Germanna Community College | Complete 200-Question Test
Bank | Verified Answers & Detailed Rationales | 100% Pass
Guarantee
EXAM 2 BLUEPRINT
Approximate
Topic Area Percentage
Questions
Safety & Fall Prevention 20% 40
Infection Control & PPE 15% 30
Restraints & Seizure Precautions 10% 20
Functional Ability & ADLs 10% 20
Nursing Process & Clinical
15% 30
Judgment
Medication Administration 10% 20
Communication &
10% 20
Documentation
NGN Case Scenarios (Integrated) 10% 20
,SECTION 1: SAFETY & FALL PREVENTION (Questions 1–40)
1. A nurse is implementing fall precautions for an older adult
patient. Which action is most appropriate?
A) Keep all four side rails up at night
B) Place the bed in the lowest position with locked wheels
C) Encourage the patient to wear non-skid socks only during the
day
D) Keep the call light on the bedside table
Answer: B) Place the bed in the lowest position with locked
wheels
Rationale: The bed should be in the lowest position and wheels
locked to reduce injury from falls. Side rails up (A) is considered
a restraint. Non-skid socks should be worn anytime the patient
is out of bed. The call light must be within easy reach, attached
to the gown or pillow.
2. Which patient is at the highest risk for falling?
A) 45-year-old post-operative day 1
B) 70-year-old with history of stroke and taking
antihypertensives
, C) 30-year-old with a broken ankle using crutches S S S S S S
D) 80-year-old with mild hearing loss S S S S
Answer: B) 70-year-old with history of stroke and taking antihypertensives
S S S S S S S S S
Rationale: The 70-year-old has multiple risk factors: advanced
S S S S S S S
age, history of stroke (hemiparesis/neglect), and
S S S S S S
antihypertensive medications (orthostatic hypotension).
S S S S
Hearing loss alone (D) is a lower risk factor.
S S S S S S S S
3. A patient uses a cane. The nurse should instruct the patient to
S S S S S S S S S S S
hold the cane on which side?
S S S S S S
A) The weaker side S S
B) The stronger sideS S
C) The side with most pain
S S S S
D) The contralateral side to the affected leg
S S S S S S
Answer: B) The stronger side S S S S
Rationale: The cane is held on the stronger side (contralateral to
S S S S S S S S S S
the weak leg) to widen the base of support and reduce the load on
S S S S S S S S S S S S S S
the weak side. Both B and D are correct as they describe the same
S S S S S S S S S S S S S S
concept.
S
4. The nurse is educating a patient on home fire safety. Which
S S S S S S S S S S
statement indicates understanding?
S S S
A) "I will use a space heater only when I am sleeping."
S S S S S S S S S S