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NR 224 FUNDAMENTALS SKILLS FINAL EXAM NEWEST 2024 ACTUAL EXAM COMPLETE 300
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NR 224 FUNDAMENTALS SKILLS FINAL EXAM NEWEST 2024 ACTUAL EXAM COMPLETE 300
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NR 224 FUNDAMENTALS SKILLS FINAL EXAMNEWEST 2024 ACTUAL EXAM COMPLETE 300
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+.
What is the most effective method to prevent the transfer of
clostridium difficile (C. Difficile) ? - ANSWER >>>>HAND
HYGIENE with soap and water is effective to physically
remove C. difficile spores from the hands. (Potter 1092)
What is the term for the [abnormal] method used to assist in
stool passage by exerting pressure to expel fecal matter
through voluntary contraction of the abdominal muscles while
maintaining a forced expiration against a closed airway? -
ANSWER >>>>Valsalva Manuever
*Normal passage of bowels should be painless, passing soft
formed stool*
Which patients are at greatest risk for cardiac dysrhythmia
and high blood pressure with the Valsalva manuever and
MUST avoid straining to pass stool? - ANSWER >>>>Patients
with cardiovascular disease, glaucoma, increased intracranial
pressure, or a new surgical wound
(Potter 1089)
,What is the term for a collection of hardened feces in the
rectum that cannot be expelled due to unrelieved
constipation? - ANSWER >>>>Fecal Impaction
Where does fecal impaction occur in the colon? - ANSWER
>>>>Rectum
Least formed stool is present in which portion of the digestive
tract? - ANSWER >>>>Ascending Colon
Most formed stool is present in which portion of the digestive
tract? - ANSWER >>>>Descending Colon
Which position should the patient be in while administering an
enema? - ANSWER >>>>Left Side-Lying or Sim's Position
Which factors would contribute to stopping enema
administration? - ANSWER >>>>If bleeding occurs, abdomen
becomes rigid and distended, pain occurs, or resistance is felt
Which enema solution is the safest for administration because
it does NOT create a danger for excess fluid absorption? -
ANSWER >>>>Normal Saline [Isotonic Solution]
Which enema solution is contraindicated in patients who are
dehydrated or young infants because of risk for fluid
imbalance? - ANSWER >>>>Hypertonic Solution
Which enema solution is considered to be hypotonic and
should NOT be repeated because of the risk of water toxicity
or circulatory overload if and because the body absorbs
excessive amounts of water? - ANSWER >>>>Tap Water
[Hypotonic Solution]
,Which enema solution lubricates the rectum and allows the
feces to absorb the oil making them soft and easier to pass? -
ANSWER >>>>Oil Retention
Which enema solution creates intestinal irritation to stimulate
peristalsis by using castile soap? - ANSWER >>>>Soapsuds
Which enema solution should used in caution in pregnant
women and elderly because it may cause an electrolyte
imbalance or damage to intestinal mucosa? - ANSWER
>>>>Soapsuds
Which laboratory test is used to measure microscopic
amounts of blood in the feces (blood that cannot be seen) -
ANSWER >>>>Guaiac Fecal Occult Blood Test
Repeat the test at least three times while the patient refrains
from ingesting foods (e.g., some raw vegetables, red meat,
poultry, fish) and medications (e.g., vitamin C, aspirin, non
steroidal anti-inflammatory drugs) that cause false-positive
results
(Potter 1100)
When analyzing a fecal specimens for ova and parasites,
what is required of the stool? - ANSWER >>>>The stool
MUST be warm.
If the stool specimen remains at room temperature,
bacteriological changes can alter the test results
, Which cathartic form is most effective because of its stimulant
effect on the rectal mucosa
(Example: Dulcolax)? - ANSWER >>>>Cathartic
Suppositories
Which foods induce a constipating effect? - ANSWER
>>>>cheese, lean meats, eggs, and pasta
Which food induce a laxative effect? - ANSWER >>>>fruits,
vegetables, bran, chocolate, alcohol, and coffee
What are the assessment findings of a normal stoma? -
ANSWER >>>>bright pink or brick red
Notify HCP of stoma is blue, purple, brown, or black which
indicates circulation problem to the stoma
How does the nurse measure the length of the NG tube for
insertion? - ANSWER >>>>Tip of the nose --> earlobe -->
xiphoid process
What is the most reliable method of verification for placement
of the NG tube? - ANSWER >>>>X-ray
Other methods include: pH test (aspirate and inspect color)
What are the ranges for body mass index? - ANSWER
>>>>Normal = 19-24
Overweight = 25-29
Obese = 30-39
Extremely Obese = > 40
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