Nursing Acceleration Challenge Exam (NACE) I
PN-RN: Foundations of NursingPractice Test
2023 WITH RATIONALES
1. An Alzheimer patient is actively resistive to basic hygiene. However, in order to
meetbasic standards for hygiene, how frequently should the patient be bathed?
Biweekly
Weekly
Two to three times weekly
Daily - Correct answer-Two to three times weekly
While adults don't usually need daily baths, they should bathe two to three times
weekly. Grab bars, shower or tub seats, tub mats, handheld showers, and proper
heating (to avoid chilling the patient) can facilitate more frequent bathing. Mild soap and
bath oil may reduce the drying of skin. Patients who are fearful of tubs and showers,
common with dementia, may receive a sponge bath or Comfort Bath with premoistened,
warmed washcloths. Thick-handled toothbrushes or electric toothbrushes may facilitate
mouth care.
2. At which time of day are patients with cognitive impairment usually MOST sensitive
tosensory overload?
Late evening
Noon
Afternoon
Early morning - Correct answer-Afternoon
Many people are more sensitive to sensory overload in the afternoon when cortisol
levels are highest. Sensory overload most often affects those with cognitive impairment
or those in stressful situations. Excess noise and activity can cause distress, agitation,
confusion, and delirium. Sensory deprivation occurs when there is too little
environmental stimulation because of reduction in sensory input because of hearing or
vision deficits, inability to recognize sensory input because of cognitive impairment, or a
boring environment. Sensory deprivation can contribute to confusion, disorientation, and
depression.
3. Which of the following is characteristic of nociceptive
pain?
Burning, stabbing, or shooting pains
Diffuse or cramping pain
Acute aching or throbbing pain localized to the site of injury
Association with chronic conditions such as diabetes or cancer - Correct answer-Acute
, aching or throbbing pain localized to the site of injury
Nociceptive pain usually correlates with the extent and type of injury: the greater the
injury, the greater the pain. It may be procedural pain (related to wound manipulation
and dressing changes) or surgical pain (related to the cutting of tissue). It may also be
continuous or cyclic, depending upon the type of injury. This type of pain, often
described as aching or throbbing, is usually localized to the area of injury and resolves
over time as healing takes place, and it usually responds to analgesia.
4. According to the three-step World Health Organization (WHO) "analgesic ladder,"
a patient complaining of moderate to severe pain unresponsive to NSAIDs may
requirewhich of the following medications?
Morphine
Demerol
Codeine
Acetaminophen - Correct answer-Codeine
Step 1: Mild to moderate pain is treated with aspirin, acetaminophen, and NSAIDs.
Step 2: Moderate to severe pain unrelieved by Step 1 medications may need opioids,
such as codeine, tramadol, or Percocet.
Step 3: Severe pain without relief from Step 1 or Step 2 medications may need stronger
opioids, such as morphine, Dilaudid, or MS-Contin
5. Which type of precautions is indicated for a patient with a surgical-site infection
andpurulent discharge?
Contact and droplet
Airborne
Droplet
Contact - Correct answer-Contact
6. Which of the following injection sites is the BEST choice for intramuscular
(IM) administration of 3 mL of medication for a well-developed adult female
of normalweight?
Deltoid
Vastus lateralis
Dorsogluteal site
Ventrogluteal site - Correct answer-Ventrogluteal site
The ventrogluteal site is the preferred IM injection site because there is little danger of
injecting into fatty tissue, large nerves, or blood vessels. In a well-developed adult, up to
4 mL can be safely injected. The dorsogluteal site is the least preferred site because of
its proximity to the sciatic nerve and large blood vessels and increased fat deposits. The
vastus lateralis site is also good because it lacks large nerves or large blood vessels.
The deltoid site is usually avoided because of the small muscle size and the proximity of
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