Fundamentals Exam 1

1. The nurse prepares to admit a patient who is immediately postoperative to

the unit following abdominal surgery. When transferring the patient from the
stretcher to the bed, she should
a. Lock the wheels to the bed and stretcher
b. Have the client use the trapeze to assist
c. Have at least four people assist with the transfer
d. Use the draw sheet to transfer the patient
2. An older adult appears agitated when the nurse requests that the patients
dentures be removed prior to surgery and states, I never go without my
teeth. Which is the best response?
a. Its for your safety. Dentures can slip and block your airway during
surgery.
b. You wouldnt want your teeth to be lost or broken during surgery
would you?
c. The anesthesiologist requires everyone to remove their dentures.
d. You seem worried. Are you concerned someone may see you without
your teeth?
3. A patient becomes infected with oral candidiasis (thrush) while receiving IV
antibiotics to treat a systemic infection. Which type of infection has the
patient developed?
a. Endogenous
b. Exogenous
c. Latent
d. Primary
4. A patient has had food poisoning with severe vomiting and diarrhea. What
would this acute illness most likely cause which could then affect skin
integrity?
a. Erythema
b. Dehydration
c. Jaundice
d. Eczema
5. Which factor(s) in the patients past medical history place(s) him at risk for
falling? Select all that apply.
a. Orthostatic hypotension
b. Appendectomy
c. Dizziness
d. Hyperthyroidism
6. You are making a bed occupied by a patient. Which of the following is a
recommended step for this procedure?
a. Lower side rail on opposite side of you.
b. Discard soiled linen onto the floor.
c. Use a bath blanket for warmth and privacy.
d. Place a draw sheet under the patients knees.
7. A hospitalized patient needs a chest x-ray. The radiology department calls the
nursing unit and says they are sending a transporter for the patient. When
entering the patients room, the priority action is
a. Explain the x-ray procedure to the patient.

b. Help the patient into a wheelchair before the transporter arrives.

c. Ask if the patient has any questions.
d. Check the patients ID bracelet.
8. The following procedures have been ordered and implemented for a
hospitalized patient. Which procedure carries the greatest risk for a hospital
required infection?
a. Enema
b. Intramuscular injections
c. Heat lamp
d. Urinary catheterization
9. A nurse is caring for an older adult patient who has been bathing in the
morning following the facilitys routine. However, at home, she always takes a
warm bath just before bedtime. Now shes having difficulty sleeping at night.
Which of the following interventions should the nurse take?
a. Ask the provider to order a sleep aid medication.
b. Offer her warm milk and crackers at 21:00.
c. Allow her to take a bath in the evening.
d. Provide denture care using warm water.
10.A nurse-manager IDs falls prevention as a unit priority. Which of the following
actions can the nurses implement to meet these goal? Select all that apply.
a. Use bed alarms to remind clients to call for help with getting up.
b. Apply soft waist restraints to confused clients.
c. Maintain a clear path to client bathrooms.
d. Make hourly rounds to client rooms.
e. Close doors to client rooms at night.
11.To use proper body mechanics while making an occupied bed for a patient on
bed rest, the nurse should
a. Place the bed in an elevated horizontal position.
b. Make sure the side rails are all down.
c. Push the patient over as far as possible onto her side.
d. Place the bed in a Semi-Fowlers position.
12.A nurse is developing a plan of care for an older adult who is malnourished
and on bed rest. Which of the following interventions would be included to
prevent skin alterations?
a. Turn and reposition every 2 hours.
b. Limit fluids to 500 mL every 24 hours.
c. Do not use lotions or creams on skin.
d. Assess vital signs every 4 hours.
13.Which of the following lists the recommended sequence for removing soiled
personal equipment when the nurse prepares to leave the patients room?
a. Gown, goggles, mask, gloves, and exit the room.
b. Gloves, wash hands, remove gown, mask, and goggles.
c. Gloves, goggles, gown, mask, and wash hands.
d. Goggles, mask, gloves, gown, wash hands.

14.Which of the following is one of the most important benefits of a nurse

helping with bathing?
a. The patient sees professional staff.
b. The nurse improves technical skills.
c. Staff-nurse relationships are more collegial.
d. Nurse-patient relationships are facilitated.
15.The nurse is planning care for a client on complete bed rest. The plan of care
should include all except which of the following.
a. Turning every 2 hours.
b. Passive and active ROM exercises.
c. Use of thromboembolic disease (TED) support hose.
d. Maintaining the client in the supine position.
16.The nurse is caring for a patient who is immobile. The nurse is aware that the
patient is at risk for impaired skin integrity because:
a. Pressure reduces circulation of affected tissue.
b. Patients with limited caloric intake develop thicker skin.
c. Inadequate blood flow leads to decreased tissue ischemia.
d. Local nerve damage leads to pain sensation.
17.A nurse has several patients at a community health center. Which of the
patients would be most at risk for developing an infection?
a. An infant who has just received first immunizations.
b. An adolescent who sprained his ankle during basketball practice.
c. An older adult with several chronic illnesses.
d. A middle-aged adult with joint pain and stiffness.
18.The nurse just removed non-sterile after changing the patients dressing.
Which of the following techniques would be most effective for hand hygiene?
a. Use of alcohol-based hand rub
b. Hand hygiene is not required since he used gloves.
c. Hand washing with antimicrobial soap.
d. Hand washing with plain soap,
19.When the nurse performs oral hygiene for an unconscious patient, which
nursing intervention is the priority?
a. Keep a suction machine available.
b. Place the client in the prone position.
c. Wear sterile gloves while brushing the clients teeth.
d. Use gauze wrapped around the fingers to clean the clients gums
20.A nurse is evaluating a patient who has right leg weakness and is learning to
use a standard walker. Which of the following actions by the patient indicates
proper use of the walker.
a. Uses a lifting motion to move the walker.
b. Uses the walker to life himself up to stand.
c. Takes step while moving the walker forward.
d. Locks elbows when stepping forward.

21.The nurse is caring for a patient who becomes nauseated and vomits without
warning. The nurse has contaminated hands. The nurses best next step is to:

a. Clean hands with wipes from the bedside table.

b. Wash hands with an antimicrobial soap and water.
c. Use an alcohol-based waterless hand gel.
d. Instruct the patient to wash his face and hands.
22.What is the most frequent cause of the spread of infection among
institutionalized patients?
a. Airborne microbes from other patients.
b. Contact with contaminated equipment.
c. Hands of healthcare workers.
d. Exposure from family members.

Answers
1. A
2. D
3. A
4. B
5. A, C
6. C
7. D
8. D
9. C
10.A, C, D
11.A
12.A
13.C
14.D
15.D
16.A
17.C
18.A
19.A
20.A
21.B
22.C