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Fundamentals of Nursing 3rd Edition Wilkinson Treas Smith Test Bank

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Fundamentals of Nursing 3rd Edition Wilkinson Treas Smith Test Bank

ISBN-13: 978-0803640771

ISBN-10: 0803640773

 

 

Description

Fundamentals of Nursing 3rd Edition Wilkinson Treas Smith Test Bank

ISBN-13: 978-0803640771

ISBN-10: 0803640773

 

 

 

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Below you will find some free nursing test bank questions from this test bank:

Chapter 25. Facilitating Hygiene

 

MULTIPLE CHOICE

 

  1. During morning care, the patient asks the nurse to shave him with a disposable razor. Before shaving him, the nurse should:
a) Have him sign a permission form
b) Check to see whether the patient is taking anticoagulants
c) Tell him that only a family member may shave a patient
d) Position him flat in bed

 

 

ANS:  B

If the patient is taking anticoagulant medication or has a bleeding disorder, he is at risk for bleeding. You should use an electric razor, not a disposable razor that may nick the patient’s skin.

 

Difficulty: Easy

Nursing Process: Interventions

Client Need: PHSI

Cognitive Level: Application

 

PTS:   1

 

  1. The nurse is caring for a patient admitted with a closed head injury. Which action by the nurse is appropriate when providing hygiene for this patient?
a) Avoid bathing the patient.
b) Use cool water for bathing.
c) Provide care in short intervals.
d) Rub briskly when towel drying.

 

 

ANS:  C

The nurse should provide care in short intervals to avoid overstimulating the patient, thereby causing a rise in his intracranial pressure. It is not necessary to avoid bathing the patient. Using cool water to bathe the patient may cause shivering, which may elevate intracranial pressure and increase metabolic demands. Rubbing briskly when drying might also overstimulate, leading to an elevation in intracranial pressure.

 

Difficulty: Difficult

Nursing Process: Interventions

Client Need: PHSI

Cognitive Level: Application

 

PTS:   1

 

  1. During the bath, the nurse observed that the patient has dry skin. The best action by the nurse is to:
a) Bathe the patient more frequently.
b) Use an emollient on the dry skin.
c) Massage the skin with warm water.
d) Discourage fluid intake.

 

 

ANS:  B

Use an emollient on the dry skin

Using an emollient will aid in soothing dry skin. Frequent bathing will increase dryness, as will discouraging fluids. Massaging skin with water will not play a role in improving dry skin.

 

Difficulty: Easy

Nursing Process: Interventions

Client Need: Safe and Effective Care

Cognitive Level: Analysis

 

PTS:   1

 

  1. The nurse is about to bathe a female patient who has an intravenous line, and needs to remove her gown. The nurse should:
a) Temporarily disconnect the IV tubing at a point close to the patient and thread it through the gown.
b) Cut the gown with scissors to allow the arm to be easily removed from gown.
c) Thread the bag and tubing through the gown sleeve, keeping the line intact.
d) Disconnect the tubing, thread it through the gown, and reconnect the tubing.

 

 

ANS:  C

Thread the bag and tubing through the gown sleeve, keeping the line intact.

If the patient has an IV line and is wearing a gown that does not have snap-open sleeves, the nurse should remove the gown first from the arm without the IV, then lower the IV container, and pass the gown over the tubing and the container, taking care to keep the container above the level of the patient’s arm. Using this technique will keep blood from backing up into the IV line. Manipulating the IV equipment may change the flow rate; flow rate must be maintained as prescribed. The nurse should not disconnect the IV tubing; this breaks the sterile system and provides a portal of entry for pathogens.

 

Difficulty: Moderate

Nursing Process: Interventions

Client Need: PHSI

Cognitive Level: Application

 

PTS:   1

 

  1. For which patient can the nurse safely delegate morning care to the nursing assistive personnel (NAP)? Assume an experienced NAP, and base your decision on patient condition. Assume there are no complications other than the conditions stated.
a) 32-year-old admitted with a closed head injury
b) 76-year-old admitted with septic shock
c) 62-year-old who underwent surgical repair of a bowel obstruction 2 days ago
d) 23-year-old admitted with an exacerbation of asthma with dyspnea on exertion

 

 

ANS:  C

Morning care for the patient who underwent surgical repair of a bowel 2 days ago can be safely delegated to the nursing assistive personnel because the patient should be stable. The patient who sustained a closed head injury may develop increased intracranial pressure during care. Therefore, he requires the critical-thinking skills of a registered nurse to perform his morning care safely. The patient admitted with septic shock may easily become unstable with care; therefore, a registered nurse is required to provide his morning care safely. The patient admitted with an exacerbation of asthma who becomes short of breath with activity also requires the critical-thinking skills of a registered nurse to detect respiratory compromise quickly.

 

Difficulty: Difficult

Nursing Process: Interventions

Client Need: Safe and Effective Care

Cognitive Level: Analysis

 

PTS:   1

 

  1. A client’s epidermis has insufficient melanin. Which nursing diagnosis is appropriate?
a) Risk for Infection
b) Risk for Impaired Skin Integrity
c) Risk for Deficient Fluid Volume
d) Impaired Skin Integrity

 

 

ANS:  B

The epidermis contains melanin, a pigment that protects against the sun’s ultraviolet rays; therefore, a person with insufficient melanin is at risk for Impaired Skin Integrity (sunburn). There are no symptoms to indicate that the client has a sunburn, only that a risk factor is present. The dermis contains blood and lymphatic vessels, nerves, bases of hair follicles, and sebaceous and sweat glands; melanin does not prevent fluid loss. Fibroblasts (not melanin), also found in the dermis, produce new cells and assist in wound healing, thereby helping to prevent infection.

 

Difficulty: Moderate

Nursing Process: Diagnosis

Client Need: HPM

Cognitive Level: Analysis

 

PTS:   1

 

  1. When making an occupied bed, which of the following is most important for the nurse to do?
a) Keep the bed in the low position.
b) Keep the siderail raised on both sides of the bed.
c) Move back and forth between the sides of the bed when adjusting linens.
d) Use a bath blanket or sheet to maintain patient warmth and privacy.

 

 

ANS:  D

Use a bath blanket or sheet to maintain patient warmth and privacy.

When making an occupied bed, the nurse should cover the patient with a bath blanket, if available, or leave the top sheet over the patient. Covering the patient prevents chilling and preserves modesty. Keeping the bed in the low position and working over raised siderails may strain the nurse’s back. Continually moving from side to side is disorganized and time consuming.

 

Difficulty: Moderate

Nursing Process: Interventions

Client Need: Safe and Effective Care

Cognitive Level: Analysis

 

PTS:   1

 

  1. Which of the following interventions would be most appropriate for a patient who has an eye infection with moderate amount of discharge?
a) Using hydrogen peroxide to clean the eye
b) Wiping from the outer canthus to the inner canthus
c) Positioning the patient on the same side as the eye to be cleansed
d) Using a different wipe to cleanse each eye

 

 

ANS:  D

To prevent cross-contamination, a different wipe should be used for each eye. Always cleanse from the inner canthus to the outer canthus to avoid forcing debris into the nasolacrimal duct. Water or normal saline should be used for cleansing the eye of any discharge.

 

Difficulty: Moderate

Nursing Process: Interventions

Client Need: PHSI

Cognitive Level: Application

 

PTS:   1

 

  1. A patient with diarrhea is incontinent of liquid stool. The nurse documents that he now has excoriated skin on his buttocks. Which finding by the nurse led to this documentation?
a) Skin was softened from prolonged exposure to moisture.
b) Superficial layers of skin were absent.
c) Epidermal layer of skin was rubbed away.
d) Lesion caused by tissue compression was present.

 

 

ANS:  B

Excoriation is a loss of the superficial layers of the skin caused by the digestive enzymes in feces. Maceration is the softening of skin from exposure to moisture. Abrasion, a rubbing away of the epidermal layer of the skin, especially over bony areas, is often caused by friction or shearing forces that occur when a patient moves in bed. Pressure ulcers are lesions caused by tissue compression and inadequate perfusion that are a result of immobility.

 

Difficulty: Moderate

Nursing Process: Assessment

Client Need: PHSI

Cognitive Level: Analysis

 

PTS:   1

 

  1. For which patient is it most important to provide frequent perineal care? The patient:
a) With active lower gastrointestinal bleeding
b) Who has had an episode of diabetic ketoacidosis
c) Who has a circumcised penis
d) With a history of acute asthma

 

 

ANS:  A

The patient admitted with active lower GI bleeding will require frequent perineal care because of the irritating effect of enzymes in the stools. The uncircumcised patient, not the circumcised patient, may require frequent perineal care. Those with diabetic ketoacidosis or who have had acute asthma do not require frequent perineal care.

 

Difficulty: Moderate

Nursing Process: Interventions

Client Need: PHSI

Cognitive Level: Application

 

PTS:   1

 

  1. A patient with dementia becomes belligerent when the nurse attempts to give him a tub bath. How should the nurse proceed?
a) Call for assistance to help the patient into the bathtub.
b) Wait for the patient to calm down, and then give him a towel bath.
c) Allow the patient to go without bathing for a day or two.
d) Ask another staff member to attempt the tub bath.

 

 

ANS:  B

Nurses need to individualize bathing to meet the needs of the patient. If the patient becomes belligerent, the nurse should wait until the patient calms down and then attempt a towel bath. Towel baths have been shown to reduce agitation significantly. The patient should not be forced into the tub. Having another staff member attempt the tub bath will most likely increase the patient’s agitation, as consistency of caregivers is important for patients with dementia.

 

Difficulty: Moderate

Nursing Process: Interventions

Client Need: Safe and Effective Care

Cognitive Level: Analysis

 

PTS:   1

 

  1. The nurse is teaching nursing assistive personnel (NAP) how to give a complete bed bath. Which instruction should the nurse include?
a) “Cleanse only those areas likely to cause odor.”
b) “Provide the patient with warm water for washing his perineum.”
c) “Wash the patient’s back, buttocks, and perineum first.”
d) “Bathe the patient from head to toe, cleanest areas first.”

 

 

ANS:  D

The nurse should instruct the NAP to give a complete bed bath (a bath for patients who must remain in bed but who are able to bathe themselves), in head-to-toe fashion, beginning with the cleanest part of the body and ending with the dirtiest. The NAP should provide the patient with a basin of warm water and allow him to wash his perineum when giving an assisted bath or bed bath (this is a total bed bath). During a partial bath, the NAP should cleanse only the areas that may cause odor or discomfort. The NAP should never begin the bath with the back, buttocks, and perineum because this violates the principle of “clean to dirty.”

 

Difficulty: Moderate

Nursing Process: Interventions

Client Need: HPM

Cognitive Level: Application

 

PTS:   1

 

  1. Which action should the nurse be sure to take when preparing a patient for a bed bath?
a) Place the nurse call device within reach.
b) Cover the patient with the top linens from the bed.
c) Have the patient completely bathe himself to promote independence.
d) Wash the patient’s body without assistance from the patient.

 

 

ANS:  A

When preparing a patient for a bed bath (a bath for patients who must remain in bed but who are able to bathe themselves), place prepackaged bathing product, bath linens, a clean gown, and other bathing supplies on the overbed table. Provide privacy, and place the nurse call device within reach. Remove the top linens from the bed, and cover the patient with a bath blanket. If the patient cannot bathe all areas of his body, complete the bath for him. The nurse performs at least part of a bed bath; if the patient bathes himself completely while remaining in bed, it is referred to as an “assist bath.”

 

Difficulty: Moderate

Nursing Process: Interventions

Client Need: Safe and Effective Care

Cognitive Level: Comprehension

Difficulty Level: Moderate

 

PTS:   1

 

  1. A patient admitted with an acute exacerbation of chronic obstructive pulmonary disease has a nursing diagnosis of Activity Intolerance. Which type of bath is preferred for this patient?
a) Tub bath
b) Complete bed bath
c) Towel bath
d) Bed bath

 

 

ANS:  C

A towel bath is a modification of the bed bath, in which a large towel and a bath blanket are placed in a plastic bag and saturated with a commercially prepared mixture of moisturizer, nonrinse cleaning agent, and water. The bag and its contents are then placed in the microwave, and they are used to bathe the patient. This bathing method is preferred for patients who have Activity Intolerance. A tub bath, complete bed bath, and conventional bed bath may deplete this patient’s energy.

 

Difficulty: Easy

Nursing Process: Interventions

Client Need: PHSI

Cognitive Level: Application

 

PTS:   1

 

  1. The school nurse is teaching a group of middle school students how to prevent tinea pedis. Which remark by a student provides evidence of learning?
a) “I can contract the infection by walking barefoot in the gymnasium’s showers.”
b) “The best way to avoid contracting the infection is to use good handwashing.”
c) “Wearing unventilated shoes prevents the fungus from gaining contact with my feet.”
d) “There is really no way to prevent its spread; it’s highly contagious.”

 

 

ANS:  A

One can contract the infection by walking barefoot in public showers, such as those in the school’s gymnasium. Good handwashing does not prevent a person from contracting tinea pedis. Wearing unventilated shoes may actually aggravate the infection by allowing moisture to accumulate in the shoes. Although the infection is highly contagious, the spread of infection can be prevented by wearing special footwear in the shower.

 

Difficulty: Moderate

Nursing Process: Evaluation

Client Need: HPM

Cognitive Level: Application

 

PTS:   1

 

  1. Bath water should be prepared at which temperature to prevent chilling and excess drying of the skin?
a) 99°F (37.2°C)
b) 102°F (38.9°C)
c) 103°F (39.4°C)
d) 105°F (40.6°C)

 

 

ANS:  D

Bath water temperature should be 105°F (40.6°C) to prevent chilling, burning, and excess drying of the skin.

 

Difficulty: Easy

Nursing Process: Interventions

Client Need: Safe and Effective Care

Cognitive Level: Knowledge

 

PTS:   1

 

  1. While assessing a patient, the nurse notes that the patient’s nails are excessively brittle. What does this finding suggest?
a) Inadequate dietary intake
b) Normal aging process
c) Fungal infection
d) Excessive use of silver salts

 

 

ANS:  A

Inadequate dietary intake or metabolic changes can cause the nails to become brittle. As a person ages, nails thicken, become ridged, and may yellow or become concave in shape. Brown or black discoloration of the nail plate may indicate a fungal infection. Bluish-gray discoloration of the nail plate signals excessive intake of silver salts.

 

Difficulty: Moderate

Nursing Process: Diagnosis

Client Need: PHSI

Cognitive Level: Analysis

 

PTS:   1

 

  1. A patient with a history of seizures who takes phenytoin is at risk for which oral problem?
a) Dryness of the mouth
b) Bitter taste
c) Demineralization of the tooth enamel
d) Gingival hyperplasia

 

 

ANS:  D

Phenytoin causes gingival hyperplasia. Medications such as atropine cause dry mouth. Bitter taste can result from drugs such as docusate sodium, a stool softener. Phenytoin does not cause demineralization of the tooth enamel.

 

Difficulty: Moderate

Nursing Process: Diagnosis

Client Need: PHSI

Cognitive Level: Comprehension

 

PTS:   1

 

  1. The nurse has been teaching a student how to perform mouth care for her unconscious patient. The student will show evidence of learning if she places the patient in which position for this care?
a) Supine
b) Prone
c) Semi-Fowler’s
d) Side-lying

 

 

ANS:  D

The nurse should position an unconscious patient in a side-lying position to provide mouth care to prevent aspiration. Supine, prone, and semi-Fowler’s positions are unsafe positions for providing mouth care for the unconscious patient.

 

Difficulty: Moderate

Nursing Process: Evaluation

Client Need: Safe and Effective Care

Cognitive Level: Comprehension

 

PTS:   1

 

  1. After receiving a course of chemotherapy, a patient begins losing hair. This adverse effect of chemotherapy should be documented as:
a) Pediculosis
b) Alopecia
c) Dandruff
d) Hirsutism

 

 

ANS:  B

Alopecia is abnormal hair loss that can occur as a result of chemotherapy. Pediculosis is an infestation of head lice. Dandruff is a condition in which there is excessive shedding of the epidermal layer of the scalp. Hirsutism is the excessive growth of body hair in women.

 

Difficulty: Moderate

Nursing Process: Assessment

Client Need: PHSI

Cognitive Level: Comprehension

 

PTS:   1

 

  1. Which of the following is a correct step in removing and cleaning a hearing aid?
a) Clean only the external surfaces, not the canal portion.
b) Clean the top part of the canal portion of the device.
c) Insert a wax loop or toothpick into the hearing aid itself.
d) Remove the battery before taking the hearing aid from the ear.

 

 

ANS:  B

The nurse should clean the top part of the canal portion of the hearing aid using the wax loop and wax brush, cotton-tipped applicator, pipe cleaner, or toothpick. Nothing should be inserted into the hearing aid. The external surfaces are cleaned with a damp cloth. The hearing aid should be turned off before removing it from the ear, but the battery is not removed at that step of the procedure. It would not likely be possible to remove the battery while the device was still in the ear.

 

Difficulty: Difficult

Nursing Process: Interventions

Client Need: Safe and Effective Care

Cognitive Level: Application

 

PTS:   1

 

  1. The patient is sitting in a chair at the bedside. The nurse is preparing to remove the patient’s artificial eye. What should the nurse ask the patient to do to best position him for this procedure?
a) Lean forward and rest the arms on the overbed table.
b) Sit back in the chair and tilt the head back.
c) Move to the bed and lie down.
d) Stand up and lean over the bed.

 

 

ANS:  C

The nurse should have the patient lie down so that if the eye is dropped when removing it, it will fall on the bed instead of the floor. Sitting back in the chair would allow access to the eye but would not protect the artificial eye from falling to the floor. Leaning forward and resting the arms on an overbed table, as well as standing up and leaning over the bed, would not provide the nurse access to the eye to remove the prosthesis.

 

Difficulty: Moderate

Nursing Process: Interventions

Client Need: Safe and Effective Care

Cognitive Level: Application

 

PTS:   1

 

MULTIPLE RESPONSE

 

  1. Which area(s) should the nurse inspect when assessing for cyanosis in a dark-skinned patient? Select all that apply.
a) Buccal mucosa
b) Around the lips
c) Palms
d) Tongue

 

 

ANS:  A, C, D

In dark-skinned people, cyanosis can be best assessed by examining the palms of the hands, soles of the feet, tongue, conjunctivae, or the buccal mucosa. In light-skinned people, the nailbeds and the area around the lips can be inspected.

 

Difficulty: Moderate

Nursing Process: Assessment

Client Need: PHSI

Cognitive Level: Knowledge

 

PTS:   1

 

  1. Which of the following is/are a benefit of bathing? Select all that apply.
a) Constricts blood vessels
b) Increases depth of respirations
c) Provides opportunity for assessments
d) Reduces sensory input

 

 

ANS:  B, C

Bathing presents an opportunity to perform a variety of assessments. Bathing also dilates blood vessels near the skin’s surface, increasing circulation. Moreover, bathing stimulates the depth of respirations and provides sensory input.

 

Difficulty: Easy

Nursing Process: Interventions

Client Need: Safe and Effective Nursing Care

Cognitive Level: Knowledge

 

PTS:   1

 

  1. For which patient(s) should the nurse avoid using back massage? Select all that apply.
a) One who underwent heart surgery 3 days ago
b) One who sustained rib fractures from a fall
c) One who underwent a lumbar laminectomy
d) One who sustained a leg fracture in a sledding accident

 

 

ANS:  A, B

Back massage is contraindicated with rib fractures, burns, and recent heart surgery. Massage is acceptable for the patients with lumbar laminectomy or leg fracture.

 

Difficulty: Easy

Nursing Process: Interventions

Client Need: PHSI

Cognitive Level: Application

 

PTS:   1