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Nursing 101 Fundamentals of Nursing Practice for Exam 1, Part 1-questions with answers
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Nursing 101 Fundamentals of Nursing Practice for Exam 1, Part 1-questions with answers
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Nursing 101 Fundamentals of Nursing Practice for Exam 1, Part 1 -questions with answers The rrnurse rrmakes rrthe rrfollowing rrentry rron rrthe rrclient's rrcare rrplan: rr"Goal rrnot rrmet. rrClient rrrefuses rrto rrambulate, rrstating, rr'I rram rrtoo rrafraid rrI rrwill rrfall'." rrThe rrnurse rrshould rrtake rrwhich rrof rrthe rrfollowing rractions? A. rrNotify rrthe rrphysician B. rrReassign rrthe rrclient rrto rranother rrnurse C. rrReexamine rrthe rrnursing rrorders D. rrWrite rra rrnew rrnursing rrdiagnosis rr- rrANSWER: rr rr➡ rrC. rrReexamine rrthe rrnursing rrorders The rrplan rrneeds rrto rrbe rrreassessed rrwhenever rrthe rrgoals rrare rrnot rrmet. rrNursing rrinterventions rrshould rrbe rrexamined rrto rrensure rrthe rrbest rrinterventions rrwere rrselected rrto rrassist rrthe rrclient rrachieve rrthe rrgoal. rrThe rrgoal rrmay rrbe rrappropriate, rrbut rrthe rrclient rrmay rrneed rrmore rrtime rrto rrachieve rrthe rrdesired rroutcome. Which rrof rrthe rrfollowing rroutcome rrgoals rrhas rrthe rrnurse rrdesigned rrcorrectly rrfor rrthe rrpostoperative rrclient's rrplan rrof rrcare? rrSelect rrall rrthat rrapply. A. rrClient rrwill rrstate rrpain rris rrless rrthan rror rrequal rrto rra rr3 rron rra rr0-10 rrpain rrscale B. rrClient rrwill rrhave rrno rrpain C. rrClient rrwill rrstate rrpain rris rrless rrthan rror rrequal rrto rra rr3 rron rra rr0-10 rrpain rrscale rrwithin rr24 rrhours D. rrClient rrwill rrstate rrpain rris rrless rrthan rror rrequal rrto rra rr5 rron rra rr0-10 rrpain rrscale rrby rrtime rrof rrdischarge E. rrClient rrwill rrbe rrmedicated rrevery rr4 rrhours rrby rrthe rrnurse rr- rrANSWER: rr rr➡ rr(C) rrand rr(D) An rroutcome rrgoal rrshould rrbe rrSMART: rrspecific, rrmeasurable, rrappropriate, rrrealistic rrand rrtimely. Twenty rrminutes rrafter rradministering rrpain rrmedication rrto rrthe rrclient, rrthe rrnurse rrreturns rrto rrask rrif rrthe rrclient's rrlevel rrof rrpain rrhas rrdecreased. rrThe rrnurse rrdocuments rrthe rrclient's rrresponse rras rrpart rrof rrwhich rrphase rrof rrthe rrnursing rrprocess? rrA. rrDiagnosis rrB. rrPlanning rrC. rrImplementation rrD. rrEvaluation rr- rrANSWER: rr rr➡ rrD. rrEvaluation rr Evaluating rris rrthe rrprocess rrof rrcomparing rrclient rrresponses rrto rrthe rroutcome rrgoals rrto rrdetermine rrwhether, rror rrto rrwhat rrdegree, rrgoals rrhave rrbeen rrmet. rrDiagnosing rridentifies rrhealth rrproblems, rrrisks, rrand rrstrengths. rrPlanning rris rrthe rrformulation rrof rrclient rrgoals rrand rrnursing rrstrategies rr(interventions) rrrequired rrto rrprevent, rrreduce, rror rreliminate rrthe rrclient's rrhealth rrproblems. rrImplementing rris rrcarrying rrout rror rrdelegating rrthe rrnursing rrinterventions. The rrnurse rrwould rruse rrwhich rrmethod rrof rrexamination rrto rrassess rrfor rrthe rrpresence rrof rra rrbruit rrin rrthe rrabdomen? rrA. rrAuscultation rrB. rrPercussion rrC. rrPalpitation rrD. rrInspection rr- rrANSWER: rr rr➡ rrA. rrAuscultation Auscultation rruses rrthe rrsense rrof rrhearing rrto rridentify rrsounds rrthat rrare rrnormal rrand rrabnormal rrduring rrthe rrassessment. rrA rrbruit rris rran rrabnormal rrsound rrof rrthe rrvenous/arterial rrsystem rrthat rris rronly rrdetectable rrby rrlistening rrwith rra rrstethoscope. rrA rrbruit rrcannot rrbe rrdetected rrby rrpercussion rror rrinspection. rrThe rrturbulent rrblood rrflow rrthat rris rrheard rras rra rrbruit rrwould rrbe rrpalpated rras rra rrthrill. In rrorder rrto rrexamine rrthe rrocular rrmobility rrof rra rrclient rrwho rrrecently rrexperienced rra rrstroke, rrthe rrnurse rrshould rrexamine rrwhich rrof rrthe rrfollowing rrcranial rrnerves? rrSelect rrall rrthat rrapply. rrA. rrCranial rrNerves rrI rrand rrVII rrB. rrCranial rrNerves rrII rrand rrV rrC. rrCranial rrNerves rrIII rrand rrIV rrD. rrCranial rrNerve rrVI rrE. rrCranial rrNerve rrIX rr- rrANSWER: rr rr➡ rrC. rrCranial rrNerves rrIII rrand rrIV D. rrCranial rrNerve rrVI Evaluation rrof rrocular rrmotility rrprovides rrinformation rrabout rrthe rrextra rrocular rrmuscles; rrthe rrorbit; rrcranial rrnerves rrIII, rrIV, rrand rrVI; rrtheir rrbrain rrstem rrconnections; rrand rrthe rrcerebral rrcortex. rrCranial rrnerves rrI, rrVII, rrand rrIX, rrrespectively, rrassess rrsmell, rrfacial rrmovement, rrswallowing, rrand rrthe rrtongue. A rrclient rrwho rris rralert rrand rrresponsive rrwas rradmitted rrdirectly rrfrom rrthe rrphysician's rroffice rrwith rra rrdiagnosis rrof rr"rule rrout rracute rrmyocardial rrinfarction." rrOf rrthe rrfollowing rralterations rrfound rron rrthe rrinitial rrassessment, rrwhich rris rrof rrgreatest rrconcern rrto rrthe rrnurse? A. rrBlood rrpressure rrsupine rris rr138/76 B. rrRespirations rrare rr28 rrand rrlabored C. rrTemperature rris rr99.8 rrF D. rrThere rrare rrinfrequent rrmissed rrapical rrbeats rr- rrANSWER: rr rr➡ rrB. rrRespirations rrare rr28 rrand rrlabored Using rrthe rrprinciples rrof rrthe rrABCs rr(airway, rrbreathing, rrand rrcirculation), rran rralteration rrin rrrespiration rris rralways rra rrprimary rrconcern. rrA rrdisturbance rrin rrnormal rrventilation rr(rate rr16-20) rris rroccurring rrsecondary rrto rrthe rrmedical rrdiagnosis rrof rrmyocardial rrinfarction. rrThe rrblood rrpressure rrremains rrin rracceptable rrrange, rrand rrthe rrslight rrtemperature rrelevation rris rrlikely rrrelated rrto rrthe rroverall rrinflammatory rrresponse rrof rrthe rrbody. rrInfrequent rrabnormalities rrof rrcardiac rrrhythm rrare rrcommon rrand rrshould rrbe rrof rrconcern rrwhen rrappearing rrfrequently rror rrwith rrlonger rrduration. The rrnurse rrpreparing rrto rrassess rrfor rrjugular rrvenous rrdistention rr(JVD) rrplaces rrthe rrclient rrinto rrwhich rrposition? rrA. rrSupine rrwith rrhead rrof rrthe rrbed rrelevated rr30 rrdegrees rrB. rrSupine rrwith rrneck rrplaced rrdownward rron rrchest rrC. rrHigh -fowler's rrwith rrhead rrelevated rrupward rrD. rrSide -lying rrwith rrno rrpillows rrunder rrthe rrhead rr- rrANSWER: rr rr➡ rrA. rrSupine rrwith rrhead rrof rrthe rrbed rrelevated rr30 rrdegreesThe benefits of buying summaries with Stuvia:
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