Adapting Health Assessment To The Hospitalized Patient

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Question 1
Free
Multiple Choice

Development of which complication is considered a never event?

Choose correct answer/s
A

Fever

B

Atelectasis

C

Pressure ulcer

D

Thrombophlebitis

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Question 2
Free
Multiple Choice

For which patient does the nurse make assessment of the oral mucous membrane a priority?

Choose correct answer/s
A

The patient who has an arteriovenous (AV) fistula

B

The patient who has a gastrostomy tube

C

The patient who uses a Ventimask

D

The patient who has a colostomy

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Question 3
Free
Multiple Choice

How does a nurse assess perfusion to the foot when a patient has a cast from the left middle calf to the toes?

Choose correct answer/s
A

Palpate the popliteal pulse of the left leg.

B

Palpate the posterior tibial pulse of the left leg.

C

Assess movement and sensation of the left toes.

D

Assess the capillary refill of the left toes.

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Question 4
Free
Multiple Choice

A nurse uses the Glasgow Coma Scale to assess which patient?

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A

The patient who has a new onset of quadriplegia

B

The patient who has tonic-clonic seizures

C

The patient who requires stimuli for responses

D

The patient who has dementia

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Question 5
Free
Multiple Choice

During the assessment, the nurse determines that the patient's Glasgow Coma Scale score is 15. What is the meaning of this number for this patient?

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A

This patient is fully conscious.

B

This patient has movement but does not open the eyes or speak.

C

This patient is unable to respond to any stimuli.

D

This patient opens the eyes but does not speak or move.

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Question 6
Multiple Choice

When performing a neurologic assessment of a male patient, a nurse discovers that shouting and shaking are necessary to arouse the patient enough to assess his neurologic status. After the patient answers questions about who he is and squeezes the nurse's hand as requested, he returns to "sleep." How does the nurse document this patient's level of consciousness?

Choose correct answer/s
A
Lethargic
B
Obtunded
C
Stuporous
D
Semicomatose
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Question 7
Multiple Choice

What data do nurses collect when assessing a patient's wound? (Select all that apply.)

Choose correct answer/s
A
Skin turgor
B
Width, length, and depth
C
Presence of pulsations
D
Wound color
E
Presence of edema
F
Drainage color
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Question 8
Multiple Choice

Which patient using respiratory equipment requires skin assessment? (Select all that apply.)

Choose correct answer/s
A
A patient using a nasal cannula
B
A patient with a tracheostomy
C
A patient using an incentive spirometer
D
A patient using a Ventimask
E
A patient with an IV
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Question 9
Multiple Choice

Which tube interferes with hearing lung sounds during auscultation? (Select all that apply.)

Choose correct answer/s
A
Gastrostomy tube
B
Chest tube
C
Nasogastric tube
D
Tracheostomy tube
E
Oral endotracheal tube
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