WGU D439 FOUNDATIONS OF NURSING
EXAM SCRIPT WITH VERIFIED ANSWERS
◉ 2.Which of the following observations made by the nurse who
is evaluating the crutch-walking technique of a patient who is to
have no weight bearing on the right leg indicates that the patient
can safely ambulate independently?
A. The patient keeps the padded area of the crutch firmly in the
axillary area when ambulating.
B. The patient advances the right leg, and both crutches together
and then advances the left leg.
C. The patient moves the left crutch with the left leg and then the
right crutch with the right leg.
D. The patient uses the bedside chair to assist in balance as
needed when ambulating in the room.
Answer: B
◉ 3.When giving home care instructions to a patient who has
multiple forearm fractures and a long arm cast on the right arm,
which information should the nurse include?
A. Keep the hand immobile to prevent soft tissue swelling.
B. Keep the right shoulder elevated on a pillow or cushion.
C. Avoid the use of nonsteroidal anti-inflammatory drugs
(NSAIDs) for the first 48 hours after the injury.
,D. Call the health care provider for increased swelling or
numbness.
Answer: D
◉ 4. A patient who has been hospitalized for 3 days with a hip
fracture has sudden onset shortness of breath and tachypnea. The
patient tells the nurse, "I feel like I am going to die!" Which action
should the nurse take first?
A. Stay with the patient and offer reassurance.
B. Administer the prescribed PRN oxygen at 4 L/min.
C. Check the patient's legs for swelling or tenderness.
D. Notify the health care provider about the symptoms.
Answer: B
◉ 5.The nursing assessment of an 80-year-old patient who
demonstrates some confusion, but no anxiety reveals that the
patient is a fall risk because she continues to get out of bed
without help despite frequent reminders. The initial nursing
intervention to prevent falls for this patient is to:
A. Place a bed alarm device on the bed.
B. Place the patient in a belt restraint.
C. Provide one-on-one observation of the patient.
D. Apply wrist restraints.
Answer: A
,◉ 6.A couple who is caring for their aging parents are concerned
about factors that put them at risk for falls. Which factors are
most likely to contribute to an increase in falls in the elderly?
(Select all that apply.)
A. Inadequate lighting
B. Throw rugs
C. Multiple medications
D. Doorway thresholds
E. Cords covered by carpets
F. Staircases with handrails
Answer: A,B,C,D,E
◉ 7.A patient has been on bed rest for over 4 days. On assessment,
the nurse identifies the following as a sign associated with
immobility:
A. Decreased peristalsis
B. Decreased heart rate
C. Increased blood pressure
D. Increased urinary output
Answer: A
◉ 8.The nurse is caring for a patient whose calcium intake must
increase because of high risk factors for osteoporosis. Which of
the following menus should the nurse recommend?
, A. Cream of broccoli soup with whole wheat crackers, cheese, and
tapioca for dessert
B. Hot dog on whole wheat bun with a side salad and an apple for
dessert
C. Low-fat turkey chili with sour cream with a side salad and fresh
pears for dessert
D. Turkey salad on toast with tomato and lettuce and honey bun
for dessert
Answer: A
◉ 9.A patient on prolonged bed rest is at an increased risk to
develop this common complication of immobility if preventive
measures are not taken:
A. Myoclonus
B. Pathological fractures
C. Pressure ulcers
D. Pruritus
Answer: C
◉ 10.Which of the following are physiological outcomes of
immobility
A. Increased metabolism
B. Reduced cardiac workload
C. Decreased lung expansion
D. Decreased oxygen demand
EXAM SCRIPT WITH VERIFIED ANSWERS
◉ 2.Which of the following observations made by the nurse who
is evaluating the crutch-walking technique of a patient who is to
have no weight bearing on the right leg indicates that the patient
can safely ambulate independently?
A. The patient keeps the padded area of the crutch firmly in the
axillary area when ambulating.
B. The patient advances the right leg, and both crutches together
and then advances the left leg.
C. The patient moves the left crutch with the left leg and then the
right crutch with the right leg.
D. The patient uses the bedside chair to assist in balance as
needed when ambulating in the room.
Answer: B
◉ 3.When giving home care instructions to a patient who has
multiple forearm fractures and a long arm cast on the right arm,
which information should the nurse include?
A. Keep the hand immobile to prevent soft tissue swelling.
B. Keep the right shoulder elevated on a pillow or cushion.
C. Avoid the use of nonsteroidal anti-inflammatory drugs
(NSAIDs) for the first 48 hours after the injury.
,D. Call the health care provider for increased swelling or
numbness.
Answer: D
◉ 4. A patient who has been hospitalized for 3 days with a hip
fracture has sudden onset shortness of breath and tachypnea. The
patient tells the nurse, "I feel like I am going to die!" Which action
should the nurse take first?
A. Stay with the patient and offer reassurance.
B. Administer the prescribed PRN oxygen at 4 L/min.
C. Check the patient's legs for swelling or tenderness.
D. Notify the health care provider about the symptoms.
Answer: B
◉ 5.The nursing assessment of an 80-year-old patient who
demonstrates some confusion, but no anxiety reveals that the
patient is a fall risk because she continues to get out of bed
without help despite frequent reminders. The initial nursing
intervention to prevent falls for this patient is to:
A. Place a bed alarm device on the bed.
B. Place the patient in a belt restraint.
C. Provide one-on-one observation of the patient.
D. Apply wrist restraints.
Answer: A
,◉ 6.A couple who is caring for their aging parents are concerned
about factors that put them at risk for falls. Which factors are
most likely to contribute to an increase in falls in the elderly?
(Select all that apply.)
A. Inadequate lighting
B. Throw rugs
C. Multiple medications
D. Doorway thresholds
E. Cords covered by carpets
F. Staircases with handrails
Answer: A,B,C,D,E
◉ 7.A patient has been on bed rest for over 4 days. On assessment,
the nurse identifies the following as a sign associated with
immobility:
A. Decreased peristalsis
B. Decreased heart rate
C. Increased blood pressure
D. Increased urinary output
Answer: A
◉ 8.The nurse is caring for a patient whose calcium intake must
increase because of high risk factors for osteoporosis. Which of
the following menus should the nurse recommend?
, A. Cream of broccoli soup with whole wheat crackers, cheese, and
tapioca for dessert
B. Hot dog on whole wheat bun with a side salad and an apple for
dessert
C. Low-fat turkey chili with sour cream with a side salad and fresh
pears for dessert
D. Turkey salad on toast with tomato and lettuce and honey bun
for dessert
Answer: A
◉ 9.A patient on prolonged bed rest is at an increased risk to
develop this common complication of immobility if preventive
measures are not taken:
A. Myoclonus
B. Pathological fractures
C. Pressure ulcers
D. Pruritus
Answer: C
◉ 10.Which of the following are physiological outcomes of
immobility
A. Increased metabolism
B. Reduced cardiac workload
C. Decreased lung expansion
D. Decreased oxygen demand
