NUR 204 Exam 3 Week 5,6,7 Questions With Complete
Solutions
mr essermans bed should be changed every
2 hours
reactive hyperemia
result of a compensatory rush of blood to an area that has been
deprived of blood flow
when assessing a reddened area it is important that it be checked
for
blanching
sensation
When Mr. Esserman is in a chair, his weight should be shifted
every:
15 mins
blanch able erythema
area has been deprived of oxygen but damage has not occurred
which of the following techniques can be used to determine if
the air filled static overlay on mr essermans bed is adequate in
reducing pressure
place a hand between mattress and the overlay
Mr. Esserman needs nutrients of all types to provide calories and
energy, but especially protein. What strategies do you
,appropriately encourage Mrs. Esserman to use in providing extra
protein in her husband's diet?
-at each meal, feed protein rich foods first
- offer yogurt or seasoned soft cooked scrambled eggs to provide
protein
Mrs. Esserman asks, "How will I know if my husband is getting
one of these bedsores?" Which of the following advice is
appropriate?
"when your husbands position is changed check for reddened
areas"
using the Braden scale which of the following score would
indicate that a person was at low risk for developing a pressure
ulcer
23
A written care plan for pressure ulcer prevention, which includes
a repositioning schedule, is established for Mr. Espreaux.
Important components include:
-use of support surfaces
- use of positioning devices
-having Mr. espreaux shift his weight periodically
in back lying positioning in bed head elevation at ____ degrees
or lower will reduce the risk for shearing from sliding down the
bed
30
,in the side lying position skin to skin pressure an be avoided
with a pillow placed between the knees at what degree
30
in assessing mr. espreaux because he is African American and
dark skinned which of the following indicators of a stage 1
pressure ulcer apply
- warmth to touch
- induration
Sally reminds the nurses caring for Mr. Espreaux about the
importance of staging any pressure ulcers. Which of the
following are true about staging?
-pressure ulcer should be staged using a staging system
- pressure ulcers should be staged when discovered
-staging is a primary criterion that guides treatment
which dressing choice is acceptable for a stage 2 pressure ulcer
- sacral specific hydrocolloid dressing
-transparent film membrane dressing
The nurse is teaching a patient with diverticulitis about
increasing fiber intake. Which of the following foods should the
nurse recommend?
banana
A patient is prescribed furosemide and is at risk of hypokalemia.
Which food choice would be beneficial to manage this potential
side effect?
oranges
, Which of the following actions should be taken by the nurse
when caring for a patient receiving total parenteral nutrition
(hyperalimentation)? (Select all that apply.)
- change in the iv tubing every 24 hours according to facility
protocol
- monitor patients blood glucose levels every 6 hours
- use an infusion pump for administration
A patient is a newly diagnosed diabetic. The nurse prioritizes
education focused on which of the following nutritional choices?
limit carbs
The nurse evaluates that nutritional education for a patient on a
clear liquid diet has been effective when the patient selects
which food item to comply with this order?
chicken broth
The nurse instructs a patient with renal failure who is receiving
hemodialysis about the type of diet needed to be consumed. The
nurse determines that the patient understands the education if the
patient selects which diet?
low in sodium phosphorous and protein
The nurse has placed a nasogastric tube for a patient requiring
enteral feeding. The nurse validates placement through pH
measurement and using clinical judgment. What gold standard
should be used to confirm placement prior to using the tube?
xray
Solutions
mr essermans bed should be changed every
2 hours
reactive hyperemia
result of a compensatory rush of blood to an area that has been
deprived of blood flow
when assessing a reddened area it is important that it be checked
for
blanching
sensation
When Mr. Esserman is in a chair, his weight should be shifted
every:
15 mins
blanch able erythema
area has been deprived of oxygen but damage has not occurred
which of the following techniques can be used to determine if
the air filled static overlay on mr essermans bed is adequate in
reducing pressure
place a hand between mattress and the overlay
Mr. Esserman needs nutrients of all types to provide calories and
energy, but especially protein. What strategies do you
,appropriately encourage Mrs. Esserman to use in providing extra
protein in her husband's diet?
-at each meal, feed protein rich foods first
- offer yogurt or seasoned soft cooked scrambled eggs to provide
protein
Mrs. Esserman asks, "How will I know if my husband is getting
one of these bedsores?" Which of the following advice is
appropriate?
"when your husbands position is changed check for reddened
areas"
using the Braden scale which of the following score would
indicate that a person was at low risk for developing a pressure
ulcer
23
A written care plan for pressure ulcer prevention, which includes
a repositioning schedule, is established for Mr. Espreaux.
Important components include:
-use of support surfaces
- use of positioning devices
-having Mr. espreaux shift his weight periodically
in back lying positioning in bed head elevation at ____ degrees
or lower will reduce the risk for shearing from sliding down the
bed
30
,in the side lying position skin to skin pressure an be avoided
with a pillow placed between the knees at what degree
30
in assessing mr. espreaux because he is African American and
dark skinned which of the following indicators of a stage 1
pressure ulcer apply
- warmth to touch
- induration
Sally reminds the nurses caring for Mr. Espreaux about the
importance of staging any pressure ulcers. Which of the
following are true about staging?
-pressure ulcer should be staged using a staging system
- pressure ulcers should be staged when discovered
-staging is a primary criterion that guides treatment
which dressing choice is acceptable for a stage 2 pressure ulcer
- sacral specific hydrocolloid dressing
-transparent film membrane dressing
The nurse is teaching a patient with diverticulitis about
increasing fiber intake. Which of the following foods should the
nurse recommend?
banana
A patient is prescribed furosemide and is at risk of hypokalemia.
Which food choice would be beneficial to manage this potential
side effect?
oranges
, Which of the following actions should be taken by the nurse
when caring for a patient receiving total parenteral nutrition
(hyperalimentation)? (Select all that apply.)
- change in the iv tubing every 24 hours according to facility
protocol
- monitor patients blood glucose levels every 6 hours
- use an infusion pump for administration
A patient is a newly diagnosed diabetic. The nurse prioritizes
education focused on which of the following nutritional choices?
limit carbs
The nurse evaluates that nutritional education for a patient on a
clear liquid diet has been effective when the patient selects
which food item to comply with this order?
chicken broth
The nurse instructs a patient with renal failure who is receiving
hemodialysis about the type of diet needed to be consumed. The
nurse determines that the patient understands the education if the
patient selects which diet?
low in sodium phosphorous and protein
The nurse has placed a nasogastric tube for a patient requiring
enteral feeding. The nurse validates placement through pH
measurement and using clinical judgment. What gold standard
should be used to confirm placement prior to using the tube?
xray
