NUAS 130SP Exam 4 Final Review T02 Mount Aloysius College.
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Free NUAS 130SP Exam 4 Final Review T02 Mount Aloysius College. Questions
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Assess lifestyle habits
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Detect disease at an early stage
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Identify healthcare beliefs
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Determine treatment options
Explanation
Correct Answer: B) Detect disease at an early stage
Health screening activities are designed to identify diseases or risk factors in individuals who may not yet have symptoms, enabling early intervention before the condition worsens. Blood pressure screening identifies hypertension early, allowing prompt treatment to prevent complications such as stroke, heart attack, or kidney disease. This falls under secondary prevention.
Assessing lifestyle habits is part of a health history or wellness assessment, not the primary purpose of a screening event. Identifying healthcare beliefs is part of a cultural or psychosocial assessment. Determining treatment options occurs after a diagnosis has been made and is the role of the healthcare provider, not a screening activity.
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Hemorrhage
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Heart failure
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Foot infection
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Acute kidney injury
Explanation
Correct Answer: A) Hemorrhage
Hemorrhage leads to rapid loss of blood volume, which directly results in fluid volume deficit. This can quickly compromise perfusion and lead to hypovolemic shock if not treated promptly.
Heart failure is associated with fluid volume excess, foot infection does not typically cause significant fluid loss, and acute kidney injury often leads to fluid retention rather than deficit.
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Auscultation of all 4 quads.
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Percussion in the upper quads.
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Palpate the patient's painful area first.
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Observe the contour of the abdomen.
Explanation
Correct Answer: D) Observe the contour of the abdomen.
The correct sequence for abdominal assessment is inspection, auscultation, percussion, then palpation — which differs from the standard assessment order used for other body systems. Inspection (observation) is always performed first, allowing the nurse to visually assess the contour, symmetry, distension, visible masses, skin changes, and movement of the abdomen before any physical contact is made.
Auscultation comes second in abdominal assessment, before percussion and palpation, because manipulating the abdomen first can artificially alter bowel sounds. Percussion is performed third to assess organ size and detect fluid or air. Palpating the painful area last — or avoiding it initially — is critical to prevent guarding, rigidity, and patient discomfort that could interfere with the rest of the examination.
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Reconnect the extension set.
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Clean the end with a cotton ball and reconnect it.
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Pull the IV from the site and insert a new catheter.
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Change the extension set tubing.
Explanation
Correct Answer: D) Change the extension set tubing.
When IV tubing or an extension set becomes contaminated by contact with non-sterile surfaces such as bed linens, the entire extension set must be replaced with new sterile tubing. Reconnecting contaminated tubing directly into the IV site introduces microorganisms into the bloodstream, creating a serious risk of catheter-related bloodstream infection (CRBSI), which can be life-threatening.
Simply reconnecting the extension set ignores the contamination that occurred and places the patient at serious infection risk. Cleaning the end with a cotton ball is insufficient — a cotton ball is not sterile and does not restore the sterility required for IV connections. Pulling the IV catheter and inserting a new one is unnecessary; the catheter at the site remains sterile and intact — only the contaminated extension set needs to be replaced.
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Increase the environmental stimuli.
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Always stick to strict deadlines.
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Speak softly and quickly.
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Accommodate for any sensory deficits.
Explanation
Correct Answer: D) Accommodate for any sensory deficits.
Older adults commonly experience age-related sensory changes including decreased hearing acuity (presbycusis), reduced visual acuity, and slower cognitive processing. Effective teaching for elderly clients requires acknowledging and accommodating these deficits — such as speaking clearly and at a moderate pace, using large-print materials, ensuring adequate lighting, and using hearing aids if needed — to ensure the information is received and understood.
Increasing environmental stimuli is counterproductive for older adults, as excess noise and distraction impair concentration and the ability to process new information. Strict teaching deadlines do not account for the slower pace at which many older adults process and retain information. Speaking softly and quickly is inappropriate — the nurse should speak at a normal to slightly elevated volume, clearly and slowly, to ensure comprehension.
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Provide written medication instructions for the client to read immediately prior to discharge.
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Discuss the information while assisting the client with his bath.
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Educate the patient about the medications as each one is administered.
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Provide instructions during a follow-up phone call the day after the client is discharged.
Explanation
Correct Answer: C) Educate the patient about the medications as each one is administered.
Teaching about each medication at the time of administration is the most efficient and effective method because it integrates education into routine care, reinforces learning through repetition across multiple administrations, and allows the client to immediately associate the information with the actual medication. This approach also allows the nurse to assess understanding and answer questions in real time.
Providing written instructions immediately before discharge is poor timing, as the client may be anxious, fatigued, or overwhelmed and unable to retain the information. Discussing medications during a bath is not an ideal learning environment, as the client is focused on personal hygiene and may feel uncomfortable or distracted. Providing instructions after discharge via phone call is too late, as the client will already be self-administering medications without having received prior education.
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Fidelity
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Morals
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Autonomy
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Nonmaleficence
Explanation
Correct Answer: D) Nonmaleficence
Nonmaleficence is the ethical principle meaning "do no harm." By carefully following the rights of medication administration (right patient, right drug, right dose, right route, right time) and performing the required checks, the nurse is actively working to prevent medication errors and protect the client from harm — a direct demonstration of nonmaleficence in practice.
Fidelity refers to keeping promises and maintaining loyalty and trustworthiness in the nurse-client relationship, not specifically to harm prevention protocols. Morals refer to personal values and beliefs about right and wrong but are not a formal ethical principle applied in clinical practice. Autonomy refers to respecting the client's right to make their own informed decisions, which is unrelated to medication safety checks.
Explanation
Correct Answer: 0.7 mL
Using the standard drug calculation formula:
Volume (mL) = Desired dose ÷ Dose on hand × Volume on hand
= 35 mg ÷ 50 mg × 1 mL
= 0.7 mL
The patient reported pain #4, which falls within the PRN range of #1–5, so the medication is appropriate to administer. The vial available contains 50 mg/mL, so to deliver the ordered 35 mg dose, the nurse should draw up 0.7 mL into the syringe for intramuscular injection.
It is important to note that meperidine (Demerol) is an opioid analgesic and the nurse must also assess respiratory rate, blood pressure, and level of consciousness before administration, and document the PRN administration with the pain score that prompted it.
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Turn the IV pump off and notify the primary nurse
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Adjust the rate of the IV fluid and notify the primary nurse
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Assess the reason the IV pump is alarming and notify the primary nurse
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Disconnect the IV tubing from the patient and notify the primary nurse
Explanation
Correct Answer: C) Assess the reason the IV pump is alarming and notify the primary nurse
The priority is to assess the cause of the alarm before taking further action. Alarms may indicate occlusion, air in the line, or completion of infusion. Immediate assessment ensures patient safety and appropriate intervention.
Turning off the pump, adjusting the rate, or disconnecting the tubing without assessment can lead to harm and are outside the student nurse’s scope without supervision.
Explanation
Correct Answer: 1.2 mL
The concentration is 250 mcg per 1 mL. To administer 300 mcg, divide 300 by 250, which equals 1.2 mL. This ensures accurate dosing based on the medication concentration provided.
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