Nurs 155 Exam 3 Questions with
Detailed Verified Answers
Question: Delirium
Ans: Reversible state of confusion-usually caused by a medical condition
Question: Depression
Ans: Mood disorder; sense of hopelessness and persistent unhappiness
Question: dementia
Ans: a gradual and irreversible loss of intellectual function
Question: Hemiparesis
Ans: weakness on one side of the body
*damage from right side of the brain affects the left side of the body and
vis versa
Question: Types of sensory deficits and examples
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Ans: Tactile: touch; peripheral neuropathy
Smell: Olfactory; anosmia
Taste: Gustatory; decreased gustatory cells
Hearing: Auditory; conductive hearing loss, sensorineural hearing loss, and
presbycusis (age related hearing loss)
Equilibrium: motion sickness or Meniere's disease
Vision: Visual; myopia, presbyopia (far sightedness-age related), cataracts
(lens of the eye affected), glaucoma (pressure on optic nerve), diabetic
retinopathy (blood vessels of eye are damaged due to diabetes), and
macular degeneration
Question: If patient begins to complain of pair or if resistance to joint
movement is met, range of motion exercises should be_____
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Ans: Range of motion exercises should be stopped; never hyperextend or
flex a joint beyond position of comfort
page 560 safety practice alert
Question: The nurse is preparing to provide wound care to a client with a
stage 1 pressure injury. Which dressing would the nurse expect to be
prescribed in the treatment
of this wound?
1. Hydrogel dressing
2. Transparent dressing
3. Antimicrobial dressing
4. Calcium alginate dressing
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Ans: 2. Transparent dressing
A stage 1 pressure injury is characterized by intact
skin with nonblanchable erythema. Dressings used to manage a stage 1
pressure injury include transparent dressings, hydrocolloid dressings, or no
dressing and leaving the wound open to air. The wound should resolve
without epidermal loss over a period of 7 to 14 days. Hydrogel dressings
are used to maintain a moist environment for wound healing. Calcium
alginate is absorbent and is used in stage 4 wounds or those with deeper
tissue injury. Antimicrobial dressings are used for pressure injuries that are
infected.
Test-Taking Strategy: Focus on the subject, the wound dressing that is
appropriate in the treatment of a stage 1 pressure injury. Remember that
dressing use is conservative in this type of pressure injury, and includes the
use of transparent dressings or no dressing. The wound is expected to heal
without epidermal loss over a period of 7 to 14 days.
Question: The nurse in a long-term care facility is observing a nursing student
provide foot care to a client with diabetes mellitus. Which action by the
nursing student would indicate a need for further teaching?
1. The nursing student tells the client to avoid soaking the feet.
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