Exam 2- NUR1020 Broward College Questions With
Complete Solutions
1. A patient presents with heatstroke. The nurse uses cool packs,
cooling blanket, and a fan. Which technique is the nurse using
when the fan produces heat loss?
a. Radiation
b. Conduction
c. Convection
d. Evaporation Correct Answers ANS: C
Convection is the transfer of heat away from the body by air
movement. Conduction is the transfer of heat from one object to
another with direct contact. Radiation is the transfer of heat from
the surface of one object to the surface of another without direct
contact between the two. Evaporation is the transfer of heat
energy when a liquid is changed to a gas.
10. The patient is found to be unresponsive and not breathing.
Which pulse site will the nurse use?
a. Radial
b. Apical
c. Carotid
d. Brachial Correct Answers ANS: C
The heart continues to deliver blood through the carotid artery to
the brain as long as possible. The carotid pulse is easily
accessible during physiological shock or cardiac arrest. The
radial pulse is used to assess peripheral circulation or to assess
the status of circulation to the hand. The brachial site is used to
,assess the status of circulation to the lower arm. The apical pulse
is used to auscultate the apical area.
14. The patient's blood pressure is 140/60. Which value will the
nurse record for the pulse pressure?
a. 60
b. 80
c. 140
d. 200 Correct Answers ANS: B
The difference between the systolic pressure and the diastolic
pressure is the pulse pressure. For a blood pressure of 140/60,
the pulse pressure is 80 (140 - 60 = 80). 140 is the systolic
pressure. 60 is the diastolic pressure. 200 is the systolic (140)
added to the diastolic (60), but this has no clinical significance.
17. A patient presents to the emergency department following a
motor vehicle crash that causes a right femur fracture. The leg is
stabilized in a full leg cast. Otherwise, the patient has no other
major injuries, is in good health, and reports only moderate
discomfort. Which is the most pertinent nursing diagnosis the
nurse will include in the plan of care?
a. Posttrauma syndrome
b. Constipation
c. Acute pain
d. Anxiety Correct Answers ANS: C
Based on the assessment data provided, the only supportive
evidence for one of the diagnosis options is ―Reports only
moderate discomfort,‖ which would support Acute pain. No
supportive evidence is provided for any of the other diagnoses.
The patient may indeed develop signs or symptoms of the other
, problems, but supportive data are presently lacking in the
provided information.
18. While completing an admission database, thenurse is
interviewing a patient who states, ―I am allergic to latex.‖
Which action will thenurse take first?
a. Immediately place thepatient in isolation.
b. Ask thepatient to describe thetype of reaction.
c. Proceed to thetermination phase of theinterview.
d. Document thelatex allergy on themedication administration
record. Correct Answers ANS: B
The nurse should further assess and ask thepatient to describe
thetype of reaction. thepatient will not need to be placed in
isolation; before terminating theinterview or documenting
theallergy, health care personnel need to be aware of what type
of response thepatient suffered.
19. Which scenario best illustrates thenurse using data validation
when making a nursing clinical decision for a patient?
a. The nurse determines to remove a wound dressing when
thepatient reveals thetime of thelast dressing change and notices
old and new drainage.
b. The nurse administers pain medicine due at 1700 at 1600
because thepatient reports increased pain and thefamily wants
something done.
c. The nurse immediately asks thehealth care provider for an
order of potassium when a patient reports leg cramps.
d. The nurse elevates a leg cast when thepatient reports
decreased mobility. Correct Answers ANS: A
Complete Solutions
1. A patient presents with heatstroke. The nurse uses cool packs,
cooling blanket, and a fan. Which technique is the nurse using
when the fan produces heat loss?
a. Radiation
b. Conduction
c. Convection
d. Evaporation Correct Answers ANS: C
Convection is the transfer of heat away from the body by air
movement. Conduction is the transfer of heat from one object to
another with direct contact. Radiation is the transfer of heat from
the surface of one object to the surface of another without direct
contact between the two. Evaporation is the transfer of heat
energy when a liquid is changed to a gas.
10. The patient is found to be unresponsive and not breathing.
Which pulse site will the nurse use?
a. Radial
b. Apical
c. Carotid
d. Brachial Correct Answers ANS: C
The heart continues to deliver blood through the carotid artery to
the brain as long as possible. The carotid pulse is easily
accessible during physiological shock or cardiac arrest. The
radial pulse is used to assess peripheral circulation or to assess
the status of circulation to the hand. The brachial site is used to
,assess the status of circulation to the lower arm. The apical pulse
is used to auscultate the apical area.
14. The patient's blood pressure is 140/60. Which value will the
nurse record for the pulse pressure?
a. 60
b. 80
c. 140
d. 200 Correct Answers ANS: B
The difference between the systolic pressure and the diastolic
pressure is the pulse pressure. For a blood pressure of 140/60,
the pulse pressure is 80 (140 - 60 = 80). 140 is the systolic
pressure. 60 is the diastolic pressure. 200 is the systolic (140)
added to the diastolic (60), but this has no clinical significance.
17. A patient presents to the emergency department following a
motor vehicle crash that causes a right femur fracture. The leg is
stabilized in a full leg cast. Otherwise, the patient has no other
major injuries, is in good health, and reports only moderate
discomfort. Which is the most pertinent nursing diagnosis the
nurse will include in the plan of care?
a. Posttrauma syndrome
b. Constipation
c. Acute pain
d. Anxiety Correct Answers ANS: C
Based on the assessment data provided, the only supportive
evidence for one of the diagnosis options is ―Reports only
moderate discomfort,‖ which would support Acute pain. No
supportive evidence is provided for any of the other diagnoses.
The patient may indeed develop signs or symptoms of the other
, problems, but supportive data are presently lacking in the
provided information.
18. While completing an admission database, thenurse is
interviewing a patient who states, ―I am allergic to latex.‖
Which action will thenurse take first?
a. Immediately place thepatient in isolation.
b. Ask thepatient to describe thetype of reaction.
c. Proceed to thetermination phase of theinterview.
d. Document thelatex allergy on themedication administration
record. Correct Answers ANS: B
The nurse should further assess and ask thepatient to describe
thetype of reaction. thepatient will not need to be placed in
isolation; before terminating theinterview or documenting
theallergy, health care personnel need to be aware of what type
of response thepatient suffered.
19. Which scenario best illustrates thenurse using data validation
when making a nursing clinical decision for a patient?
a. The nurse determines to remove a wound dressing when
thepatient reveals thetime of thelast dressing change and notices
old and new drainage.
b. The nurse administers pain medicine due at 1700 at 1600
because thepatient reports increased pain and thefamily wants
something done.
c. The nurse immediately asks thehealth care provider for an
order of potassium when a patient reports leg cramps.
d. The nurse elevates a leg cast when thepatient reports
decreased mobility. Correct Answers ANS: A
