,1. Multiple Choice: Which of the following is a critical step in the
management of a patient with a suspected stroke?
A) Immediate administration of oral anticoagulants
B) Assessment for thrombolytic therapy eligibility
C) Placement in a supine position
D) Administration of high-flow oxygen
Correct Answer: B) Assessment for thrombolytic therapy
eligibility
Rationale: Rapid assessment for thrombolytic therapy is crucial
in the management of a stroke to determine if the patient is a
candidate for this treatment, which can significantly improve
outcomes if administered within the appropriate time frame.
2. Fill-in-the-Blank: The most common early sign of a pressure
ulcer in an immobilized patient is ________.
Correct Answer: Non-blanchable erythema
Rationale: Non-blanchable erythema indicates persistent
redness and is often the first sign of skin damage that may
progress to a pressure ulcer if not addressed promptly.
3. True/False: Hyperglycemia is less detrimental to wound
healing than hypoglycemia.
Correct Answer: False
Rationale: Both hyperglycemia and hypoglycemia can impair
wound healing. However, hyperglycemia can lead to increased
infections and delayed wound healing due to its effects on the
immune system and blood flow.
, in a healthcare setting?
A) Regularly scheduled toileting rounds
B) Use of high-top shoes for all patients
C) Bed alarms for high-risk patients
D) Adequate lighting in patient rooms
Correct Answers: A) Regularly scheduled toileting rounds, C)
Bed alarms for high-risk patients, D) Adequate lighting in patient
rooms
Rationale: Scheduled toileting, bed alarms, and adequate
lighting are evidence-based interventions that reduce the risk of
falls. High-top shoes are not a standard part of fall prevention
protocols.
5. Multiple Choice: In administering blood transfusions, what is
the primary nursing intervention to prevent acute hemolytic
reactions?
A) Pre-medication with antihistamines
B) Double-checking blood type compatibility
C) Warming the blood to body temperature
D) Infusing the blood slowly over four hours
Correct Answer: B) Double-checking blood type compatibility
Rationale: Ensuring blood type compatibility is the most critical
step in preventing acute hemolytic reactions during blood
transfusions.
6. Fill-in-the-Blank: The recommended angle for inserting a
needle during an intramuscular injection is ________ degrees.
Correct Answer: 90
Rationale: A 90-degree angle ensures that the needle reaches
deep into the muscle tissue for proper medication absorption.
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