NUR 160-Hondros Exam 1 UPDATED
Exam Questions and CORRECT Answers
just culture - Correct Answer- workers are protected from disciplinary action when they
report injuries, errors, or near misses
close-ended question - Correct Answer- What is your name?
false reassurance - Correct Answer- Everything will be fine
Why Assess? - Correct Answer- To identify changes in pt condition, to help foresee areas of
concern
RN - Correct Answer- who does the initial assessment?
Within 24 hours - Correct Answer- When should an initial assessment be done?
discharge planning - Correct Answer- What should we pay attention to when a pt is post op
knee replacement and they live on 2nd floor
Steps of an assessment - Correct Answer- 1. Introduce self
2. Explain procedure
3. wash hands
4. Identify pt
5. Provide privacy
6. Inspect, auscultate, palpate
Correct, then continue - Correct Answer- If a concern arises during assessment (Ex: pt c/o
SOB. Sit up, apply O2 or check tubing, teach inhale through nose, exhale through mouth)
Order of assessmet - Correct Answer- Subjective then Objective (helps to identify ares of
focus)
, Inspect airway, auscultate lungs - Correct Answer- If pt c/o sore throat or recent cold
Serous Drainage - Correct Answer- Clear(Good or indifferent)
Sanginous Drainage - Correct Answer- Blood-red(a little is ok, alot is bad)
Serosanginous Drainage - Correct Answer- Pink-mix of blood and serous(This is ok)
Purulent Drainage - Correct Answer- Puss (assess for infection and notify MD)
Absent Bowel Sounds - Correct Answer- Auscultate 5 mins per quadrant (Silence means
NOTHING) (20 minute total) assess for an obstruction and notify MD
Normal IM injection reaction - Correct Answer- Burning at site, itching at site, bruising
Abnormal IM injection Reaction - Correct Answer- vomiting, constipation, dry mouth, rash
(systemic)
TB testing - Correct Answer- 1. Must be read 48-72 hrs (assessed)
2. Document date, time of injection and reading, as well as result
3. Mild swelling is normal
TB result-negative - Correct Answer- 10mm- healthcare workers are a strict 10
TB result-positive - Correct Answer- red, raised (induration)
Positive TB result - Correct Answer- This means that the person has been exposed to TB
At risk for TB - Correct Answer- nursing homes, jails, homeless, certain meds, some other
countries, healthcare workers
Exam Questions and CORRECT Answers
just culture - Correct Answer- workers are protected from disciplinary action when they
report injuries, errors, or near misses
close-ended question - Correct Answer- What is your name?
false reassurance - Correct Answer- Everything will be fine
Why Assess? - Correct Answer- To identify changes in pt condition, to help foresee areas of
concern
RN - Correct Answer- who does the initial assessment?
Within 24 hours - Correct Answer- When should an initial assessment be done?
discharge planning - Correct Answer- What should we pay attention to when a pt is post op
knee replacement and they live on 2nd floor
Steps of an assessment - Correct Answer- 1. Introduce self
2. Explain procedure
3. wash hands
4. Identify pt
5. Provide privacy
6. Inspect, auscultate, palpate
Correct, then continue - Correct Answer- If a concern arises during assessment (Ex: pt c/o
SOB. Sit up, apply O2 or check tubing, teach inhale through nose, exhale through mouth)
Order of assessmet - Correct Answer- Subjective then Objective (helps to identify ares of
focus)
, Inspect airway, auscultate lungs - Correct Answer- If pt c/o sore throat or recent cold
Serous Drainage - Correct Answer- Clear(Good or indifferent)
Sanginous Drainage - Correct Answer- Blood-red(a little is ok, alot is bad)
Serosanginous Drainage - Correct Answer- Pink-mix of blood and serous(This is ok)
Purulent Drainage - Correct Answer- Puss (assess for infection and notify MD)
Absent Bowel Sounds - Correct Answer- Auscultate 5 mins per quadrant (Silence means
NOTHING) (20 minute total) assess for an obstruction and notify MD
Normal IM injection reaction - Correct Answer- Burning at site, itching at site, bruising
Abnormal IM injection Reaction - Correct Answer- vomiting, constipation, dry mouth, rash
(systemic)
TB testing - Correct Answer- 1. Must be read 48-72 hrs (assessed)
2. Document date, time of injection and reading, as well as result
3. Mild swelling is normal
TB result-negative - Correct Answer- 10mm- healthcare workers are a strict 10
TB result-positive - Correct Answer- red, raised (induration)
Positive TB result - Correct Answer- This means that the person has been exposed to TB
At risk for TB - Correct Answer- nursing homes, jails, homeless, certain meds, some other
countries, healthcare workers
