NSG 3023 CHAPTER 29 QUIZ
NSG 3023 CHAPTER 29 QUIZ
Chapter 29: Hygiene
Potter: Essentials for Nursing Practice, 8th Edition
MULTIPLE CHOICE
1. The nurse is working on a long-term rehabilitation unit, is providing care for a 46-year-old
woman who was the victim of a violent crime and suffered ...
1. The nurse is working on a long-term rehabilitation unit, is providing care for a 46-year-old
woman who was the victim of a violent crime and suffered a head injury. The patient has an
endotracheal tube, which is secured with tape. The tape is crusted with dried secretions. The
nurse is providing personal hygiene for the patient and needs to replace the tape. What is the
best way for the nurse to remove the tape?
a. Soak it with warm moist washcloths.
b. Pull it gently away from the skin.
c. Saturate it with denatured alcohol.
d. Soak it with adhesive remover.
ANS: A
When patients have nasogastric, feeding, or endotracheal tubes inserted through the nose,
change the tape, anchoring the tube at least once a day. When the tape becomes moist from
nasal secretions, the skin and mucosa can easily become macerated (softened by soaking).
Friction from a tube causes tissue injury. Anchor tubing correctly with tape or fixative
devices to minimize tension or friction on the nares. Pulling away gently is preferred after
soaking with warm moist clothes. Alcohol and adhesive remover are not recommended.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 773
OBJ: Correctly perform hygiene procedures for the care of the patient’s skin, perineum,
feet and nails, mouth, eyes, ears, and nose. TOP: Nursing Process: Implementation
MSC: Client Needs: Management of Care
2. The student nurse caring for a 56-year-old patient with acquired immunodeficiency
syndrome (AIDS). While providing oral care for the patient the student nurse notes that the
gums are reddened and bleed easily. The student nurse identifies this as a sign of what
condition?
a. Dental caries
b. Gingivitis
c. Oral herpes
d. Thrush
ANS: B
Gingivitis is inflammation of the gums, and dental caries is tooth decay produced by
interaction of food with bacteria that forms plaque. Thrush is a yeast infection in the mouth
and oral herpes are open sores in the mouth around the mucous membrane.
PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: 748-749
OBJ: Discuss conditions that place patients at risk for impaired oral mucous membranes.
TOP: Nursing Process: Assessment MSC: Client Needs: Basic Care and Comfort
, 3. A 25-year-old patient was admitted to the surgical floor wearing contact lenses. Assistive
personnel ask the nurse if contact lenses need special attention. The nurse informs the
assistive personnel that non–extended-wear contacts left in the eyes for an extended period
of time can cause which of the following?
a. Blindness
b. Corneal injury
c. Otitis externa
d. Otitis media
ANS: B
Corneal injury can occur in patients who leave their contacts in for an extended period of
time. Patients are admitted to hospitals or agencies in unresponsive or confused states.
Remove contact lenses, and rinse lenses and eyes with a sterile saline solution. Physical
limitations create inability to safely insert or remove contact lenses or to cleanse the lenses.
Contact lenses cannot cause blindness, otitis externa, or otitis media.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 772
OBJ: Correctly perform hygiene procedures for the care of the patient’s skin, perineum,
feet and nails, mouth, eyes, ears, and nose. TOP: Nursing Process: Implementation
MSC: Client Needs: Reduction of Risk Potential
4. A 45-year-old woman with diabetes who has been hospitalized with diabetic ketoacidosis.
Which of the following is most important for the nurse to assess during bath time?
a. Skin bruising
b. Condition of teeth
c. Sensation to the foot
d. Skin folds for dirt
ANS: C
Assess patients with diseases that affect peripheral circulation and sensation for the
adequacy of circulation and sensation of the feet. Palpate the dorsalis pedis and posterior
tibial pulses and assess for intact sensation to light touch, pinprick, and temperature. Foot
ulceration is the most common single risk factor for lower extremity amputations among
persons with diabetes. The other responses are necessary to assess but not the highest
priority for this patient with a diabetic diagnosis.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 754
OBJ: Explain the importance of foot care for the patient with diabetes.
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
5. A nursing student who is working on a postsurgical unit assisting patients with personal
hygiene plans to provide a back rub to each of her patients. The nursing student discusses
the importance of this activity because research demonstrates that it enhances patient
comfort and relaxation with the nurse assigned to these patients. The nurse instructs her that
back rubs would be contraindicated on which of the following patients?
a. A 56-year-old patient with a colon resection
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