PN 106 Foundations of Nursing Fundamentals

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Free PN 106 Foundations of Nursing Fundamentals Questions

1.

When applying ophthalmic ointments, the nurse should: (Select all that apply.)

  • remove gloves and perform hand hygiene.

  • ask the client to roll the eye around and from side to side

  • remove excess ointment from the lid with a cotton ball.

  • fill only the center of the conjunctival sac.

  • ask the client to close the eyelids tightly to distribute ointment.

Explanation

Correct Answer:

B. ask the client to roll the eye around and from side to side; C. remove excess ointment from the lid with a cotton ball

Explanation of Correct Answers

B. ask the client to roll the eye around and from side to side


After ophthalmic ointment is placed in the conjunctival sac, instructing the client to roll the eye gently in all directions allows the ointment to spread evenly over the cornea and conjunctiva. This ensures maximum contact of the medication with the eye tissues, improving absorption and therapeutic effectiveness.

C. remove excess ointment from the lid with a cotton ball


After application, some ointment may remain on the eyelid margins, which can cause discomfort or blurred vision if left in place. Using a clean cotton ball to gently remove this excess promotes comfort, prevents eye irritation, and maintains hygiene without disturbing the medication already inside the conjunctival sac.


2.

A patient who has had three enemas and is still passing feces is being cared for by a nurse. Next steps for the nurse?

  • Administer additional enemas until the stool clears completely

  • Check the patient’s electrolyte levels before repeating enemas

  • Discontinue enemas and switch to oral laxatives

  • Notify the provider immediately after the third enema

Explanation

Correct Answer:

B. Check the patient’s electrolyte levels before repeating enemas

Explanation of Correct Answer

Repeated enemas can lead to significant electrolyte imbalances, particularly loss of sodium and potassium, which can cause serious complications. If a patient continues to pass stool after three enemas, the nurse should assess electrolyte levels before administering additional enemas. Monitoring and correcting imbalances ensures patient safety and prevents complications such as arrhythmias or dehydration.


3.

A nurse is preparing to collect a 24-hour urine specimen for a patient. What is the best way to ensure that all staff and visitors know the urine must be saved?

  • Tell the patient only and rely on them to remind others

  • Place a reminder note in the patient’s chart

  • Place a sign over the bed and toilet stating all urine must be saved

  • Remind staff verbally at the start of each shift only

Explanation

Correct Answer:

C. Place a sign over the bed and toilet stating all urine must be saved

Explanation of Correct Answer

For a 24-hour urine collection, it is crucial that no urine is accidentally discarded, as this would invalidate the entire test. Placing a clear, visible sign over the patient’s bed and toilet alerts all staff, family, and visitors that every voided specimen must be saved. This ensures compliance and accuracy of the collection.


4.

A nurse is teaching a patient how to perform routine colostomy care at home. Which steps should the nurse include in the instructions?

  • Cut the wafer opening ½ inch larger than the stoma, remove old appliance, apply new one without cleaning the skin

  • Remove the old pouch, clean and dry the skin, cut the wafer opening 1/8 inch larger than the stoma, and apply the new pouch

  • Remove the old pouch, cut the wafer opening 1 inch larger than the stoma, and apply directly over soiled skin

  • Cleanse the stoma only with alcohol, then apply the new pouch without measuring

Explanation

Correct Answer:

B. Remove the old pouch, clean and dry the skin, cut the wafer opening 1/8 inch larger than the stoma, and apply the new pouch

Explanation of Correct Answer

Colostomy care involves removing the old pouching system, gently cleansing the skin around the stoma with warm water, and drying it thoroughly. The opening of the wafer or skin barrier should be cut about 1/8 inch larger than the stoma to avoid constriction while still protecting the skin. Once prepared, the new pouch is applied securely to maintain a proper seal and prevent leakage.


5.

A nurse is reviewing laboratory results for a patient and notes an abnormally high calcium level. What is the medical term for elevated calcium in the blood?

  • Hypocalcemia

  • Hypercalcemia

  • Hyperkalemia

  • Hypokalemia

Explanation

Correct Answer:

B. Hypercalcemia

Explanation of Correct Answer

Hypercalcemia is the term used to describe elevated calcium levels in the blood. It may occur due to hyperparathyroidism, malignancy, excessive calcium or vitamin D intake, or certain medications. Symptoms can include muscle weakness, fatigue, kidney stones, constipation, confusion, and cardiac arrhythmias. Prompt recognition and management are important to prevent complications associated with high calcium levels.


6.

Is it ok to apply suction when inserting a catheter into a tracheotomy?

  • Yes, continuous suction should be applied during insertion

  • Yes, intermittent suction prevents tissue damage during insertion

  • No, suction should not be used while placing the catheter

  • No, suction is never used during tracheotomy care

Explanation

Correct Answer:

C. No, suction should not be used while placing the catheter

Explanation of Correct Answer

Suction must never be applied during insertion of a catheter into a tracheostomy. Applying suction on the way in can traumatize the mucosa, cause bleeding, and remove oxygen, leading to hypoxia. The catheter should first be gently inserted to the appropriate depth, and suction is only applied while withdrawing the catheter to safely and effectively clear secretions.


7.

A nurse is teaching a patient about dietary sources of potassium. Which foods should the nurse recommend as good sources of potassium?

  • White bread, rice, and applesauce

  • Avocados, oranges and orange juice, bananas, meats, milk, potatoes, and raisins

  • Cheese, eggs, butter, and margarine

  • Lettuce, cucumbers, and celery

Explanation

Correct Answer:

B. Avocados, oranges and orange juice, bananas, meats, milk, potatoes, and raisins

Explanation of Correct Answer

Potassium-rich foods include avocados, bananas, oranges and orange juice, potatoes, raisins, meats, and milk. These foods support muscle function, nerve conduction, and fluid balance. Patients with hypokalemia are encouraged to increase these foods in their diet, while those with hyperkalemia or kidney disease may need to limit them to prevent dangerous elevations in serum potassium levels.


8.

A nurse is teaching a student about the stages of grief related to dying. How might anger be expressed during this stage?

  • “I feel at peace with what’s happening.”

  • “Why me?” while placing blame on others such as doctors, nurses, family, or even God

  • “If I can just live long enough to see my grandchild, I’ll be satisfied.”

  • “There must be some mistake in the diagnosis.”

Explanation

Correct Answer:

B. “Why me?” while placing blame on others such as doctors, nurses, family, or even God

Explanation of Correct Answer

In the anger stage of dealing with death, individuals often feel resentment and ask “Why me?” They may search for a cause or direct displaced anger toward caregivers, loved ones, or a higher power. This anger is a normal part of the grieving process and reflects the struggle with loss of control. Nurses should respond with empathy and understanding, recognizing this as a natural reaction to impending death.


9.

The UAP reports the client is complaining of dizziness and nausea after the administration of eardrops. What is the most likely cause of the dizziness?

  • Cerumen or drainage is occluding the ear canal

  • The client failed to remain in the side-lying position long enough.

  • Too much pressure was applied during instillation, with subsequent injury to the eardrum.

  • The medication was too cold when it was administered.

Explanation

Correct Answer:

D. The medication was too cold when it was administered.

Explanation of Correct Answer

Eardrops that are too cold can stimulate the vestibular apparatus in the inner ear, leading to dizziness, vertigo, and nausea. This occurs because the temperature difference alters fluid movement in the semicircular canals, disturbing balance. To prevent this, ear medications should be warmed to room temperature before administration, ensuring comfort and avoiding vestibular side effects.


10.

A nurse is explaining different types of surgical procedures to a group of students. How should the nurse describe palliative surgery?

  • A surgery performed to permanently cure a disease

  • A surgery done only for diagnostic purposes

  • A surgery that alleviates symptoms and provides comfort but does not necessarily cure the disease or heal the injury

  • A surgery performed strictly for cosmetic enhancement

Explanation

Correct Answer:

C. A surgery that alleviates symptoms and provides comfort but does not necessarily cure the disease or heal the injury

Explanation of Correct Answer

Palliative surgery is performed to relieve symptoms, improve quality of life, and provide comfort when curing the disease is not possible. Examples include removing part of a tumor to reduce pain or obstruction. Unlike curative surgery, it does not aim to eliminate the underlying condition but focuses on symptom management and patient well-being, especially in advanced or terminal illness.


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