Fundamentals of Nursing Final Exam Review

A nurse is caring for a patient in the ICU who is being monitored for a possible cerebral aneurysm following a lost of consciousness in the emergency room. The nurse anticipates preparing the pt for ordered diagnostic tests. This nurse's knowledge of the diagnostic procedures for this condition reflects which aspect of nursing?

A. The art of nursing

B. The science of nursing

C. The caring aspect of nursing

D. The holistic approach to nursing

B. The science of nursing

A nurse is formulating a clinical question in PICO format. What does the letterP represent?

A. Comparison to another similar treatment

B. Clearly defined, focused literature review

C. Specific identification of the desired outcome

D. Explicit descriptions of the population of interest

D. Explicit descriptions of the population of interest

Insulin

Removes excess glucose from the blood and stores it as glycogen in the liver.

Which nurse who was influential in the development of nursing in North America is regarded as the founder of American nursing?

A. Clara Barton

B. Lillian Wald

C. Lavina Dock

D. Florence Nightingale

D. Florence Nightingale

The student nurse learns that illnesses are classified as either acute or chronic. Which are examples of chronic illnesses? Select all that apply.

A. Diabetes mellitus

B. Bronchial pneumonia

C. Rheumatoid arthritis

D. Cystic fibrosis

E. Fractured hip

F. Otitis media

A, C, & D

World War II had a tremendous effect on the nursing profession. Which development occurred during this period?

A. The role of the nurse was broadened

B. There was a decreased emphasis on education

C. Nursing was practiced mainly in hospital settings

D. There was an overabundance of nurses

A. The role of the nurse was broadened

One of the 4 broad aims of nursing practice is to restore health. Which examples of nursing interventions reflect this goal? Select all that apply.

A. A nurse counsels adolescents in a drug rehabilitation program

B. A nurse performed ROM exercises for a pt on bedrest

C. A nurse shows a diabetic pt how to inject insulin

D. A nurse recommends a yoga class for a busy executive

E. A nurse provides hospice care for a pt with end-stage cancer

F. A nurse teaches a nutrition class at a local high school

A, B, and C

Postpartum Urinary System Adaptations

-GFR and renal flow rate increases

-Loss of voiding sensation

-Postpartum diuresis

When the newborn cheek is touched, the cheek turns toward the stimulus

Rooting

Overweight BMI

>25 mg/dL

How many patient identifiers is required, and what are they?

2

Name and date of birth

Pain and anxiety can alter these vital signs

HR, RR, and BP

1. A nurse assesses patients in a physician's office who are experiencing different levels of health and illness. Which statements best define the concepts of health and illness? Select all that apply.

A. Health and illness are the same for all people.

B. Health and illness are individually defined by each person.

C. People with acute illnesses are actually healthy.

D. People with chronic illnesses have poor health beliefs.

E. Health is more than the absence of illness.

F. Illness is the response of a person to a disease.

B, E, & F

Method of communication between health care providers about patients (the handoff)

SBAR

When the newborn's head is turned to one side, the arm on that side is extended out

Tonic neck

True or false: Diarrhea is a common concern postpartum

False. Constipation is a common concern if iron is administered

This is the angle for a subcutaneous injection

45 degrees

A nurse has volunteered to give influenza immunizations at a local clinic. What level of care is the nurse demonstrating?

A. Tertiary

B. Secondary

C. Primary

D. Promotive

C. Primary

The outer most layer of the skin

Epidermis

First step in the abdominal assessment

Inspection

Obesity BMI

>30 mg/dL

When the bottom of the foot is stroked upwards, the newborn's toes flare out

Babinski

Health promotion activities may occur on a primary, secondary, or tertiary level. Which activities are considered tertiary health promotion? Select all that apply.

A. A nurse runs an immunization clinic in the inner city.

B. A nurse teaches a patient with an amputation how to care for the residual limb.

C. A nurse provides range-of-motion exercises for a paralyzed patient.

D. A nurse teaches parents of toddlers how to childproof their homes.

E. A school nurse provides screening for scoliosis for the students.

F. A nurse teaches new parents how to choose and use an infant car seat.

B & C

When does menstruation return after birth for non lactating women?

7-9 weeks

Nursing students should not drink this when stressed

Alcohol

A nurse administers a dose of an oral medication for hypertension to a patient who immediately vomits after swallowing the pill. What would be the appropriate initial action of the nurse in this situation?

A. Readminister the medication and notify the primary care provider.

B. Readminister the pill in a liquid form if possible.

C. Assess the vomit, looking for the pill.

D. Notify the primary care provider.

C. If a patient vomits immediately after swallowing an oral pill, the nurse should assess the vomit for the pill or fragments of it. The nurse should then notify the primary care provider to see if another dosage should be administered.

Identify goals of Healthy People 2020 related to diabetes

-Reduce the disease and economic burden of diabetes mellitus and improve the quality of life for at risk persons

-Reduce disease risk through healthful diets and achievements and management of healthy body weights

True or False: RhoGAM is given to the mom when the mother is positive and baby is negative

False. Mother must be negative and baby must be positive

Chloride normal values

97-107 mEq/L

Degree of stretch of the ventrical at the end of diastole

Preload

True or False:Baby blues are a serious postpartum problem that requires treatment

False. These are mild depressive symptoms, anxiety, irritability, mood swings, tearfulness, increased sensitivity, and fatigue.

Usually peaks at 4-5 days and resolves by day 10

A nurse is interviewing a newly admitted patient. Which question would be considered culturally sensitive?

A. "Do you think you will be able to eat the food we have here?"

B. "Do you understand that we can't prepare special meals?"

C. "What types of food do you eat for meals?"

D. "Why can't you just eat our food while you are here?"

C

Which acid-base imbalance would the nurse suspect after assessing the following arterial blood gas values: pH, 7.30; PaCO2, 36 mm Hg; HCO3−, 14 mEq/L?

A. Respiratory acidosis

B. Respiratory alkalosis

C. Metabolic acidosis

D. Metabolic alkalosis

C

When either the palm of the hand or the ball of the foot is touched, the digits wrap around the object

Grasp

pH normal values

7.35-7.45

A nurse is administering an oral medication to a patient via a gastric tube. The nurse observes the medication enter the tube, and then the tube becomes clogged. What would be the appropriate initial action of the nurse in this situation?

A. Attempt to dislodge the medication with a 10-mL syringe.

B. Notify the primary care provider.

C. Remove the tube and replace it with another tube.

D. Flush the tube with 60 mL of water.

A. If medication becomes clogged in a gastric tube, the nurse should attach a 10-mL syringe on the end of the tube and pull back and lightly apply pressure to the plunger in a repetitive motion to attempt to dislodge the medication. If the medication does not move through the tube, the nurse should notify the primary care provider, who may request the tube be replaced.

HCO3 normal values

22-26 mEq/L

When does menstruation return for lactating women?

It's dependent on breast feeding frequency and duration. Anywhere from 2-18 months.

A nurse is teaching a novice nurse how to provide culturally competent care to patients in a culturally diverse community health clinic. Although all of the following are important to providing culturally competent nursing care, which one is most basic?

A. Learning the predominant language of the community

B. Obtaining significant information about the community

C. Treating each patient at the clinic as an individual

D. Recognizing the importance of the patient's family

C

A nurse witnesses a street robbery and is assessing a 26-year-old female patient who is the victim. The patient has minor scrapes and bruises and tells the nurse, "I've never been so scared in my life." What other symptoms would the nurse expect to find related to the fight-or-flight response to stress? Select all that apply.

A. Increased heart rate

B. Decreased muscle strength

C. Increased mental alertness

D. Increased blood glucose levels

E. Decreased cardiac output

F. Decreased peristalsis

A, C, D The sympathetic nervous system functions under stress to bring about the fight-or-flight response by increasing the heart rate, increasing muscle strength, increasing cardiac output, increasing blood glucose levels, and increasing mental alertness. Increased peristalsis is brought on by the parasympathetic nervous system under normal conditions and at rest.

Risk factors that we can do something about

Modifiable risk factors

Sodium normal values

135-145 mEq/L

Potassium normal values

3.5-5.0 mEq/L

Vaginal discharge that occurs after birth and continues for approximately 4-8 weeks

Lochia

Jean's attorney was careful to explain in her defense that Jean had specialty knowledge, experience, and clinical judgment and had met certain criteria established by a nongovernmental association, as a result of which she was granted recognition in a specified practice area. What is this sort of credential called?

A. Accreditation

B. Licensure

C. Certification

D. Board approval

C

Factors affecting the heart rate

-Age

-Sex

-Exercise

-Fever

-Medications

-Hypovolemia/dehydration

-Stress

-Position

Normal total serum Calcium level

8.6-10.2 mg/dL

A medication order reads: "K-Dur, 20 mEq po b.i.d." When and how does the nurse correctly give this drug?

A. Daily at bedtime by subcutaneous route

B. Every other day by mouth

C. Twice a day by the oral route

D. Once a week by transdermal patch

C

Questions to ask before taking temperature

-Food

-Beverages

-Gum

-Drinking/Smoking

Magnesium normal values

1.3-2.3 mEq/L

A nurse is interviewing a patient who just received news that he has pancreatic cancer. The patient tells the nurse that getting cancer could never happen to him. Which defense mechanism is this patient demonstrating?

A. Projection

B. Denial

C. Displacement

D. Repression

B

A patient's health history of breast cancer that runs in the family is what type of risk factor?

Non-modifiable risk factor

Laws affecting nursing practice (Think PHMPG)

-Right of Privacy

-HIPAA

-Malpractice

-Patient's Bill of Rights

-Good Samaritan Law

Rubra

Deep red mixture, first 3-4 days

A nurse administers the wrong medication to a patient and the patient is harmed. The physician who ordered the medication did not read the documentation that the patient was allergic to the drug. Which statement is true regarding liability for the administration of the wrong medication?

A. The nurse is not responsible, because the nurse was merely following the doctor's orders.

B. Only the nurse is responsible, because the nurse actually administered the medication.

C. Only the physician is responsible, because the physician actually ordered the drug.

D. Both the nurse and the physician are responsible for their respective actions.

D. Nurses are legally responsible for carrying out the orders of the physician in charge of a patient unless an order would lead a reasonable person to anticipate injury if it were carried out. If the nurse should have anticipated injury and did not, both the prescribing physician and the administering nurse are responsible for the harms to which they contributed.

Phosphate normal values

2.5-4.5 mg/dL

Normal ionized serum calcium level

4.5-5.1 mg/dL

Base excess or deficit values

-2 to +2 mMol/L

A patient tells the nurse that she would like to use a mechanical barrier for birth control. Which method might the nurse recommend?

A. Diaphragm

B. Oral contraceptive pills

C. Depo-Provera

D. Evra patch

A The diaphragm is the only barrier method of contraception listed; all the other methods are hormonal.

Serum Bicarbonate

25-29 mEq/L

A female patient who is receiving chemotherapy for breast cancer tells the nurse, "The treatment for this cancer is worse than the disease itself. I'm not going to come for my therapy anymore." The nurse responds by using critical thinking skills to address this patient problem. Which action is the first step the nurse would take in this process?

A. The nurse judges whether the patient database is adequate to address the problem.

B. The nurse considers whether or not to suggest a counseling session for the patient.

C. The nurse reassesses the patient and decides how best to intervene in her care.

D. The nurse identifies several options for intervening in the patient's care and critiques the merit of each option.

C. The first step when thinking critically about a situation is to identify the purpose or goal of your thinking. Reassessing the patient helps to discipline thinking by directing all thoughts toward the goal. Once the problem is addressed, it is important for the nurse to judge the adequacy of the knowledge, identify potential problems, use helpful resources, and critique the decision.

Serosa

2nd stage, pinkish-brownish discharge, expelled 3-10 days.

Drugs used to open airways

Bronchodilators

PCO2 normal values

35-45 mm Hg

A nurse is administering a pain medication to a patient. In addition to checking his identification bracelet, the nurse correctly verifies his identity by:

A. Asking the patient his name

B. Reading the patient's name on the sign over the bed

C. Asking the patient's roommate to verify his name

D. Asking, "Are you Mr. Brown?"

A

PO2 normal values

80-100 mm Hg

Prenatal vitamins, immunizations, providing education on health habits

Primary prevention

A nurse is assessing a 15-year-old female patient who is diagnosed with anorexia. Following the assessment, the nurse recommends that the patient meet with a nutritionist. This action best exemplifies the use of:

A. Clinical judgment

B. Clinical reasoning

C. Critical thinking

D. Blended competencies

A

What are verbal, nonverbal, written, and electronic?

Types of communication

Bradykinin

-Causes loval vasodilation

-Stimulates nerve endings to cause pain

-Causes the release of arachidonic acid from cell membrane

This is what the body does in response to stressors

Adapt

This organ needs 25% of our bld supply and is affected with a decrease in perfusion

Kidneys

A medication order reads: "Hydromorphone, 2 mg IV every 3 to 4 hours PRN pain." The prefilled cartridge is available with a label reading "Hydromorphone 2 mg/1 mL." The cartridge contains 1.2 mL of hydromorphone. Which nursing action is correct?

A. Give all the medication in the cartridge because it expanded when it was mixed.

B. Call the pharmacy and request the proper dose.

C. Refuse to give the medication.

D. Dispose of 0.2 mL correctly before administering the drug.

D. Many cartridges are overfilled, and some of the medication needs to be discarded. Always check the volume needed to provide the correct dose with the volume in the syringe. Giving the excess medication in the cartridge may result in adverse effects for the patient. For this dose, it is not necessary to call the pharmacy or refuse to give the medication, provided the order is written correctly.

Calling an older adult honey or sweety

Elder speak

An act passed in 2002 to protect patient privacy

HIPPA

pH: 7.5

PCO2: 32

HCO3: 36

Metabolic alkalosis

The organ responsible for long-term acid-base balance

Kidneys

The nurse collects objective and subjective data when conducting patient assessments. Which patient conditions are examples of subjective data? Select all that apply.

A. A patient tells the nurse that she is feeling nauseous.

B. A patient's ankles are swollen.

C. A patient tells the nurse that she is nervous about her test results.

D. A patient complains of having a rash on her arm that is itchy.

E. A patient rates his pain as a 7 on a scale of 1 to 10.

F. A patient vomits after eating supper.

A, C, D, E

Amount of blood that is pumped through the heart each minute

3.5-8 L/min

A patient requires 40 units of NPH insulin and 10 units of regular insulin daily subcutaneously. What is the correct sequence when mixing insulins?

A. Inject air into the regular insulin vial and withdraw 10 units; then, using the same syringe, inject air into the NPH vial and withdraw 40 units of NPH insulin.

B. Inject air into the NPH insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the regular insulin vial and withdraw 10 units; then, withdraw 40 units of NPH insulin.

C. Inject air into the regular insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the NPH insulin vial and withdraw 40 units; then, withdraw 10 units of regular insulin.

D. Inject air into the NPH insulin vial and withdraw 40 units; then, using the same syringe, inject air into the regular insulin vial and withdraw 10 units of regular insulin.

B Regular or short-acting insulin should never be contaminated with NPH or any insulin modified with added protein. Placing air in the NPH vial first without allowing the needle to contact the solution ensures that the regular insulin will not be contaminated.

The primary source of heat in the body

Metabolism

When a nurse enters the patient's room to begin a nursing history, the patient's wife is there. What should the nurse do?

A. Introduce oneself and thank the wife for being present.

B. Introduce oneself and ask the wife if she wants to remain.

C. Introduce oneself and ask the wife to leave.

D. Introduce oneself and ask the patient if he would like the wife to stay.

D

The best person to report pain

The person having the pain

A nurse can be negligent if they fail to follow these

Standards of practice

Alba

Final stage, occurs 10-14 days, but can last 3-6 weeks postpartum

A nurse is administering heparin subcutaneously to a patient. What is the correct technique for this procedure?

A. Aspirate before giving and gently massage after the injection.

B. Do not aspirate; massage the site for 1 minute.

C. Do not aspirate before or massage after the injection.

D. Massage the site of the injection; aspiration is not necessary but will do no harm.

C. When giving heparin subcutaneously, the nurse should not aspirate or massage, so as not to cause trauma or bleeding in the tissues.

pH: 72.

PCO2: 24

HCO3: 16

Metabolic acidosis

The nurse is surprised to detect an elevated temperature (102°F) in a patient scheduled for surgery. The patient has been afebrile and shows no other signs of being febrile. What is the first thing the nurse should do?

A. Inform the charge nurse.

B. Inform the surgeon.

C. Validate the finding.

D. Document the finding.

C. The nurse should first validate the finding if it is unusual, deviates from normal, and is unsupported by other data. Should the initial recording prove to be in error, it would have been premature to notify the charge nurse or the surgeon. The nurse should be sure that all data recorded are accurate, thus all data should be validated before documentation if there are any doubts about accuracy.

Closing of these gives off the Lub dub sounds

Heart valves

This organ is most sensitive to shifts in potassium

The heart

This is how to help clear the airway for an infant

Suction

A term used meaning no fever

Afebrile

QSEN

Quality & Safety Education for Nurses

Goal: To meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the health care systems within which they work.

Providing spiritual care is mandated by these

Accrediting bodies

What issues are covered by state legislation?

-Scope of practice for LPNs, RNs, & APNs

-Nursing educational requirement

-Composition and disciplinary authority of the BON

Bacteria in the mouth has been linked to these diseases

Diabetes and heart disease

The resistance to left ventricular ejection

Systemic vascular resistance

What are the issues covered by federal legislation?

-Medicare and medicaid provisions related to reimbursement for nursing services

The client must be able to do this to use the numeric pain scale

Self-report

A perfect Glosclow coma score

15