PN 106 Foundations of Nursing Fundamentals at Nightgale College PN

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Free PN 106 Foundations of Nursing Fundamentals at Nightgale College PN Questions

1.

A nurse is preparing to care for a patient who identifies as a Jehovah’s Witness. What is their belief regarding the use of blood products?

  • Blood transfusions are permitted if the patient gives consent

  • Taking blood into the body is prohibited, and transfusion of blood or blood products is not permitted

  • Only plasma products are permitted, but whole blood is not

  • Blood products may be accepted only in life-threatening emergencies

Explanation

Correct Answer:

B. Taking blood into the body is prohibited, and transfusion of blood or blood products is not permitted

Explanation of Correct Answer

Jehovah’s Witnesses believe that accepting blood into the body is against their religious teachings, based on their interpretation of scripture. As a result, transfusion of whole blood, red cells, white cells, platelets, or plasma is not permitted. Nurses must respect this belief and explore acceptable alternatives, such as volume expanders, erythropoietin, or non-blood management strategies, while ensuring patient autonomy and informed decision-making.


2.

A nurse is reviewing laboratory results for a patient with a urinary condition. The nurse knows that the normal range for urine specific gravity is which of the following?

  • 1.000 to 1.005

  • 1.010 to 1.030

  • 1.040 to 1.060

  • 1.070 to 1.090

Explanation

Correct Answer:

B. 1.010 to 1.030

Explanation of Correct Answer

The normal specific gravity of urine ranges from 1.010 to 1.030. This value reflects the kidney’s ability to concentrate or dilute urine based on the body’s hydration status. A low specific gravity indicates dilute urine and possible overhydration, while a high value suggests concentrated urine, often due to dehydration or reduced renal function.


3.

A nurse is caring for a postoperative patient. When is it appropriate to start the patient on a clear liquid diet?

  • As soon as the patient is fully awake from anesthesia

  • When the patient expresses hunger

  • When bowel sounds are detected by auscultation

  • Immediately after the surgical procedure ends

Explanation

Correct Answer:

C. When bowel sounds are detected by auscultation

Explanation of Correct Answer

A clear liquid diet should begin only after bowel sounds are detected by auscultation, indicating the return of gastrointestinal motility. Starting oral intake too early, before peristalsis returns, increases the risk of nausea, vomiting, and abdominal distention. Confirming bowel sounds ensures the GI tract can tolerate fluids and helps prevent postoperative complications such as ileus.


4.

A nurse is providing dietary counseling to an overweight Hispanic patient. Which recommendation is most appropriate to support healthier eating habits?

  • Eliminate all carbohydrates from meals

  • Reduce fried foods and sugar intake

  • Follow a high-protein, high-fat diet

  • Avoid all traditional cultural foods

Explanation

Correct Answer:

B. Reduce fried foods and sugar intake

Explanation of Correct Answer

For an overweight patient, especially within cultural dietary patterns that may include fried foods and sugary drinks or desserts, reducing fried foods and limiting sugar intake are key recommendations. These changes lower excess calorie consumption, improve heart health, and support gradual weight loss. The goal is to encourage healthier preparation methods and balanced meals rather than complete elimination of cultural food preferences.


5.

A nurse is preparing to obtain a sterile urine specimen from a patient with a Foley catheter. Which steps should the nurse follow in the correct order?

  • Perform hand hygiene and put on gloves, swab port with alcohol, insert needle and aspirate 3 mL of urine, clamp tubing, then unclamp catheter

  • Clamp tubing, perform hand hygiene and put on gloves, swab port with alcohol, insert needle and aspirate 3 mL of urine, unclamp catheter

  • Clamp tubing, perform hand hygiene and put on gloves, insert needle and aspirate 3 mL of urine, swab port with alcohol, unclamp catheter

  • Perform hand hygiene and put on gloves, clamp tubing, insert needle and aspirate 3 mL of urine, swab port with alcohol, unclamp catheter

Explanation

Correct Answer:

B. Clamp tubing, perform hand hygiene and put on gloves, swab port with alcohol, insert needle and aspirate 3 mL of urine, unclamp catheter

Explanation of Correct Answer

When collecting a urine specimen from a Foley catheter, the nurse should first clamp the tubing below the port so urine can collect. After performing hand hygiene and donning gloves, the port is disinfected with an alcohol swab to prevent contamination. Using a sterile syringe, about 3 mL of urine is aspirated from the port. Finally, the catheter is unclamped to restore drainage. This sequence ensures sterility and accurate specimen collection.


6.

A nurse is monitoring a patient who is experiencing hyperventilation due to anxiety. The nurse understands that hyperventilation causes which acid–base disorder?

  • Metabolic acidosis

  • Respiratory alkalosis

  • Metabolic alkalosis

  • Respiratory acidosis

Explanation

Correct Answer:

B. Respiratory alkalosis

Explanation of Correct Answer

Hyperventilation leads to excessive exhalation of carbon dioxide, which lowers the partial pressure of CO₂ in the blood. This reduction in CO₂ decreases carbonic acid levels, causing the blood pH to rise above normal. The result is respiratory alkalosis. In contrast, respiratory acidosis occurs when CO₂ is retained due to hypoventilation, not rapid breathing.


7.

A nurse is teaching a patient about different types of surgical procedures. How should the nurse describe exploratory surgery?

  • Surgery done to permanently treat a known condition

  • Surgery done strictly for cosmetic purposes

  • Surgery done to provide further data and determine a diagnosis for a problem

  • Surgery done only to relieve symptoms without curing the disease

Explanation

Correct Answer:

C. Surgery done to provide further data and determine a diagnosis for a problem

Explanation of Correct Answer

Exploratory surgery is performed when the cause of a patient’s symptoms is unclear and further information is needed for diagnosis. It allows direct visualization and assessment of internal structures, often leading to identification of disease processes such as tumors, infections, or internal bleeding. Unlike curative or palliative surgery, the primary purpose is diagnostic rather than treatment-focused.


8.

A client has been prescribed eye drops for the treatment of glaucoma. The nurse is observing the client self-administer the eye drops. Which action by the client requires further teaching?

  • The client looks upward toward the ceiling and administers the eye drops in the conjunctival sac

  • While administering the eye drops, a drop lands on the client's outer lid, so the client administers another drop.

  • The client cleans the eye from the inner to the outer canthus

  • The client touches the conjunctival sac with the eyedropper to make sure she is in the correct location

Explanation

Correct Answer:

D. The client touches the conjunctival sac with the eyedropper to make sure she is in the correct location.

Explanation of Correct Answer

The tip of the eyedropper must never touch the eye or conjunctival sac because it contaminates the dropper and increases the risk of introducing infection into the eye. Sterility of the medication container is essential in preventing complications, especially in clients with glaucoma who are already at risk for vision loss. The dropper should be held just above the conjunctival sac without making contact.


9.

A nurse is providing dietary teaching to a patient recently diagnosed with diabetes mellitus. Which recommendation is most appropriate?

  • Eliminate all carbohydrates from the diet

  • Reduce sodium and fat intake, and eat carbohydrates in moderate amounts

  • Follow a high-fat, low-fiber diet for better glucose control

  • Eat sweets freely as long as insulin is taken

Explanation

Correct Answer:

B. Reduce sodium and fat intake, and eat carbohydrates in moderate amounts

Explanation of Correct Answer

For diabetic patients, dietary management focuses on controlling blood glucose while reducing cardiovascular risks. Carbohydrates should not be eliminated but consumed in moderate amounts with attention to portion control and balance across meals. Reducing sodium and fat helps lower the risk of hypertension and heart disease, common complications in diabetes. A balanced, heart-healthy diet is key to long-term management.


10.

The nurse is teaching the client how to use an MDI with a spacer device. Which statement, if made by the client, indicates further teaching is required?

  • "I should rinse my mouth with warm water, then spit the water out after each use of the MDI."

  • "I should remove the mouthpiece cover from the inhaler and spacer, insert the MDI into the end of the spacer, and shake the inhaler well for 2 to 5 seconds."

  • "I should close my mouth around the mouthpiece of the spacer, depress the medication canister and breathe in slowly and fully for 5 seconds, then hold my breath for approximately 10 seconds."

  • "I should wait 20 to 30 seconds between puffs and 2 to 5 minutes between inhalations of different medications. I should administer the inhaled steroids first followed by the bronchodilator."

Explanation

Correct Answer:

D. "I should wait 20 to 30 seconds between puffs and 2 to 5 minutes between inhalations of different medications. I should administer the inhaled steroids first followed by the bronchodilator."

Explanation of Correct Answer

This statement indicates a need for further teaching because the order of administration is incorrect. The bronchodilator should be administered first to open the airways, allowing better penetration of the corticosteroid. Steroids are always given after the bronchodilator. While the timing between puffs (20–30 seconds) and between different medications (2–5 minutes) is correct, the reversal of the medication order requires correction.


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