PNR 105 Foundations of Nursing

PNR 105 Foundations of Nursing

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Free PNR 105 Foundations of Nursing Questions

1. A nurse is teaching a group of students about risk factors for acid–base imbalances. Which conditions can place a patient at greater risk?
  • Hypertension, seasonal allergies, and mild arthritis
  • Kidney disease, diarrhea, severe vomiting, electrolyte disturbances, certain drugs or toxins, and metabolic diseases
  • Sprains, fractures, and minor infections
  • Nearsightedness, hearing loss, and skin rashes

Explanation

Acid–base imbalances can result from conditions that disrupt normal renal, gastrointestinal, or metabolic function. Kidney disease impairs the body’s ability to excrete acids or conserve bicarbonate. Diarrhea and severe vomiting cause significant loss of bicarbonate or gastric acid, respectively. Electrolyte disturbances alter buffering systems, while ingestion of drugs or toxins and metabolic diseases interfere with normal acid–base regulation. These conditions require close monitoring to prevent life-threatening imbalances.
2. A client is attempting to put pills in his mouth from a medicine cup and drops one pill on the bed sheet. The nurse should:
  • retrieve the pill from the linens and allow the client to take it.
  • discard the pill and get another from the dose pack.
  • scoop up the pill in a souffle cup and hand the cup to the client.
  • report the loss of the pill as a medication error.

Explanation

A pill that has fallen onto bed linens is considered contaminated and unsafe to administer. To ensure infection control and medication safety, the nurse must discard the dropped pill and obtain a new one from the original supply or dose pack. This protects the client from potential pathogens while ensuring the correct medication is given as prescribed.
3. 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

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.
4. A nurse is teaching a patient how to collect a mid-stream urine specimen. Which instruction should the nurse include?
  • Collect the first portion of urine directly into the container
  • Cleanse the urethral area, begin urinating, stop, then collect the mid-portion of urine
  • Save the last portion of urine voided for the specimen
  • Collect all urine during a 24-hour period for analysis

Explanation

A mid-stream urine specimen requires cleaning the urethral opening, discarding the initial flow of urine, and then collecting the middle portion. This method reduces contamination from bacteria normally present at the urethral opening and external genitalia. It is the preferred technique for bacterial culture and routine urine screening to ensure accurate results.
5. 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

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.
6. A nurse is inserting a Foley catheter for a patient. While inflating the retention balloon, what should the nurse observe?
  • The patient’s urine output in the drainage tubing
  • The patient’s facial expressions for signs of discomfort
  • The color of the patient’s urine in the drainage bag
  • The position of the catheter tubing on the bed

Explanation

When inflating the Foley catheter balloon, the nurse must carefully observe the patient’s facial expressions for discomfort or pain. Discomfort may indicate the balloon is being inflated while still in the urethra rather than the bladder, which can cause trauma. If pain is noted, inflation should stop immediately and the catheter repositioned. Monitoring the patient’s response ensures correct placement and prevents injury.
7. When you collect a sputum specimen, what do you do first?
  • Offer the client a tissue to cough into
  • Rinse the mouth with water
  • Have the client take several shallow breaths
  • Instruct the client to cough deeply into the container

Explanation

Before collecting a sputum specimen, the client should rinse the mouth with water to remove food particles, saliva, and oral bacteria. This step prevents contamination and ensures the specimen collected is truly from the lower respiratory tract. A clean specimen increases the accuracy of laboratory results for diagnosing infection or other pulmonary conditions.
8. 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

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.
9. When you suction your patient through the nasopharyngeal route, what amount of suction do you use?
  • 40 to 60 mm Hg
  • 80 to 120 mm Hg
  • 140 to 160 mm Hg
  • 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.
10. If you see a patient walking to the bathroom without their oxygen on, what do you do?
  • Immediately place the oxygen back on without explanation
  • Ask the patient if there is something wrong
  • Call the provider to report noncompliance
  • Restrict the patient from walking to the bathroom

Explanation

When a patient is not wearing prescribed oxygen, the nurse should first ask if something is wrong. The patient may be uncomfortable with the device, unable to tolerate it, or experiencing side effects. Exploring the reason allows the nurse to educate, adjust the delivery method if needed, and promote safe oxygen use rather than assuming noncompliance or restricting mobility.

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