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Exam (elaborations)

WGU D442 Basic Nursing Skills |PA |Pre - Assessment -Solved

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WGU D442 Basic Nursing Skills |PA |Pre - Assessment -Solved

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WGU D442 Basic Nursing Skills |PA |Pre -
Assessment -Solved

1. Which action is most effective for preventing the transmission of infection in a
healthcare setting?
A. Wearing a mask for every patient encounter
B. Performing hand hygiene at appropriate times
C. Using sterile gloves for all procedures
D. Keeping patients isolated

2. When should a nurse perform hand hygiene after removing gloves?
A. Only when the gloves appear contaminated
B. After touching the next patient
C. Immediately after glove removal
D. At the end of the shift

3. Which position is generally preferred for a patient experiencing difficulty
breathing?
A. Supine
B. Prone
C. Trendelenburg
D. High-Fowler's

4. A nurse is preparing to measure an oral temperature. Which action is
appropriate?
A. Place the thermometer under the tongue against the teeth
B. Ask the patient to bite the thermometer
C. Place the thermometer in the posterior sublingual pocket
D. Measure immediately after the patient drinks hot coffee

5. Which finding should the nurse report immediately?
A. Pulse 78/min
B. Respirations 16/min
C. Blood pressure 118/72 mm Hg
D. Oxygen saturation of 84%

6. Which pulse site is commonly used during routine adult vital-sign assessment?
A. Popliteal
B. Femoral
C. Radial
D. Temporal

7. When counting respirations, the nurse should:
A. Tell the patient to breathe normally

,B. Ask the patient to take deep breaths
C. Observe respirations without drawing attention to the counting
D. Count for 5 seconds and multiply by 12

8. Which blood-pressure cuff placement is correct?
A. Cuff placed over clothing
B. Cuff wrapped loosely around the forearm
C. Cuff placed snugly around the upper arm with the artery marker aligned
appropriately
D. Cuff placed below the elbow

9. Which assessment finding is consistent with orthostatic hypotension?
A. Increased blood pressure after standing
B. Decrease in blood pressure accompanied by symptoms after position change
C. Increased oxygen saturation
D. Increased temperature after standing

10. What is the primary purpose of using an incentive spirometer?
A. Decrease blood pressure
B. Measure oxygen saturation
C. Promote lung expansion and help prevent atelectasis
D. Treat pulmonary edema

11. Which instruction should the nurse provide when teaching incentive-spirometer
use?
A. Exhale forcefully into the device
B. Inhale slowly and deeply through the mouthpiece
C. Use it only when shortness of breath occurs
D. Breathe rapidly through the mouthpiece

12. Which patient is at greatest risk for developing a pressure injury?
A. Ambulatory adult with normal nutrition
B. Young adult who exercises daily
C. Immobile patient with poor nutritional intake
D. Patient who changes position independently

13. Which intervention is most appropriate for preventing pressure injuries?
A. Massage reddened bony prominences
B. Keep the patient in one position
C. Reposition the patient regularly and reduce pressure on bony areas
D. Use donut-shaped rings under all affected areas

14. A nurse observes nonblanchable redness over a patient's sacral area. How
should this finding be interpreted?
A. Normal skin variation
B. Stage 4 pressure injury
C. Possible Stage 1 pressure injury
D. Healing Stage 3 injury

, 15. Which action helps reduce friction and shear when repositioning a patient?
A. Pulling the patient directly across the bed
B. Using a lift sheet or appropriate repositioning device
C. Raising the head of bed as high as possible
D. Leaving the patient's feet unsupported

16. Which nutrient is especially important for tissue repair and wound healing?
A. Sodium
B. Protein
C. Cholesterol
D. Caffeine

17. Which finding is most concerning in a patient with a wound?
A. Pink granulation tissue
B. Minimal serous drainage
C. Increasing redness, warmth, swelling, and purulent drainage
D. Intact surrounding skin

18. Which type of drainage is typically clear or pale yellow?
A. Purulent
B. Sanguineous
C. Serous
D. Fecal

19. Which type of wound drainage consists primarily of fresh blood?
A. Serous
B. Purulent
C. Sanguineous
D. Serosanguineous

20. What is the purpose of sterile technique?
A. Reduce patient anxiety
B. Prevent introduction of microorganisms into a sterile field
C. Eliminate all microorganisms from the environment
D. Replace hand hygiene

21. Which action contaminates a sterile field?
A. Keeping sterile objects above waist level
B. Opening a sterile package away from the body
C. Reaching over the sterile field
D. Maintaining the field within view

22. Which item is considered sterile?
A. The outer 1-inch border of a sterile drape
B. The nurse's uniform
C. The center portion of a properly prepared sterile field
D. The outside of a sterile package

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