Nursing 110 Exam one review questions with
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precise detailed answers
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The |nurse |is |visiting |the |patient |for |the |first |time |this |shift. |She |introduces |herself |and |asks |the |
patient |several |questions |related |to |his |condition. |While |doing |so, |and |without |being |obvious, |she |is |
looking |at |the |color |of |his |eyes |and |is |assessing |his |ears |and |nose |for |discharge |and |the |symmetry |of |
his |mouth. |Which |assessment |technique |is |the |nurse |using?
A: |palpation
B: |percussion
C: |inspection
D: |auscultation |- |correct |answer |C: |inspection
The |patient |is |admitted |with |fever |and |acute |lower |abdominal |pain. |He |has |taken |tylenol |but |says |he |
still |feels |feverish. |Before |taking |the |patient's |temperature, |the |nurse |may:
A: |touch |the |patients |skin |with |the |dorsal |of |her |hand
B: |touch |the |patients |skin |with |the |pads |of |her |finger
C: |palpate |the |skin |using |the |bimanual |method
D: |touch |the |patients |skin |with |the |palmar |side |of |her |hand |- |correct |answer |A: |touch |the |patients |
skin |with |the |dorsal |of |her |hand
What |should |the |nurse |do |when |preparing |to |complete |an |assessment |for |a |16 |year |old |patient?
A: |focus |on |the |illness |behaviors
B: |plan |for |a |diminished |energy |level
C: |treat |the |patient |as |an |individual
D: |have |the |parents |present |throughout |- |correct |answer |C: |treat |the |patient |as |an |individual
The |general |survey |begins |with |a |review |of |the |patient's |primary |health |problems |and |an |evaluation |
of |the |patient's |vital |signs, |height |and |weight, |general |behavior, |and |appearance. |It |also |provides |
information |about |the |patient's |illness, |hygiene, |skin |condition, |body |image, |and |emotional |state. |
Which |of |the |following |cannot |be |delegated |to |nursing |assistive |personnel?
,A: |reporting |subjectives |signs |and |symptoms
B: |measuring |the |patients |height |and |weight
C: |monitoring |I&O
D: |obtaining |initial |vital |signs |- |correct |answer |D: |obtaining |initial |vital |signs
The |nurse |is |preparing |to |examine |a |patient |who |has |chronic |lung |disease. |She |realizes |that |the |
patient |most |likely |will |need |to |be |in |which |position |for |the |examination?
A: |high |fowlers
B: |supine
C: |side-lying
D: |prone |- |correct |answer |A: |High |fowlers
Nursing |diagnoses |meet |specific |criteria |so |they |accurately |reflect |both |the |celints |problem |and |the |
possible |etiology |involved. |Of |the |following |statements, |which |one |is |an |example |of |an |appropriately |
written |nursing |diagnosis?
A: |cardiac |output |decreased |related |to |motor |vehicle |accidents
B: |potential |for |injury |related |to |improper |teaching |in |the |use |of |crutches
C: |ineffective |airway |clearance |related |to |increased |secretions
D: |risk |for |change |in |body |image |related |to |cancer |- |correct |answer |C: |ineffective |airway |clearance |
related |to |increased |secretions
Where |is |the |pulmonic |area |for |auscultation |found?
A: |second |intercostal |space |on |the |right |side
B: |second |intercostal |space |on |the |left |side
C: |third |intercostal |space
D: |fourth |intercostal |space |along |the |sternum |- |correct |answer |B: |second |intercostal |space |on |the |left
|side
While |performing |a |cardiovascular |assessment |on |a |patient |with |suspected |left-sided |congestive |heart
|failure, |the |nurse |is |unable |to |palpate |the |PMI |with |the |patient |lying |supine. |What |might |her |next |
step |be?
,A: |have |the |patient |turn |onto |his |left |side
B: |have |the |patient |lean |forward
C: |have |the |patient |move |to |a |sitting |position
D: |palpate |the |PMI |to |the |right |of |the |midclavicular |line |- |correct |answer |A: |have |the |patient |turn |
onto |his |left |side
Which |of |the |following |should |the |nurse |implement |for |assessment |of |the |carotid |artery?
A: |massaging |the |arteries |briskly
B: |using |the |diaphragm |of |the |stethoscope
C: |palpating |each |carotid |artery |separately
D: |placing |the |patient |in |a |supine |position |- |correct |answer |C: |Palpating |each |carotid |artery |separately
Which |of |the |following |is |an |unexpected |finding |after |a |cardiac |assessment?
A: |a |pulse |rate |of |72 |beats |per |minute.
B: |jugular |vein |pulsation |with |the |patient |supine.
C: |PMI |found |at |the |midclavicular |line.
D: |a |sustained |swishing |sound |during |systole |or |diastole. |- |correct |answer |D: |a |sustained |swishing |
sound |during |systole |or |diastole
How |should |the |nurse |document |an |exaggeration |of |the |posterior |curvature |of |the |thoracic |spine |
found |during |the |assessment |of |a |90 |year |old |patient?
A: |lordosis.
B: |osteoporosis.
C: |scoliosis.
D: |kyphosis. |- |correct |answer |D: |kyphosis
A |nurse |is |documenting |a |patient's |breath |sounds. |Crackles |are |heard |as:
A: |loud, |low-pitched, |coarse |sounds.
B: |high-pitched, |musical |squeaks.
C: |dry, |granting |sounds |on |inspiration.
, D: |high-pitched, |fine |sounds |at |the |end |of |inspiration |- |correct |answer |D: |high-pitched, |fine |sounds |at
|the |end |of |inspiration
A |53 |year |old |client |is |seen |at |the |clinic |for |a |yearly |physical |examination. |In |evaluating |the |client's |
weight, |the |nurse |also |considers |the |age |and |height. |This |is |an |example |of:
A: |defining |the |client |problem.
B: |recognizing |gaps |in |data |assessment.
C: |comparing |data |with |normal |health |patterns.
D: |drawing |conclusions |about |the |client's |response. |- |correct |answer |C: |comparing |data |with |normal |
health |patterns
The |nurse |is |preparing |to |perform |a |focused |respiratory |assessment |on |a |client. |The |nurse |should |be |
cognizant |of |what |anatomical |characteristic |of |the |lungs?
A: |the |left |lung |is |approximately |one-third |larger |than |the |right |lung.
B: |the |right |lung |has |three |lobes, |while |the |left |lung |has |two |lobes.
C: |the |lower |lobes |of |both |lungs |are |primarily |located |toward |the |anterior |chest |wall.
D: |the |lungs |are |structurally |symmetrical |but |functionally |differently. |- |correct |answer |B: |the |right |
lung |has |three |lobes |while |the |left |lung |has |two |lobes
The |nurse |has |diagnosed |the |client's |problem |as |altered |elimination. |Form |the |database |the |nurse |
identifies |all |the |following |as |appropriate |etiologics |for |this |diagnosis |except:
A: |poor |fiber |intake.
B: |limited |fluid |intake.
C: |total |hip |replacement.
D: |lower |abdominal |discomfort. |- |correct |answer |C: |total |hip |replacement
The |nurse |is |concerned |that |atelectasis |may |develop |as |a |postoperative |complication. |Which |of |the |
following |is |an |appropriate |diagnostic |label |for |this |problem |should |it |occur?
A: |ineffective |airway |clearance.
B: |impaired |gas |exchange.
C: |decreased |cardiac |output
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precise detailed answers
| |
The |nurse |is |visiting |the |patient |for |the |first |time |this |shift. |She |introduces |herself |and |asks |the |
patient |several |questions |related |to |his |condition. |While |doing |so, |and |without |being |obvious, |she |is |
looking |at |the |color |of |his |eyes |and |is |assessing |his |ears |and |nose |for |discharge |and |the |symmetry |of |
his |mouth. |Which |assessment |technique |is |the |nurse |using?
A: |palpation
B: |percussion
C: |inspection
D: |auscultation |- |correct |answer |C: |inspection
The |patient |is |admitted |with |fever |and |acute |lower |abdominal |pain. |He |has |taken |tylenol |but |says |he |
still |feels |feverish. |Before |taking |the |patient's |temperature, |the |nurse |may:
A: |touch |the |patients |skin |with |the |dorsal |of |her |hand
B: |touch |the |patients |skin |with |the |pads |of |her |finger
C: |palpate |the |skin |using |the |bimanual |method
D: |touch |the |patients |skin |with |the |palmar |side |of |her |hand |- |correct |answer |A: |touch |the |patients |
skin |with |the |dorsal |of |her |hand
What |should |the |nurse |do |when |preparing |to |complete |an |assessment |for |a |16 |year |old |patient?
A: |focus |on |the |illness |behaviors
B: |plan |for |a |diminished |energy |level
C: |treat |the |patient |as |an |individual
D: |have |the |parents |present |throughout |- |correct |answer |C: |treat |the |patient |as |an |individual
The |general |survey |begins |with |a |review |of |the |patient's |primary |health |problems |and |an |evaluation |
of |the |patient's |vital |signs, |height |and |weight, |general |behavior, |and |appearance. |It |also |provides |
information |about |the |patient's |illness, |hygiene, |skin |condition, |body |image, |and |emotional |state. |
Which |of |the |following |cannot |be |delegated |to |nursing |assistive |personnel?
,A: |reporting |subjectives |signs |and |symptoms
B: |measuring |the |patients |height |and |weight
C: |monitoring |I&O
D: |obtaining |initial |vital |signs |- |correct |answer |D: |obtaining |initial |vital |signs
The |nurse |is |preparing |to |examine |a |patient |who |has |chronic |lung |disease. |She |realizes |that |the |
patient |most |likely |will |need |to |be |in |which |position |for |the |examination?
A: |high |fowlers
B: |supine
C: |side-lying
D: |prone |- |correct |answer |A: |High |fowlers
Nursing |diagnoses |meet |specific |criteria |so |they |accurately |reflect |both |the |celints |problem |and |the |
possible |etiology |involved. |Of |the |following |statements, |which |one |is |an |example |of |an |appropriately |
written |nursing |diagnosis?
A: |cardiac |output |decreased |related |to |motor |vehicle |accidents
B: |potential |for |injury |related |to |improper |teaching |in |the |use |of |crutches
C: |ineffective |airway |clearance |related |to |increased |secretions
D: |risk |for |change |in |body |image |related |to |cancer |- |correct |answer |C: |ineffective |airway |clearance |
related |to |increased |secretions
Where |is |the |pulmonic |area |for |auscultation |found?
A: |second |intercostal |space |on |the |right |side
B: |second |intercostal |space |on |the |left |side
C: |third |intercostal |space
D: |fourth |intercostal |space |along |the |sternum |- |correct |answer |B: |second |intercostal |space |on |the |left
|side
While |performing |a |cardiovascular |assessment |on |a |patient |with |suspected |left-sided |congestive |heart
|failure, |the |nurse |is |unable |to |palpate |the |PMI |with |the |patient |lying |supine. |What |might |her |next |
step |be?
,A: |have |the |patient |turn |onto |his |left |side
B: |have |the |patient |lean |forward
C: |have |the |patient |move |to |a |sitting |position
D: |palpate |the |PMI |to |the |right |of |the |midclavicular |line |- |correct |answer |A: |have |the |patient |turn |
onto |his |left |side
Which |of |the |following |should |the |nurse |implement |for |assessment |of |the |carotid |artery?
A: |massaging |the |arteries |briskly
B: |using |the |diaphragm |of |the |stethoscope
C: |palpating |each |carotid |artery |separately
D: |placing |the |patient |in |a |supine |position |- |correct |answer |C: |Palpating |each |carotid |artery |separately
Which |of |the |following |is |an |unexpected |finding |after |a |cardiac |assessment?
A: |a |pulse |rate |of |72 |beats |per |minute.
B: |jugular |vein |pulsation |with |the |patient |supine.
C: |PMI |found |at |the |midclavicular |line.
D: |a |sustained |swishing |sound |during |systole |or |diastole. |- |correct |answer |D: |a |sustained |swishing |
sound |during |systole |or |diastole
How |should |the |nurse |document |an |exaggeration |of |the |posterior |curvature |of |the |thoracic |spine |
found |during |the |assessment |of |a |90 |year |old |patient?
A: |lordosis.
B: |osteoporosis.
C: |scoliosis.
D: |kyphosis. |- |correct |answer |D: |kyphosis
A |nurse |is |documenting |a |patient's |breath |sounds. |Crackles |are |heard |as:
A: |loud, |low-pitched, |coarse |sounds.
B: |high-pitched, |musical |squeaks.
C: |dry, |granting |sounds |on |inspiration.
, D: |high-pitched, |fine |sounds |at |the |end |of |inspiration |- |correct |answer |D: |high-pitched, |fine |sounds |at
|the |end |of |inspiration
A |53 |year |old |client |is |seen |at |the |clinic |for |a |yearly |physical |examination. |In |evaluating |the |client's |
weight, |the |nurse |also |considers |the |age |and |height. |This |is |an |example |of:
A: |defining |the |client |problem.
B: |recognizing |gaps |in |data |assessment.
C: |comparing |data |with |normal |health |patterns.
D: |drawing |conclusions |about |the |client's |response. |- |correct |answer |C: |comparing |data |with |normal |
health |patterns
The |nurse |is |preparing |to |perform |a |focused |respiratory |assessment |on |a |client. |The |nurse |should |be |
cognizant |of |what |anatomical |characteristic |of |the |lungs?
A: |the |left |lung |is |approximately |one-third |larger |than |the |right |lung.
B: |the |right |lung |has |three |lobes, |while |the |left |lung |has |two |lobes.
C: |the |lower |lobes |of |both |lungs |are |primarily |located |toward |the |anterior |chest |wall.
D: |the |lungs |are |structurally |symmetrical |but |functionally |differently. |- |correct |answer |B: |the |right |
lung |has |three |lobes |while |the |left |lung |has |two |lobes
The |nurse |has |diagnosed |the |client's |problem |as |altered |elimination. |Form |the |database |the |nurse |
identifies |all |the |following |as |appropriate |etiologics |for |this |diagnosis |except:
A: |poor |fiber |intake.
B: |limited |fluid |intake.
C: |total |hip |replacement.
D: |lower |abdominal |discomfort. |- |correct |answer |C: |total |hip |replacement
The |nurse |is |concerned |that |atelectasis |may |develop |as |a |postoperative |complication. |Which |of |the |
following |is |an |appropriate |diagnostic |label |for |this |problem |should |it |occur?
A: |ineffective |airway |clearance.
B: |impaired |gas |exchange.
C: |decreased |cardiac |output
