fundamentals of nursing

Fundamental of Nursing Practice Quiz Part 1

Test your knowledge about fundamental of nursing practice quiz which includes concept of nursing.

fundamentals of nursing
Fundamental of Nursing Practice Quiz

If a nurse administers an injection to a patient who refuses that injection, she has committed

a. Assault and battery
b. Negligence
c. Malpractice
d. None of the above

Rationale:

A is the correct answer. Assault is the unjustifiable attempt or threat to touch or injure another person. The battery is the unlawful touching of another person or the carrying out of threatened physical harm. Thus, any act that a nurse performs on the patient against his will is considered assault and battery.

If a patient asks the nurse her opinion about particular physicians and the nurse replies that the physician is incompetent, the nurse could be held liable for

a. Slander
b. Libel
c. Assault
d. Respondent superior

Rationale:

A is the correct answer. Oral communication that injures an individual’s reputation is considered slander. Written communication that does the same is considered libel.

A registered nurse reaches to answer the telephone on a busy pediatric unit, momentarily turning away from a 3 month-old infant she has been weighing. The infant falls off the scale, suffering a skull fracture. The nurse could be charged with

a. Defamation
b. Assault
c. Battery
d. Malpractice

Rationale:

D is the correct answer. Malpractice is defined as injurious or unprofessional actions that harm another. It involves professional misconduct, such as omission or commission of an act that a reasonable and prudent nurse would or would not do. In this example, the standard of care was breached; a 3-month-old infant should never be left unattended on a scale.

Which of the following is an example of nursing malpractice?

a. The nurse administers penicillin to a patient with a documented history of allergy to the drug. The patient experiences an allergic reaction and has cerebral damage resulting from anoxia.
b. The nurse applies a hot water bottle or a heating pad to the abdomen of a patient with abdominal cramping.
c. The nurse assists a patient out of bed with the bed locked in position; the patient slips and fractures his right humerus
d. The nurse administers the wrong medication to a patient and the patient vomits. This information is documented and reported to the physician and the nursing supervisor.

Rationale:

A. The three elements necessary to establish a nursing malpractice are nursing error (administering penicillin to a patient with a documented allergy to the drug), injury (cerebral damage), and proximal cause (administering the penicillin caused the cerebral damage). Applying a hot water bottle or heating pad to a patient without a physician’s order does not include the three required components. Assisting a patient out of bed with the bed locked in position is the correct nursing practice; therefore, the fracture was not the result of malpractice. 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.

Practice Question Test

Results

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#1. A patient is admitted to the hospital with complaints of nausea, vomiting, diarrhea, and severe abdominal pain. Which of the following would immediately alert the nurse that the patient has bleeding from the GI tract?

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. A complete blood count does not provide immediate results and does not always immediately reflect blood loss. Changes in vital signs may be caused by factors other than blood loss. Abdominal girth is unrelated to blood loss.

#2. The correct sequence for assessing the abdomen is

Because percussion and palpation can affect bowel motility and thus bowel sounds, they should follow auscultation in the abdominal assessment. Tympanic percussion, measurement of abdominal girth, and inspection are methods of assessing the abdomen. Assessing for distention, tenderness, and discoloration around the umbilicus can indicate various bowel-related conditions, such as cholecystitis, appendicitis, and peritonitis.

#3. High-pitched gurgles head over the right lower quadrant are

C is the correct answer. Hyperactive sounds indicate increased bowel motility; two or three sounds per minute indicate decreased bowel motility. Abdominal cramping with hyperactive, high pitched tinkling bowel sounds can indicate a bowel obstruction.

#4. A patient about to undergo abdominal inspection is best placed in which of the following positions?

C is the correct answer. The supine position (also called the dorsal position), in which the patient lies on his back with his face upward, allows for easy access to the abdomen. In the prone position, the patient lies on his abdomen with his face turned to the side. In the Trendelenburg position, the head of the bed is tilted downward to 30 to 40 degrees so that the upper body is lower than the legs. In the lateral position, the patient lies on his side.

#5. For a rectal examination, the patient can be directed to assume which of the following positions?

D is the correct answer. All of these positions are appropriate for a rectal examination. In the genupectoral (knee-chest) position, the patient kneels and rests his chest on the table, forming a 90-degree angle between the torso and upper legs. In Sims’ position, the patient lies on his left side with the left arm behind the body and his right leg flexed. In the horizontal recumbent position, the patient lies on his back with legs extended and hips rotated outward.

#6. During a Romberg test, the nurse asks the patient to assume which position?

B is the correct answer. During a Romberg test, which evaluates for sensory or cerebellar ataxia, the patient must stand with feet together and arms resting at the sides—first with eyes open, then with eyes closed. The need to move the feet apart to maintain this stance is an abnormal finding. 22. A. The pulse pressure is the difference between the systolic and diastolic blood pressure readings – in this case, 54.

#7. If a patient’s blood pressure is 150/96, his pulse pressure is

A is the correct answer. The pulse pressure is the difference between the systolic and diastolic blood pressure readings – in this case, 54.

#8. A patient is kept off food and fluids for 10 hours before surgery. His oral temperature at 8 a.m. is 99.8 F (37.7 C) This temperature reading probably indicates

D is the correct answer. A slightly elevated temperature in the immediate preoperative or postoperative period may result from the lack of fluids before surgery rather than from infection. Anxiety will not cause an elevated temperature. Hypothermia is abnormally low body temperature.

#9. Which of the following parameters should be checked when assessing respirations?

D is the correct answer. The quality and efficiency of the respiratory process can be determined by appraising the rate, rhythm, depth, ease, sound, and symmetry of respirations.

#10. .A 38-year old patient’s vital signs at 8 a.m. are axillary temperature 99.6 F (37.6 C); pulse rate, 88; respiratory rate, 30. Which findings should be reported?

D is the correct answer. Under normal conditions, a healthy adult breathes in a smooth uninterrupted pattern 12 to 20 times a minute. Thus, a respiratory rate of 30 would be abnormal. A normal adult body temperature, as measured on an oral thermometer, ranges between 97° and 100°F (36.1° and 37.8°C); an axillary temperature is approximately one degree lower and rectal temperature, one degree higher. Thus, an axillary temperature of 99.6°F (37.6°C) would be considered abnormal. The resting pulse rate in an adult ranges from 60 to 100 beats/minute, so a rate of 88 is normal.

finish

Which of the following signs and symptoms would the nurse expect to find when assessing an Asian patient for postoperative pain following abdominal surgery?

a. Decreased blood pressure and heart rate and shallow respirations
b. Quiet crying
c. Immobility, diaphoresis, and avoidance of deep breathing or coughing
d. Changing position every 2 hours

Rationale:

C is the correct answer. An Asian patient is likely to hide his pain. Consequently, the nurse must observe for objective signs. In an abdominal surgery patient, these might include immobility, diaphoresis, and avoidance of deep breathing or coughing, as well as increased heart rate, shallow respirations (stemming from pain upon moving the diaphragm and respiratory muscles), and guarding or rigidity of the abdominal wall. Such a patient is unlikely to display emotion, such as crying.

You may also visit Fundamental of Nursing Question and Rationale Part I

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