NURSING FINAL EXAM QUESTIONS WITH
ACCURATE ANSWERS
● As an RN, how could you establish that a NAP is competent to perform a task?
correct answer These actions would establish whether a NAP is competent to
perform a task:
● Check facility records for documented proof that the person has demonstrated
competence.
● Find out how often the NAP has performed the task.
● Find out whether the NAP has worked with patients with similar diagnoses.
● Observe and evaluate the NAP's performance.
● Briefly describe how urine is formed. correct answer Urine is formed in the
nephrons. The renal arteries bring blood to the kidneys and into the glomeruli.
Blood pressure forces plasma, dissolved substances, and small proteins out of the
porous glomeruli into the Bowman's capsule to form a liquid called filtrate. The
filtrate moves from Bowman's capsule into the tubular network of the nephrons
where 99% of the fluid is reabsorbed. About 1% of filtrate returns, as urine, to the
collecting tubule, which transports it into the ureters.
● Describe the effects on nutrition of (a) smoking and (b) heavy alcohol use.
correct answer The effects on nutrition are as follows:
● Smoking. Smokers use Vitamin C faster than nonsmokers. Even children
exposed to secondhand smoke tend to have lower plasma levels of ascorbate
than unexposed children (Aghdassi, Royall, & Allard, 1999; Preston, 2003). If the
person cannot quit smoking, a vitamin C supplement may help compensate.
● Alcohol. A 12-oz beer contains 150 kcal; a juice-based cocktail contains about
160 kcal. Such drinks can add many unnecessary calories to the regular diet. In
addition, alcohol significantly decreases the rate of fat metabolism, contributing
to obesity. Excessive alcohol use interferes with adequate nutrition by (a)
,replacing the food in the person's diet, (b) depressing the appetite, (c) decreasing
the absorption of nutrients by its toxic effects on intestinal mucosa, and (d)
impairing the storage of nutrients. People who use alcohol heavily will need
multivitamin supplements, especially rich in B vitamins and folic acid.
● Describe the physical assessment you would perform for a client with
constipation. correct answer Physical assessment for bowel elimination includes
examination of the abdomen, rectum, and anus.
● Recall that in abdominal assessment, the order of the exam is inspection,
auscultation, percussion, and palpation.
● Observe the size, shape, and contour of the abdomen, and listen to bowel
sounds.
● Percuss and palpate the abdomen for tenderness, presence of air or solid, and
presence of masses.
● Inspect the anus for signs of hemorrhoids.
● Depending on the policies of your institution as well as your skill with
assessment, you might also palpate the anus and rectum for the presence of stool
or masses.
● How can you help a patient adapt psychologically to living with a bowel
diversion? correct answer The following nursing interventions help a patient
adapt psychologically to a bowel diversion (other answers are possible):
● Being willing to talk with a patient about his reaction to the stoma and concerns
about living with an ostomy
● Taking a caring approach when providing stoma care
● Allowing adequate time for the patient to learn about self-care
● Coordinating a visit by a volunteer from the United Ostomy Association
● Providing information about a community support group of people living with
an ostomy or other bowel diversion
,● How often should the urine collection bag be emptied? correct answer Empty
the urine collection bag at least every 8 hours, or more often if it is full, to make it
more convenient for the patient to ambulate.
● Identify and describe the types of enteral nutrition tubes. correct answer ● A
nasogastric (NG) tube terminates in the stomach.
● A nasoenteric (NE) tube terminates in the small intestine.
● A gastrostomy tube (G-tube), percutaneous gastrostomy tube (PEG) tube,
jejunostomy tube, or G-button is inserted into the stomach or jejunum,
respectively, through the skin and abdominal wall.
● A percutaneous jejunostomy (PEJ) tube is inserted into the stomach through the
abdominal wall and advanced into the jejunum.
● Identify at least 10 physical examination findings that would lead you to suspect
nutritional problems. correct answer Answers may include any of the following
examination findings:
● An increase in temperature
● An elevated BP may be related to fluid volume excess; a low BP may be a sign of
dehydration. Heart rate usually responds in an inverse fashion.
● A BMI less than18 or greater than25
● An appearance of illness
● Poor skin turgor
● Poor wound healing
● Constipation
● Any areas of warmth or erythema require investigation
● Red, swollen skin lesions, excessive bleeding and xerosis
, ● Abnormal nail findings
● Hair that grows slowly, is thin, or easily breaks
● Irritation of the mouth, teeth, and gums
● Facial paralysis or drooping of one side of the face
● An enlarged thyroid gland
● Bounding pulses or a weak, thready pulse
● Edema
● An abdomen that is scaphoid or concave, round to protuberant, or generally
enlarged
● Hyperactive or hypoactive bowel sounds
● Thin extremities with excess skinfolds
● Enlarged skinfold measurements
● Joint swelling, deformities, or limitation in range of motion
● Joint pain on palpation or with movement
● Cognitive deficits or severe psychiatric disorders
● Motor or sensory deficits
● Confusion, weakness, or diminished reflexes
● Identify at least four functions of water. correct answer Water has the following
functions:
● Solvent. Water is the basic solvent for the body's chemical processes, assisting
in the regulation of nerve impulses and muscle contractions.
● Transport. Circulating as blood, water serves a medium for transporting oxygen,
nutrients, and metabolic wastes.
● Body structure and form. Water "fills in the spaces" in body tissues (e.g., in
muscle) providing structure and form to the body.
ACCURATE ANSWERS
● As an RN, how could you establish that a NAP is competent to perform a task?
correct answer These actions would establish whether a NAP is competent to
perform a task:
● Check facility records for documented proof that the person has demonstrated
competence.
● Find out how often the NAP has performed the task.
● Find out whether the NAP has worked with patients with similar diagnoses.
● Observe and evaluate the NAP's performance.
● Briefly describe how urine is formed. correct answer Urine is formed in the
nephrons. The renal arteries bring blood to the kidneys and into the glomeruli.
Blood pressure forces plasma, dissolved substances, and small proteins out of the
porous glomeruli into the Bowman's capsule to form a liquid called filtrate. The
filtrate moves from Bowman's capsule into the tubular network of the nephrons
where 99% of the fluid is reabsorbed. About 1% of filtrate returns, as urine, to the
collecting tubule, which transports it into the ureters.
● Describe the effects on nutrition of (a) smoking and (b) heavy alcohol use.
correct answer The effects on nutrition are as follows:
● Smoking. Smokers use Vitamin C faster than nonsmokers. Even children
exposed to secondhand smoke tend to have lower plasma levels of ascorbate
than unexposed children (Aghdassi, Royall, & Allard, 1999; Preston, 2003). If the
person cannot quit smoking, a vitamin C supplement may help compensate.
● Alcohol. A 12-oz beer contains 150 kcal; a juice-based cocktail contains about
160 kcal. Such drinks can add many unnecessary calories to the regular diet. In
addition, alcohol significantly decreases the rate of fat metabolism, contributing
to obesity. Excessive alcohol use interferes with adequate nutrition by (a)
,replacing the food in the person's diet, (b) depressing the appetite, (c) decreasing
the absorption of nutrients by its toxic effects on intestinal mucosa, and (d)
impairing the storage of nutrients. People who use alcohol heavily will need
multivitamin supplements, especially rich in B vitamins and folic acid.
● Describe the physical assessment you would perform for a client with
constipation. correct answer Physical assessment for bowel elimination includes
examination of the abdomen, rectum, and anus.
● Recall that in abdominal assessment, the order of the exam is inspection,
auscultation, percussion, and palpation.
● Observe the size, shape, and contour of the abdomen, and listen to bowel
sounds.
● Percuss and palpate the abdomen for tenderness, presence of air or solid, and
presence of masses.
● Inspect the anus for signs of hemorrhoids.
● Depending on the policies of your institution as well as your skill with
assessment, you might also palpate the anus and rectum for the presence of stool
or masses.
● How can you help a patient adapt psychologically to living with a bowel
diversion? correct answer The following nursing interventions help a patient
adapt psychologically to a bowel diversion (other answers are possible):
● Being willing to talk with a patient about his reaction to the stoma and concerns
about living with an ostomy
● Taking a caring approach when providing stoma care
● Allowing adequate time for the patient to learn about self-care
● Coordinating a visit by a volunteer from the United Ostomy Association
● Providing information about a community support group of people living with
an ostomy or other bowel diversion
,● How often should the urine collection bag be emptied? correct answer Empty
the urine collection bag at least every 8 hours, or more often if it is full, to make it
more convenient for the patient to ambulate.
● Identify and describe the types of enteral nutrition tubes. correct answer ● A
nasogastric (NG) tube terminates in the stomach.
● A nasoenteric (NE) tube terminates in the small intestine.
● A gastrostomy tube (G-tube), percutaneous gastrostomy tube (PEG) tube,
jejunostomy tube, or G-button is inserted into the stomach or jejunum,
respectively, through the skin and abdominal wall.
● A percutaneous jejunostomy (PEJ) tube is inserted into the stomach through the
abdominal wall and advanced into the jejunum.
● Identify at least 10 physical examination findings that would lead you to suspect
nutritional problems. correct answer Answers may include any of the following
examination findings:
● An increase in temperature
● An elevated BP may be related to fluid volume excess; a low BP may be a sign of
dehydration. Heart rate usually responds in an inverse fashion.
● A BMI less than18 or greater than25
● An appearance of illness
● Poor skin turgor
● Poor wound healing
● Constipation
● Any areas of warmth or erythema require investigation
● Red, swollen skin lesions, excessive bleeding and xerosis
, ● Abnormal nail findings
● Hair that grows slowly, is thin, or easily breaks
● Irritation of the mouth, teeth, and gums
● Facial paralysis or drooping of one side of the face
● An enlarged thyroid gland
● Bounding pulses or a weak, thready pulse
● Edema
● An abdomen that is scaphoid or concave, round to protuberant, or generally
enlarged
● Hyperactive or hypoactive bowel sounds
● Thin extremities with excess skinfolds
● Enlarged skinfold measurements
● Joint swelling, deformities, or limitation in range of motion
● Joint pain on palpation or with movement
● Cognitive deficits or severe psychiatric disorders
● Motor or sensory deficits
● Confusion, weakness, or diminished reflexes
● Identify at least four functions of water. correct answer Water has the following
functions:
● Solvent. Water is the basic solvent for the body's chemical processes, assisting
in the regulation of nerve impulses and muscle contractions.
● Transport. Circulating as blood, water serves a medium for transporting oxygen,
nutrients, and metabolic wastes.
● Body structure and form. Water "fills in the spaces" in body tissues (e.g., in
muscle) providing structure and form to the body.
