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Name: ___________________________________
Clinical Instructor: Raesar Jay F. Torralba RN
Score: ________
Date: _________
The physician orders a maintenance dose of 5,000 units of subcutaneous heparin (an
anticoagulant) daily. Nursing responsibilities for Mrs. Mitchell now include:
Reviewing daily activated partial thromboplastin time (APTT) and prothrombin time.
Reporting an APTT above 45 seconds to the physician
Assessing the patient for signs and symptoms of frank and occult bleeding
All of the above
6. The four main concepts common to nursing that appear in each of the current conceptual
models are:
a.
Person, nursing, environment, medicine
b.
Person, health, nursing, support systems
c.
Person, health, psychology, nursing
d.
Person, environment, health, nursing
7. In Maslows hierarchy of physiologic needs, the human need of greatest priority is:
a.
Love
b.
Elimination
c.
Nutrition
d.
Oxygen
Competency Appraisal I
8. The family of an accident victim who has been declared brain-dead seems amenable to
organ donation. What should the nurse do?
a.
b.
c.
d.
Discourage them from making a decision until their grief has eased
Listen to their concerns and answer their questions honestly
Encourage them to sign the consent form right away
Tell them the body will not be available for a wake or funeral
9. A new head nurse on a unit is distressed about the poor staffing on the 11 p.m. to 7 a.m.
shift. What should she do?
a.
Complain to her fellow nurses
b.
Wait until she knows more about the unit
c.
Discuss the problem with her supervisor
d.
Inform the staff that they must volunteer to rotate
10.
a.
b.
c.
d.
Which of the following principles of primary nursing has proven the most satisfying to
the patient and nurse?
Continuity of patient care promotes efficient, cost-effective nursing care
Autonomy and authority for planning are best delegated to a nurse who knows the
patient well
Accountability is clearest when one nurse is responsible for the overall plan and its
implementation.
The holistic approach provides for a therapeutic relationship, continuity, and efficient
nursing care.
11.
If nurse administers an injection to a patient who refuses that injection, she has
committed:
a.
Assault and battery
b.
Negligence
c.
Malpractice
d.
None of the above
12.
If patient asks the nurse her opinion about a particular physicians and the nurse replies
that the physician is incompetent, the nurse could be held liable for:
a.
Slander
b.
Libel
c.
Assault
d.
Respondent superior
13.
Which of the following signs and symptoms would the nurse expect to find when
assessing an Asian patient for postoperative pain following abdominal surgery?
Competency Appraisal I
a.
b.
c.
d.
16.
A patient is admitted to the hospital with complaints of nausea, vomiting, diarrhea, and
severe abdominal pain. Which of the following would immediately alert the nurse that the
patient has bleeding from the GI tract?
a.
Complete blood count
b.
Guaiac test
c.
Vital signs
d.
Abdominal girth
17. The correct sequence for assessing the abdomen is:
a.
Tympanic percussion, measurement of abdominal girth, and inspection
b.
Assessment for distention, tenderness, and discoloration around the umbilicus.
c.
Percussions, palpation, and auscultation
d.
Auscultation, percussion, and palpation
18.
a.
c.
19.
During a Romberg test, the nurse asks the patient to assume which position?
Sitting
b.
Standing
Genupectoral
d.
Trendelenburg
22.
a.
c.
23.
A patient is kept off food and fluids for 10 hours before surgery. His oral temperature at
8 a.m. is 99.8 F (37.7 C) This temperature reading probably indicates:
a.
Infection
b.
Hypothermia
c.
Anxiety
d.
Dehydration
24.
a.
c.
25.
A 38-year old patients vital signs at 8 a.m. are axillary temperature 99.6 F (37.6 C);
pulse rate, 88; respiratory rate, 30. Which findings should be reported?
a.
Respiratory rate only
b.
Temperature only
c.
Pulse rate and temperature
d.
Temperature and respiratory rate
26.
a.
b.
Competency Appraisal I
c.
d.
27.
a.
c.
28.
The absence of which pulse may not be a significant finding when a patient is admitted
to the hospital?
a.
Apical
b.
Radial
c.
Pedal
d.
Femoral
29.
a.
b.
Which of the following patients is at greatest risk for developing pressure ulcers?
An alert, chronic arthritic patient treated with steroids and aspirin
An 88-year old incontinent patient with gastric cancer who is confined to his bed at
home
c.
An apathetic 63-year old COPD patient receiving nasal oxygen via cannula
d.
A confused 78-year old patient with congestive heart failure (CHF) who requires
assistance to get out of bed.
30.
a.
b.
c.
d.
31.
a.
c.
The physician orders the administration of high-humidity oxygen by face mask and
placement of the patient in a high Fowlers position. After assessing Mrs. Paul, the nurse
writes the following nursing diagnosis: Impaired gas exchange related to increased
secretions. Which of the following nursing interventions has the greatest potential for
improving this situation?
Encourage the patient to increase her fluid intake to 200 ml every 2 hours
Place a humidifier in the patients room.
Continue administering oxygen by high humidity face mask
Perform chest physiotheraphy on a regular schedule
The most common deficiency seen in alcoholics is:
Thiamine
b.
Riboflavin
Pyridoxine
d.
Pantothenic acid
32.
a.
To assess the kidney function of a patient with an indwelling urinary (Foley) catheter,
the nurse measures his hourly urine output. She should notify the physician if the urine
output is:
a.
Less than 30 ml/hour
b.
64 ml in 2 hours
c.
90 ml in 3 hours
d.
125 ml in 4 hours
34.
a.
c.
35.
Competency Appraisal I
a.
b.
c.
d.
36.
a.
b.
c.
d.
37.
a.
b.
c.
d.
38.
a.
c.
39.
a.
After 1 week of hospitalization, Mr. Gray develops hypokalemia. Which of the following
is the most significant symptom of his disorder?
a.
Lethargy
b.
Increased pulse rate and blood pressure
c.
Muscle weakness
d.
Muscle irritability
41.
a.
b.
c.
d.
42.
a.
b.
c.
d.
43.
a.
b.
c.
d.
Competency Appraisal I
44.
a.
b.
c.
d.
45.
a.
c.
46.
a.
c.
47.
a.
c.
Which of the following is the most common cause of dementia among elderly persons?
Parkinsons disease
b.
Multiple sclerosis
Amyotrophic lateral sclerosis (Lou Gerhigs disease)
d.
Alzheimers disease
48.
a.
b.
c.
d.
The nurses most important legal responsibility after a patients death in a hospital is:
Obtaining a consent of an autopsy
Notifying the coroner or medical examiner
Labeling the corpse appropriately
Ensuring that the attending physician issues the death certification
49.
a.
b.
c.
d.
50.
a.
b.
c.
d.
When a patient in the terminal stages of lung cancer begins to exhibit loss of
consciousness, a major nursing priority is to:
Protect the patient from injury
Insert an airway
Elevate the head of the bed
Withdraw all pain medications
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Prepared by:
Raesar Jay F. Torralba, RN
Clinical Instructor
Competency Appraisal I