Final Exam: NR224/ NR 224 Fundamentals – Skills Final Exam Review| Comprehensive Guide with Verified Answer| (2023/2024) Latest Update| 100% Correct |Chamberlain

Final Exam: NR224/ NR 224 Fundamentals – Skills Final Exam Review| Comprehensive Guide with Verified Answer| (2023/2024) Latest Update| 100% Correct |Chamberlain Q: A nurse is explaining to a group of nursing students the various factors that can affect a client's heart rate. List 5 factors that can cause tachycardia and 5 factors that can cause bradycardia. Answer: Tachycardia: -Exercise -Fever/heat -Anxiety -Loss of blood -Positive chronotropic drugs Bradycardia: -Hypothermia -Long-term exercise(athletes) -Unrelieved severe pain -Negative chronotropic drugs -Lying down Q: A nurse is preparing to complete a set of vital signs. What assessment questions should be asked regarding blood pressure? How is a cuff select- ed? Where is it placed? Why does this matter? Answer: What assessment questions should be asked regarding blood pressure? Have you have AV fistulas or a mastectomy? How is a cuff selected? Based on the size of the clients arm Where is it placed? Align cuff artery mark with brachial artery Why does this matter? Ensures that proper pressure is applied during inflation Q: A nurse obtains a blood pressure reading of 140/92 on a client admitted after a surgical procedure. The client denies any history of hypertension. Which of the following actions should the nurse take first? A. Contact the provider and request a prescription for a medication to de- crease the blood pressure B. Have another nurse obtain the blood pressure C. Return in 30 minutes and retake the blood pressure D. Ask the client if they are having any pain Answer: C. Return in 30 minutes and retake the blood pressure Q: A nurse is instructing unlicensed assistive personnel (UAP) about caring for a client with low platelet count. Which of the following instructions is the priority for measuring vital signs in this client? A. Avoid rectal temperatures B. Count radial pulse for 30 seconds and multiply by 2 C. Have client rest for 5 minutes before assessing HR, RR, or BP D. Assess for nail polish prior to placing pulse oximeter Answer: A. Avoid rectal temperatures Q: The Unlicensed Assistive Personnel (UAP) provides you with vital signs on your clients. Which client would you see first based on the following information? A. 88-year-old male client admitted with pneumonia, RR 28, SPo2 89% B. 50-year-old female client admitted after surgery for repair of fractured leg with BP 160/86 and HR 72 C. 60-year-old male client with venous ulcer from diabetes with Temp 99. 1 F and HR 84 D. 75-year-old female client post surgical from mastectomy of left breast 2 days ago with RR 22, BP 148/62 Answer: A. 88-year-old male client admitted with pneumonia, RR 28, SPo2 89% Q: Which of the following clients are at most risk for tachypnea? (select all that apply) A. Client admitted with several rib fractures B. Woman who is 9 months pregnant C. A client admitted with hypothermia D. A postop client waking from general anesthesia E. A 3 pack per day smoker with pneumonia Answer: A. Client admitted with several rib fractures B. Woman who is 9 months pregnant E. A 3 pack per day smoker with pneumonia Q: Risk Factors for Pressure Ulcer Development Answer: -Very thin and very obese people -Age related changes -Fluid loss during illness -Moisture/fluids/stool against the skin -Diseases of the skin -Immobility -Comorbidities Q: Skin assessment Answer: -Color -Odor -Consistency -Amount -Measurements(Length x width x depth) -Type of tissue(granulation, eschar, slough) Q: Healing process Answer: Primary Intention: Wound that is closed Secondary Intention: Wound edges not approximated Tertiary Intention: Wound that is left open for several days; then wo approximated