NUR 218 Exam 1 || Error-free Answers 100%.
You have delegated vital signs to assistive personnel. The assistant informs you that the patient
has just finished a bowl of hot soup. The nurse's most appropriate advice would be to
A. Take a rectal temperature.
B. Take the oral temperature as planned.
C. Advise the patient to drink a glass of cold water.
D. Wait 30 minutes and take an oral temperature. correct answers D. Wait 30 minutes and take an
oral temperature
You notice that a teenager has an irregular pulse. The best action you should take includes
A.Reading the history and physical.
B.Assessing the apical pulse rate for 1 full minute.
C.Auscultating for strength and depth of pulse.
D.Asking whether the patient feels any palpitations or faintness of breath correct answers
B.Assessing the apical pulse rate for 1 full minute.
A postoperative patient is breathing rapidly. You should immediately:
A. Call the physician.
B. Count the respirations.
C. Assess the oxygen saturation.
D. Ask the patient if he feels uncomfortable. correct answers C. Assess the oxygen saturation.
When assessing the blood pressure of a school-aged child, using an adult cuff of normal size will
affect the reading and produce a value that is
A.Accurate.
B.Indistinct.
C.Falsely low.
,D.Falsely high. correct answers D.Falsely high.
When a smiling and cooperative patient complains of discomfort, nurses caring for this patient
often harbor misconceptions about the patient's pain. Which of the following is true?
A.Chronic pain is psychological in nature.
B.Patients are the best judges of their pain.
C.Regular use of narcotic analgesics leads to drug addiction.
D.Amount of pain is reflective of actual tissue damage. correct answers B.Patients are the best
judges of their pain.
A patient is admitted to a medical unit for a home-acquired pressure ulcer. The patient has
Alzheimer's disease and has been incontinent of urine. The nurse inserts a Foley catheter. You
will identify a link in the infection chain as
A.Restraints.
B.Poor hygiene.
C.Foley catheter.
D.Improper positioning correct answers C.Foley catheter.
You are caring for a patient who underwent surgery 48 hours ago. On physical assessment, you
notice that the wound looks red and swollen. The patient's WBCs are elevated. You should
A.Start antibiotics.
B.Notify the physician.
C.Document the findings and reassess in 2 hours.
D.Place the patient on isolation precautions. correct answers B.Notify the physician.
The use of diagnostic reasoning involves a rigorous approach to clinical practice and
demonstrates that critical thinking cannot be done______________.
A.logically
B.haphazardly
, C.independently
D.in a vacuum correct answers B.haphazardly
A client comes into the emergency room. What is the first thing you would do?
A.Assessment - secondary data
B.Implementation of intervention
C.Nursing Diagnosis
D.Assessment - primary data correct answers D.Assessment - primary data
The nurse is assigned to care for four clients. In planning client rounds, which client should the
nurse assess first?
A.A client scheduled for a chest x-ray
B.A client requiring daily dressing changes
C.A postoperative client preparing for discharge
D.A client receiving nasal oxygen who had difficulty breathing during the previous shift correct
answers D.A client receiving nasal oxygen who had difficulty breathing during the previous shift
An 85 y.o. client from a residential care facility is brought into the emergency department.
Numerous bruises and abrasions in various stages of healing are present on the client's face and
arms. The attendant for the residential facility explains that the client fell down. What is the
priority nursing action?
A) Call the residential facility and ask for an incident report
B) Put ice on the bruises and cover the abrasions with protective gauze
C) Notify the supervisor regarding the possibility of an abusive situation?
D) Perform a head-to-toe assessment and determine the extent of the injuries correct answers D)
Perform a head-to-toe assessment and determine the extent of the injuries
The nursing process organizes your approach while delivering nursing care. To provide the best
professional care to patients, nurses need to incorporate nursing process and
__________________.
You have delegated vital signs to assistive personnel. The assistant informs you that the patient
has just finished a bowl of hot soup. The nurse's most appropriate advice would be to
A. Take a rectal temperature.
B. Take the oral temperature as planned.
C. Advise the patient to drink a glass of cold water.
D. Wait 30 minutes and take an oral temperature. correct answers D. Wait 30 minutes and take an
oral temperature
You notice that a teenager has an irregular pulse. The best action you should take includes
A.Reading the history and physical.
B.Assessing the apical pulse rate for 1 full minute.
C.Auscultating for strength and depth of pulse.
D.Asking whether the patient feels any palpitations or faintness of breath correct answers
B.Assessing the apical pulse rate for 1 full minute.
A postoperative patient is breathing rapidly. You should immediately:
A. Call the physician.
B. Count the respirations.
C. Assess the oxygen saturation.
D. Ask the patient if he feels uncomfortable. correct answers C. Assess the oxygen saturation.
When assessing the blood pressure of a school-aged child, using an adult cuff of normal size will
affect the reading and produce a value that is
A.Accurate.
B.Indistinct.
C.Falsely low.
,D.Falsely high. correct answers D.Falsely high.
When a smiling and cooperative patient complains of discomfort, nurses caring for this patient
often harbor misconceptions about the patient's pain. Which of the following is true?
A.Chronic pain is psychological in nature.
B.Patients are the best judges of their pain.
C.Regular use of narcotic analgesics leads to drug addiction.
D.Amount of pain is reflective of actual tissue damage. correct answers B.Patients are the best
judges of their pain.
A patient is admitted to a medical unit for a home-acquired pressure ulcer. The patient has
Alzheimer's disease and has been incontinent of urine. The nurse inserts a Foley catheter. You
will identify a link in the infection chain as
A.Restraints.
B.Poor hygiene.
C.Foley catheter.
D.Improper positioning correct answers C.Foley catheter.
You are caring for a patient who underwent surgery 48 hours ago. On physical assessment, you
notice that the wound looks red and swollen. The patient's WBCs are elevated. You should
A.Start antibiotics.
B.Notify the physician.
C.Document the findings and reassess in 2 hours.
D.Place the patient on isolation precautions. correct answers B.Notify the physician.
The use of diagnostic reasoning involves a rigorous approach to clinical practice and
demonstrates that critical thinking cannot be done______________.
A.logically
B.haphazardly
, C.independently
D.in a vacuum correct answers B.haphazardly
A client comes into the emergency room. What is the first thing you would do?
A.Assessment - secondary data
B.Implementation of intervention
C.Nursing Diagnosis
D.Assessment - primary data correct answers D.Assessment - primary data
The nurse is assigned to care for four clients. In planning client rounds, which client should the
nurse assess first?
A.A client scheduled for a chest x-ray
B.A client requiring daily dressing changes
C.A postoperative client preparing for discharge
D.A client receiving nasal oxygen who had difficulty breathing during the previous shift correct
answers D.A client receiving nasal oxygen who had difficulty breathing during the previous shift
An 85 y.o. client from a residential care facility is brought into the emergency department.
Numerous bruises and abrasions in various stages of healing are present on the client's face and
arms. The attendant for the residential facility explains that the client fell down. What is the
priority nursing action?
A) Call the residential facility and ask for an incident report
B) Put ice on the bruises and cover the abrasions with protective gauze
C) Notify the supervisor regarding the possibility of an abusive situation?
D) Perform a head-to-toe assessment and determine the extent of the injuries correct answers D)
Perform a head-to-toe assessment and determine the extent of the injuries
The nursing process organizes your approach while delivering nursing care. To provide the best
professional care to patients, nurses need to incorporate nursing process and
__________________.
