N1J02 Review #2

The movement of molecules across a concentration gradient using chemical energy is called

• Diffusion

• Osmosis

• Filtration

• Active transport

Which of these statements in the history of presenting illness of diarrhea is the "V" in OPQRSTUV?

• "I think it might be gluten causing the problem"

• "I have sharp cramps that go along with the diarrhea"

• "I have missed two weeks of work because of it, which has affected my pay"

• "I think I am dehydrated because of it"

Which of the following symptoms might you notice if a patient has a fluid deficit?

• Bounding pulse, dry mucus membranes, thirst

• Slow skin turgor, hypotension, edema

• Loss of 1.5 lbs in 24 hours, lightheadedness,

  confusion

• Gain of 1.5 lbs in 24 hours, hypotension, thready pulse

The nurse is measuring intake and output. They should include the following in output (select all that apply)

• Blood draws

• Oral fluids

• Emesis

• Diarrhea

• Tears

You document that the patient has dyspnea. This is:

• Shortness of breath

• Use of accessory muscles to breathe

• Nasal flaring

• Wheezing heard on auscultation

When assessing for chest expansion, which of the following is part of the correct technique?

• Ask the patient to say "99" while you palpate with the ulnar surface of the hand

• Ask the patient to take a deep breath

• Place hands between T9-T10 on the anterior chest wall

• Pinch a small amount of skin on the lateral chest

When auscultating, what sounds should the nurse hear over the mainstem bronchi?

• Resonant

• Bronchial

• Bronchovesicular

• Tracheal

The four main categories of the general survey are:

• appearance, posture, mobiliy, mood and expression

• level of consciousness, body structure, gait, dress and hygiene

• appearance, body structure, mobility, behaviour

• level of consciousness, posture, range of motion, behaviour

What would be part of your environmental assessment when you first go in to see your patient in the AM? Select all:

• IV site assessment

• Bedrails

• Callbell within reach

• allergy band

• Cues about the patient's support system (e.g. photos)

The nurse should do the following in the standard head to toe assessment (select all that apply):

• Auscultation of apical pulse

• Palpation of femoral and popliteal pulses

• Auscultation of all lobes of the lungs for air entry

• Percussion of four quadrants of the abdomen

• Inspection and palpation of the skin for lesions, turgor, colour and temperature