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NUR 518: Clinical Essentials Questions With Complete Solutions

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NUR 518: Clinical Essentials Questions With Complete
Solutions

1. A nurse is caring for a patient who has just had major
abdominal surgery to resect a portion of his colon. What is the
most reliable sign that the patient has significant postoperative
pain?
A. The patient rates his pain a 7 on a scale of 0 to 10.
B. The patient winces and guards the area as the nurse gently
palpates the abdomen.
C. The patient is having trouble sleeping and has become
irritable.
D. The patient is moaning softly and frowning, with a pinched
expression on his face. Correct Answer A. The patient rates his
pain a 7 on a scale of 0 to 10.

1. A patient prescribed to receive two units of packed red blood
cells is to receive a dose of intravenous medication between the
two units. How would the nurse administer the medication?
A. In the IV line for the blood product during the transfusion
B. In the IV line for the blood product when the line is flushed
with normal saline
C. In oral form
D. Through another IV line Correct Answer D. Through
another IV line

1. An otherwise strong, healthy patient with a lower leg cast is
learning to ambulate with axillary crutches. Which gait is most
appropriate?
A. Any gait is appropriate
B. Four point gait

,C. Three point gait
D. Two point gait Correct Answer C. Three point gait

1. How does soap work?
A. Creates a sheetlike microscopic barrier between the skin and
microorganisms in the environment
B. Emulsifies fat and oil so that dirt and microorganisms can be
mechanically removed
C. Kills all microorganisms exposed to the lather
D. Removes visible soiling but is ineffective in isolating,
removing, or killing microorganisms Correct Answer B.
Emulsifies fat and oil so that dirt and microorganisms can be
mechanically removed

1. The nurse has delegated to nursing assistive personnel (NAP)
the skill of assisting with a bedpan for a patient who has had
discomfort when walking to the bathroom. Which statement
made by the NAP requires the nurse's follow-up?
A. "Do you still need a stool sample for the lab?"
B. "If I can get someone to help, I'll walk her to the bathroom."
C. "The patient reports that moving is uncomfortable for her.
Has she had pain medication recently?"
D. "The patient told me that she's had problems with
hemorrhoids in the past." Correct Answer B. "If I can get
someone to help, I'll walk her to the bathroom."

1. The nurse is preparing to make an occupied bed for a patient
who is on aspiration precautions. What will the nurse do to
ensure the safety of this patient during the bed change?
A. Keep the head of the bed no lower than a 30-degree angle.
B. Fold a pillow in half and place it under the patient's head.

,C. Lower the bed to a flat position and place two pillows
beneath the patient's head.
D. Ask another caregiver to hold the patient's head during the
bed change. Correct Answer A. Keep the head of the bed no
lower than a 30-degree angle.

1. The nurse who is preparing to make an unoccupied bed
should do what to ensure his or her personal safety?
A. Put on sterile gloves.
B. Place the call light within the nurse's reach.
C. Place the bed at a comfortable working height.
D. Place a laundry bag on the bedside chair. Correct Answer C.
Place the bed at a comfortable working height.

1. The Thomas-Kilmann conflict management style that is
usually the most effective is:
A. Accommodating
B. Avoiding
C. Collaborating
D. Competing Correct Answer C. Collaborating

1. What will the nurse instruct nursing assistive personnel
(NAP) to do when measuring a patient's rectal temperature using
an electronic thermometer?
A. Place the patient in the Fowler's position.
B. Wear sterile gloves during the process.
C. Insert the probe in the direction of the knees.
D. Use the probe with the red tip. Correct Answer D. Use the
probe with the red tip.

, 1. When caring for a patient receiving oxygen by nasal cannula,
which of the following is a priority to help maintain good skin
integrity?

A. Frequently applying moisturizing lotion to facial areas that
come into contact with the cannula.
B. Removing the cannula every 2 hours for no longer than 10
minutes.
C. Assessing the patient's external ears, nares, and nasal mucosa
for breakdown at least once per shift.
D. Instructing the patient to inform staff of any problems with
facial dryness or cracking. Correct Answer C. Assessing the
patient's external ears, nares, and nasal mucosa for breakdown at
least once per shift.

Rationale: Frequent assessment is a priority and will help the
nurse identify early signs of skin breakdown. Although applying
lotion is appropriate, this option is not the best way to maintain
good skin integrity. It may not be appropriate to remove the
cannula in a patient for whom oxygen therapy has been ordered.
The patient may be unaware of facial skin areas that are dry or
cracking.

1. When positioning a hemiplegic patient in the supported
Fowler's position, what is the primary reason a trochanter roll is
placed alongside the patient's legs?
A. To reduce the risk of a fall while the side rails are down
B. To reduce the risk of contracture
C. To control pain
D. To cushion the legs Correct Answer B. To reduce the risk of
contracture

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