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(UF) NUR 3737C PRINCIPLES OF PERSONALIZED NURSING CARE 1 FINAL EXAM
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(UF) NUR 3737C PRINCIPLES OF PERSONALIZED NURSING CARE 1 FINAL EXAM
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(UF) NUR 3737C PRINCIPLES OFPERSONALIZED NURSING CARE 1 FINAL
EXAM
A patient with a 3-day history of a stroke that left her confused and unable
to communicate returns from interventional radiology following placement
of a gastrostomy tube. The patient had been taking hydrocodone/APAP
5/325 up to four tablets/day before her stroke for the past year to manage
her arthritic pain. The health care provider's order reads as follows:
"Hydrocodone/APAP 5/325 1 tab, per gastrostomy tube, q4h, prn." Which
action by the nurse is most appropriate?
1. No action is required by the nurse because the order is appropriate.
2. Request to have the order changed to around the clock (ATC) for the
first 48 hours.
3. Ask for a change of medication to meperidine (Demerol) 50 mg IVP, q3h,
prn.
4. Begin the hydrocodone/APAP when the patient shows nonverbal
symptoms of pain. - ✔✔ANSW✔✔..2. Request to have the order changed
to around the clock (ATC) for the first 48 hours.
Place the following steps in the correct order for administration of patient-
controlled analgesia:
1. Insert drug cartridge into infusion device and prime tubing.
2. Wipe injection port of maintenance IV line vigorously with antiseptic
swab for 15 seconds and allow to dry.
3. Demonstrate to patient how to push medication demand button.
4. Secure connection and anchor PCA tubing with tape.
5. Instruct patient to notify a nurse for possible side effects or changes in
the severity or location of pain.
6. Insert needleless adapter into injection port nearest patient.
,7. Apply clean gloves. Check infuser and patient-control module for
accurate labeling or evidence of leaking.
8. Program computerized PCA pump as ordered to deliver prescribed
medication dose and lockout interval.
9. Attach needleless adapter to tubing adapter of patient- controlled
module. - ✔✔ANSW✔✔..3. Demonstrate to patient how to push medication
demand button.
5. Instruct patient to notify a nurse for possible side effects or changes in
the severity or location of pain.
7. Apply clean gloves. Check infuser and patient-control module for
accurate labeling or evidence of leaking.
1. Insert drug cartridge into infusion device and prime tubing.
9. Attach needleless adapter to tubing adapter of patient- controlled
module.
2. Wipe injection port of maintenance IV line vigorously with antiseptic
swab for 15 seconds and allow to dry.
6. Insert needleless adapter into injection port nearest patient.
4. Secure connection and anchor PCA tubing with tape.
8. Program computerized PCA pump as ordered to deliver prescribed
medication dose and lockout interval.
When teaching a patient about transcutaneous electrical nerve stimulation
(TENS), which of the following represent an accurate description of the
nonpharmacological therapy? (Select all that apply.)
1. Turn TENS on before patient feels discomfort.
2. TENS works peripherally and centrally on nerve receptors.
3. TENS does not require a health care provider order.
4. Remove any skin preparations before aaching TENS electrodes.
5. Placing electrodes directly over or near the pain site works best. -
✔✔ANSW✔✔..2. TENS works peripherally and centrally on nerve
receptors.
4. Remove any skin preparations before aaching TENS electrodes.
5. Placing electrodes directly over or near the pain site works best.
Match the characteristics on the left with Acute Pain or Chronic Pain
A. has a protective effect
B. lasts more than 3 to 6 months
,C. usually has identifiable causes
D. dramatically affects quality of life
E. viewed as a disease
F. eventually resolves with or without treatment - ✔✔ANSW✔✔..Acute
pain: a, c, f
Chronic pain: b, d, e
A patient has been on contact isolation for 4 days because of a hospital-
acquired infection. He has had few visitors and few opportunities to leave
his room. His ambulation is also still limited. Which are the correct nursing
interventions to reduce sensory deprivation? (Select all that apply.)
1. Teaching how activities such as reading and using crossword puzzles
provide stimulation
2. Moving him to a room away from the nurses' station
3. Turning on the lights and opening the room blinds
4. Sitting down, speaking, touching, and listening to his feelings and
perceptions
5. Providing auditory stimulation for the patient by keeping the television on
continuously - ✔✔ANSW✔✔..1. Teaching how activities such as reading
and using crossword puzzles provide stimulation
3. Turning on the lights and opening the room blinds
4. Sitting down, speaking, touching, and listening to his feelings and
perceptions
The home care nurse is instructing an assistive personnel about
interventions to facilitate location of items for patients with vision
impairment. Which are effective strategies for enhancing a patient's
impaired vision? (Select all that apply.)
1. Use of fluorescent lighting
2. Use of warm incandescent lighting
3. Use of yellow or amber lenses to decrease glare
4. Use of adjustable blinds, sheer curtains, or draperies
5. Indirect lighting to reduce glare - ✔✔ANSW✔✔..2. Use of warm
incandescent lighting
3. Use of yellow or amber lenses to decrease glare
4. Use of adjustable blinds, sheer curtains, or draperies
, In general, most children are not developmentally or physiologically ready
for toilet training until which age:
1-2
2-3
3-4
4-5 - ✔✔ANSW✔✔..2-3
The nurse would use which of the following scales to help clients identify
the characteristics of their bowel movements?
Morse Fall Scale
Norton Scale
Braden Scale
Bristol Stool Scale - ✔✔ANSW✔✔..Bristol Stool Scale
A nurse is working with a client who experiences constipation. The nurse
recognizes that additional education is needed when the client states the
following:
a) "I should plan for routine physical activity to help improve my bowel
habits."
b) "I plan to drink at least 1,500ml of fluids per day to help promote a
regular bowel movement."
c) "Fiber is a really important aspect of my diet that I should plan to
incorporate more often."
d) "I plan to take my stimulant laxative every day for at least the next 6
months to make sure it's working." - ✔✔ANSW✔✔..d) "I plan to take my
stimulant laxative every day for at least the next 6 months to make sure it's
working."
Which of the following does not need to be irrigated?
Colostomy
Ileostomy - ✔✔ANSW✔✔..Ileostomy
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