1
Which of the following interventions is most important to prevent nosocomial infections?
- ANSWER...-Hand hygiene
Standard precautions - ANSWER...-are used on every patient because it is not always
known whether a patient is infected.
latex allergies - ANSWER...-are more common in nurses and in frequently hospitalized
patients.
example of inspection - ANSWER...-skin pink, visual information
The patient is complaining of abdominal pain. What technique is used to form an overall
impression? - ANSWER...-light palpation
tympany is a percussion sound commonly located in the - ANSWER...-abdomen
Which organs or body areas does the nurse auscultate as part of the admitting
assessment? - ANSWER...-heart, lungs, abdomen
What technique facilitates accurate auscultation? - ANSWER...-The chestpiece of the
stethoscope is sealed against the skin.
When assessing the child, the nurse makes the following adaptation to the usual
techniques: - ANSWER...-A pediatric stethoscope is used for better contact.
The nurse assesses the following vital signs in a 78-year-old man: T 36.6°C, temporal;
P 72 bpm, regular, 2+; R 18 breaths/minute, regular, no use of accessory muscles; BP
142/92 mm Hg. Which of the findings is abnormal? - ANSWER...-BP
four characteristics of respirations - ANSWER...-rate, rhythm, depth, quality
The patient's radial pulse is weak and thready. The next action of the nurse is to -
ANSWER...-compare findings to previous findings and opposite extremity.
The nurse notes an irregular radial pulse in a patient. Further evaluation includes
assessing - ANSWER...-for a pulse deficit
Which actions will result in an inaccurate BP reading? - ANSWER...-Obtaining a BP
immediately after the patient has entered the room;
Using a BP cuff 80% of the arm circumference