D439 EXAM STUDY SHEET INCLUDING ALL
ACTUAL EXAM QUESTIONS AND SOLUTIONS
2026.
◍ guided imagery. Answer: -mind/body intervention
-Concentrating on an image or series of images to treat pathological
conditions
◍ Maslow's Hierarchy of Needs. Answer: -where (1) physiological
needs are PRIORITY then (2) safety and security, (3) love and
belonging needs. (4) self esteem needs, and FINALLY (5) self
actualization needs
The nurse planning care for a client experiencing dystocia determines
that the priority is which action?
1. Position changes and providing comfort measures
2. Explanations to the client about what is happening
3. Monitoring for changes in the condition of the birthing parent and
fetus
4. Encouraging the use of breathing techniques learned in childbirth
preparatory classes
Answer: 3
,Test-Taking Strategy: Note the strategic word, priority, and use
Maslow's Hierarchy of Needs theory to prioritize, remembering that
physiological needs come first. The nurse needs to have knowledge of
the client's priority needs and generate solutions. All the options are
correct and would be implemented during the care of a client with
dystocia. Also note that the correct option is the only one that
addresses both the birthing parent and the fetus. Remember to use
Maslow's Hierarchy of Needs theory to help prioritize and generate
solutions!
◍ EHR system and limitations. Answer: -EHR AND EMR are
different from eachother
-A health care agency often relies on the nursing history model
included in the electronic health record (EHR) as the organizing
framework for an assessment. However, EHR frameworks are often
medically driven. Frameworks developed from nursing theories are
more holistic and patient-centered, providing a more comprehensive
patient review.
-When it comes to the EMR freezing it's best to notify IT or when the
computer system shuts down during data entry. The nurse should
follow established protocols and prepare to re-enter data as a late
entry when the system is operational. Also never attempt to reboot or
fix the EMR system which may prolong the complication.
It's also not recommended to print EMR from a backup server without
proper authorization and ensuring data privacy and security.
-patient outcome data; and use clinical decision support systems. The
electronic health record (EHR) is an efficient method for documenting
and managing patient health care information (see Chapter 26.)
Computerized physician/provider order entry (CPOE), allowing
,health care providers to directly enter medical orders, is a critical
patient safety initiative especially in the area of medication ordering
and administration
-Change-of-shift, hand-off reporting, and hourly bedside rounds are
ways to keep all health care providers and patients informed
◍ Hand Hygeine. Answer: -hand washing does not kill
microorganisms but reduces the amount of them present
-four techniques: hand washing, antiseptic hand wash, antiseptic hand
rub, surgical hand antisepsis
-4 elements of hand washing: water, friction, soap , and time
◍ Dosage Calculation (ml, tbsp->ml). Answer:
◍ VITAL SIGNS. Answer: -what to do if reassessment is needed
-know the pt usual range of vital signs (baseline)
-assess respiratory
Factors affecting vital signs of older adults:
◍ MOBILITY: How do you use crutches?. Answer: TYPES OF
GAITS:
-2-point: 2 points (crutch or foot) on the ground: pt moves right crutch
and left foot together, left crutch and right foot together
-4 point gait:
, -3 point gait: moving both crutches and the injured leg at the same
time
-weight is on both hands
support weight at the hand grips, with elbow flexed at 30 degrees,
position crutches on the unaffected side when sitting or raising from
the chair
-How to use crutches: Do Not Adjust Crutch Settings After Fitting
(Should be 3 Finger Widths Between Axilla and Top of Crutch)
Support Body Weight on Hand Grips (Not Axilla), With Elbows
Flexed or bent at 30 Degrees
-an accurate measurement is important and the distance between the
axillae and arm piece has to be 2-3 finger widths in the axilla space
and the arm bars
-all weight should be on the hand grips
-when ambulating pt, stand on their affected (weak) side
-never rest armpit on the axillary bars
◍ Wound Care and skin integrity (ch 48). Answer: -levels of intention
-wound care
-wound stages
-what to do if device is causing irritation on pts skin
◍ Stages of wounds:. Answer: 1.) unblanchable/surface: intact skin,
may appear differently in darker skin. redness, hardness and heat
present.
ACTUAL EXAM QUESTIONS AND SOLUTIONS
2026.
◍ guided imagery. Answer: -mind/body intervention
-Concentrating on an image or series of images to treat pathological
conditions
◍ Maslow's Hierarchy of Needs. Answer: -where (1) physiological
needs are PRIORITY then (2) safety and security, (3) love and
belonging needs. (4) self esteem needs, and FINALLY (5) self
actualization needs
The nurse planning care for a client experiencing dystocia determines
that the priority is which action?
1. Position changes and providing comfort measures
2. Explanations to the client about what is happening
3. Monitoring for changes in the condition of the birthing parent and
fetus
4. Encouraging the use of breathing techniques learned in childbirth
preparatory classes
Answer: 3
,Test-Taking Strategy: Note the strategic word, priority, and use
Maslow's Hierarchy of Needs theory to prioritize, remembering that
physiological needs come first. The nurse needs to have knowledge of
the client's priority needs and generate solutions. All the options are
correct and would be implemented during the care of a client with
dystocia. Also note that the correct option is the only one that
addresses both the birthing parent and the fetus. Remember to use
Maslow's Hierarchy of Needs theory to help prioritize and generate
solutions!
◍ EHR system and limitations. Answer: -EHR AND EMR are
different from eachother
-A health care agency often relies on the nursing history model
included in the electronic health record (EHR) as the organizing
framework for an assessment. However, EHR frameworks are often
medically driven. Frameworks developed from nursing theories are
more holistic and patient-centered, providing a more comprehensive
patient review.
-When it comes to the EMR freezing it's best to notify IT or when the
computer system shuts down during data entry. The nurse should
follow established protocols and prepare to re-enter data as a late
entry when the system is operational. Also never attempt to reboot or
fix the EMR system which may prolong the complication.
It's also not recommended to print EMR from a backup server without
proper authorization and ensuring data privacy and security.
-patient outcome data; and use clinical decision support systems. The
electronic health record (EHR) is an efficient method for documenting
and managing patient health care information (see Chapter 26.)
Computerized physician/provider order entry (CPOE), allowing
,health care providers to directly enter medical orders, is a critical
patient safety initiative especially in the area of medication ordering
and administration
-Change-of-shift, hand-off reporting, and hourly bedside rounds are
ways to keep all health care providers and patients informed
◍ Hand Hygeine. Answer: -hand washing does not kill
microorganisms but reduces the amount of them present
-four techniques: hand washing, antiseptic hand wash, antiseptic hand
rub, surgical hand antisepsis
-4 elements of hand washing: water, friction, soap , and time
◍ Dosage Calculation (ml, tbsp->ml). Answer:
◍ VITAL SIGNS. Answer: -what to do if reassessment is needed
-know the pt usual range of vital signs (baseline)
-assess respiratory
Factors affecting vital signs of older adults:
◍ MOBILITY: How do you use crutches?. Answer: TYPES OF
GAITS:
-2-point: 2 points (crutch or foot) on the ground: pt moves right crutch
and left foot together, left crutch and right foot together
-4 point gait:
, -3 point gait: moving both crutches and the injured leg at the same
time
-weight is on both hands
support weight at the hand grips, with elbow flexed at 30 degrees,
position crutches on the unaffected side when sitting or raising from
the chair
-How to use crutches: Do Not Adjust Crutch Settings After Fitting
(Should be 3 Finger Widths Between Axilla and Top of Crutch)
Support Body Weight on Hand Grips (Not Axilla), With Elbows
Flexed or bent at 30 Degrees
-an accurate measurement is important and the distance between the
axillae and arm piece has to be 2-3 finger widths in the axilla space
and the arm bars
-all weight should be on the hand grips
-when ambulating pt, stand on their affected (weak) side
-never rest armpit on the axillary bars
◍ Wound Care and skin integrity (ch 48). Answer: -levels of intention
-wound care
-wound stages
-what to do if device is causing irritation on pts skin
◍ Stages of wounds:. Answer: 1.) unblanchable/surface: intact skin,
may appear differently in darker skin. redness, hardness and heat
present.
