QUESTIONS & ANSWERS\(RATED
A+)
Which of the following would be the most appropriate for you as the student nurse to
do next? - ANSWERPerform a Glasgow Coma Score (GCS).
When performing a physical examination of Winnie which of the following would be
most appropriate? - ANSWERTry to minimise position changes for her.
For which patient condition would you most likely expect a capillary refill time longer
than two seconds? - ANSWERPeripheral vascular disease
Which one of the following is a myth about pain in the older adult? - ANSWERElderly
people who are confused or cognitively impaired do not have pain.
As part of your cardiovascular assessment you are going to assess Joyce's apical
impulse. What is the correct location to auscultate the apical impulse? -
ANSWERFifth intercostal space, left midclavicular line.
Which of the following represents the break in sounds between the first and second
sounds when auscultating Joyce's blood pressure? - ANSWERAuscultatory gap.
Which test would be most appropriate to perform when assessing Winnies eye
muscle strength and cranial nerve function? - ANSWERExtra ocular movement test.
Which of the following nursing assessments will give you objective data relating to
the functioning of Winnies cerebellum? - ANSWERCoordination The registered
nurse is having difficulty eliciting a patellar reflex. Which of the following would be
most appropriate for the nurse to have Winnie do? , Lock the fingers together and
pull against each other.
Winnies patellar reflex is normal. Which of the following is the correct number to
document this? - ANSWER2+
Which of the following would be the most likely sign of a frontal lobe contusion? -
ANSWERDifficulty speaking
You are having difficulty auscultating Joyce's heart sounds - ANSWERspecifically S1
and S2. Which of the following would help? , Palpate the carotid pulse while
auscultating the heart.
Which type of pain would be associated with arthritis? - ANSWERSomatic
, You are assessing Joyce's pain. Which of the following would lead you to suspect
that she is experiencing pain? - ANSWERFacial grimacing, leaning forward
When assessing Rangi which part of the body would you assess for the presence of
central cyanosis? - ANSWEROral mucosa.
Which of the following processes is not required in order for effective respiration to
occur? - ANSWERObstruction.
Which of the following is a warning sign of acute respiratory distress? - ANSWERA
blue tinge to the mouth and lips.
Which of the following would be most important for you to remember when
auscultating Rangi's posterior chest? - ANSWERListen at each site for at least one
complete respiratory cycle.
When auscultating the apices of Rangi's lungs - ANSWERwhere would you place
your stethoscope?, Slightly above the clavicle.
Which of the following describes a wheeze? - ANSWERHigh-pitched, musical
sounds heard primarily during expiration
Which of the following signs is not associated with increased work of breathing? -
ANSWERRespiratory rate of 12 breaths per minute.
You are aware that it is important to break the chain of infection - ANSWERwhich of
the following is an example of a nursing intervention that is implemented to reduce a
reservoir of infection for a patient?, Changing soiled dressings.
Which is NOT one of the 5 moments of hand hygiene? - ANSWERBefore reading
your patients notes.
Which statement about PPE is incorrect? - ANSWERYou do not need to perform
hand hygiene if you have worn gloves.
Which of the is not an element in the chain of infection? - ANSWERFormation of
immunoglobulin
When performing a comprehensive assessment - ANSWERwhich part of the body
would you assess for information about the motor function of cranial nerve VII?,
Head and face
You are preparing to assess Mrs Jones' distance visual acuity. Given that she wears
reading glasses which of the following would be most appropriate? - ANSWERAsk
Mrs Jones to remove her glasses before testing
During Mrs Jones' ocular exam you shine a light into one eye and the pupil of the
other eye constricts. What of the following do you interpret this as? -
ANSWERConsensual response