favorite bath oil for aroma
therapy.
c. Instruct the patient to stay in the tub no longer
than 30 minutes.
d. Check on the patient every 20 minutes.
ANS: A
38. When teaching parents how to provide oral care to
their child, the nurse instructs them to:
a. give bottles with juice at bedtime.
b. begin dental visits after the child is 8 years old.
c. allow the preschool child to floss his teeth
without parental supervision.
d. limit snacks to three or four per day.
ANS: D
39. The nurse is about to provide oral hygiene to an
unconscious patient. To do so, she places the patient in which position?
a. Fowler’s
b. Semi-Fowler’s
c. Sims’
d. Supine
ANS: C
40. A nurse recognizes that a shampoo may be
contraindicated for a bed-bound patient with:
a. heart disease.
b. diabetes mellitus.
c. a neck injury.
d. a bleeding disorder.
ANS: C
41. Shaving with a disposable razor is contraindicated
for a patient with:
a. heart disease.
b. diabetes mellitus.
c. a head injury.
d. a bleeding disorder.
ANS: D
42. Shaving with a disposable razor is contraindicated
for a patient with:
a. heart disease.
b. diabetes mellitus.
c. a head injury.
d. a bleeding disorder.
ANS: D
43. When evaluating the shaving of a patient done by a
family member, the nurse determines that the technique is done appropriately
when:
a. long strokes are used.
b. the razor is held at a 45-degree angle to the skin.
c. shaving is done against the direction of hair
growth.
d. a cool cloth is used on the skin before the shave.
ANS: B
44. The nurse is providing nail care for the patient
who wants his fingernails “done.” The nurse should:
a. clip the fingernails gently to prevent injury.
b. clean under the nails using an orange stick.
c. soak the fingernails no longer than 10 minutes.
d. clean under the nails using the end of a cotton
swab.
ANS: C
45. The nurse assesses the patient’s skin and notices
an abrasion. Which of the following best describes this type of skin
abnormality?
a. A papulopustular skin eruption
b. Rough texture on the skin surface
c. Erythema and scaly, oozing areas
d. A scraping away of the epidermis
ANS: D
46. The nurse is caring for a gentleman who has dry
skin. When the following interventions are compared, which would be most
appropriate for this patient?
a. Limiting the frequency of bathing
b. Using a fat-free soap for washing
c. Using warm water and moisturizers
d. Bathing with hot water to increase blood flow
ANS: C
47. The patient confides in the nurse that she is
bothered by the fact that she has alopecia. How should the nurse respond to
this information?
a. Shave hair off of the affected area.
b. Use permethrin (Nix).
c. Offer the patient access to scarves or wigs.
d. Place a drop of oil on the area.
ANS: C
48. The patient requires postural drainage three times
a day. Which of the following bed positions would be most appropriate for this
task?
a. Fowler’s position
b. Trendelenburg’s position
c. Reverse Trendelenburg’s position
d. Semi-Fowler’s position
ANS: B
49. The skin, the largest human body organ, protects
us from heat, light, injury, and infection and does which of the following?
(Select all that apply.)
a. Helps regulate body temperature
b. Stores water, vitamin D, and fat
c. Helps to sense pain
d. Prevents the entry of bacteria
Ans: ALL OF THE ABOVE
50. Critically ill patients on a ventilator are at
risk for ventilator-associated pneumonia (VAP). Sources of VAP include: (Select
all that apply.)
a. bacteria in the oral pharynx.
b. dental plaque.
c. chlorhexidine rinses.
d. frequent oral hygiene.
ANS: AB
51. Critically ill patients on a ventilator are at
risk for ventilator-associated pneumonia (VAP). Sources of VAP include: (Select
all that apply.)
a. bacteria in the oral pharynx.
b. dental plaque.
c. chlorhexidine rinses.
d. frequent oral hygiene.
ANS: AB
52. When taking a shower in the home setting, the
patient at risk for falls may benefit from: (Select all that apply.)
a. installation of grab bars.
b. adhesive strips applied to the tub floor.
c. addition of a shower chair or stool.
d. a hydraulic lift.
Ans: A, B, C
53. Patients at greatest risk for developing serious
foot problems include those with: (Select all that apply.)
a. peripheral neuropathy.
b. peripheral vascular disease.
c. pancreatitis.
d. diabetes.
Ans: A, B, D
54. Patients at greatest risk for developing serious
foot problems include those with: (Select all that apply.)
a. peripheral neuropathy.
b. peripheral vascular disease.
c. pancreatitis.
d. diabetes.
Ans: A, B, D
55. The development of diabetic foot ulcers is
dependent on which of the following? (Select all that apply.)
a. Peripheral neuropathy
b. Tissue ischemia
c. Trauma to the foot
d. Pain in the affected extremity
Ans: A, B, C
56. A patient is admitted with the diagnosis of
pediculosis capitis (head lice). Proper treatment for this condition would
include which of the following? (Select all that apply.)
a. Use of medicated shampoo or permethrin (Nix)
b. Use of products containing lindane
c. Combing the hair with a nit comb for 2 to 3 days
after treatment
d. Washing linens in cold water for 30 minutes
Ans: A, C
57. The ____________ is the largest human organ.
Ans: Skin
58. The first line of defense against external injury
and infection contains several thin layers of cells undergoing different stages
of maturation. This first line of defense is known as the _______.
Ans: Epidermis
59. _________________ provides an acidic coating to
protect the epidermis against penetration from chemicals and microorganisms; it
also minimizes loss of water and plasma proteins.
Ans: Sebum
60. ________________ removes sweat, oil, dirt and
bacteria and helps maintain skin integrity.
Ans: Bathing
61. The act of chewing is also known as
________________.
Ans: Mastication
62. ______________ are mucous membranes with
underlying supportive tissue that encircle the neck of erupted teeth to hold
them in place.
Ans: Gingivae
63. Regular oral hygiene is necessary to maintain the
integrity of tooth surfaces and to prevent gum inflammation known as
____________.
Ans: Gingivitis
64. Tissue that surrounds the fingernail, slowly grows
over the nail, and must be regularly pushed back with a soft nail brush is
known as the __________________.
Ans: Cuticle
65. Many foot ulcers are due to repeat trauma over
time, often caused by ________________.
Ans: Poorly fitting shoes
66. ________________ is defined as excessive growth of
body and facial hair.
Ans: Hirsutism
67. _____________ is balding patches in the periphery
of the hairline.
Ans: Alopecia
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