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1. The patient is performing self-care. which of the following would the nurse
recognize as improper hygiene?
a. the patient places their dentures in warm water
b. the patient wipes their eyes from inner to outer with a washcloth
c. the patient cleans their hands with a hand sanitizer, before they eat
d. the patient wipes their perineum from back to front - Correct Answer: d.
the patient wipes their perineum from back to front
2. Which of the following precautions would the nurse adhere to, when caring for
a patient with Tuberculosis?
a. contact
b. standard
c. airborne
d. droplet - Correct Answer: c. airborne
VITAL SIGNS
3. Which of the following vital signs would be of concern to the nurse?
,a. temp-100.2 orally, patient started antibiotics 2 hours ago
b. respiratory rate- 36 one day after surgery
c. pulse-100, patient complaining of pain scale 8/10
d. BP-110/60, patient positioned on their left side - Correct Answer: b.
respiratory rate- 36 one day after surgery
4. The patient has an irregular radial pulse after 30 seconds. which of the
following would the nurse do next?
a. call the healthcare provider
b. have another nurse check the pulse
c. document in the patient chart
d. obtain an apical pulse - Correct Answer: d. obtain an apical pulse (one full
min)
5. The patient is in the hospital and is experiencing tachycardia. which of the
following is a contributing factor?
a. the patient has anxiety
b. the patient is an athlete
c. pain medication was given 1hr ago
d. the patient has a temp of 98.2 - Correct Answer: a. the patient has anxiety
6. Which of the following can alter a blood pressure reading?
a. using a large BP cuff on an obese patient
, b. releasing the valve of the BP cuff too slowly
c. playing the stethoscope below the blood pressure cuff
d. inflating the cuff 30mmHg higher after palpating the last heart sound -
Correct Answer: b. releasing the valve of the BP cuff too slowly
SKIN AND WOUND CARE
7. Which abnormal skin color finding would indicate redness in face or areas of
pressure ulcers?
a. pallor
b. ecchymosis
c. erythema
d. petechiae - Correct Answer: c. erythema
8. A nurse suspects a wound infection after noting what type of drainage?
a. sanguineous
b. serous
c. serosanguineous
d. purulent - Correct Answer: d. purulent
9. A wound fails to heal properly and begins to separate. the nurse documents this
as
a. dehiscence
b. granulation tissue