Fundamentals of Nursing Practice Quiz 23

Answer: D – Use the Z-track technique

Explanation: During the procedure, skin and tissue are pulled and held firmly while a long needle is inserted into the muscle. After the medication is injected, the skin and tissue are released. The needle track that forms during this procedure takes the shape of the letter “Z,” which gives the procedure its name. This zigzag track line is what prevents medication from leaking from the muscle into surrounding tissue.

Answer: B – Maintain the patient in an orthopneic position as needed

Explanation: When a patient develops dyspnea and shortness of breath, the orthopneic position encourages maximum chest expansion and keeps the abdominal organs from pressing against the diaphragm, thus improving ventilation, Bed rest and oxygen by Venturi mask at 24% would improve oxygenation of the tissues and cells but must be ordered by a physician, Allowing for rest periods decreases the possibility of hypoxia.

Answer: C – Orthopnea

Explanation: Orthopnea is difficulty of breathing except in the upright position, Tachypnea is rapid respiration characterized by quick, shallow breaths, Eupnea is normal respiration – quiet, rhythmic, and without effort.

Answer: C – Giving the patient breakfast

Explanation: A platelet count evaluates the number of platelets in the circulating blood volume. The nurse is responsible for giving the patient breakfast at the scheduled time, The physician is responsible for instructing the patient about the test and for writing the order for the test.

Answer: B – Mashed potatoes and broiled chicken

Explanation: Mashed potatoes and broiled chicken are low in natural sodium chloride. Ham, olives, and chicken bouillon contain large amounts of sodium and are contraindicated on a low sodium diet.

Answer: D – All of the above

Explanation: All of the identified nursing responsibilities are pertinent when a patient is receiving heparin. The normal activated partial thromboplastin time is 16 to 25 seconds and the normal prothrombin time is 12 to 15 seconds; these levels must remain within two to two and one half the normal levels. All patients receiving anticoagulant therapy must be observed for signs and symptoms of frank and occult bleeding (including hemorrhage, hypotension, tachycardia, tachypnea, restlessness, pallor, cold and clammy skin, thirst and confusion); blood pressure should be measured every 4 hours and the patient should be instructed to report promptly any bleeding that occurs with tooth brushing, bowe

Answer: D – Person, environment, health, nursing

Explanation: The focus concepts that have been accepted by all theorists as the focus of nursing practice from the time of Florence Nightingale include the person receiving nursing care, his environment, his health on the health illness continuum, and the nursing actions necessary to meet his needs.

Answer: D – Oxygen

Explanation: Maslow, who defined a need as a satisfaction whose absence causes illness, considered oxygen to be the most important physiologic need; without it, human life could not exist, According to this theory, other physiologic needs (including food, water, elimination, shelter, rest and sleep, activity and temperature regulation) must be met before proceeding to the next hierarchical levels on psychosocial needs.

Answer: B – Listen to their concerns and answer their questions honestly

Explanation: The brain-dead patient’s family needs support and reassurance in making a decision about organ donation, Because transplants are done within hours of

Answer: C – Discuss the problem with her supervisor

Explanation: Although a new head nurse should initially spend time observing the unit for its strengths and weakness, she should take action if a problem threatens patient safety. In this case, the supervisor is the resource person to approach.