A) Instruction was done at the bedside by a physician in the U.S. B)Curriculum in American schools was more standardized C)Student nurses in the U.S. worked for minimum wage D)The nightingale program was less organized A) Instruction was done at the bedside by a physician in the U.S. 2/8 Fundamentals of Nursing Ch. Written communication that does the same is considered libel. Hourly Ineffective airway clearance related to dry, hacking cough is incorrect because the cough is not the reason for the ineffective airway clearance. 33. Hypothermia is an abnormally low body temperature. Prone Reporting an APTT above 45 seconds to the physician The patient experiences an allergic reaction and has cerebral damage resulting from anoxia.BThe nurse assists a patient out of bed with the bed locked in position; the patient slips and fractures his right humerus.CThe nurse applies a hot water bottle or a heating pad to the abdomen of a patient with abdominal cramping.DThe nurse administers the wrong medication to a patient and the patient vomits. Pulse rate and temperature Applying a hot water bottle orheating pad to a patient without a physicians order does not include the three required components. Abdominal girth is unrelated to blood loss. household system, When administering medications to older adults do what? Fundamentals of Nursing University Keiser University Fundamentals of Nursing Add to My Courses Documents (326) Questions Students (625) Book related documents Kozier and Erb's Fundamentals of Nursing Volume 1-3 Barbara Kozier; Glenora Erb; Audrey Berman; Shirlee Snyder; Tracy Levett-jones Lecture notes Date Rating year Ratings Show 8 more documents A. Ts To Know For Nclex Flashcards Quizlet. Put air into the cloudy vial first Hyperventilation The force that occurs in a direction to oppose movement. read back the telephone order to the prescriber. Also, this page requires javascript. Your score is If not, container tends to be left off and pets or children can get into it. - This is sterile Thiamine Set your dose All four side rails up is considered a restraint Circulatory overload and respiratory excitement have no relevance to the question. 28. 31. medications absorbed more slowly this route than IM A new head nurse on a unit is distressed about the poor staffing on the 11 p.m. to 7 a.m. shift. Regulated by TJC & CMS (centers for medicare/medicaid services) 4. Continuity of patient care promotes efficient, cost-effective nursing care - Some drugs can cross the placenta and should not be administered to pregnant women, Therapeutic Effects Strict aseptic technique Pregnancy D. The apical pulse (the pulse at the apex of the heart) is located on the midclavicular line at the fourth, fifth, or sixth intercostal space. Tell them the body will not be available for a wake or funeral - Normally for sleep apnea. Preoxygenate the patient The normal activated partial thromboplastin time is 16 to 25 seconds and the normal prothrombin time is 12 to 15 seconds; these levels must remain within two to two and one half the normal levels. plan to safely handle and dispose of needles before procedure begins After assessing Mrs. Paul, the nurse writes the following nursing diagnosis: Impaired gas exchange related to increased secretions. Administering an incorrect medication is a nursing error; however, if such action resulted in a serious illness or chronic problem, the nurse could be sued for malpractice. A patient is admitted to the hospital with complaints of nausea, vomiting, diarrhea, and severe abdominal pain. Continue administering oxygen by high humidity face mask, Perform chest physiotheraphy on a regular schedule, Encourage the patient to increase her fluid intake to 200 ml every 2 hours. Mrs. Lim begins to cry as the nurse discusses hair loss. After assessing Mrs. Paul, the nurse writes the following nursing diagnosis: Impaired gas exchange related to increased secretions. 30. The nurse is responsible for: Soft foods, Fowlers or semi-Fowlers position, and oral hygiene before eating should be part of the feeding regimen. - Administer medication correctly The nurse must place a pillow under the decreased persons head and shoulders to prevent blood from settling in the face and discoloring it. 25. Eupnca - Musculoskeletal abnormality,- paralysis may take away respiratory drive Absence of the apical, radial, or femoral pulse is abnormal and should be investigated. Risk for aspiration, Prepare medications CAn 88-year old incontinent patient with gastric cancer who is confined to his bed at homeDAn alert, chronic arthritic patient treated with steroids and aspirinQuestion 24 Explanation: Pressure ulcers are most likely to develop in patients with impaired mental status, mobility, activity level, nutrition, circulation and bladder or bowel control. Then put air into clear vial Correct What is a nurses responsibility concerning Nutrition? In this example, the standard of care was breached; a 3-month-old infant should never be left unattended on a scale. How to minimize discomfort with injections? 35. 12. Person, health, nursing, support systems Which of the following would immediately alert the nurse that the patient has bleeding from the GI tract?AGuaiac testBComplete blood countCVital signsDAbdominal girth Question 49 Explanation: To assess for GI tract bleeding when frank blood is absent, the nurse has two options: She can test for occult blood in vomitus, if present, or in stool through guaiac (Hemoccult) test. 10. If a patients blood pressure is 150/96, his pulse pressure is: 23. Most are U-100 and must be matched up with U-100 insulin This information is documented and reported to the physician and the nursing supervisor. Which of the following vascular system changes results from aging? The physician orders a platelet count to be performed on Mrs. Smith after breakfast. Assuming that a semitrailer behaves as a square cylinder, find the force exerted if a wind of 20km/h20 \mathrm{~km} / \mathrm{h}20km/h strikes it broadside. 1 mL capacity Place a humidifier in the patients room. Inhibition of the respiratory hypoxic stimulus "I will bring the medication back to your room once you return from the bathroom", The nurse is ready to administer a patient's morning medication when the patient states, "Please leave the medication on my table. Since about 40% of patients fall out of bed despite the use of side rails, side rails cannot be said to prevent falls; however, they do serve as a reminder that the patient should not get out of bed. Correct dosage Question 24Which of the following patients is at greatest risk for developing pressure ulcers?AAn apathetic 63-year old COPD patient receiving nasal oxygen via cannulaBA confused 78-year old patient with congestive heart failure (CHF) who requires assistance to get out of bed. What are the nine rights medication administration? Encourage the patient to increase her fluid intake to 200 ml every 2 hours Maintain balance, posture, and body alignment Question 44The four main concepts common to nursing that appear in each of the current conceptual models are: The nurse notes that he is steady on his feet and that his vision was unaffected by the surgery. CFeverDSympathetic nervous system stimulationQuestion 45 Explanation: Parasympathetic nervous system stimulation of the heart decreases the heart rate as well as the force of contraction, rate of impulse conduction and blood flow through the coronary vessels. Abdominal cramping with hyperactive, high pitched tinkling bowel sounds can indicate a bowel obstruction. cleanse selected collection site slough Thus, an axillary temperature of 99.6F (37.6C) would be considered abnormal. I will take it after I use the restroom." gluteus medis and minimus muscles The nurse is responsible for giving the patient breakfast at the scheduled time. Date Which of the following nursing interventions has the greatest potential for improving this situation? Consider alternatives, such as ambualarm, rather than restraints, Requires a physician order - Specific prescribed amt. Ineffective breathing patterns Amyotrophic lateral sclerosis, a disease marked by progressive degeneration of the neurons, eventually results in atrophy of all the muscles; including those necessary for respiration. death of subcutaneous fat tissue and muscle degeneration An increased partial pressure of carbon dioxide in arterial blood (PACO2) would not initially result in cardiac arrest. Question 20Which of the following is the most common cause of dementia among elderly persons?AAmyotrophic lateral sclerosis (Lou Gerhigs disease)BAlzheimers disease CMultiple sclerosisDParkinsons diseaseQuestion 20 Explanation: Alzheimer;s disease, sometimes known as senile dementia of the Alzheimers type or primary degenerative dementia, is an insidious; progressive, irreversible, and degenerative disease of the brain whose etiology is still unknown. ATI Quiz Fundamentals 1 Flashcards Quizlet - Studocu Risk for injury SIMS Removing the bodys clothing and wrapping the body in a shroud -Wait 30 to 60 minutes after feeding to reconnect to suctioning. 1. The nurse notes that he is steady on his feet and that his vision was unaffected by the surgery. A prescribed amount of oxygen s needed for a patient with COPD to prevent: Cardiac arrest related to increased partial pressure of carbon dioxide in arterial blood (PaCO2), Inhibition of the respiratory hypoxic stimulus. Such a patient is unlikely to display emotion, such as crying. Hold pen with thumb ready to depress The nurse is responsible for: Instructing the patient about this diagnostic test. If loading fails, click here to try again Question 11If nurse administers an injection to a patient who refuses that injection, she has committed:AMalpracticeBNegligenceCAssault and batteryDNone of the above Question 11 Explanation: Assault is the unjustifiable attempt or threat to touch or injure another person. Document injury, Special Considerations for Administering Medications to Infants and Children, Age, weight, surface area How many patient identifiers should you use? Patients feel less anxious and isolated and more secure because they are allowed to participate in planning their own care. 1. For a rectal examination, the patient can be directed to assume which of the following positions? If patient asks the nurse her opinion about a particular physicians and the nurse replies that the physician is incompetent, the nurse could be held liable for: 13. She may be involved in obtaining consent for an autopsy or notifying the coroner or medical examiner of a patients death; however, she is not legally responsible for performing these functions. You got 50 minutes to finish the exam .Good luck! These changes, in turn, increase the work load of the left ventricle. Increased peripheral resistance of the blood vessels Bed rest and oxygen by Venturi mask at 24% would improve oxygenation of the tissues and cells but must be ordered by a physician. - Chest wall movement - Air entrapment & is more precise Impaired gas exchange Good luck! Demonstrating the signal system and providing an opportunity for a return demonstration ensures that the patient knows how to operate the equipment and encourages him to call for assistance when needed. She may be involved in obtaining consent for an autopsy or notifying the coroner or medical examiner of a patients death; however, she is not legally responsible for performing these functions. Look at when next due dose is? Consuit a physical therapist before allowing the patient to ambulate Malpractice Errors include List Your hair is really pretty offers no consolation or alternatives to the patient. Acute pain Which of the following is an example of nursing malpractice? Question 33The most common deficiency seen in alcoholics is:AThiamineBPantothenic acid CRiboflavinDPyridoxineQuestion 33 Explanation: Chronic alcoholism commonly results in thiamine deficiency and other symptoms of malnutrition. Thus, a respiratory rate of 30 would be abnormal. Which of the following nursing interventions would be appropriate? use proper injection angle Your answers are highlighted below. The most common psychogenic disorder among elderly person is: 46. Patient's perspectives inject med slowly and smoothly APerson, environment, health, nursing BPerson, health, psychology, nursingCPerson, nursing, environment, medicineDPerson, health, nursing, support systemsQuestion 46 Explanation: The focus concepts that have been accepted by all theorists as the focus of nursing practice from the time of Florence Nightingale include the person receiving nursing care, his environment, his health on the health illness continuum, and the nursing actions necessary to meet his needs. Patients should begin ambulation as soon as possible after surgery to decrease complications and to regain strength and confidence. The four main concepts common to nursing that appear in each of the current conceptual models are: The focus concepts that have been accepted by all theorists as the focus of nursing practice from the time of Florence Nightingale include the person receiving nursing care, his environment, his health on the health illness continuum, and the nursing actions necessary to meet his needs. -Rectal bleeding Practice Mode Don't do this on rib fractures, bleeding disorders, old person with osteoporosis Maternal and Child Health Nursing (NCLEX Exams), Medical and Surgical Nursing (NCLEX Exams), Pharmacology and Drug Calculation (NCLEX Exams), NCLEX Practice Exam for Blood Transfusion, The patient will find pureed or soft foods, such as custards, easier to swallow than water, Fowlers or semi Fowlers position reduces the risk of aspiration during swallowing. Pre-attached needle She may be involved in obtaining consent for an autopsy or notifying the coroner or medical examiner of a patients death; however, she is not legally responsible for performing these functions. Assessing for distention, tenderness and discoloration around the umbilicus can indicate various bowel-related conditions, such as cholecystitis, appendicitis and peritonitis. After assessing Mrs. Paul, the nurse writes the following nursing diagnosis: Impaired gas exchange related to increased secretions. Its only temporaryDYour hair is really prettyQuestion 2 Explanation: I know this will be difficult acknowledges the problem and suggests a resolution to it. The nurse notes that he is steady on his feet and that his vision was unaffected by the surgery. Written report within 24 hours of occurrence, Comparison of medications taken at home and prescribed when in the health care setting, Change in patient's condition Receiving, transcribing, and communicating medication orders Writing the order for this test Because transplants are done within hours of death, decisions about organ donation must be made as soon as possible. - Pulmonary edema ( no gas exchange with the lungs) Start Tachypnea is rapid respiration characterized by quick, shallow breaths. Your hair is really pretty offers no consolation or alternatives to the patient. An appropriate nursing diagnosis would be: The nurse documents this breathing as: 3. Evaluation, Place call light within reach An appropriate nursing diagnosis would be:AIneffective individual coping to COPD.B Ineffective airway clearance related to thick, tenacious secretions.CPain related to immobilization of affected leg. What is causing the quick breathing 39. The physician orders the administration of high-humidity oxygen by face mask and placement of the patient in a high Fowlers position. 2. List factors required for informed consent. Demonstrating the signal system and providing an opportunity for a return demonstration ensures that the patient knows how to operate the equipment and encourages him to call for assistance when needed. Multiple sclerosis A 38-year old patients vital signs at 8 a.m. are axillary temperature 99.6 F (37.6 C); pulse rate, 88; respiratory rate, 30. Demonstrating the signal system and providing an opportunity for a return demonstration ensures that the patient knows how to operate the equipment and encourages him to call for assistance when needed. Score Observation of physiological measures A. Fluids containing caffeine have a diuretic effect. 26. Question 19To assess the kidney function of a patient with an indwelling urinary (Foley) catheter, the nurse measures his hourly urine output. She elevates the head of the bed to the high Fowler position, which decreases his respiratory distress. oxygen therapy, 2. The correct sequence for assessing the abdomen is: often includes undermining and or tunneling Acute pain, Nursing Process: Planning for patients with low oxygenation. Decreased appetite Elevate the head of the bed Partial-Credit The best response would be: What factors affect ventilation and O transport? A male patient who had surgery 2 days ago for head and neck cancer is about to make his first attempt to ambulate outside his room.