WorksheetsExam 2 Review
Total questions: 20
Worksheet time: 7mins
A penrose drain should be emptied every 4 hours, true or false
True
False
You're guess is as good as mine
Sounds like a good idea
When developing learning objectives, what is HIGHEST priority?
Patient's age
Learning needs of the patient
Availability of family
Past experiences of the nurse
A nurse has to teach the patient how to administer injections. What is MOST important for the nurse to assess?
Patient's ability to read
Patient's preferred language
Patient's willingness to learn
The patient's learning style
A patient is at risk for impaired skin integrity. What is a priority nursing intervention?
Keep head of bed at 45 degrees or higher
Turn patient every 3 hours while in bed
Perform Braden scale every other day
Reposition patient in chair every hour
The nurse notices a reddened non-blanchable area on the patient's coccyx. The patient has developed a what?
Stage 1 pressure ulcer
Stage 2 pressure ulcer
Stage 3 pressure ulcer
Stage 4 pressure ulcer
The nurse should consider all of the following when teaching an older adult EXCEPT
Lighting
Previously taught materials
Providing all teaching in one session
Readiness to learn
True or False: Stuffed animals can be used to teach children self care
True
False
Inappropriate
Why not
All are included in the Braden Scale EXCEPT
Age
Mobility
Friction
Nutrition
True or False: Non-verbal communication has little to no meaning
True
False
Doubtful
Perhaps
The nurse is assessing this patient's Jackson Pratt drain. What action should the nurse do FIRST
Depress the bulb
Document the amount of drainage
Secure drain to patient's gown
Empty the drain
True or False: Handoff report has little effect on patient outcomes
True
False
I doubt it
Can I ask a friend
A patient calls out and states that he fell. What documentation is best ?
Pt found on floor, appears to have tripped over IV pole
Pt reported fall, continue to monitor
Unwitnessed fall. Pt found sitting upright on floor. Pt denies pain
Pt won't listen to nurse and stay in bed, pt fell getting up on own
When using an EHR you can protect a patient's privacy by doing everything EXCEPT
Disposing of papers with patient's name on it in designated bin
Minimize Epic screen before walking away
Writing only patient's initials on care organizer
Use passwords that contain capital letters, symbols, and numbers
When is the BEST time for the nurse to document a patient's physical assessment
After assessing all the patients the nurse is assigned to
Before completing assessment
Any time as long as it is completed by end of shift
Immediately after completing assessment
True or False: Asking a patient "why" can be therapeutic and beneficial to the patient.
True
False
Absolutely
Sure
S1 S2 sounds are made by what?
Contraction of the heart
Closure of the heart valves
Ejection of blood from the heart
Murmurs
A patient's feet are cool and the capillary refill on their toes are greater than 3 seconds. What should the nurse assess next?
Dorsalis pedis pulse
Femoral pulse
Capillary refill in the fingers
Sensation in the extremities
True or False: The nurse can use a non-English speaking patient's family member as a translator
True
False
Maybe
I need to look that over again
What is the maximum amount of oxygen that can be administered via nasal cannula?
4 liters
6 liters
8 liters
10 liters
True or False: The bag on a nonrebreather mask should remain flat to ensure the patient does not retain carbon dioxide (CO2)
True
False
Maybe
Doesn't sound right
