Nurcing assistient Test number 3 study guide
The nursing assistant is transferring a large bundle of soiled linens from a bed to the linen hamper by holding them away from his body. A colleague tells the nursing assistant that he should hold the linens close to his body to maintain good body mechanics. How can the nursing assistant respond to his colleague's advice?
"I don't want to transfer germs from the bedding to my uniform."
When reporting a patient's pain to the nurse, the nursing assistant's statement that is most clinically useful is:
"Mr. Jimenez is having throbbing pain in his knee that he rates at 8/10."
The nursing assistant is to ambulate the patient who has pain from surgery on his right hip. To make the ambulation more tolerable, the nursing assistant:
.wait 30 minutes after the patient received pain medication.
When taking a rectal temperature, the nursing assistant inserts the thermometer into the rectum of an adult:
1 inch.
The patient who is most at risk for an injury from a heat application is:
5-year-old who has muscle spasms.
The nursing assistant takes an axillary temperature on a patient and records the temperature. To represent the site of the temperature, the nursing assistant also records the letter:
A.
Which guideline should the nursing assistant follow when making a bed?
Change linens when they become wet or soiled, regardless of the time of day.
Which practice is correct when handling linens?
Collect linens in the order of use.
A nursing assistant is providing care for a resident who uses continuous positive airway pressure (CPAP) to manage his sleep apnea. Which of the following guidelines should the nursing assistant use when assisting the resident with his CPAP?
Ensure that there is a tight seal between the mask and the resident's nose.
The nurse has asked the nursing assistant to assess a patient's apical heart rate before administering his medication. How should the nursing assistant position a patient to assess the patient's apical pulse?
In a sitting position
The nursing assistant discusses a patient's care needs with a colleague while on a night shift. The nursing assistant becomes aware the colleague is talking quite loudly near the door of a patient's room. The best statement by the nursing assistant is:
Let's go to the nurses' station and talk about this."
What kind of bed is prepared when the sheet, blanket, and bedspread of a bed are turned back, or fanfolded?
Open bed
Which patient of a hospital unit may require a bed protector (soaker pad)?
Patient who has wound with a large amount of drainage
The nursing assistant is aware of the importance of ensuring that a bottom sheet stays snug and unwrinkled. This action is important because wrinkled bottom sheets can cause what problem for the patient's or resident's skin?
Pressure
After helping transfer the patient to a wheelchair, the nursing assistant has gathered her soiled linens into the center of the bed. Which should the nursing assistant do next?
Put the linens in a linen bag or in the linen hamper
The nursing assistant is making an occupied bed. Which is correct? (Select all that apply.)
Raise the bed for good body mechanics. Keep the person in good body alignment. Cover the person with a bath blanket.
When making a bed in a health care facility, which practice should be avoided?
Shaking the linens to remove wrinkles prior to placing on the bed.
The nursing assistant prepares which type of bed for a person arriving on a stretcher?
Surgical
What type of bed is normally left in an elevated position?
Surgical
What is the primary purpose for placing a bed cradle onto a person's bed?
To keep the top linens away from the person's lower extremities
Which patient may benefit most from an air-filled pressure-relieving mattress?
Woman who is immobile and weighs 90 lb
In an unoccupied room or after a person is discharged the bed is prepared as:
a closed bed.
The nursing assistant prevents the spread of infection when using an electronic thermometer by using:
a disposable sheath is used to cover the probe
The patient is in a coma as a result of her recent stroke. Her son and daughter-in-law are concerned that she is too cold as she lies in her hospital bed. The nursing assistant may have to intervene if the children bring in:
an electric blanket.
The nursing assistant controls noise on the health care unit by:
answering phones and signal lights promptly.
Two nursing assistants obtain apical and radial pulse rates at the same time. One nursing assistant states the patient has a pulse deficit of 12 beats per minute. This information would be obtained by the following data:
apical pulse 88 beats per minute, radial pulse 76 beats per minute.
The patient sought medical help after injuring her ankle. She states she "twisted her ankle on a rug in my home." To relieve the patient's pain, the nursing assistant:
applies a commercially prepared ice pack.
The site most likely to have access to a kitchen where a patient may independently prepare a meal is a/an:
assisted-living facility.
The nursing assistant ensures the call light control is kept within the patient's reach:
at all times.
When counting respiratory rate of a patient, the best action of the nursing assistant is to:
avoid telling the patient that the nursing assistant is counting respirations.
The unit is receiving a morbidly obese patient. Prior to his arrival, the nursing assistant obtains a:
bariatric bed.
To prevent the mattress of a resident's bed from sagging the nursing assistant obtains a:
bed board.
A patient has ulcers on his legs that he reports are painful when any item touches his legs. To protect his legs from pain the nursing assistant obtains a:
bed cradle.
The resident has a draining wound. To keep the wound drainage from soiling the bed linens the nursing assistant uses a/an:
bed protector or soaker pad.
Vital signs consist of: (Select all that apply.)
blood pressure. respirations. pulse rate.
The item the nursing assistant may place on a patient's over-bed table is a/an:
box of tissues.
When taking a person's blood pressure, the nursing assistant places the diaphragm of the stethoscope over the:
brachial artery.
A modification that is found in a hospitalized patient's bathroom is a:
call light or intercom system.
Making an occupied bed involves:
changing the linens while the person is still in the bed.
The nursing assistant needs additional supplies when performing a procedure. The nursing assistant obtains these supplies from the:
clean utility room.
Clean, dry, wrinkle-free linens help to prevent:
complications such as pressure ulcers and odors.
Heat application is contraindicated for:
control of bleeding.
A patient is unlikely to be able to customize and personalize his or her environment as home-like in a/an:
critical care unit.
Cold applications provide pain relief because they:
decrease the blood flow to the painful area.
Sleep medications should be used with caution in older adults because the medications can cause:
decreased alertness during the day.
The pressure that is caused by the blood when the heart muscle relaxes is called:
diastolic pressure.
When heat is applied to the skin, blood vessels:
dilate and increase circulation to the area.
The people who are at high risk for injury from heat or cold applications are people who are:
disoriented or taking pain medications.
The health care facility is kept clean by:
each member of the health care team.
The nurse states to the nursing assistant the patient has an increased body temperature. The nursing assistant knows this means the patient is:
febrile.
The nursing assistant is measuring the pulse rate of a patient who is receiving cardiopulmonary resuscitation. The nursing assistant should:
feel for the pulse rate at the carotid or femoral artery.
A patient's weight has increased by 4 lb over the past 72 hours. The nursing assistant interprets this finding as a result of:
fluid accumulation.
The nursing assistant made a mistake while taking the patient's blood pressure. The nursing assistant then:
fully deflates the cuff and waits at least 1 minute before reinflating it.
The nursing assistant should use particular caution when providing a heat application to a resident who:
has a decreased level of consciousness.
The patient who may benefit from being placed in Trendelenburg's position is the patient who:
has low blood pressure and recently fainted.
The hospitalized patient who is likely to experience chronic pain is the patient who:
has rheumatoid arthritis in both knees.
The nursing assistant is taking oral temperatures for a group of patients. The nursing assistant takes a temperature by a different route for those patients who: (Select all that apply.)
have eaten within 15 minutes. recently had teeth extracted. are unconscious.
The resident, age 82, has recently moved to a long-term care facility from her own apartment. She has been experiencing sleep difficulties as she adjusts to her new surroundings. The nursing assistant would recognize that older adults:
have similar sleep needs to younger adults, but often have difficulty achieving sufficient sleep.
The nursing assistant's responsibilities in a hospital include:
helping patients keep their belongings neat and clean.
The nursing assistant uses a mitered corner to:
hold the top sheet, blanket, and bedspread in place.
A young adult with a consistent blood pressure measurement above 150/90 has:
hypertension.
The nurse has asked the nursing assistant to weigh the patient. Before assisting the patient onto the scale, the nursing assistant should ask the patient:
if needs to use the bathroom.
A bedpan for a patient in a hospital is usually stored:
inside the bedside table.
The nursing assistant is showing respect for the patient when she (Select all that apply)
inspects the patient's personal storage area with the patient's permission. closes the curtain or room divider before providing care.
The nursing assistant has finished taking the 28-year-old patient's vital signs, yielding the following data: Temperature: 99.2°F orally Pulse: 88 beats per minute, strong and regular Respiratory rate: 18 breaths per minute, regular depth and rhythm Blood pressure: 148/92 mm Hg The nursing assistant best interprets these data findings as the patient:
is currently hypertensive.
The patient who would most likely receive care in a sub acute care unit is a patient who:
is not well enough to go home, but not sick enough to be in a hospital room.
The nursing assistant takes an oral temperature reading because it:
is simple to do and causes the person minimal discomfort.
The nurse has asked the nursing assistant to obtain and apply a footboard to a new resident's bed. The rationale for using this device is to:
keep the resident's feet in the proper alignment.
The nursing assistant is employed in a hospital. Bed making is part of the job responsibility for the nursing assistant and is important because: (Select all that apply)
keeping the bed linens clean, dry, and wrinkle-free can prevent problems, such as pressure ulcers, from occurring. infections can be spread with inappropriate handling of linens in a hospital. a neat, well-made bed is a sign that the hospital provides capable, competent care to its patients.
The nurse told the nursing assistant that the patient has dyspnea. Dyspnea is described as:
labored or difficult respirations.
The nursing assistant is taking a patient's blood pressure positions the arm:
level with the heart with the palm facing up
The resident, age 83, appears flushed. Her oral temperature is 99.8°F. The conclusion the nursing assistant makes from these data findings is that the resident/resident's:
may be fighting an infection.
The unit of measurement used to record blood pressure is:
millimeters of mercury (mm Hg).
The health care facility uses a numeric pain scale. The patient describes the pain as "6." The nursing assistant knows this pain is being described as:
moderate pain.
The wheels on the patient's bed are unlocked when:
moving the bed to clean under it.
The nursing assistant closes the privacy curtain when the:
nursing assistant is providing personal care for the patient.
The patient in an extended-care facility recently had hip surgery and uses a walker for mobility. To increase his independence, the nursing assistant:
obtains an elevated seat for the commode.
The nursing assistant responded to a call light in a patient's room and finds the patient lying on the floor. Her roommate states that the patient fell immediately after standing up from the edge of her bed. The nursing assistant recognizes the health problem that may have contributed to the patient's fall is:
orthostatic hypotension.
The nursing assistant may be instructed to place a patient in Trendelenburg's position when the:
patient's head needs to be lower than her feet.
The term pulse rhythm is described as the:
pattern of the pulsations and the pauses between each pulsation.
The patient is to receive a moist heat application to her right arm. It is most important for the nursing assistant to remember that moist heat:
penetrates faster and deeper than dry heat.
The nursing assistant has accidentally brought three flat sheets into the resident's room, instead of two. Regarding extra flat sheet the nursing assistant:
places it in the soiled linen hamper.
The nursing assistant is placing a lift sheet on the bed to aid in moving the patient in the bed. The nursing assistant
places the lift sheet so that it extends above the patient's shoulders to below the buttocks.
Odor control in the patient environment is achieved by:
promptly removing and cleaning dirty emesis basins, urinals, bedpans, briefs, and linens.
A nursing assistant is listening to a resident's apical pulse while a colleague palpates the patient's radial pulse. The abnormal finding the nursing assistants are measuring is:
pulse deficit.
The nursing assistant is counting the pulse rate at the most common site. The nursing assistant places his fingers over the:
radial artery.
The nursing assistant protects himself or herself from back injury when making beds by:
raising the bed to a comfortable working height.
The patient is to have heat applied to the leg with an Aquamatic pad, an electric dry heat application. Precautions the nursing assistant takes with this therapy is to:
refill the heating unit if the water level drops below the fill line.
A patient who has lower back pain is receiving a dry heat application in the form of an electric heating pad. When checking the patient's skin, the nursing assistant notes that it is bright red. The nursing assistant responds to this finding by:
removing the heating pad and informing the nurse.
The nursing assistant has used an electronic thermometer to take an adult resident's oral temperature and has obtained a reading of 99.5°F. The nursing assistant interprets this resident's temperature as the:
resident's temperature is near the higher end of the normal range.
To prevent the spread of infection when handling soiled linens the nursing assistant:
rolls the linens toward the center of the bed to confine the soiled area inside.
The nursing assistant responds promptly to a call light and meets the patient's need for:
safety and security.
While working a night shift, the nursing assistant notes that an obese, male patient snores loudly and that his breathing occasionally stops for a few seconds at a time. This observation should signal the nursing assistant to the possibility that the patient may be experiencing:
sleep apnea.
The instrument used to measure blood pressure is a/an:
sphygmomanometer.
The nurse reports to the nursing assistant the patient has orthostatic hypotension. The nursing assistant understands this is a:
sudden decrease in blood pressure that occurs when a person stands up from a sitting or lying position.
The nursing assistant has just finished taking the patient's vital signs. The patient's blood pressure measurement appears abnormal. The nursing assistant's first action is to:
take the blood pressure again and reports findings to the nurse immediately.
The resident is in a coma. When making his bed the nursing assistant:
talks reassuringly to the resident while making his bed explaining the procedure.
The nursing assistant is determining the respiratory rate of a patient whose respirations are irregular by counting:
the number of respirations for 1 full minute.
The nursing assistant rechecks the resident's weight periodically. Rechecking the resident's weight is important because:
the resident's medication dosage may need to be adjusted if he gains or loses weight.
The nursing assistant avoids using his thumb when measuring the pulse rate because the:
thumb has its own pulse rate.
An action of the nursing assistant takes to promote residents' sleep in a long-term care setting is: Your Answer
turning off lights in common areas, provided it is safe to do so.
The day shift nursing assistant is to provide care to a small area of the patient's body. To better able to see the area, the nursing assistant:
uses the over-the-bed light in the patient's room.
Body fluids have leaked through the linens to the rubberized mattress. To properly clean the mattress, the nursing assistant: (Select all that apply.)
wears gloves. uses an appropriate cleaning solution to wipe the mattress.
The nursing assistant places the pillow on the bed:
with the closed end of the pillowcase toward the door and the seam away from the patient's neck.
The best action a nursing assistant can take to prevent dry, cold applications from burning or blistering the skin is:
wrapping the cold plastic or rubber bag in a protective cloth before applying to the skin.
