PROCEDURES

A patient is scheduled for a Magnetic Resonance Imaging (MRI) scan. Which instruction should the nurse include?

A. “You may keep transdermal patches such as nicotine or nitroglycerin in place.”
B. “Remove all metal-containing items, including jewelry, hair clips, and hearing aids, before the procedure.”
C. “It is acceptable to bring credit cards and electronic devices.”
D. “Fasting for 8 hours is required before all MRI procedures.”

Answer: B

Rationale: MRI uses a powerful magnetic field.

Patient is anxious and claustrophobic about MRI. What is the best response?

Choices:

A. “You must proceed regardless of discomfort.”
B. “An open MRI may be an option, or sedation can be given to help you tolerate the procedure.”
C. “Claustrophobia is not a concern.”
D. “You should cancel the procedure.”

B. “An open MRI may be an option, or sedation can be given to help you tolerate the procedure.”

Which situation is the most significant contraindication/precaution before CT scan with contrast?

A. Mild claustrophobia
B. History of iodine allergy but tolerated contrast previously with premedication
C. A patient who is 10 weeks pregnant requiring abdominal imaging
D. Mild anxiety with stable vital signs

✅ ay harm the developing fetus.

Answer: C

A patient undergoes a bone scan. Which post-procedure instruction is appropriate?

A. Restrict fluid intake for 24 hours

B. Encourage increased oral fluid intake and frequent voiding after the procedure
C. Strict bed rest
D. Avoid voiding for several hours

Answer: B

Rationale: Bone scan uses a radioactive tracer.

After the procedure:
✅ Drink plenty of fluids
✅ Void frequently

What is the initial nursing priority before transporting the patient with fracture

A. Apply ice pack to reduce swelling

B. Perform neurovascular assessment of the affected limb

C. Immobilize the affected extremity using proper splinting technique

D. Encourage passive range of motion to assess joint function

Answer: C. Immobilize the affected extremity

Rationale:

In fracture management, the FIRST priority before moving or transporting the patient is:

Bone broken into several distinct fragments. What type of fracture?

Choices:

A. Greenstick fracture
B. Comminuted fracture
C. Impacted fracture
D. Avulsion fracture

Answer: B. Comminuted fracture

Left-sided weakness after stroke. Proper cane use?

A. Hold cane in left hand
B. Hold cane in right hand (strong side)
C. Place cane directly in front of weak foot
D. Keep elbow fully extended

Answer: B

Rationale:

Rule:

🦯 Cane goes on the STRONG side

Which of the following represents the correct sequence of using crutches when going up the stairs?

A. Move crutches and affected leg first, then push up with the unaffected leg

B. Move the unaffected leg first onto the step, then advance crutches and affected leg together

C. Move both legs together onto the step, then advance the crutches afterward

D. Advance the crutches first, then move the affected leg followed by the unaffected leg

Answer: B

Rationale:

Going UP stairs:

⬆ Good leg goes to heaven

The nurse provides discharge instructions regarding safe use of the walker to another patient with right leg weaker than the left.

Which of the following is the correct order of using a walker when one leg is weaker than the other?

A. Move the stronger leg forward, then move the walker and weak leg together

B. Move the walker forward first, then move the weak leg, followed by the stronger leg

C. Move the walker and weak leg forward together, then move the stronger leg forward

D. Move both legs forward first, then advance the walker

Answer: B

Rationale:

Correct walker sequence:

1⃣ Move walker forward
2⃣ Move weak leg forward
3⃣ Move strong leg forward

Which of the following demonstrates the correct procedure for assessing visual acuity using a Snellen chart?

A. Ask the patient to stand 3 meters from the chart, read with both eyes open, and record one measurement

B. Ask the patient to sit 6 meters (20 feet) from the chart, cover one eye, and read the letters on the chart; testing is done using the right eye first, then the left eye, then both eyes together

C. Ask the patient to stand 1 meter from the chart and read the smallest line possible without covering either eye

D. Ask the patient to read the chart while walking slowly toward it to determine functional vision

Answer: B

Rationale:

The standard Snellen chart procedure:

👁 Position patient 20 feet (6 meters) from chart

The patient is able to read the line marked 20/40 on the Snellen chart. What does this result mean?

A. The patient can see at 20 feet what a normal eye can see at 20 feet

B. The patient can see at 40 feet what a normal eye can see at 20 feet

C. The patient can see at 20 feet what a normal eye can see at 40 feet

D. The patient has complete loss of central vision

Answer: C

Rationale: Snellen Fraction

20/40

First number (20):
➡ Distance patient stands from chart

Second number (40):
➡ Distance at which a person with normal vision can read that line

A patient is prescribed with medicated eye drops to be instilled twice daily. The nurse emphasizes techniques to reduce systemic absorption and prevent adverse effects of the medication.

Which of the following statements by the patient indicates correct understanding of how to prevent systemic absorption of eye drops?

A. “I will blink several times after instilling the drops to spread the medication evenly.”

B. “I will gently press the inner corner of my eye near the nose for 1 to 2 minutes after applying the drops.”

C. “I will rinse my eye with water immediately after instilling the medication to remove excess drops.”

D. “I will tilt my head backward and massage my eyelid after putting in the drops.”

Answer: B

Rationale:

This technique is called:

Nasolacrimal Occlusion

After eye drops:

1. Close eyes gently

2. Press inner canthus (tear duct)

3. Hold for 1–2 minutes

Which of the following demonstrates the correct technique for positioning the ear during otoscopic examination in children younger than 3 years old?

A. Pull the pinna upward and backward to straighten the ear canal

B. Pull the pinna downward and backward to straighten the ear canal

C. Pull the pinna straight outward to align the canal

D. Leave the pinna in its natural position without manipulation

B. Pull the pinna downward and backward to straighten the ear canal

Another patient reports difficulty hearing conversations, especially in noisy environments. The patient states, “I can hear people talking, but I can’t clearly understand the words.” The nurse performs hearing tests. Findings include: air conduction heard longer than bone conduction (Rinne test) and sound lateralized to the right ear (Weber test). The patient also has difficulty hearing high-frequency sounds such as consonants.

A. Conductive hearing loss in the left ear
B. Conductive hearing loss in the right ear
C. Sensorineural hearing loss in the left ear
D. Normal hearing findings

Answer: C. Sensorineural hearing loss in the left ear

Rationale: Rinne positive (AC > BC) is normal or sensorineural loss. Weber lateralizes to the unaffected ear in sensorineural hearing loss. Since sound is louder in the right ear, the left ear has sensorineural loss.

Which of the following additional subjective findings is MOST consistent with conductive hearing loss?

A. Patient speaks in a loud voice
B. Patient speaks softly
C. Patient complains that people mumble
D. Patient exhibits no changes in volume of speaking

Answer: B. Patient speaks softly

Rationale: Patients with conductive hearing loss hear their own voice louder through bone conduction and therefore tend to speak more softly.

Which of the following actions by the nurse demonstrates the most appropriate communication technique for a patient with impaired hearing?

A. Speak while turning away from the patient to reduce pressure on communication
B. Face the patient directly and ensure the face is well-lit while speaking
C. Speak with objects in the mouth to exaggerate lip movement for clarity
D. Stand behind the patient and speak slowly into the ear

Answer: B. Face the patient directly and ensure the face is well-lit while speaking

Rationale: This facilitates lip-reading, facial expression recognition, and clear communication.

A 40-year-old patient is prescribed otic antibiotic drops for the right ear. Which of the following positions is MOST appropriate during administration?

A. Lie on the right side
B. Sit upright and tilt the head slightly forward
C. Lie on the left side
D. Lie supine with the head flat on the bed

Answer: C. Lie on the left side

Rationale: The affected ear should face upward. For the right ear, the patient should lie on the left side.

A nurse is preparing to perform ear irrigation for a patient with impacted cerumen in the left ear. Which of the following positions is MOST appropriate?

A. Lie on the left side
B. Lie on the right side
C. Sit upright with the head tilted backward
D. Lie supine with the head flat

Answer: B. Lie on the right side

Rationale: During irrigation, the affected ear should be positioned downward to facilitate drainage. For the left ear, the patient lies on the right side.