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 caring for a patient who is passing continuous small amounts of stool, suggesting possible fecal impaction. Which type of enema would the nurse anticipate being ordered?
  • Tap water enema
  • Oil retention enema
  • Fleet enema
  • Soap suds enema

Explanation

A Fleet enema is a hypertonic solution commonly used to relieve constipation and clear fecal impaction. In patients passing continuous small amounts of stool, this often indicates overflow around an impaction. The Fleet enema works by drawing water into the bowel, stimulating peristalsis, and softening stool, making it effective for clearing impactions and restoring normal bowel function.
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. A nurse is caring for a patient who continues to pass stool after receiving three enemas. What should the nurse do next?
  • 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

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.
4. 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

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.
5. A nurse is caring for a patient following a cardiac catheterization. How often should the nurse assess the catheter insertion site during the first hour after the procedure?
  • Every 30 minutes for the first hour, then every 2 hours
  • Every 5 minutes for the first hour, then every hour
  • Every 10 to 15 minutes for the first hour, while temperature is checked every 6 hours
  • Every 60 minutes for the first hour, then every 4 hours

Explanation

After a cardiac catheterization, the catheter insertion site must be closely monitored for bleeding, hematoma, or compromised circulation. The standard is to assess the site every 10 to 15 minutes for the first hour, then less frequently as the patient stabilizes. In addition, body temperature is monitored every 6 hours to detect possible infection. These steps ensure early recognition of complications.
6. What is the best assessment technique to use to determine if you should suction a patient with a tracheotomy?
  • Observe for restlessness
  • Check oxygen saturation
  • Auscultate the lungs
  • Ask the patient if suctioning is needed

Explanation

The most reliable assessment technique to determine if suctioning is required is auscultating the lungs. Listening for adventitious breath sounds such as rhonchi or gurgling indicates the presence of secretions that need removal. While changes in oxygen saturation or patient behavior may suggest hypoxia, lung auscultation provides direct evidence of secretion buildup and the need for suctioning.
7. 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

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.
8. The nurse administering a nasal medication via an atomizer bottle should:
  • have the client tilt the head forward.
  • have the client sit up straight.
  • have the client squeeze the bottle while inhaling.
  • leave the other nostril open while giving the medication.

Explanation

For proper administration of nasal medication with an atomizer, the client should gently inhale through the nostril while squeezing the bottle. This coordinated action ensures the medication is carried into the nasal passages and evenly distributed over the mucosa for effective absorption. Failure to inhale while squeezing would cause the spray to remain mostly in the anterior nose, limiting its therapeutic effect.
9. A nurse is reviewing arterial blood gas (ABG) results and clinical symptoms for a patient with suspected respiratory alkalosis. Which findings would the nurse expect?
  • pH less than 7.35, PaCO₂ greater than 45 mm Hg, bradypnea, lethargy
  • pH greater than 7.45, PaCO₂ less than 35 mm Hg, hyperventilation, confusion, lightheadedness
  • pH 7.35–7.45, PaCO₂ 35–45 mm Hg, normal respirations, stable mentation
  • pH less than 7.35, PaCO₂ less than 35 mm Hg, tachypnea, drowsiness

Explanation

Respiratory alkalosis occurs when hyperventilation, often caused by anxiety or pain, leads to excessive exhalation of carbon dioxide. This reduces PaCO₂ below 35 mm Hg and raises blood pH above 7.45. Clinical signs include hyperventilation, confusion, and lightheadedness due to cerebral vasoconstriction from low CO₂ levels. Recognizing these findings helps guide interventions such as encouraging slow, controlled breathing.
10. A nurse is teaching a patient about nonpharmacologic measures that can help control pain. Which interventions should the nurse include?
  • Back rubs, foot rubs, and slow rhythmic deep breathing
  • Increasing noise and distractions in the room
  • Withholding comfort measures until medication is given
  • Encouraging the patient to avoid movement and activity completely

Explanation

Nonpharmacologic pain control methods can be used alone for mild discomfort or in combination with medications for stronger relief. Back rubs and foot rubs promote relaxation and comfort, while slow rhythmic deep breathing reduces tension and enhances oxygenation. These measures are simple, safe, and effective strategies to help patients manage pain without relying solely on medications.

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