Test your basic knowledge |

Nursing Fundamentals 3

Instructions:

Answer 50 questions in 30 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What is a definition of a delusion?
Nursing dx
A false - fixed belief that cannot be corrected through reasoning.
The result is accurate patient dB
Best heard over large airways due to secretions in lungs - sounds like gurgles - snorts

2. Asking a patient what would you do if there is a fire in the wastebasket - is a way to assess their
ID'ing status of exisiting problems and locating new issues
Fast and deep respirations seen in patient's with acidosis
Toddler
Abstract thinking

3. Blood passes through the heart valves In what order?
Tricuspid - mitral and the aortic
Nurse
Approach from front - walk slow - stand to side - crouch low - offer hand - call by name - wait for response
Symptoms

4. The fifth vital sign is
Pain
Functional decline - cardiovascular distress - incontinence - pressure ulcers - aggitation - muscle atrohpy
Decision assessment
Medical

5. Ongoing assessments are useful in

6. If an abnormal finding is revealed during assessment - the nurse should
Preschool is cause and effect - school age begins to use logical thought process.
Double check equip and patient
Paradoxical reaction
No

7. Name the 5 'W's' of assessing a change in LOC
Confusion Assessment Method
Pain
Wind (hypoxia/pneumonia) - water (UTI/dehydration) - wound (infection/sepsis) - walk (DVT - showering clots) and weird (new drugs)
Symptoms

8. Data gathered via instrumention (pulse ox) is considered
No
Have them do simple math problems
EdFED- Q
Objective

9. Are changes in vital signs a reliable indicator of chronic pain?
No
Hearing loss
To ID the problem
Nurse

10. The purpose of an intitial assement serves to?
No
Medical
Assess over all health status and identify the problem
Fast and deep respirations seen in patient's with acidosis

11. Types of hearing loss include
Stroke volume x's heart rate
Functional decline - cardiovascular distress - incontinence - pressure ulcers - aggitation - muscle atrohpy
Sensorineural (auditory or cortical nerve - or brain stem malfunction) - conductive (bones in middle ear) - mixed (damage to inner/middle/outer ear or auditory nerve)
To simulate eating motions with the hands

12. Describe the purpose of a mental status exam
To simulate eating motions with the hands
Viral infection
Loss of taste
Defining a baseline of cognitive function - any changes or deviations from norm.

13. At What age do you begin to use logical thought process?
School age childen
Pt's underlying feelings
Hygeine - DOB - work hx
Symptoms

14. What is the nursing process?
A systematic method for organizing and delivering effective and efficient goal centric nursing care based on problem solving principles.
Decreased arterial perfusion
Decision assessment
A personal experience that does whatever the person in pain says it does

15. A patient failing to answer questions or displaying a reluctance to participate in group or family activities may be experiencing
Delerium has stimulus that is misinterpreted - whereas a halluciantion has no stimulus.
Confusion Assessment Method
Hearing loss
Trauma or illness

16. When dealing with a confused patient - should the nurse acknowledge the patient's underlying feelings or the content of the delusion?

17. Sleep deprivation can effect
Learning - memory and adaptation to stress
# of packs per day x # of years smoked
Pain
Have them do simple math problems

18. Side effects of putting confused pts in restraints include
Vesicular (peripheral lung areas)
Functional decline - cardiovascular distress - incontinence - pressure ulcers - aggitation - muscle atrohpy
A systematic method for organizing and delivering effective and efficient goal centric nursing care based on problem solving principles.
Risk of falls increases

19. Once a medical dx has been made - who is accountable for the reporting s/s of complications?
Nurse
Surgically implanted device for deaf or hard or hearing - also called bionic ear.
Sensorineural (auditory or cortical nerve - or brain stem malfunction) - conductive (bones in middle ear) - mixed (damage to inner/middle/outer ear or auditory nerve)
Have them do simple math problems

20. An example of a primary source is
Having to use more than one pillow when sleeping
Medical
Snap - crackle - pops; velcro - bubble wrap
The patient

21. Nursing dx provides basis of
Trauma or illness
Interventions for which the nurse is accountable
Communicate using hands and eyes.
Decision assessment

22. What is the difference between hallucination and delirium?
Delerium has stimulus that is misinterpreted - whereas a halluciantion has no stimulus.
Functional decline - cardiovascular distress - incontinence - pressure ulcers - aggitation - muscle atrohpy
Maslow
Pain

23. What does CAM stand for
Surgically implanted device for deaf or hard or hearing - also called bionic ear.
Confusion Assessment Method
Decision assessment
Double check equip and patient

24. At What age do you begin to put thoughts into words?
Trauma or illness
ID'ing status of exisiting problems and locating new issues
Toddler
Bacterial infection

25. What would cause changes in congitive development later in life (middle adulthood)?
Secondary soureces (family - friends)
Trauma or illness
Objective
Sensory motor

26. Where can you hear bronchovesicular breath sounds?
Pain
ID'ing status of exisiting problems and locating new issues
Hygeine - DOB - work hx
Anteriorly @ intercostal spaces 1 and 2. Posteriorly between the scapulae.

27. A nursing dx is best described as
Edema
Sensory motor (birth - 2 years) - Preoperational (2-7) - Concrete operational (7-11) - Formal operational (11- adult)
Clinical judement about a patient - family or community response to actual or potential health problems and life processes.
Nurse

28. At What age do you begin to use decision making?
Clinical judement about a patient - family or community response to actual or potential health problems and life processes.
Adolescence
Nurse
Confusion Assessment Method

29. What is the formula for determining pack years?
Best heard over large airways due to secretions in lungs - sounds like gurgles - snorts
Stroke volume x's heart rate
The result is accurate patient dB
# of packs per day x # of years smoked

30. When a patient has increased neutrophils - this may indicate what?
Fluid volume deficit related to poor intake
Hearing loss
Have them do simple math problems
Bacterial infection

31. Expiration sounds are heard longer than inspiration In What area?
Decreased arterial perfusion
Disorganized thinking and altered LOC
Sensory motor (birth - 2 years) - Preoperational (2-7) - Concrete operational (7-11) - Formal operational (11- adult)
Broncial (heard over trachea)

32. What is the difference between a nursing dx and a med dx?
Med dx often involves problems with organ systems or disease and is the reason for admission to the hospital
Sensory motor (birth - 2 years) - Preoperational (2-7) - Concrete operational (7-11) - Formal operational (11- adult)
The patient
Functional decline - cardiovascular distress - incontinence - pressure ulcers - aggitation - muscle atrohpy

33. What is the cognitive difference between a preschooler and schoolage child?
Preschool is cause and effect - school age begins to use logical thought process.
Nursing dx
A systematic method for organizing and delivering effective and efficient goal centric nursing care based on problem solving principles.
Bacterial infection

34. What is a component of the cognitive part of critical thinking skills?
Best heard over large airways due to secretions in lungs - sounds like gurgles - snorts
Bacterial infection
Knowing What to do/how to make a decision based upon available data.
Hearing loss

35. Examples of personal information
Pt's with oxygenation and perfusion problems
Hygeine - DOB - work hx
Focused
Pain in legs assoc w walking

36. When a patient has increased lymphocytes - this may indicate what?
Trend assessment (shift report)
Viral infection
Decreased arterial perfusion
Loss of taste

37. When performing an ongoing assessment for a patient with disturbed thinking the nurse should be sure to include
Level of stress - risk for violence - anxiety level - patient unmet needs
Anteriorly @ intercostal spaces 1 and 2. Posteriorly between the scapulae.
Learning - memory and adaptation to stress
Ongoing assessment

38. A patient that is dying is on morphine. The family is concerned the prs breathing will stop. What is the correct RN response?

39. Factors that may reduce the efficacy of pulse oximetry include
Initial assessment
To simulate eating motions with the hands
Nailpolish - skin color - too bright light - poor peripheral blood flow - patient is too cold - low HgB levels -
Sensorineural (auditory or cortical nerve - or brain stem malfunction) - conductive (bones in middle ear) - mixed (damage to inner/middle/outer ear or auditory nerve)

40. Would a nursing dx be part of the primary or secondary dx?
Immature immune system - structures close together lends to easy spreading from on area to another.
Toddler
Secondary
A personal experience that does whatever the person in pain says it does

41. What do rhonchi sound like?
Best heard over large airways due to secretions in lungs - sounds like gurgles - snorts
Maslow
Focused
Knowing What to do/how to make a decision based upon available data.

42. Intermittent claudication is caused by?
Defining a baseline of cognitive function - any changes or deviations from norm.
Bacterial infection
Decreased arterial perfusion
Med dx often involves problems with organ systems or disease and is the reason for admission to the hospital

43. Orthopnea is described as?
A systematic method for organizing and delivering effective and efficient goal centric nursing care based on problem solving principles.
Having to use more than one pillow when sleeping
Pt's with oxygenation and perfusion problems
A personal experience that does whatever the person in pain says it does

44. When performing an interview with a patient with vision loss - select the correct questions for obtaining an accurate vision history
Eye hygeine - accomodating factors - what was the level of decline - how long has it been
Secondary
Nailpolish - skin color - too bright light - poor peripheral blood flow - patient is too cold - low HgB levels -
Sensory motor

45. What do rales sound like?
8.4
Abstract thinking
Objective
Snap - crackle - pops; velcro - bubble wrap

46. Ageusia is
Toddler
Decreased arterial perfusion
Paradoxical reaction
Loss of taste

47. Data validation assures
Trauma or illness
The result is accurate patient dB
Ongoing assessment
Fast and deep respirations seen in patient's with acidosis

48. When using restraints in a confused patient
Risk of falls increases
Edema
Surgically implanted device for deaf or hard or hearing - also called bionic ear.
ID'ing status of exisiting problems and locating new issues

49. If patient reports pain of 3 on scale of 0-10 - What is the appropriate class of pain reliever?
Non - opiod (ex: NSAID/acetominaphen)
Hemoglobin
Pain
Decision assessment

50. A potential adverse rx of chemically restraining a confused patient would be
Long and s/t memory - attention - ability to calculate problems/abstract thinking - delusions/perceptual disturbances
Paradoxical reaction
Assess over all health status and identify the problem
Pain in legs assoc w walking