BSN 205 Hallmark Final Exam - Questions and Answers What does the nurse do after attaching the hooks to the holes in the sling on a hydraulic lift? A.
... [Show More] Lower the head of the bed. B. Remove the patient's eyeglasses. C. Have the patient cross the arms over the chest. D. Elevate the head of the bed. When using a hydraulic lift to transfer a patient from the bed to a chair, when does the nurse turn off the check valve? A. After the patient crosses the arms over the chest B. After the patient's eyeglasses are removed C. As soon as the patient has been placed in the chair D. When the nurse removes the straps When preparing for safe patient transfer using a hydraulic lift, the nurse performs which action first? A. Assesses the patient for weakness, dizziness, or postural hypotension B. Arranges for at least three healthcare personnel to assist in the transfer C. Makes sure the patient agrees to the intervention D. Applies clean gloves Which position is used when applying the sling to transfer a patient from the bed to a chair with a hydraulic lift? A. Prone B. Side-lying C. Supine D. Sims Which action would decrease a patient's pain before a transfer with a hydraulic lift? A. Stop the transfer if the patient expresses or displays physical signs of pain. B. Explain the procedure to the patient before beginning the transfer. C. Administer a prescribed analgesic 30 to 60 minutes before the transfer. D. Postpone the transfer if the patient reports having physical pain or anxiety before the transfer. Which position is used when applying the sling to transfer a patient from the bed to a chair with a hydraulic lift? A. Prone B. Side-lying C. Supine D. Sims When preparing to apply elastic stockings, why does the nurse assess for skin discoloration? A. To identify the potential risk for deep vein thrombosis (DVT) B. To identify improper patient positioning C. To select the proper stocking size D. To determine whether a sequential compression device is needed Which condition is not associated with venous stasis, part of Virchow's triad? A. Pregnancy B. Obesity C. Anxiety D. Immobility Why does the nurse remove the patient's elastic stockings at least once per shift? A. To permit the skin to breathe. B. To wash the legs with a disposable bath product. C. To air out the stockings and allow sweat to evaporate. D. To check the skin for irritation or breakdown. Why might the nurse choose not to apply a pair of prescribed elastic stockings to a patient's legs? A. The patient will have a scheduled bath in a few hours. B. The patient says they are too tight. C. The patient's skin is irritated. D. The patient has become fully ambulatory. After determining the proper size stocking and assessing the patient's circulatory status, a nurse delegates the application of elastic stockings to nursing assistive personnel (NAP). The nurse discovers that the NAP has been using moisturizer on the patient's legs before applying the stockings. What is the best action by the nurse? A. Explain that moisturizer may cause excessive skin softening, which can lead to skin breakdown. B. Instruct NAP to use a small amount of cornstarch or powder. C. Ask the patient if he or she is allergic to the moisturizer. D. Inspect the patient's skin for color variations.
TRUE/FALSE: A contaminated or traumatic wound may show signs of infection within 24 hours. A surgical wound infection usually develops postoperatively within 14 days. False TRUE/FALSE: Healing by primary intention is expected when the edges of a clean surgical incision are sutured or stapled together, tissue loss is minimal or absent, and the wound is uncontaminated by microorganisms. True Which of the following patients has the least risk for developing a wound infection? A. An 80-year-old man who has a burn B. A 17-year-old patient who has a metal fragment lodged in his thigh C. A 30-year-old female who had an episiotomy after childbirth D. A patient receiving chemotherapy who has a surgical incision E. A patient with peripheral vascular disease and an ulcer on the heel Which of the following may indicate internal hemorrhage? (select all that apply) A. Distention or swelling of the affected body part B. Elevated white blood cells C. Decrease in blood pressure and increase in pulse D. Change in the type and amount of drainage When teaching a patient about wound healing, what should the nurse tell the patient? Inadequate nutrition delays wound healing and increases risk of infection. The nurse is caring for a patient who had knee replacement surgery 5 days ago. The patient's knee appears red and is very warm to the touch. The patient requests pain medication. Which of the following would be a correct explanation of what the nurse has assessed? The patient is showing signs of postoperative infection The nurse is caring for a patient after major abdominal surgery. Which of the following demonstrates correct understanding of wound dehiscence? The nurse should be alert for an increase in serosanguinous drainage from the wound. The nurse reports that a patient has a wound on his abdomen that is healing by secondary intention. The nurse understands this means the patient: Is at greater risk for infection. A postoperative diabetic patient had an exploratory laparotomy (incision in the abdomen) 5 days ago. The patient's history indicates obesity with a body mass index (BMI) of 32 and smoking 1 pack/day. Based on this information, the nurse understands the patient should be observed for: Wound dehiscence. [Show Less]