Worksheets111 Unit 3 Review
Total questions: 39
Worksheet time: 20mins
The nurse know DTaP protects against which diseases? Select all that apply
Diphtheria
Polio
Pertussis
Tetanus
Typhoid fever
The nurse is caring for a pediatric client diagnosed with HIV. How can the nurse coordinate the necessary isolation precautions?
Ensure everyone on the unit wears gloves all the time.
Remind the staff that standard precautions are needed.
Post a sign on the door of all clients with HIV or infective disorders.
Teach the client to warn others that they have HIV.
Which of the following symptoms indicates to the home health nurse that a client has an infection?
The client has a rash
The client has a heart murmur
The client has lymphadenopathy
The client has mystagmus
The community health nurse teaches a class on disease prevention at a community health fair. One of the participants states, "I have heard the term incubation period but I do not know what it means." Which of the following is the best response by the nurse?
It is the time for a new drug to be tested before it is brought into the market.
It is the time between when a person gets infected and when actual symptoms appear.
It is the time it takes between when a vaccine is administered and when it takes effect.
It is the recommended time period for a newborn to be kept in an incubator or isolette.
The nurse observes a staff member prepare to leave the room of a client on droplet precautions. The nurse should intervene if which action is observed?
The staff member removes the gloves by pulling them off inside out.
The staff member holds onto the outer surface of the facemask while pulling the mask away from the face.
The staff member unties the gown and removes it without touching the outside of the gown.
The nurse performs hand hygiene upon entering and exiting the room.
A client is admitted to the hospital with a temperature of 38.3 C (101 F) and a WBC count of 3,000/mm3. The nurse should institute which precaution?
Contact precautions
Airborne precautions
Droplet precautions
Neutropenic precautions
The nurse knows which signs or symptoms of rubeola are exhibited before the appearance of the rash?
Diarrhea, intestinal cramps, and lack of appetite
Runny nose, coughing, and high fever
Itching, fever, and cold sores
Sore throat and swollen lymph nodes
a parent calls the clinic to report that their child has been exposed to varicella zoster. The nurse should inform the parent that the incubation period for varicella zoster is which length of time?
1 day
2-4 days
1 week
2-3 weeks
The nurse observes a staff member enter a client's room wearing a fit-tested respiratory device. The nurse determines care is appropriate if the staff member is caring for which client?
A client diagnosed with varicella
A client diagnosed with mumps
A client diagnosed with vacomycin-resistant Enterococcus (VRE)
A client diagnosed with pertussis
The nurse understands the MMR vaccine protects clients from which diseases?
Measles, mumps, rubeola
Measles, mumps, roseola
Measles, mumps, rubella
Measles, mumps, varicella
The nurse counsels the parent of a 12-year-old diagnosed with varicella zoster about when the child can return to school. The nurse determines that teaching is effective if the parent makes which statement?
My child can return to school after the blisters stop erupting.
My child can return to school when the itching is controlled.
My child can return to school when the lesions are crusted.
My child can return to school when the macules disappear.
The nurse in a well-child clinic receives a phone call from the parent of a 6-month-old client who received the DTaP vaccine 3 days ago. The nurse is most concerned if the parent makes which statement?
There is firmness and swelling at the injection site.
My baby is crying continuously.
My baby's temperature is 38.3C (101F).
My baby seems to be irritable and clingy.
The nurse understands that signs of localized skin infection include which assessment findings? Select all that apply
Erythema
WBC count > 10.0 x 103
Edema
Heat
Pain/tenderness
The nurse understands which medication is used in the treatment of viral infections?
Fluconazole
Azithromycin
Phenazopyridine
Oseltamivir
A client has been ordered to have blood cultures drawn. The nurse understands which statements are correct regarding blood cultures? Select all that apply
Two sets of blood cultures are obtained from two different sites
The name of antibiotics the client is receiving should be listed on the lab requisition slip
Resistant medications listed on the sensitivity report are effective against the specific bacteria identified
Culture and sensitivity results are available within 8 hours of the lab drawn
An order must be obtained prior to lab work being obtained
A client reports nausea, abdominal pain and excessive, watery diarrhea for the last 3 days. Based on these assessment findings, the nurse should recommend which intervention?
Vancomycin intravenously
Stool culture for clostridium difficile (C-Diff)
Linezolid intravenously
IV Pyelorogram
The nurse assesses erythema, edema, warmth and tenderness over intact skin on a client's right lower leg. Based on these findings, the nurse suspects which disease process?
Stage 1 Pressure Injury
Deep Tissue Pressure Injury (DTPI)
Cellulitis
Moisture associated skin damage
The nurse is providing discharge teaching to a female client with recurrent urinary tract infections. What information should be included in client teaching? Select all that apply
Increase by mouth intake of fluids
Void every 6-8 hours
Avoid bubble baths and feminine hygiene products
Drink 8 ounces of beer a day
Clean the perineum from front to back
An infant client has been admitted to the hospital with pertussis. Which nursing interventions are appropriate for client care? Select all that apply
Administer antibiotics
Provide a cool mist vaporizer for the client's room
Administer intravenous fluids
Encourage small, more frequent meals
Allow client periods of rest throughout the day
The nurse is caring for a client who eviscerated their abdominal wound. Which action should the nurse take first?
Apply sterile towels soaked with sterile NS
Gently push the organs back into the abdomen
Administer intravenous prn pain medication
Place the client in High Fowler's position
The nurse identifies which of the following as the greatest risk factor for pressure injury development?
Diarrhea
Immobility
Anemia
Pruritus
The nurse identified which diet is best for a client with multiple wounds?
High protein, low fat, high iron
High vitamin C, high protein, high carbohydrate
High vitamin A, high calcium, high fat
High vitamin B, high protein, low carbohydrate
The nurse notes a patient has a reddened area on the coccyx. WHat should the nurse do first?
Notify the healthcare provider
Reposition the client
Massage the area of erythema
Place the client in High Fowler's
The nurse is teaching a client about wound healing. Which outcome indicates wound healing?
Decreased granulation tissue
Evidence of undermining and tunneling
Streaks of erythema in the per-wound
Wound bed red, moist and free of slough
A client is being treated for a wound infection. The nurse should continually perform which action?
Check and record the client's temperature
Send samples of wound drainage for culture
Assess the perfusion in the area
Evaluate the results of urine cultures
The nurse assess a client with a sacral pressure injury. The pressure injury is 3 cm deep, 2 cm wide with an irregular border. The muscle tissue is affected. How should the nurse stage the wound?
1
2
3
4
The nurse prepares the client with a macular rash with open vesicles for an oatmeal bath. What is the purpose of an oatmeal bath?
Decrease the itching
Cleanse the area
Debride the rash
Decrease bacteria on the skin
The nurse is caring for a client with an abdominal wound. The nurse notes there is purulent drainage from the wound. Which action should the nurse take first?
Contact the healthcare provider for an antibiotic
Place the client on contact precautions
Irrigate the wound
Obtain a wound culture
The nurse assesses this wound over a bony prominence on a client. How should the nurse stage the wound?
1
2
3
DTPI
The nurse understands which finding places the client at the highest risk for delayed wound healing?
Hemoglobin 16 g/dL
Albumin 3.8 g/dL
WBC 14.0 x103
Platelets 230 x 103
An infant has a flat, red, shiny rash noted. Select the most appropriate nursing interventions? Select all that apply
Change the infant's diaper frequently
Apply Dakins solution to the affected area and allow to dry
Gently wash the area with a soft clothe and non-fragrant soap
Utilize topical products that contain petroleum and zinc
Stage the wound and complete a modified Braden scale
Which statement(s) below are correct when the nurse is packing a client's wound? Select all that apply
Pack the wound with dressing material that is saturated with sterile NS
Cover all open areas with loose and fluffy packing
Keep the periwound dry and free of packing materials
Document the number of packing materials utilized during the dressing change
Assess the wound drainage, wound bed and periwound for signs of wound healing and signs of infection
The nurse understands which treatment modality assist in wound healing by increasing the amount of oxygenated blood supplied to a wound?
Surgical debridement
Jackson Pratt (JP) drain
Wet to dry dressing changes
Hyperbaric chamber
The nurse recognizes that a fan blowing on the client is an example of what type of heat transfer?
Conduction
Convection
Radiation
Evaporation
Shivering increases the production of _______ and is initiated by the _________ in the brain.
heat; hypothalamus
vasoconstriction; hypocampus
epinephrine; thymus
serotonin; thyroid
Nursing interventions for pyrexia include which of the following (Select all that apply)
Cool oral fluids
Warm nasogastric lavage
Cold compresses
Increase the room temperature
Encourage carbohydrates
The nurse palpates an enlarged lymph node. What specific assessments should the nurse complete on this client? (Select all that apply)
Location
Size
Tenderness
Consistency
Mobility
The nurse suspects an acute bacterial infection when the client's CBC with differential shows an elevation of which of the following white blood cells?
Lymphocytes
Basophils
Mature neutrophils
Monocytes
Immature neutrophils
Which organs are part of the immune system?
Gallbladder and pancreas
Liver and kidneys
Spleen and thymus
Heart and lungs
