Verified Answers
Besides meticulous hand hygiene, identify another practice that helps reduce the risk
of spreading infection?
Maintaining a clean environment in the patient's room
Restricting visitors to immediate family only
Leaving gloves on to administer medications
Placing the patient on droplet precautions Ans: Maintaining a clean environment in the
patient's room
When should a gown be worn?
When the patient's hygiene is poor
When the nurse is assisting with medication administration
When the patient has shingles
When blood or body fluids may get on the nurse's clothing Ans: When blood or body
fluids may get on the nurse's clothing
The nurse has redressed a wound and now plans to administer medications. What
should the nurse remember to do next?
Leave gloves on to administer medications.
Remove gloves and perform hand hygiene before leaving the room.
,Remove gloves and perform hand hygiene before administering the medication.
Leave the medication on the bedside table to avoid having to remove gloves. Ans:
Remove gloves and perform hand hygiene before administering the medication.
List the steps for applying personal protection equipment (PPE) in order.1. Apply
gown, pull sleeves down to wrist.2. Apply surgical mask.3. Apply eyewear.4. Apply
clean gloves.5. Bring glove cuffs over gown.
1, 2, 3, 4, 5
2, 1, 3, 4, 5
4, 1, 2, 3, 5
3, 2, 1, 4, 5 Ans: 1, 2, 3, 4, 5
Identify the situations in which a nurse should remove gloves and perform hand
hygiene. (Select all that apply.)
Only after providing wound care
When leaving a patient's room
When all tasks for a patient are completed
When going from a contaminated to a clean site Ans: When leaving a patient's room,
When going from a contaminated to a clean site
A patient asks the nurse why his mouth is so dry after radiation therapy to his head
and neck. What is the most appropriate response from the nurse?
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,"Radiation reduces the flow of saliva."
"Radiation causes the mucous lining of the mouth to become thin."
"It would be best to discuss this with your radiation oncologist."
"Drinking more fluids will help to alleviate the problem." Ans: "Radiation reduces the
flow of saliva."
A patient with chemotherapy-related stomatitis calls the physician's office to talk with
the nurse. What suggestions should the nurse make to help this patient?
Rinse 2 to 3 times a day with an alcohol-based mouthwash and use a water-based
mouth moisturizer afterward.
Rinse the mouth before and after meals and at bedtime with a saltwater or baking soda
solution per protocol, and apply a moisturizing gel to the lips if needed.
Brush the teeth gently with water before each meal and suck on mints to help alleviate
discomfort.
Discomfort and irritation may be minimized by using a toothette sponge moistened
with water to clean the teeth and the oral cavity. Ans: Rinse the mouth before and
after meals and at bedtime with a saltwater or baking soda solution per protocol, and
apply a moisturizing gel to the lips if needed.
When cleansing the eyes, which of the following should the nurse avoid doing?
Cleanse each eye from the outer canthus to the inner canthus.
Avoid cross-contamination by using different parts of the washcloth for each eye.
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, Close the eyelids of the unconscious patient to maintain eye moisture and prevent
injury.
Apply a warm, damp cloth for 2 to 3 minutes to crusts that have formed before
removal. Ans: Cleanse each eye from the outer canthus to the inner canthus.
1. Raise bed to working height and lower side rail from side where you are standing. 2.
Perform hand hygiene and apply gloves. 3. Remove soiled top sheet and bedspread and
place in linen bag. 4. Place bath blanket on patient and assist to a side-lying position
facing away from you. 5. Apply fanfolded bottom sheet, mattress pad, and drawsheet.
6. Lower side rail on remaining side, unfold linens from under patient, and complete
bed making. 7. Raise side rail on completed side and ask patient to turn toward you,
rolling over layered linens to the other side. 8. Place top sheet on patient along with
bedspread or blanket if desired; make foot pleat, tuck, and miter corners at foot of
bed. 9. Position patient, raise side rail, lower bed to lowest position with brakes
locked, and place call light within reach. 10. Assess environment for safety, identify
patient, provide privacy, and explain procedure. Ans: 10, 2, 1, 3, 4, 5, 7, 6, 8, 9
The nurse is caring for a male patient who has asked to be shaved with a disposable
razor. The nurse knows that she will need to take which of the following into
consideration? (Select all that apply.)
The condition of the skin and any irritated or open areas
Laboratory values (e.g., anticoagulation studies such as PT, platelet count) and whether
the patient is receiving anticoagulation therapy, which would indicate a bleeding
tendency
The ability of the patient to help with the procedure and to manipulate the razor
Intake of fluids, to determine hydration of the skin Ans: The condition of the skin and
any irritated or open areas, Laboratory values (e.g., anticoagulation studies such as PT,
platelet count) and whether the patient is receiving anticoagulation therapy, which
would indicate a bleeding tendency
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