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Nursing Fundamentals 3

Instructions:

Answer 50 questions in 15 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. Examples of personal information
An 80 y/o patient that has emergency surgery
Disorganized thinking and altered LOC
Hygeine - DOB - work hx
Bacterial infection

2. When performing an interview with a patient with vision loss - select the correct questions for obtaining an accurate vision history
Daily
Double check equip and patient
Eye hygeine - accomodating factors - what was the level of decline - how long has it been
Focused

3. Where can wheezes best be heard?
Upper airways
Secondary
Communicate using hands and eyes.
Disorganized thinking and altered LOC

4. What is a definition of a delusion?
Ongoing assessment
Family - spouse - someone other than a healthcare worker - previous medical records.
A false - fixed belief that cannot be corrected through reasoning.
A personal experience that does whatever the person in pain says it does

5. Expiration sounds are heard longer than inspiration In What area?
Pulmonary artery - left atrium - mitral valve - left ventricle - aortic valve
Upper airways
Broncial (heard over trachea)
Irregular respirations (fast/slow) often seen at end of life

6. What are the components of a mental status exam that are not part of a regular assessment?
Surgically implanted device for deaf or hard or hearing - also called bionic ear.
Med dx often involves problems with organ systems or disease and is the reason for admission to the hospital
Medical
Long and s/t memory - attention - ability to calculate problems/abstract thinking - delusions/perceptual disturbances

7. Why are young children at greater risk for respiratory infection?
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)
Edema
Immature immune system - structures close together lends to easy spreading from on area to another.

8. Diabetes is a _________ dx
ADPIE - Assessment - Dx - Planning - Implentation and Evaluation
Medical
To ID the problem
Hygeine - DOB - work hx

9. What are the ABCDE's of pain management?
Ask - Believe - Choose - Deliver - Empower
Pulmonary artery - left atrium - mitral valve - left ventricle - aortic valve
Objective
Maslow

10. When speaking with a patient with moderate hearing loss the RN should
Level of stress - risk for violence - anxiety level - patient unmet needs
Delerium has stimulus that is misinterpreted - whereas a halluciantion has no stimulus.
Communicate using hands and eyes.
Sensory motor (birth - 2 years) - Preoperational (2-7) - Concrete operational (7-11) - Formal operational (11- adult)

11. What is the correct approach when dealing with older adults?
EdFED- Q
Hemoglobin
Approach from front - walk slow - stand to side - crouch low - offer hand - call by name - wait for response
Vesicular (peripheral lung areas)

12. The fifth vital sign is
Pain
Initial assessment
Non - opiod (ex: NSAID/acetominaphen)
Nurse

13. An ongoing assessment is performed
Daily
Snap - crackle - pops; velcro - bubble wrap
Med dx often involves problems with organ systems or disease and is the reason for admission to the hospital
A false - fixed belief that cannot be corrected through reasoning.

14. What would cause changes in congitive development later in life (middle adulthood)?
Stroke volume x's heart rate
The result is accurate patient dB
Trauma or illness
Maslow

15. When a patient has increased neutrophils - this may indicate what?
Double check equip and patient
# of packs per day x # of years smoked
To simulate eating motions with the hands
Bacterial infection

16. The order of air flow into the lungs is
Decreased sense of taste
A false - fixed belief that cannot be corrected through reasoning.
Nares - nasopharynx - trachea - bronchi - broncioles - alveoli
Pt's underlying feelings

17. What is responsible for transporting O2 in the blood
The process of storing - learning - retrieving - and using info.
Eye hygeine - accomodating factors - what was the level of decline - how long has it been
Trend assessment (shift report)
Hemoglobin

18. The purpose of an initial assessment is
Eye hygeine - accomodating factors - what was the level of decline - how long has it been
Ongoing assessment
To ID the problem
Communicate using hands and eyes.

19. Which patient would be most likely to experience sensory overload?
An 80 y/o patient that has emergency surgery
8.4
Pain on inspiration and expiration; superficial squeaking or grating
Edema

20. An example of a nursing dx would be
Approach from front - walk slow - stand to side - crouch low - offer hand - call by name - wait for response
To simulate eating motions with the hands
Vesicular (peripheral lung areas)
Fluid volume deficit related to poor intake

21. Asking a patient what would you do if there is a fire in the wastebasket - is a way to assess their
Decision assessment
Abstract thinking
Pain on inspiration and expiration; superficial squeaking or grating
Family - spouse - someone other than a healthcare worker - previous medical records.

22. Describe the purpose of a mental status exam
To ID the problem
Pulmonary artery - left atrium - mitral valve - left ventricle - aortic valve
Decreased sense of taste
Defining a baseline of cognitive function - any changes or deviations from norm.

23. The path of blood from the lungs to the heart is
Data collection - data validation - data organization - data analysis - and data reporting/recording.
Decreased arterial perfusion
Pulmonary artery - left atrium - mitral valve - left ventricle - aortic valve
Sensorineural (auditory or cortical nerve - or brain stem malfunction) - conductive (bones in middle ear) - mixed (damage to inner/middle/outer ear or auditory nerve)

24. Where can you hear bronchovesicular breath sounds?
Have them do simple math problems
Inattention and acute increase/decrease in cognitive function
Anteriorly @ intercostal spaces 1 and 2. Posteriorly between the scapulae.
Adolescence

25. The assessment that includes the patient's overhall health status
# of packs per day x # of years smoked
Initial assessment
Adolescence
Sensory motor (birth - 2 years) - Preoperational (2-7) - Concrete operational (7-11) - Formal operational (11- adult)

26. An example of a secondary source is
Symptoms
Ongoing assessment
Functional decline - cardiovascular distress - incontinence - pressure ulcers - aggitation - muscle atrohpy
Family - spouse - someone other than a healthcare worker - previous medical records.

27. A patient failing to answer questions or displaying a reluctance to participate in group or family activities may be experiencing
Hearing loss
Nailpolish - skin color - too bright light - poor peripheral blood flow - patient is too cold - low HgB levels -
Pain
Preschool is cause and effect - school age begins to use logical thought process.

28. What scale is used to determine eating and feeding issues in adults with confusion
Hemoglobin
ID'ing status of exisiting problems and locating new issues
Sup/inferior vena cava - into the r/atrium - tricuspid - rt ventricle - pulmonary veins
EdFED- Q

29. Would a nursing dx be part of the primary or secondary dx?
Objective
Long and s/t memory - attention - ability to calculate problems/abstract thinking - delusions/perceptual disturbances
Level of stress - risk for violence - anxiety level - patient unmet needs
Secondary

30. What is the formula for cardiac output?

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31. What are Piaget's stages of cognitive development
Functional decline - cardiovascular distress - incontinence - pressure ulcers - aggitation - muscle atrohpy
Decreased sense of taste
Eye hygeine - accomodating factors - what was the level of decline - how long has it been
Sensory motor (birth - 2 years) - Preoperational (2-7) - Concrete operational (7-11) - Formal operational (11- adult)

32. A patient that is easily fatigued may have a HgB lab value of?
Decreased sense of taste
Risk of falls increases
8.4
Ask - Believe - Choose - Deliver - Empower

33. Data from the last 24/48 hours that included patterns would be a part of
Trend assessment (shift report)
Tricuspid - mitral and the aortic
Nursing
Irregular respirations (fast/slow) often seen at end of life

34. Orthopnea is described as?
Having to use more than one pillow when sleeping
Pt's with oxygenation and perfusion problems
Trend assessment (shift report)
Risk of falls increases

35. What is cognition?
Paradoxical reaction
Surgically implanted device for deaf or hard or hearing - also called bionic ear.
Trend assessment (shift report)
The process of storing - learning - retrieving - and using info.

36. Once a medical dx has been made - who is accountable for the reporting s/s of complications?
Vesicular (peripheral lung areas)
Immature immune system - structures close together lends to easy spreading from on area to another.
Nurse
Hemoglobin

37. All body system data is not necessary which type of assessment
Risk of falls increases
Long and s/t memory - attention - ability to calculate problems/abstract thinking - delusions/perceptual disturbances
Focused
EdFED- Q

38. If patient reports pain of 3 on scale of 0-10 - What is the appropriate class of pain reliever?
Learning - memory and adaptation to stress
Edema
Non - opiod (ex: NSAID/acetominaphen)
Data collection - data validation - data organization - data analysis - and data reporting/recording.

39. What is the cognitive difference between a preschooler and schoolage child?
Preschool is cause and effect - school age begins to use logical thought process.
To simulate eating motions with the hands
Best heard over large airways due to secretions in lungs - sounds like gurgles - snorts
Communicate using hands and eyes.

40. The site where gas exchange occurs is
Daily
Having to use more than one pillow when sleeping
Nursing
Capillaries

41. What is pain?
Snap - crackle - pops; velcro - bubble wrap
Hemoglobin
Fluid volume deficit related to poor intake
A personal experience that does whatever the person in pain says it does

42. Data gathered via instrumention (pulse ox) is considered
Objective
Hygeine - DOB - work hx
Hearing loss
Sensory motor (birth - 2 years) - Preoperational (2-7) - Concrete operational (7-11) - Formal operational (11- adult)

43. When noticing a patient with dementia has stopped eating - the RN's first response is?
Pulmonary artery - left atrium - mitral valve - left ventricle - aortic valve
Defining a baseline of cognitive function - any changes or deviations from norm.
To simulate eating motions with the hands
Maslow

44. Types of hearing loss include
No
Sensorineural (auditory or cortical nerve - or brain stem malfunction) - conductive (bones in middle ear) - mixed (damage to inner/middle/outer ear or auditory nerve)
Family - spouse - someone other than a healthcare worker - previous medical records.
ID'ing status of exisiting problems and locating new issues

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

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46. What is the purpose of the nursing process?
Interventions for which the nurse is accountable
Functional decline - cardiovascular distress - incontinence - pressure ulcers - aggitation - muscle atrohpy
Serves to expedite dx and tx of actual and potential health problems
Nurse

47. One way to test a person's cognitive ability and abstract thinking ability would be to
Have them do simple math problems
Anteriorly @ intercostal spaces 1 and 2. Posteriorly between the scapulae.
ID'ing status of exisiting problems and locating new issues
Trend assessment (shift report)

48. What factors may indicate plural rub?
Pain on inspiration and expiration; superficial squeaking or grating
Decreased arterial perfusion
Learning - memory and adaptation to stress
Pain

49. ABG's would be an important lab value for What types of patient's?

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50. The path of blood from the heart to the lungs is
Confusion Assessment Method
Focused
Decision assessment
Sup/inferior vena cava - into the r/atrium - tricuspid - rt ventricle - pulmonary veins