PrepU Fundamentals of Nursing N1 QUIZ 1

The nurse is preparing to perform handwashing. What are the steps?

1. Turn on the faucet and adjust force and temperature of the water. 2. Wet the hand and wrists. 3. Apply soap. 4. Wash the palms and backs of the hands for at least 20 seconds. 5. Pat the hands dry with a paper towel. 6. Turn the faucet off with a paper towel.

A nurse is engaged in a nurse-client relationship. Which communication techniques would be important for the nurse to avoid? Select all that apply. False reassurance Giving advice Exploring Silence Summarizing

False reassurance Giving advice

Which technique would a nurse employ when using listening skills appropriately when interviewing a client? The nurse would try to avoid body gestures when listening to the client. The nurse would not allow conversation to lapse into periods of silence. The nurse would listen to the themes in the client's comments. The nurse would stand close to the client and maintain eye contact.

The nurse would listen to the themes in the client's comments.

Establishing the criteria for the education and licensure of nurses is a component of: a state's nurse practice act. the ANA Standards of Practice. the U.S. Department of Health and Human Services' Healthy People 2020 document. evidence-based practice.

a state's nurse practice act.

The student nurse is practicing communication skills by talking with several different clients in the hospital. In which instances would silence be appropriate? Select all that apply. allowing the client time to reflect on his thoughts reflecting on the communication that has occurred after asking the client a question when the client is upset and needs time to compose himself when the nurse doesn't know the answer to a question

allowing the client time to reflect on his thoughts reflecting on the communication that has occurred after asking the client a question when the client is upset and needs time to compose himself

It is acceptable for the nurse to accept a verbal order from the physician in which situation? during a medical emergency upon admission of the client to the unit immediately prior to discharge prior to the client leaving the floor for therapy

during a medical emergency

What are the values of the caring, professional nurse identified by the American Association of Colleges of Nursing (AACN)? Select all that apply. sympathy integrity human dignity self-sacrifice autonomy

integrity human dignity autonomy

Which characteristic would indicate a professional relationship? Select all that apply. focus on both parties involved needs reflective of the current situation open self-disclosure by the nurse relationship terminated with goal achievement assessment of needs for enjoyment

needs reflective of the current situation relationship terminated with goal achievement

The nurse is assessing a new client's blood pressure, using a manual sphygmomanometer. Which sound constitutes the client's systolic blood pressure? the first appearance of faint but distinctive tapping sounds the last sound before there is complete and continuous silence the first sound that is audible after the auscultatory gap the transition from tapping sounds to muffled sounds

the first appearance of faint but distinctive tapping sounds

A client who underwent a hysterectomy 4 days ago says to the nurse, "I wonder if I'll still feel like a woman." Which response would most likely encourage the client to expand on this and express her concerns in more specific terms? "Do you feel like you are not a woman?" "Do you want more children?" "Feel like a woman . . ." Remaining silent

"Feel like a woman . . ." This response is a reflective comment, which allows the client to reflect and elaborate on her feelings. Remaining silent is a skill that is appropriate many times, but not the most appropriate in the situation at hand. Asking a yes/no question such as "Do you want more children?" does not encourage the client to reflect and elaborate on her feelings. The question "When did you begin to wonder about this?" does not direct the client in a direction for more reflection on her feelings.

A nurse is conducting a health history for a client with a chronic respiratory problem. What question might the nurse ask to assess for orthopnea? "Do you have problems breathing when you walk up stairs?" "Does your medication help you breathe better?" "How many pillows do you sleep on at night to breathe better?" "Tell me about your breathing difficulties since you stopped smoking."

"How many pillows do you sleep on at night to breathe better?" Orthopnea is shortness of breath (dyspnea) that occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair.

When performing fall risk assessments, which client does the nurse determine is most at risk for falls? A 50-year-old male being cared for in an unfamiliar health care environment A 60-year-old male with weakness in his left side and slowed reaction time A 70-year-old female with postural hypotension who wears eyeglasses, but has no history of falls An 80-year-old female with a history of falling last year and breaking a hip

A 70-year-old female with postural hypotension who wears eyeglasses, but has no history of falls

The Quality and Safety Education for Nurses (QSEN) initiative has identified which key competencies for nurses? Select all that apply. A. Client-centered care B. Teamwork and collaboration C. Evidence-based practice D. Quality improvement E. Correct documentation

A, B, C, D Client-centered care Teamwork and collaboration Evidence-based practice Quality improvement

Based on its jurisdiction, which actions may a state licensing board of nursing take? Select all that apply. A. Allow graduates of approved schools of nursing to take the NCLEX B. Authorize nurses to practice nursing in any state C. License nurses during the lifetime of the holder D. Deny licensing due to criminal actions E. Protect nurses from being suspended for professional misconduct F. Issue special licenses to nurses practicing in long-term care facilities as a priority

A, C, D Allow graduates of approved schools of nursing to take the NCLEX License nurses during the lifetime of the holder Deny licensing due to criminal actions

The nurse is using the nursing process to plan care for a client who has just been admitted to the hospital. Place in order the steps of the nursing process that the nurse would use for this client. Use all options. A. The nurse observes that the client is short of breath, coughing, and expectorating thick, yellow sputum. B. The nurse administers an intravenous antibiotic every 12 hours. C. The nurse evaluates lung sounds and vital signs for effectiveness of treatment. D. The nurse plans to teach the client about deep breathing, coughing sputum into a tissue, and disposing of the tissue in an appropriate receptacle. E. The nurse analyzes the data and determines that the client is experiencing an oxygenation problem.

A, E, D, B, C 1. The nurse observes that the client is short of breath, coughing, and expectorating thick, yellow sputum. 2. The nurse analyzes the data and determines that the client is experiencing an oxygenation problem. 3. The nurse plans to teach the client about deep breathing, coughing sputum into a tissue, and disposing of the tissue in an appropriate receptacle. 4. The nurse administers an intravenous antibiotic every 12 hours. 5. The nurse evaluates lung sounds and vital signs for effectiveness of treatment.

A nurse is applying the nursing process and is in the diagnosis phase. With which activities would the nurse be involved? Select all that apply. Collecting subjective and objective data Organizing data Analyzing data Identifying patterns Identifying indicators of potential dysfunction

Analyzing data Identifying patterns Identifying indicators of potential dysfunction

The following are prescriptions on a client's chart. Which of these are using acceptable abbreviations and are correctly stated? Select all that apply. zolpidem 5 mg po at hs psyllium 1 packaged dose po mixed in 8 ounces OJ daily DNR digoxin .125 mg po every day HCTZ 50 mg twice daily obtain clean catch UA

DNR obtain clean catch UA

The nurse is caring for a client that is disoriented and places the client in soft wrist restraints to discourage pulling at a nasogastric tube. Which nursing action is appropriate? (Select all that apply.) Obtain order from a licensed provider within 1 hour of restraint application. Withhold information from family regarding restraints due to HIPAA. Check circulation and skin condition every 2 hours. Offer regular, frequent opportunities for toileting. Maintain restraints until discharge.

Obtain order from a licensed provider within 1 hour of restraint application. Check circulation and skin condition every 2 hours. Offer regular, frequent opportunities for toileting.

A nurse is documenting client care in the client's health record. When recording the information, which abbreviation would be appropriate for the nurse to use? Select all that apply. D/C per OS PO mL cc

PO mL

The nurse is caring for a client that is agitated and combative. What action can the nurse take other than the use of physical restraints? Select all that apply Medicate with benzodiazepines and sleeping agents. Reduce stimulation, noise, and light. Place all four side rails up Provide a safe environment Distract and redirect in a commanding voice. Use simple, clear explanations and directions. Use a large plant or piece of furniture as a barrier to limit wandering from designated area.

Reduce stimulation, noise, and light. Provide a safe environment Use simple, clear explanations and directions. Use a large plant or piece of furniture as a barrier to limit wandering from designated area.

When assessing a client's vital signs, a nursing student has explained to the client each of their next actions prior to assessing the client's temperature, pulse, and blood pressure. However, the nursing student did not announce their intention to assess the client's respiratory rate prior to measuring it. What is the rationale for the nursing student's decision to withhold this information? The client may alter the rate of respirations if the client is aware that his breaths are being counted. The nurse likely assessed the client's respiratory rate simultaneous when counting the heart rate. Temperature, pulse, and blood pressure are more volatile than respiratory rate. Tachypnea is an expected finding among hospitalized individuals.

The client may alter the rate of respirations if the client is aware that his breaths are being counted.

Which activity takes place during the working phase of the nurse-client relationship? Select all that apply. The client participates actively in the relationship. The client genuinely expresses concerns to the nurse. The client identifies the goals accomplished in the relationship. The client describes the role that the nurse plays in the relationship. The client and nurse identify goals of the relationship.

The client participates actively in the relationship. The client genuinely expresses concerns to the nurse.

A nurse is documenting care for clients in a hospital setting. Which documenting errors may potentially increase the nurse's risk for legal problems? Select all that apply. The content reflects client needs. The content includes descriptions of situations that are out of the ordinary. The content is not in accordance with professional standards. There are lines between the entries. The documentation is not countersigned. Dates and times of entries are omitted.

The content is not in accordance with professional standards. There are lines between the entries. Dates and times of entries are omitted.

The nursei s developing helping relationships with clients during their care. Which statements describe qualities of a helping relationship? Select all that apply. The helping relationship occurs spontaneously. The helping relationship is characterized by an equal sharing of information. The helping relationship is built on the client's needs, not on those of the helping person. A friendship must develop from an effective helping relationship. A helping relationship is dynamic. A helping relationship is purposeful and time limited.

The helping relationship is built on the client's needs, not on those of the helping person. A helping relationship is dynamic. A helping relationship is purposeful and time limited.

The nurse is using nonverbal communication when caring for a group of clients. Which situation reflects non-verbal communication? Select all that apply. The nurse is maintaining eye contact when changing a client's dressing The nurse documents on the SBAR form and sends it to the transferring unit The nurse gives a brochure to a client upon discharge The nurse has a smile when being thanked for caring for a family member The nurse is using a quiet tone of voice

The nurse is maintaining eye contact when changing a client's dressing The nurse has a smile when being thanked for caring for a family member The nurse is using a quiet tone of voice

Which nursing actions help improve listening skills when conversing with clients? Select all that apply. The nurse sits with the client with arms crossed. The nurse always maintains eye contact with the client in a face-to-face pose. The nurse uses appropriate facial expressions and body gestures to indicate attention to what the client is saying. The nurse thinks before responding to the client, even if this creates a lull in the conversation. The nurse listens for themes in the client's comments. If an action being performed does not allow for conversation, the nurse pretends to listen to the client rather than interrupting the client's conversation.

The nurse uses appropriate facial expressions and body gestures to indicate attention to what the client is saying. The nurse thinks before responding to the client, even if this creates a lull in the conversation. The nurse listens for themes in the client's comments.

The nurse is interviewing a client who is newly admitted to the unit. Which techniques used by the nurse will facilitate communication during the interview? Select all that apply. Use broad opening statements. Share observations. Use silence. Use reassuring clichés. Give approval.

Use broad opening statements. Share observations. Use silence.

The nurse is orienting a new graduate nurse and reviewing documentation. Which documentation performance would include best practices for charting? Select all that apply. Use long narratives to be sure that the documentation is understood. Always use complete sentences. Use only approved abbreviations. Always use the client's name and words referring to the client in each entry. Use partial sentences and phrases.

Use only approved abbreviations. Use partial sentences and phrases.

A physician tells the nurse that nursing is a discipline, but not a profession. Which criteria should the nurse utilize to demonstrate that nursing is increasingly recognized as a profession? Select all that apply. Well-defined body of knowledge Code of ethics Ongoing research Regulation by the medical profession Sets standards

Well-defined body of knowledge Code of ethics Ongoing research Sets standards

The nurse is preparing to measure a client's rectal temperature. Which supplies and equipment should the nurse have available before beginning the procedure? Select all that apply. an electronic thermometer with a rectal probe disposable probe cover water-soluble lubricating gel sterile gloves a bedpan

an electronic thermometer with a rectal probe disposable probe cover water-soluble lubricating gel

The nurse is caring for several clients on a telemetry unit. Which clients' pulse rates need to be assessed for 1 full minute? Select all that apply. clients with abnormally slow pulse rates clients with regular rhythms clients with irregular pulse rates clients recovering from anesthesia clients with fast pulse rates

clients with abnormally slow pulse rates clients with irregular pulse rates clients with fast pulse rates

During discharge planning, the nurse is assessing home safety for a client who has repeatedly fallen. Which condition increases the client's risk for falls? Select all that apply. climbs two flights of stairway to get to his bedroom prefers to use the bathtub when taking a bath drinks 2 shots of alcoholic beverages before dinner takes a diuretic pill early in the morning uses non-skid socks all day

climbs two flights of stairway to get to his bedroom prefers to use the bathtub when taking a bath drinks 2 shots of alcoholic beverages before dinner takes a diuretic pill early in the morning

A nurse is caring for a client with orthostatic hypotension. Which nursing interventions are appropriate to decrease the risk of falls? Select all that apply. encourage oral fluid intake encourage slow movement from the bed to the chair encourage intake of protein-rich foods encourage removal of compression stockings encourage the client to use the call light prior to getting out of bed encourage the use of the call light for help to the bathroom

encourage oral fluid intake encourage slow movement from the bed to the chair encourage the client to use the call light prior to getting out of bed encourage the use of the call light for help to the bathroom

When taking a telephone order from a physician, the nurse verifies that they understand the order by: repeating the order back to the physician. faxing the written order to the physician's office. asking the physician to summarize the orders given. confirming the order with the nurse manager.

repeating the order back to the physician.

When communicating with a client, the nurse uses reflection for which purpose? to have the client elaborate on thoughts and feelings to determine the sequence of events in the conversation to investigate the situation to help problem solve to keep the client on the topic of concern

to have the client elaborate on thoughts and feelings The reflective question technique involves repeating what the person has said or describing the person's feelings. It encourages patients to elaborate on their thoughts and feelings. Exploring helps clients express their concerns and solve their problems by investigating the situation, exploring how they feel about it, and what some alternatives might be. Focusing helps the client stay on the topic. Sequencing determines events in chronological order.