NSE 111 FINAL REVIEW EXAM
QUESTIONS WITH CORRECT
ANSWERS
What is maceration? - Answer-Softening and breaking down of skin due to prolonged
exposure to moisture.
What causes skin maceration? - Answer-Wound drainage, excessive perspiration,
incontinence, and sitting in wet briefs.
How can skin breakdown be assessed? - Answer-By observing areas of skin that differ
in color, temperature, and texture compared to surrounding skin.
What does the Braden Scale assess? - Answer-The risk of skin breakdown in patients.
What are the risk categories on the Braden Scale? - Answer-15-16 = low risk, 13-14 =
mid risk, 12 or less = high risk.
What is an important nursing intervention for preventing pressure ulcers? - Answer-
Encouraging frequent position changes and using pillows for support.
What is the purpose of range of motion (ROM) exercises? - Answer-To maintain or
improve mobility and prevent hazards of immobility.
What are the types of range of motion exercises? - Answer-Active ROM, Active
Assistive ROM, and Passive ROM.
What should be assessed during ROM exercises? - Answer-Stiffness, swelling, pain,
and limited movement.
What nutritional components are essential for wound healing? - Answer-Adequate
protein, carbohydrates, fats, minerals, and vitamins.
Which vitamins are important for wound healing? - Answer-Vitamin A (to decrease
steroid side effects) and Vitamin C (for collagen synthesis).
What are some considerations for personal hygiene care? - Answer-Social practices,
personal preferences, body image, and physical condition.
What is the critical judgment model in nursing? - Answer-A framework to help nurses
assess and analyze cues in patient care.
,What factors influence personal hygiene? - Answer-Cultural variables, socioeconomic
status, health benefits, and physical limitations.
What should be done to assist patients with mobility? - Answer-Encourage small shifts
in position and use proper support for joints.
What is the role of the nurse in falls risk assessment? - Answer-To identify risk factors
and implement appropriate interventions.
What are common falls risk factors? - Answer-Age, previous history of falls, confusion,
and sensory deficits.
What is the importance of clear communication in falls risk interventions? - Answer-To
ensure patient understanding and compliance with safety measures.
What should be done after turning a patient? - Answer-Use pillows to support their
alignment in the new position.
What is the significance of assessing skin temperature? - Answer-To identify areas of
potential skin breakdown or infection.
What is the maximum amount of movement available at a joint called? - Answer-Range
of motion (ROM).
What should be monitored during ROM exercises? - Answer-Signs of fatigue,
discomfort, and tolerance to the exercises.
What is the primary goal of hygiene care? - Answer-To assess and support the client's
physical, psycho-social, spiritual, and cultural needs.
What is the importance of minimizing exposure during bathing? - Answer-To maintain
the dignity of the client and minimize the time they are unclothed.
What should be assessed before providing a bath? - Answer-The client's self-care
ability and preferences.
What is the proper sequence for washing the body? - Answer-Start from the cleanest
part (face) and work downward towards the feet.
What is the correct method for washing the eyes? - Answer-Use a different part of the
washcloth for each eye and wash from inner to outer canthus.
What precautions should be taken when providing peri-care? - Answer-Move from front
to back and cleanse the meatus first.
, What are the risk factors for impaired skin integrity? - Answer-Immobilization, reduced
sensation, nutrition alterations, secretions, vascular insufficiency, and external devices.
What is the recommended technique for nail care? - Answer-Soak fingers, clean under
nails, trim straight across, and gently push cuticles back.
What should be assessed for foot care in patients with diabetes? - Answer-Adequacy of
circulation, sensation, and daily foot care to prevent ulcers.
How should clothing be changed for a client? - Answer-Encourage the client to do as
much as possible and support limbs when changing garments.
What techniques can be used for oral hygiene in clients with dementia? - Answer-Use a
hand-over-hand technique and a two-person approach for assistance.
What is the significance of using gloves during shaving care? - Answer-To maintain
hygiene and protect both the client and caregiver.
What is the best practice for cleaning the ears? - Answer-Use a moistened washcloth to
clean the auricles and never insert sharp objects.
What should be done to ensure the client is comfortable during bathing? - Answer-
Ensure the client is warm, comfortable, and assess their tolerance for activity.
What is the proper way to assess skin integrity during a bath? - Answer-Check skin,
hair, eyes, ears, nose, mouth, nails, and feet for condition.
What is the purpose of using a bath blanket? - Answer-To provide privacy and warmth
during the bathing process.
What is the recommended approach for clients with peripheral vascular disease? -
Answer-Assess for adequacy of circulation and provide careful foot care.
What is the recommended method for washing the face? - Answer-Use a clean
washcloth and move from the center outwards.
What should be done if a client has a history of Deep Vein Thrombosis? - Answer-Avoid
using long firm strokes on lower limbs during bathing.
What aspects should be assessed during an oral hygiene assessment? - Answer-Color,
hydration, texture, gums, tongue, teeth, lips, and breath.
What are some common oral problems to look for during an assessment? - Answer-
Pain, inflammation, infection, lesions, fissures, and ulcers.
QUESTIONS WITH CORRECT
ANSWERS
What is maceration? - Answer-Softening and breaking down of skin due to prolonged
exposure to moisture.
What causes skin maceration? - Answer-Wound drainage, excessive perspiration,
incontinence, and sitting in wet briefs.
How can skin breakdown be assessed? - Answer-By observing areas of skin that differ
in color, temperature, and texture compared to surrounding skin.
What does the Braden Scale assess? - Answer-The risk of skin breakdown in patients.
What are the risk categories on the Braden Scale? - Answer-15-16 = low risk, 13-14 =
mid risk, 12 or less = high risk.
What is an important nursing intervention for preventing pressure ulcers? - Answer-
Encouraging frequent position changes and using pillows for support.
What is the purpose of range of motion (ROM) exercises? - Answer-To maintain or
improve mobility and prevent hazards of immobility.
What are the types of range of motion exercises? - Answer-Active ROM, Active
Assistive ROM, and Passive ROM.
What should be assessed during ROM exercises? - Answer-Stiffness, swelling, pain,
and limited movement.
What nutritional components are essential for wound healing? - Answer-Adequate
protein, carbohydrates, fats, minerals, and vitamins.
Which vitamins are important for wound healing? - Answer-Vitamin A (to decrease
steroid side effects) and Vitamin C (for collagen synthesis).
What are some considerations for personal hygiene care? - Answer-Social practices,
personal preferences, body image, and physical condition.
What is the critical judgment model in nursing? - Answer-A framework to help nurses
assess and analyze cues in patient care.
,What factors influence personal hygiene? - Answer-Cultural variables, socioeconomic
status, health benefits, and physical limitations.
What should be done to assist patients with mobility? - Answer-Encourage small shifts
in position and use proper support for joints.
What is the role of the nurse in falls risk assessment? - Answer-To identify risk factors
and implement appropriate interventions.
What are common falls risk factors? - Answer-Age, previous history of falls, confusion,
and sensory deficits.
What is the importance of clear communication in falls risk interventions? - Answer-To
ensure patient understanding and compliance with safety measures.
What should be done after turning a patient? - Answer-Use pillows to support their
alignment in the new position.
What is the significance of assessing skin temperature? - Answer-To identify areas of
potential skin breakdown or infection.
What is the maximum amount of movement available at a joint called? - Answer-Range
of motion (ROM).
What should be monitored during ROM exercises? - Answer-Signs of fatigue,
discomfort, and tolerance to the exercises.
What is the primary goal of hygiene care? - Answer-To assess and support the client's
physical, psycho-social, spiritual, and cultural needs.
What is the importance of minimizing exposure during bathing? - Answer-To maintain
the dignity of the client and minimize the time they are unclothed.
What should be assessed before providing a bath? - Answer-The client's self-care
ability and preferences.
What is the proper sequence for washing the body? - Answer-Start from the cleanest
part (face) and work downward towards the feet.
What is the correct method for washing the eyes? - Answer-Use a different part of the
washcloth for each eye and wash from inner to outer canthus.
What precautions should be taken when providing peri-care? - Answer-Move from front
to back and cleanse the meatus first.
, What are the risk factors for impaired skin integrity? - Answer-Immobilization, reduced
sensation, nutrition alterations, secretions, vascular insufficiency, and external devices.
What is the recommended technique for nail care? - Answer-Soak fingers, clean under
nails, trim straight across, and gently push cuticles back.
What should be assessed for foot care in patients with diabetes? - Answer-Adequacy of
circulation, sensation, and daily foot care to prevent ulcers.
How should clothing be changed for a client? - Answer-Encourage the client to do as
much as possible and support limbs when changing garments.
What techniques can be used for oral hygiene in clients with dementia? - Answer-Use a
hand-over-hand technique and a two-person approach for assistance.
What is the significance of using gloves during shaving care? - Answer-To maintain
hygiene and protect both the client and caregiver.
What is the best practice for cleaning the ears? - Answer-Use a moistened washcloth to
clean the auricles and never insert sharp objects.
What should be done to ensure the client is comfortable during bathing? - Answer-
Ensure the client is warm, comfortable, and assess their tolerance for activity.
What is the proper way to assess skin integrity during a bath? - Answer-Check skin,
hair, eyes, ears, nose, mouth, nails, and feet for condition.
What is the purpose of using a bath blanket? - Answer-To provide privacy and warmth
during the bathing process.
What is the recommended approach for clients with peripheral vascular disease? -
Answer-Assess for adequacy of circulation and provide careful foot care.
What is the recommended method for washing the face? - Answer-Use a clean
washcloth and move from the center outwards.
What should be done if a client has a history of Deep Vein Thrombosis? - Answer-Avoid
using long firm strokes on lower limbs during bathing.
What aspects should be assessed during an oral hygiene assessment? - Answer-Color,
hydration, texture, gums, tongue, teeth, lips, and breath.
What are some common oral problems to look for during an assessment? - Answer-
Pain, inflammation, infection, lesions, fissures, and ulcers.
