TEST BANK FOR CLINICAL NURSING
SKILLS AND TECHNIQUES 10TH
EDITION BY ANNE GRIFFIN PERRY,
PATRICIA A. POTTER CHAPTER 1-43
ACTUAL VERIFIED NGN QUESTIONS
AND WELL EXPLAINED 100%
CORRECT ANSWERS WITH
RATIONALES LATEST 2025 UPDATE
GRADED A+ WITH 100%
GUARANTEED SUCCESS AFTER
DOWNLOAD
Chapter 1: Using Evidence in
Nursing Practice Nursing School Test Banks
MULTIPLE CHOICE
5. A patient with anemia is at risk for developing pressure ulcers as a result of
which of the following?
, a.
Increased sedation
b.
Edematous tissues
c.
Reduced tensile strength
d.
Diminished oxygen to the tissues
ANS:
D
Decreased hemoglobin reduces the oxygen-carrying capacity of the blood and the
amount of oxygen available to the tissues, thus increasing the risk for pressure
ulcers. Anemia does not cause increased sedation, edematous tissue, or reduced
tensile strength.
DIF:
Cognitive Level: Comprehension REF: Text reference: p. 997
OBJ:
Identify risk factors for the development of pressure ulcers.
TOP:
Anemia KEY: Nursing Process Step: Assessment
MSC:
NCLEX: Physiological Integrity
6. In a long-term care agency, how often should the nurse reassess a patient for risk
of a pressure ulcer?
a.
Every 1 to 2 days
b.
Every time the nurse sees the patient
c.
Weekly for the first few weeks of stay
d.
Monthly for the first 4 months of stay
ANS:
, C
In a long-term care agency, the patient is assessed every week for 4 weeks and then
quarterly, or whenever the patient's condition changes. An assessment schedule of
every 1 to 2 days would be more appropriate for acute care than in the long-term
care setting. The patient is not reassessed for risk in the long-term setting every
time the nurse sees the patient. The new patient in long-term care is reassessed
weekly rather than monthly after he is admitted.
DIF:
Cognitive Level: Knowledge REF: Text reference: p. 998
OBJ:
Describe guidelines for the prevention of pressure ulcers.
TOP:
Reassessment of Pressure Ulcer Risk
KEY:
Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
7. The patient with a nasogastric (NG) tube in place may experience skin
breakdown:
a.
in the nose.
b.
on the tongue.
c.
behind the ears.
d.
around the lips.
ANS:
A
NG and oxygen cannulas can cause pressure on the nares, leading to pressure
ulcers. Skin breakdown around the lips and tongue may result from oral airways or
endotracheal (ET) tubes. Skin breakdown behind the ears may result from pressure
from the oxygen cannula or the patient's pillow.
DIF:
Cognitive Level: Knowledge REF: Text reference: p. 999
, OBJ:
Describe guidelines for the prevention of pressure ulcers.
TOP:
Reassessment of Pressure Ulcer Factors
KEY:
Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
8. The nurse is caring for a darkly pigmented patient who is immobile and needs
turning every 2 hours. While turning the patient, to what should the nurse who is
performing the assessment pay particular attention?
a.
Edema in the sacrum
b.
Skin texture
c.
Skin temperature
d.
Pallor or mottling of the skin
ANS:
C
Darkly pigmented skin does not always have visible blanching. Its color differs from
that of surrounding skin. Skin temperature changes may be an important early
indicator of a stage I pressure ulcer. Edema is not an initial indication of a pressure
ulcer. Do not massage any reddened or discolored pressure points. Areas of
nonblanchable erythema or discolored areas may indicate that deeper tissue
damage is present. Massage in this area may worsen the inflammation by further
damaging underlying damaged blood vessels. Pallor or mottling will be difficult or
impossible to see in a patient with darkly pigmented skin.
DIF:
Cognitive Level: Application REF: Text reference: p. 994
OBJ:
Describe guidelines for the prevention of pressure ulcers.
TOP:
Reassessment of Pressure Ulcer Factors
SKILLS AND TECHNIQUES 10TH
EDITION BY ANNE GRIFFIN PERRY,
PATRICIA A. POTTER CHAPTER 1-43
ACTUAL VERIFIED NGN QUESTIONS
AND WELL EXPLAINED 100%
CORRECT ANSWERS WITH
RATIONALES LATEST 2025 UPDATE
GRADED A+ WITH 100%
GUARANTEED SUCCESS AFTER
DOWNLOAD
Chapter 1: Using Evidence in
Nursing Practice Nursing School Test Banks
MULTIPLE CHOICE
5. A patient with anemia is at risk for developing pressure ulcers as a result of
which of the following?
, a.
Increased sedation
b.
Edematous tissues
c.
Reduced tensile strength
d.
Diminished oxygen to the tissues
ANS:
D
Decreased hemoglobin reduces the oxygen-carrying capacity of the blood and the
amount of oxygen available to the tissues, thus increasing the risk for pressure
ulcers. Anemia does not cause increased sedation, edematous tissue, or reduced
tensile strength.
DIF:
Cognitive Level: Comprehension REF: Text reference: p. 997
OBJ:
Identify risk factors for the development of pressure ulcers.
TOP:
Anemia KEY: Nursing Process Step: Assessment
MSC:
NCLEX: Physiological Integrity
6. In a long-term care agency, how often should the nurse reassess a patient for risk
of a pressure ulcer?
a.
Every 1 to 2 days
b.
Every time the nurse sees the patient
c.
Weekly for the first few weeks of stay
d.
Monthly for the first 4 months of stay
ANS:
, C
In a long-term care agency, the patient is assessed every week for 4 weeks and then
quarterly, or whenever the patient's condition changes. An assessment schedule of
every 1 to 2 days would be more appropriate for acute care than in the long-term
care setting. The patient is not reassessed for risk in the long-term setting every
time the nurse sees the patient. The new patient in long-term care is reassessed
weekly rather than monthly after he is admitted.
DIF:
Cognitive Level: Knowledge REF: Text reference: p. 998
OBJ:
Describe guidelines for the prevention of pressure ulcers.
TOP:
Reassessment of Pressure Ulcer Risk
KEY:
Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
7. The patient with a nasogastric (NG) tube in place may experience skin
breakdown:
a.
in the nose.
b.
on the tongue.
c.
behind the ears.
d.
around the lips.
ANS:
A
NG and oxygen cannulas can cause pressure on the nares, leading to pressure
ulcers. Skin breakdown around the lips and tongue may result from oral airways or
endotracheal (ET) tubes. Skin breakdown behind the ears may result from pressure
from the oxygen cannula or the patient's pillow.
DIF:
Cognitive Level: Knowledge REF: Text reference: p. 999
, OBJ:
Describe guidelines for the prevention of pressure ulcers.
TOP:
Reassessment of Pressure Ulcer Factors
KEY:
Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
8. The nurse is caring for a darkly pigmented patient who is immobile and needs
turning every 2 hours. While turning the patient, to what should the nurse who is
performing the assessment pay particular attention?
a.
Edema in the sacrum
b.
Skin texture
c.
Skin temperature
d.
Pallor or mottling of the skin
ANS:
C
Darkly pigmented skin does not always have visible blanching. Its color differs from
that of surrounding skin. Skin temperature changes may be an important early
indicator of a stage I pressure ulcer. Edema is not an initial indication of a pressure
ulcer. Do not massage any reddened or discolored pressure points. Areas of
nonblanchable erythema or discolored areas may indicate that deeper tissue
damage is present. Massage in this area may worsen the inflammation by further
damaging underlying damaged blood vessels. Pallor or mottling will be difficult or
impossible to see in a patient with darkly pigmented skin.
DIF:
Cognitive Level: Application REF: Text reference: p. 994
OBJ:
Describe guidelines for the prevention of pressure ulcers.
TOP:
Reassessment of Pressure Ulcer Factors
