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Topics or concepts included in this exam are:
- Various questions about Fundamentals of Nursing
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- Answers and rationales are given below. Be sure to read them.
- If you need more clarifications, please direct them to the comments section.
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Fundamentals of Nursing NCLEX Practice Quiz 13 (25 Questions)
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Fundamentals of Nursing NCLEX Practice Quiz 13 (25 Questions)
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1. Which element in the circular chain of infection can be eliminated by preserving skin integrity?
C. Mode of transmission
D. Portal of entry
2. Which of the following will probably result in a break in sterile technique for respiratory isolation?
A. Opening the patient’s window to the outside environment
B. Turning on the patient’s room ventilator
C. Opening the door of the patient’s room leading into the hospital corridor
D. Failing to wear gloves when administering a bed bath
3. Which of the following patients is at greater risk for contracting an infection?
4. Effective hand washing requires the use of:
A. Soap or detergent to promote emulsification
B. Hot water to destroy bacteria
C. A disinfectant to increase surface tension
D. All of the above
5. After routine patient contact, hand washing should last at least:
A. 30 seconds
B. 1 minute
C. 2 minutes
D. 3 minutes
6. Which of the following procedures always requires surgical asepsis?
7. Sterile technique is used whenever:
A. Strict isolation is required
B. Terminal disinfection is performed
C. Invasive procedures are performed
D. Protective isolation is necessary
8. Which of the following constitutes a break in sterile technique while preparing a sterile field for a dressing change?
A. Using sterile forceps, rather than sterile gloves, to handle a sterile item
B. Touching the outside wrapper of sterilized material without sterile gloves
C. Placing a sterile object on the edge of the sterile field
D. Pouring out a small amount of solution (15 to 30 ml) before pouring the solution into a sterile container
9. A natural body defense that plays an active role in preventing infection is:
10. All of the following statement are true about donning sterile gloves except:
A. The first glove should be picked up by grasping the inside of the cuff.
B. The second glove should be picked up by inserting the gloved fingers under the cuff outside the glove.
C. The gloves should be adjusted by sliding the gloved fingers under the sterile cuff and pulling the glove over the wrist
D. The inside of the glove is considered sterile
11. When removing a contaminated gown, the nurse should be careful that the first thing she touches is the:
A. Waist tie and neck tie at the back of the gown
B. Waist tie in front of the gown
C. Cuffs of the gown
D. Inside of the gown
12. Which of the following nursing interventions is considered the most effective form or universal precautions?
A. Cap all used needles before removing them from their syringes
B. Discard all used uncapped needles and syringes in an impenetrable protective container
C. Wear gloves when administering IM injections
D. Follow enteric precautions
13. All of the following measures are recommended to prevent pressure ulcers except:
A. Massaging the reddened area with lotion
B. Using a water or air mattress
C. Adhering to a schedule for positioning and turning
D. Providing meticulous skin care
14. Which of the following blood tests should be performed before a blood transfusion?
15. The primary purpose of a platelet count is to evaluate the:
A. Potential for clot formation
B. Potential for bleeding
C. Presence of an antigen-antibody response
D. Presence of cardiac enzymes
16. Which of the following white blood cell (WBC) counts clearly indicates leukocytosis?
17. After 5 days of diuretic therapy with 20mg of furosemide (Lasix) daily, a patient begins to exhibit fatigue, muscle cramping and muscle weakness. These symptoms probably indicate that the patient is experiencing:
18. Which of the following statements about chest X-ray is false?
A. No contradictions exist for this test
B. Before the procedure, the patient should remove all jewelry, metallic objects, and buttons above the waist
C. A signed consent is not required
D. Eating, drinking, and medications are allowed before this test
19. The most appropriate time for the nurse to obtain a sputum specimen for culture is:
A. Early in the morning
B. After the patient eats a light breakfast
C. After aerosol therapy
D. After chest physiotherapy
20. A patient with no known allergies is to receive penicillin every 6 hours. When administering the medication, the nurse observes a fine rash on the patient’s skin. The most appropriate nursing action would be to:
A. Withhold the moderation and notify the physician
B. Administer the medication and notify the physician
C. Administer the medication with an antihistamine
D. Apply cornstarch soaks to the rash
21. All of the following nursing interventions are correct when using the Z-track method of drug injection except:
A. Prepare the injection site with alcohol
B. Use a needle that’s a least 1” long
C. Aspirate for blood before injection
D. Rub the site vigorously after the injection to promote absorption
22. The correct method for determining the vastus lateralis site for I.M. injection is to:
A. Locate the upper aspect of the upper outer quadrant of the buttock about 5 to 8 cm below the iliac crest
B. Palpate the lower edge of the acromion process and the midpoint lateral aspect of the arm
C. Palpate a 1” circular area anterior to the umbilicus
D. Divide the area between the greater femoral trochanter and the lateral femoral condyle into thirds, and select the middle third on the anterior of the thigh
23. The mid-deltoid injection site is seldom used for I.M. injections because it:
A. Can accommodate only 1 ml or less of medication
B. Bruises too easily
C. Can be used only when the patient is lying down
D. Does not readily parenteral medication
24. The appropriate needle size for insulin injection is:
A. 18G, 1 ½” long
B. 22G, 1” long
C. 22G, 1 ½” long
D. 25G, 5/8” long
25. The appropriate needle gauge for intradermal injection is:
Answers and Rationale
Gauge your performance by counter checking your answers to the answers below. Learn more about the question by reading the rationale. If you have any disputes or questions, please direct them to the comments section.
1. Answer: D. Portal of entry
Option D: In the circular chain of infection, pathogens must be able to leave their reservoir and be transmitted to a susceptible host through a portal of entry, such as broken skin.
2. Answer: C. Opening the door of the patient’s room leading into the hospital corridor
- Option C: Respiratory isolation, like strict isolation, requires that the door to the door patient’s room remain closed.
- Options A and B: However, the patient’s room should be well ventilated, so opening the window or turning on the ventricular is desirable.
- Option D: The nurse does not need to wear gloves for respiratory isolation, but good hand washing is important for all types of isolation.
3. Answer: A. A patient with leukopenia
- Option A: Leukopenia is a decreased number of leukocytes (white blood cells), which are important in resisting infection.
Options B, C, and D: None of the other situations would put the patient at risk for contracting an infection; taking broad-spectrum antibiotics might actually reduce the infection risk.
4. Answer: A. Soap or detergent to promote emulsification
- Option A: Soaps and detergents are used to help remove bacteria because of their ability to lower the surface tension of water and act as emulsifying agents.
- Option B: Hot water may lead to skin irritation or burns.
5. Answer: A. 30 seconds
- Option A: Depending on the degree of exposure to pathogens, hand washing may last from 10 seconds to 4 minutes. After routine patient contact, hand washing for 30 seconds effectively minimizes the risk of pathogen transmission.
6. Answer: B. Urinary catheterization
- Option B: The urinary system is normally free of microorganisms except at the urinary meatus. Any procedure that involves entering this system must use surgically aseptic measures to maintain a bacteria-free state.
7. Answer: C. Invasive procedures are performed
- Option C: All invasive procedures, including surgery, catheter insertion, and administration of parenteral therapy, require sterile technique to maintain a sterile environment. All equipment must be sterile, and the nurse and the physician must wear sterile gloves and maintain surgical asepsis. In the operating room, the nurse and physician are required to wear sterile gowns, gloves, masks, hair covers, and shoe covers for all invasive procedures.
- Option A: Strict isolation requires the use of clean gloves, masks, gowns and equipment to prevent the transmission of highly communicable diseases by contact or by airborne routes.
- Option B: Terminal disinfection is the disinfection of all contaminated supplies and equipment after a patient has been discharged to prepare them for reuse by another patient.
- Option D: The purpose of protective (reverse)isolation is to prevent a person with seriously impaired resistance from coming into contact who potentially pathogenic organisms.
8. Answer: C. Placing a sterile object on the edge of the sterile field
- Option C: The edges of a sterile field are considered contaminated. When sterile items are allowed to come in contact with the edges of the field, the sterile items also become contaminated.
9. Answer: B. Body hair
- Option B: Hair on or within body areas, such as the nose, traps and holds particles that contain microorganisms.
- Options A and C: Yawning and hiccupping do not prevent microorganisms from entering or leaving the body.
- Option D: Rapid eye movement marks the stage of sleep during which dreaming occurs.
10. Answer: D. The inside of the glove is considered sterile
- Option D: The inside of the glove is always considered to be clean, but not sterile.
11. Answer: A. Waist tie and neck tie at the back of the gown
- Option A: The back of the gown is considered clean, the front is contaminated. So, after removing gloves and washing hands, the nurse should untie the back of the gown; slowly move backward away from the gown, holding the inside of the gown and keeping the edges off the floor; turn and fold the gown inside out; discard it in a contaminated linen container; then wash her hands again.
12. Answer: B. Discard all used uncapped needles and syringes in an impenetrable protective container
- Option B: According to the Centers for Disease Control (CDC), blood-to-blood contact occurs most commonly when a health care worker attempts to cap a used needle.
- Option A: Therefore, used needles should never be recapped; instead they should be inserted in a specially designed puncture resistant, labeled container.
- Option C: Wearing gloves is not always necessary when administering an I.M. injection.
- Option D: Enteric precautions prevent the transfer of pathogens via feces.
13. Answer: A. Massaging the reddened area with lotion
- Option A: Nurses and other healthcare professionals previously believed that massaging a reddened area with lotion would promote venous return and reduce edema to the area. However, research has shown that massage only increases the likelihood of cellular ischemia and necrosis to the area.
14. Answer: B. Blood typing and cross-matching
- Option B: Before a blood transfusion is performed, the blood of the donor and recipient must be checked for compatibility. This is done by blood typing (a test that determines a person’s blood type) and cross-matching (a procedure that determines the compatibility of the donor’s and recipient’s blood after the blood types has been matched). If the blood specimens are incompatible, hemolysis and antigen-antibody reactions will occur.
15. Answer: A. Potential for clot formation
- Option A: Platelets are disk-shaped cells that are essential for blood coagulation. A platelet count determines the number of thrombocytes in blood available for promoting hemostasis and assisting with blood coagulation after injury.
- Option B: It also is used to evaluate the patient’s potential for bleeding; however, this is not its primary purpose. The normal count ranges from 150,000 to 350,000/mm3. A count of 100,000/mm3 or less indicates a potential for bleeding; count of less than 20,000/mm3 is associated with spontaneous bleeding.
16. Answer: D. 25,000/mm³
- Option D: Leukocytosis is any transient increase in the number of white blood cells (leukocytes) in the blood. Normal WBC counts range from 5,000 to 100,000/mm3. Thus, a count of 25,000/mm3 indicates leukocytosis.
17. Answer: A. Hypokalemia
- Option A: Fatigue, muscle cramping, and muscle weaknesses are symptoms of hypokalemia (an inadequate potassium level), which is a potential side effect of diuretic therapy. The physician usually orders supplemental potassium to prevent hypokalemia in patients receiving diuretics.
- Option C: Anorexia is another symptom of hypokalemia.
- Option D: Dysphagia means difficulty swallowing.
18. Answer: A. No contradictions exist for this test
- Option A: Pregnancy or suspected pregnancy is the only contraindication for a chest X-ray. However, if a chest X-ray is necessary, the patient can wear a lead apron to protect the pelvic region from radiation.
- Option B: Jewelry, metallic objects, and buttons would interfere with the X-ray and thus should not be worn above the waist.
- Option C: A signed consent is not required because a chest X-ray is not an invasive examination.
- Option D: Eating, drinking and medications are allowed because the X-ray is of the chest, not the abdominal region.
19. Answer: A. Early in the morning
- Option A: Obtaining a sputum specimen early in this morning ensures an adequate supply of bacteria for culturing and decreases the risk of contamination from food or medication.
20. Answer: A. Withhold the moderation and notify the physician
- Option A: Initial sensitivity to penicillin is commonly manifested by a skin rash, even in individuals who have not been allergic to it previously. Because of the danger of anaphylactic shock, the nurse should withhold the drug and notify the physician, who may choose to substitute another drug.
- Option C: Administering an antihistamine is a dependent nursing intervention that requires a written physician’s order.
- Option D: Although applying cornstarch to the rash may relieve discomfort, it is not the nurse’s top priority in such a potentially life-threatening situation.
21. Answer: D. Rub the site vigorously after the injection to promote absorption
- Option D: The Z-track method is an I.M. injection technique in which the patient’s skin is pulled in such a way that the needle track is sealed off after the injection. This procedure seals medication deep into the muscle, thereby minimizing skin staining and irritation. Rubbing the injection site is contraindicated because it may cause the medication to extravasate into the skin.
22. Answer: D. Divide the area between the greater femoral trochanter and the lateral femoral condyle into thirds, and select the middle third on the anterior of the thigh
- Option D: The vastus lateralis, a long, thick muscle that extends the full length of the thigh, is viewed by many clinicians as the site of choice for I.M. injections because it has relatively few major nerves and blood vessels. The middle third of the muscle is recommended as the injection site. The patient can be in a supine or sitting position for an injection into this site.
23. Answer: A. Can accommodate only 1 ml or less of medication
- Option A: The mid-deltoid injection site can accommodate only 1 ml or less of medication because of its size and location (on the deltoid muscle of the arm, close to the brachial artery and radial nerve).
24. Answer: D. 25G, 5/8” long
- Option D: A 25G, 5/8” needle is the recommended size for insulin injection because insulin is administered by the subcutaneous route.
- Option A: An 18G, 1 ½” needle is usually used for I.M. injections in children, typically in the vastus lateralis.
- Option C: A 22G, 1 ½” needle is usually used for adult I.M. injections, which are typically administered in the vastus lateralis or ventrogluteal site.
25. Answer: D. 26G
- Option D: Because an intradermal injection does not penetrate deeply into the skin, a small-bore 26G-27G needle is recommended. This type of injection is used primarily to administer antigens to evaluate reactions for allergy or sensitivity studies.
Options A, B, and C: A 20G needle is usually used for I.M. injections of oil-based medications; a 22G-25G needle for I.M. injections; and a 25G needle, for subcutaneous insulin injections.
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