PNR 105 Foundations of Nursing
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Free PNR 105 Foundations of Nursing Questions
1. A nurse is reviewing proper care of an indwelling urinary catheter with a student nurse. Which of the following should be included in the procedure?
- A. Keep the drainage bag above the level of the bladder to promote flow
- B. Maintain a closed drainage system at all times
- C. Disconnect the tubing regularly to measure urine output
- D. Provide perineal care only once daily
Explanation
Maintaining a closed drainage system is a critical step in preventing infection with an indwelling catheter. Along with this, the nurse should measure urine output regularly, observe drainage and urine characteristics at each encounter, keep the drainage bag below the bladder to prevent backflow, provide perineal and insertion site care twice daily, and secure the catheter to the leg. These measures promote comfort, accurate monitoring, and infection prevention.
2. A nurse is providing dietary counseling to an overweight Hispanic patient. Which recommendation is most appropriate to support healthier eating habits?
- A. Eliminate all carbohydrates from meals
- B. Reduce fried foods and sugar intake
- C. Follow a high-protein, high-fat diet
- D. Avoid all traditional cultural foods
Explanation
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.
3. A nurse begins a shift on a busy medical-surgical unit and will be caring for multiple clients. Which client does the nurse assess first?
- A. A client who would like some acetaminophen (Tylenol) for a mild headache
- B. A client who needs discharge teaching about an antibiotic
- C. A client who just received nitroglycerin for chest pain
- D. A client who has a question about her daily medications
Explanation
The priority for the nurse is to assess the client who just received nitroglycerin for chest pain. Chest pain may indicate myocardial ischemia or infarction, which is a life-threatening condition. After giving nitroglycerin, it is essential to quickly reassess the client’s pain level, vital signs, and response to the medication. This ensures that the treatment is effective and identifies if additional interventions are needed.
4. When you suction your patient through the nasopharyngeal route, what amount of suction do you use?
- A. 40 to 60 mm Hg
- B. 80 to 120 mm Hg
- C. 140 to 160 mm Hg
- D. 180 to 200 mm Hg
Explanation
The recommended suction pressure for nasopharyngeal suctioning is 80 to 120 mm Hg. This level is strong enough to effectively remove secretions without causing trauma to the delicate mucosal tissues. Using pressures higher than this increases the risk of airway injury, hypoxia, and discomfort, while lower pressures may be ineffective at clearing secretions.
5. A nurse is assessing a postoperative patient for urinary retention. At what urine output level would the nurse anticipate the need for insertion of a Foley catheter?
- A. Less than 10 mL/hr
- B. Less than 20 mL/hr
- C. Less than 30 mL/hr
- D. Less than 50 mL/hr
Explanation
Urine output of less than 30 mL/hr is considered inadequate and may indicate urinary retention, dehydration, or impaired renal perfusion. In such cases, the nurse may anticipate the need for Foley catheter insertion to closely monitor urinary output and relieve retention. Consistent urine output below this threshold requires prompt assessment and intervention to prevent complications such as acute kidney injury.
6. 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?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hyperkalemia
- D. Hypokalemia
Explanation
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.
7. 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?
- A. Blood transfusions are permitted if the patient gives consent
- B. Taking blood into the body is prohibited, and transfusion of blood or blood products is not permitted
- C. Only plasma products are permitted, but whole blood is not
- D. Blood products may be accepted only in life-threatening emergencies
Explanation
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.
8. A nurse is preparing to administer a cleansing enema to a patient. Which steps demonstrate proper procedure?
- A. Place the patient in right Sims’ position, use cold water, insert 2 inches, and hold container at hip level
- B. Place the patient in left Sims’ position, use water at 100–105°F, lubricate tip, insert 4 inches, and hold container 12–18 inches above rectum
- C. Place the patient supine, use hot water, insert 1 inch, and hold container at shoulder height
- D. Place the patient in Fowler’s position, use lukewarm water, insert 6 inches, and hold container at waist level
Explanation
The correct procedure for administering an enema includes positioning the patient in left Sims’ position to allow the solution to follow the natural curve of the sigmoid colon. The water should be warmed to 100–105°F to avoid cramping. The enema tip must be lubricated and inserted 4 inches into the rectum. The enema container is held 12–18 inches above the rectum, allowing the solution to flow for 5–10 minutes to achieve effective cleansing.
9. A nurse is teaching a group of students about the World Health Organization (WHO) three-step ladder approach for pain management. What are the correct steps?
- A. Begin with opioids for severe pain, then taper to mild analgesics, then discontinue therapy
- B. Start with nonopioid drugs with or without adjuvants; if pain persists, add opioids for mild to moderate pain; if pain still persists, switch to opioids for moderate to severe pain
- C. Use adjuvant therapy alone first, then nonopioids, then opioids only if all else fails
- D. Begin with surgical interventions, then add nonopioids, then opioids if needed
Explanation
The WHO three-step ladder provides a structured approach to pain management. Step 1 begins with nonopioid drugs such as acetaminophen or NSAIDs, possibly combined with adjuvant therapies. Step 2 adds an opioid appropriate for mild to moderate pain if control is inadequate. Step 3 advances to stronger opioids for moderate to severe pain. This progression ensures safe, effective, and individualized pain relief.
10. A nurse is assessing an elderly patient for possible fluid and electrolyte imbalance. Which symptom would be most concerning and require further evaluation?
- A. Increased appetite
- B. Confusion
- C. Strong thirst sensation
- D. Improved skin turgor
Explanation
In older adults, confusion is a key symptom of fluid and electrolyte imbalance. Age-related changes reduce the body’s ability to maintain fluid balance, and older patients may not always express thirst. Electrolyte disturbances, dehydration, or fluid overload can alter neurological function, leading to confusion. This symptom should always be taken seriously, as it may indicate an underlying imbalance requiring prompt correction.
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