FUNDAMENTAL EXAM 3 FINAL EXAM
1. A client has been admitted to a post-surgical unit with a patient-
controlled analgesia (PCA) system. Which statement is true of this
medication delivery system?
ANS The dose that is delivered when the client actives the machine is
preset
2. Which nursing intervention would be appropriate for preventing
urinary tract infection?
ANS Perineal cleaning after each incontinent episode
3. You are caring for a 49-year-old client in an acute care facility. Your client
recently had an increase in blood pressure. The baseline blood pressure
was 110/68 and the client now has a blood pressure of 200/110. You
determine that you need to call the provider. Which information will be
provided as the "B" in the ISBARR communication technique?
ANS Blood pressure of 200/110
4. A client is receiving physical therapy following knee surgery. This is
an example of what type of care.
ANS Tertiary
5. The nurse is caring for a patient who has a stage III pressure ulcer.
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,Which type of healing will the nurse focus the care plan?
ANS Secondary intention
6. A client suddenly begins to feel light-headed and dyspneic. What
objective data anticipate finding in the focused assessment?
ANS Tachypnea
7. What is an appropriate outcome for a client who needs nursing assistance
with voiding?
ANS The client will empty the bladder completely at least every four
hours while awake with nursing assistance.
8. What nursing organizational statement defines the social context of
nursing and the standards of professional nursing practice?
ANS The ANA Nursing's social policy statement
9. Which of the following are culturally sensitive considerations? (Select all
that apply)
ANS a. Recognizing that culture is an important component of
individuality.
b. Recognizing that each person holds various beliefs about pain.
c. Respecting patient's right to respond to pain in their own manner.
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, f. Allowing people of different cultures the right to worship as they
please.
10.A female resident in a long- term care facility is embarrassed about her
incontinence. What nursing intervention could aid in meeting the goal of
reducing incontinence episodes?
ANS Teach the patient Kegel exercises at regular intervals daily.
11.The client who is bed-bound complains of lower abdominal pain and
pelvic pressure. Bowel sounds are present in all four quadrants and last
bowel movement was yesterday. What should be assessed next?
ANS Ask the patient when they last voided.
3/9
1. A client has been admitted to a post-surgical unit with a patient-
controlled analgesia (PCA) system. Which statement is true of this
medication delivery system?
ANS The dose that is delivered when the client actives the machine is
preset
2. Which nursing intervention would be appropriate for preventing
urinary tract infection?
ANS Perineal cleaning after each incontinent episode
3. You are caring for a 49-year-old client in an acute care facility. Your client
recently had an increase in blood pressure. The baseline blood pressure
was 110/68 and the client now has a blood pressure of 200/110. You
determine that you need to call the provider. Which information will be
provided as the "B" in the ISBARR communication technique?
ANS Blood pressure of 200/110
4. A client is receiving physical therapy following knee surgery. This is
an example of what type of care.
ANS Tertiary
5. The nurse is caring for a patient who has a stage III pressure ulcer.
1/9
,Which type of healing will the nurse focus the care plan?
ANS Secondary intention
6. A client suddenly begins to feel light-headed and dyspneic. What
objective data anticipate finding in the focused assessment?
ANS Tachypnea
7. What is an appropriate outcome for a client who needs nursing assistance
with voiding?
ANS The client will empty the bladder completely at least every four
hours while awake with nursing assistance.
8. What nursing organizational statement defines the social context of
nursing and the standards of professional nursing practice?
ANS The ANA Nursing's social policy statement
9. Which of the following are culturally sensitive considerations? (Select all
that apply)
ANS a. Recognizing that culture is an important component of
individuality.
b. Recognizing that each person holds various beliefs about pain.
c. Respecting patient's right to respond to pain in their own manner.
2/9
, f. Allowing people of different cultures the right to worship as they
please.
10.A female resident in a long- term care facility is embarrassed about her
incontinence. What nursing intervention could aid in meeting the goal of
reducing incontinence episodes?
ANS Teach the patient Kegel exercises at regular intervals daily.
11.The client who is bed-bound complains of lower abdominal pain and
pelvic pressure. Bowel sounds are present in all four quadrants and last
bowel movement was yesterday. What should be assessed next?
ANS Ask the patient when they last voided.
3/9
