NS 660 Exam #1 Hygiene – Questions With Reliable
Solutions
The student nurse is teaching a family member the importance of foot care for
his or her mother, who has diabetes. Which safety precautions are important
for the family member to know to prevent infection? Correct Answer -
Cut nails frequently.
Assess skin for redness, abrasions, and open areas daily*
Soak feet in water at least 10 minutes before nail care.
Apply lotion to feet daily.*
Clean between toes after bathing.*
Because of a patient's risk for infection, it is important to assess skin for
redness, abrasions, and open areas daily. Apply lotion to feet daily to keep the
skin hydrated, but do not leave excess lotion on the skin. Clean between toes
carefully after bathing to avoid maceration. Do not cut nails or soak the feet of
a patient with diabetes because this may create skin breakdown and open
sores, leading to skin breakdown or infection.
A patient with a malignant brain tumor requires oral care. The patient's level
of consciousness has declined, with the patient only being able to respond to
voice commands. What is the correct order for administration of oral care?1. If
patient is uncooperative or having difficulty keeping mouth open, insert an
oral airway. 2. Raise bed, lower side rail, and position patient close to side of
bed with head of bed raised up to 30 degrees. 3. Using a brush moistened with
chlorhexidine paste, clean chewing and inner tooth surfaces first. 4. For
patients without teeth, use a toothette moistened in chlorhexidine rinse to
clean oral cavity. 5. Remove partial plate or dentures if present. 6. Gently
brush tongue but avoid stimulating gag reflex. Correct Answer - 2, 5, 1, 3,
6, 4
The American Dental Association suggests that patients who are at risk for
poor hygiene use the following interventions for oral care: Correct Answer -
Use antimicrobial toothpaste.*
Brush teeth 4 times a day.
Use 0.12% chlorhexidine gluconate (CHG) oral rinses.*
Use a soft toothbrush for oral care.*
, Avoid cleaning the gums and tongue.
The American Dental Association guidelines (2014) for effective oral hygiene
include brushing the teeth at least twice a day with an American Dental
Association approved fluoride toothpaste. Use antimicrobial toothpastes and
0.12% CHG oral rinses for patients at increased risk for poor oral hygiene
(e.g., older adults and patients with cognitive impairments and who are
immunocompromised). Rounded soft bristles stimulate the gums without
causing abrasion and bleeding. Patients should clean gum and the surface of
the tongue.
A patient receiving chemotherapy experiences stomatitis. The nurse advises
the patient to use: Correct Answer - Community mouthwash.
Alcohol-based mouth rinse.
Normal saline rinses.*
Firm toothbrush.
Normal saline is the safest solution to use in caring for a patient with
stomatitis. Alcohol and community mouthwashes can be irritating and
burning. A soft toothbrush should be used.
When you are assigned to a patient who has a reduced level of consciousness
and requires mouth care, which physical assessment techniques should you
perform before the procedure? Correct Answer - Oxygen saturation
Heart rate
Respirations*
Gag reflex*
Response to painful stimulus
Check a patient's respirations and whether there is a gag reflex present to
determine risk for aspiration and to establish a baseline for the patient's
condition.
A nurse is assigned to care for the following patients. Which of the patients is
most at risk for developing skin problems and thus requiring thorough
bathing and skin care? Correct Answer - A 44-year-old female who has
had removal of a breast lesion and is having her menstrual period.
Solutions
The student nurse is teaching a family member the importance of foot care for
his or her mother, who has diabetes. Which safety precautions are important
for the family member to know to prevent infection? Correct Answer -
Cut nails frequently.
Assess skin for redness, abrasions, and open areas daily*
Soak feet in water at least 10 minutes before nail care.
Apply lotion to feet daily.*
Clean between toes after bathing.*
Because of a patient's risk for infection, it is important to assess skin for
redness, abrasions, and open areas daily. Apply lotion to feet daily to keep the
skin hydrated, but do not leave excess lotion on the skin. Clean between toes
carefully after bathing to avoid maceration. Do not cut nails or soak the feet of
a patient with diabetes because this may create skin breakdown and open
sores, leading to skin breakdown or infection.
A patient with a malignant brain tumor requires oral care. The patient's level
of consciousness has declined, with the patient only being able to respond to
voice commands. What is the correct order for administration of oral care?1. If
patient is uncooperative or having difficulty keeping mouth open, insert an
oral airway. 2. Raise bed, lower side rail, and position patient close to side of
bed with head of bed raised up to 30 degrees. 3. Using a brush moistened with
chlorhexidine paste, clean chewing and inner tooth surfaces first. 4. For
patients without teeth, use a toothette moistened in chlorhexidine rinse to
clean oral cavity. 5. Remove partial plate or dentures if present. 6. Gently
brush tongue but avoid stimulating gag reflex. Correct Answer - 2, 5, 1, 3,
6, 4
The American Dental Association suggests that patients who are at risk for
poor hygiene use the following interventions for oral care: Correct Answer -
Use antimicrobial toothpaste.*
Brush teeth 4 times a day.
Use 0.12% chlorhexidine gluconate (CHG) oral rinses.*
Use a soft toothbrush for oral care.*
, Avoid cleaning the gums and tongue.
The American Dental Association guidelines (2014) for effective oral hygiene
include brushing the teeth at least twice a day with an American Dental
Association approved fluoride toothpaste. Use antimicrobial toothpastes and
0.12% CHG oral rinses for patients at increased risk for poor oral hygiene
(e.g., older adults and patients with cognitive impairments and who are
immunocompromised). Rounded soft bristles stimulate the gums without
causing abrasion and bleeding. Patients should clean gum and the surface of
the tongue.
A patient receiving chemotherapy experiences stomatitis. The nurse advises
the patient to use: Correct Answer - Community mouthwash.
Alcohol-based mouth rinse.
Normal saline rinses.*
Firm toothbrush.
Normal saline is the safest solution to use in caring for a patient with
stomatitis. Alcohol and community mouthwashes can be irritating and
burning. A soft toothbrush should be used.
When you are assigned to a patient who has a reduced level of consciousness
and requires mouth care, which physical assessment techniques should you
perform before the procedure? Correct Answer - Oxygen saturation
Heart rate
Respirations*
Gag reflex*
Response to painful stimulus
Check a patient's respirations and whether there is a gag reflex present to
determine risk for aspiration and to establish a baseline for the patient's
condition.
A nurse is assigned to care for the following patients. Which of the patients is
most at risk for developing skin problems and thus requiring thorough
bathing and skin care? Correct Answer - A 44-year-old female who has
had removal of a breast lesion and is having her menstrual period.
