Nurs 311 Exam UPDATED ACTUAL QUESTIONS
AND CORRECT ANSWERS
What will the nurse instruct nursing assistive personnel (NAP) to do when measuring a
patient's rectal temperature using an electronic thermometer? - CORRECT
ANSWER Use the probe with the red tip.
what contraindicates taking a rectal temperature measurement - CORRECT
ANSWER Patient has painful and swollen hemorrhoids.
Which nursing action best evaluates the effectiveness of an antipyretic medication in a patient
with an oral temperature of 101.6°F? - CORRECT ANSWER Assess oral temperature
30 minutes after the agent is administered.
Which instruction might the nurse give to nursing assistive personal (NAP) that is applicable
only to tympanic temperature assessment? - CORRECT ANSWER Gently tug the
pinna backward, up, and out before inserting the probe.
Which instruction might the nurse give to nursing assistive personnel (NAP) that is
applicable only to temporal artery temperature assessment? - CORRECT
ANSWER Place the sensor flush on the patient's forehead.
During the admissions process, the nurse initially assesses the patient's radial pulse primarily
for what purpose? - CORRECT ANSWER Establishment of a baseline as part of the
patient's vital signs
What will the nurse instruct nursing assistive personal (NAP) to do when measuring an adult
patient's radial pulse? - CORRECT ANSWER Palpate the patient's inner wrist on the
thumb side with the fingertips of your two middle fingers.
What is the nurse's priority action if a patient's radial pulse has an irregular rhythm? -
CORRECT ANSWER Assess the patient for a pulse deficit.
,Inadequate oxygenation to the body will cause the radial pulse to become: - CORRECT
ANSWER Tachycardic
Which action would best assess the effect of exercise on a patient's radial pulse
measurement? - CORRECT ANSWER Measuring the patient's radial pulse before and
after exercise
Which action can the nurse take to keep a patient from consciously controlling his or her
breathing during an assessment? - CORRECT ANSWER Assess respiration after
measuring the pulse.
On the last assessment of a patient's respiration, her respiratory rate was 10 breaths per
minute. What should the nurse do when conducting the next assessment of this patient's
respiratory rate? - CORRECT ANSWER Count breaths for 60 seconds.
When measuring a patient's respiratory rate, the nurse will count the number of completed
respiratory cycles per minute. What is the definition of a respiratory cycle? - CORRECT
ANSWER The number of inspirations and expirations per minute.
During the assessment of a patient's respiratory rate, when the second hand reaches the 15-
second mark, the respiratory count is 8. What should the nurse do at this time? - CORRECT
ANSWER Continue to count the patient's breaths for a full 60 seconds.
The nurse plans to assess a patient's respiratory rate; however, the patient has just returned
from ambulating to the bathroom. What should the nurse do to minimize the effect of
exercise on the patient's respiratory rate? - CORRECT ANSWER Encourage the
patient to rest for 10 minutes before assessing respiration.
The nurse is preparing to assess a patient's blood pressure. What would cause the blood
pressure reading to be inaccurately high? - CORRECT ANSWER Blood pressure cuff
is too loose around the arm
What would cause the nurse to delay the assessment of a patient's blood pressure? -
CORRECT ANSWER Patient has just finished having a cigarette
, The nurse has just measured a patient's blood pressure and is waiting 2 minutes to measure
the pressure again. What is the purpose of taking two measurements? - CORRECT
ANSWER Minimize the effect of anxiety
The nurse is teaching a patient about ways to reduce blood pressure. What will the nurse
include in these instructions? - CORRECT ANSWER Ensure that your diet has an
adequate daily intake of calcium.
Where should the nurse measure the blood pressure of a patient recovering from a left-sided
mastectomy? - CORRECT ANSWER Use the right arm to take the blood pressure.
The nurse is planning to measure a patient's blood pressure. What does the systolic
measurement represent? - CORRECT ANSWER The pressure exerted against the
arterial wall.
You have assigned a new nursing assistive personnel (NAP) to take routine vital signs. You
notice that the NAP's last three patients have had unusually low blood pressure that you have
had to confirm. What is the most likely reason the NAP is obtaining falsely low blood
pressure readings? - CORRECT ANSWER The blood pressure cuff is too wide for arm
circumference.
What should the nurse do if the patient's blood pressure is not within normal limits? -
CORRECT ANSWER This is the correct response, because the patient must be
assessed for possible cardiovascular problems.
What would the nurse do to prevent the spread of infection when assessing a patient's blood
pressure? - CORRECT ANSWER Clean the stethoscope with alcohol before and after
using it.
You have assigned a new nursing assistive personnel (NAP) to take routine vital signs. An
experienced NAP has been asked to retake a blood pressure that the newly hired NAP has
taken three times this week. As the nurse, what action do you take? - CORRECT
ANSWER Observe the NAP as she obtains a blood pressure and pulse on a patient.
AND CORRECT ANSWERS
What will the nurse instruct nursing assistive personnel (NAP) to do when measuring a
patient's rectal temperature using an electronic thermometer? - CORRECT
ANSWER Use the probe with the red tip.
what contraindicates taking a rectal temperature measurement - CORRECT
ANSWER Patient has painful and swollen hemorrhoids.
Which nursing action best evaluates the effectiveness of an antipyretic medication in a patient
with an oral temperature of 101.6°F? - CORRECT ANSWER Assess oral temperature
30 minutes after the agent is administered.
Which instruction might the nurse give to nursing assistive personal (NAP) that is applicable
only to tympanic temperature assessment? - CORRECT ANSWER Gently tug the
pinna backward, up, and out before inserting the probe.
Which instruction might the nurse give to nursing assistive personnel (NAP) that is
applicable only to temporal artery temperature assessment? - CORRECT
ANSWER Place the sensor flush on the patient's forehead.
During the admissions process, the nurse initially assesses the patient's radial pulse primarily
for what purpose? - CORRECT ANSWER Establishment of a baseline as part of the
patient's vital signs
What will the nurse instruct nursing assistive personal (NAP) to do when measuring an adult
patient's radial pulse? - CORRECT ANSWER Palpate the patient's inner wrist on the
thumb side with the fingertips of your two middle fingers.
What is the nurse's priority action if a patient's radial pulse has an irregular rhythm? -
CORRECT ANSWER Assess the patient for a pulse deficit.
,Inadequate oxygenation to the body will cause the radial pulse to become: - CORRECT
ANSWER Tachycardic
Which action would best assess the effect of exercise on a patient's radial pulse
measurement? - CORRECT ANSWER Measuring the patient's radial pulse before and
after exercise
Which action can the nurse take to keep a patient from consciously controlling his or her
breathing during an assessment? - CORRECT ANSWER Assess respiration after
measuring the pulse.
On the last assessment of a patient's respiration, her respiratory rate was 10 breaths per
minute. What should the nurse do when conducting the next assessment of this patient's
respiratory rate? - CORRECT ANSWER Count breaths for 60 seconds.
When measuring a patient's respiratory rate, the nurse will count the number of completed
respiratory cycles per minute. What is the definition of a respiratory cycle? - CORRECT
ANSWER The number of inspirations and expirations per minute.
During the assessment of a patient's respiratory rate, when the second hand reaches the 15-
second mark, the respiratory count is 8. What should the nurse do at this time? - CORRECT
ANSWER Continue to count the patient's breaths for a full 60 seconds.
The nurse plans to assess a patient's respiratory rate; however, the patient has just returned
from ambulating to the bathroom. What should the nurse do to minimize the effect of
exercise on the patient's respiratory rate? - CORRECT ANSWER Encourage the
patient to rest for 10 minutes before assessing respiration.
The nurse is preparing to assess a patient's blood pressure. What would cause the blood
pressure reading to be inaccurately high? - CORRECT ANSWER Blood pressure cuff
is too loose around the arm
What would cause the nurse to delay the assessment of a patient's blood pressure? -
CORRECT ANSWER Patient has just finished having a cigarette
, The nurse has just measured a patient's blood pressure and is waiting 2 minutes to measure
the pressure again. What is the purpose of taking two measurements? - CORRECT
ANSWER Minimize the effect of anxiety
The nurse is teaching a patient about ways to reduce blood pressure. What will the nurse
include in these instructions? - CORRECT ANSWER Ensure that your diet has an
adequate daily intake of calcium.
Where should the nurse measure the blood pressure of a patient recovering from a left-sided
mastectomy? - CORRECT ANSWER Use the right arm to take the blood pressure.
The nurse is planning to measure a patient's blood pressure. What does the systolic
measurement represent? - CORRECT ANSWER The pressure exerted against the
arterial wall.
You have assigned a new nursing assistive personnel (NAP) to take routine vital signs. You
notice that the NAP's last three patients have had unusually low blood pressure that you have
had to confirm. What is the most likely reason the NAP is obtaining falsely low blood
pressure readings? - CORRECT ANSWER The blood pressure cuff is too wide for arm
circumference.
What should the nurse do if the patient's blood pressure is not within normal limits? -
CORRECT ANSWER This is the correct response, because the patient must be
assessed for possible cardiovascular problems.
What would the nurse do to prevent the spread of infection when assessing a patient's blood
pressure? - CORRECT ANSWER Clean the stethoscope with alcohol before and after
using it.
You have assigned a new nursing assistive personnel (NAP) to take routine vital signs. An
experienced NAP has been asked to retake a blood pressure that the newly hired NAP has
taken three times this week. As the nurse, what action do you take? - CORRECT
ANSWER Observe the NAP as she obtains a blood pressure and pulse on a patient.
