Nursing Board Review: Fundamentals Of Nursing Practice Test

Subjective data are apparent only to the person affected and can or verified only by that person.

The nurse will assume the role of a teacher in this therapeutic relationship. The other roles are inappropriate in this situation.

The nursing process is goal-oriented. It is also systematic, patient-centered, and dynamic.

Bells’ palsy is the paralysis of the motor component of the 7th caranial nerve, resulting in facial sag, inability to close the eyelid or the mouth, drooling, flat nasolabial fold and loss of taste on the affected side of the face.

A safety device on the wrist may impair blood circulation. Therefore, the nurse should assess the patient for signs of impaired circulation such as bluish fingernails, cool and pale fingers. Palpable radial and ulnar pulses, capillary refill within 3 seconds are all normal findings.

The client is in denial stage because she is unready to face the reality that loss is happening and she assumes artificial cheerfulness.

Providing a grieving person an opportunity to tell their story allows the person to express feelings. This is therapeutic in assisting the client resolve grief.

Decreased in sensory functions could cause a geriatric patient to have difficulty retaining knowledge about the newly prescribed medications. Absence of family support and no interest on learning may affect compliance, not knowledge retention. Decreased plasma levels do not alter patient’s knowledge about the drug.

Elevating the head of the bed during an enteral feeding prevents aspiration. The patient may be placed on the right side to prevent aspiration. Enteral feedings are given at room temperature to lessen GI distress. The enteral tubing should be changed every 24 hours to limit microbial growth.

Diminished breath sound is a life threatening problem therefore it is highly priority because they pose the greatest threat to the patient’s well-being.

The primary level focuses on health promotion. Secondary level focuses on health maintenance. Tertiary focuses on rehabilitation. There is n Curative level of preventive health care problems.

Hyperthermia is a NANDA-approved nursing diagnosis. Diabetes Mellitus, Angina and Chronic Renal Failure are medical diagnoses.

The normal serum sodium level is 135 to 145 mEq/L, the client is having hypernatremia. Pia should avoid food high in sodium like processed food. Broccoli, cabbage and tomatoes are good source of Vitamin C.

The thyroid is part of the endocrine system. Heart, sinus and thymus are not.

Resonance is loud, low-pitched and long duration that’s heard most commonly over an air-filled tissue such as a normal lung.

The nursing process is patient-centered, not nurse-centered. It can be use in any setting, and the steps are related. The nursing process can’t solve all patient health problems.

Independent nursing interventions involve actions that nurses initiate based on their own knowledge and skills without the direction or supervision of another member of the health care team.

Chronic pain s usually defined as pain lasting longer than 6 months.

Vesicle is a circumscribed circulation containing serous fluid or blood and less than 1 cm (ex. Blister, chicken pox).

During the application of medication it is inappropriate to instill the medication directly into the tympanic membrane. The right thing to do is instill the medication along the lateral wall of the auditory canal.

Algor mortis is the decrease of the body’s temperature after death. Livor mortis is the discoloration of the skin after death. Rigor mortis is the stiffening of the body that occurs about 2-4 hours after death.

Prolonged Vitamin B9 deficiency will lead to megaloblastic anemia while pernicious anemia results in deficiency in Vitamin B12. Prolonged deficiency of Vitamin C leads to scurvy and Pellagra results in deficiency in Vitamin B3.

3-day diet recall is an example of dietary history. This is used to indicate the adequacy of food intake of the client.

Kussmaul breathing is also called as hyperventilation. Seen in metabolic acidosis and renal failure. Shallow breaths interrupted by apnea refers to Biot’s breathing. Prolonged gasping inspiration followed by a very short, usually inefficient expiration is apneustic breathing and marked rhythmic waxing and waning of respirations from very deep to very shallow breathing and temporary apnea is the Cheyne-stokes breathing.

Jason is the primary source; his mother is a secondary source. The data is objective because it can be perceived by the senses, verified by another person observing the same patient, and tested against accepted standards or norms.