NSS II

Question 1

Temperature’s normal range?

Answer 1

36.0 - 37.5^C

Question 2

Pulse’s normal range?

Answer 2

60-100 beats per min

Question 3

Respiration’s normal range?

Answer 3

12-20 breaths per min

Question 4

Blood Pressure’s normal range?

Answer 4

Systolic = 125-110mmHg
Dystolic = 60-80mmHg

Question 5

What are 2 arteries used to measure blood pressure?

Answer 5

Brachial artery
Popliteal artery

Question 6

3 Characteristics of pulse?

Answer 6

Rate
Rhythm
Volume

Question 7

3 Characteristics of respiration?

Answer 7

Rate
Rhythm
Depth

Question 8

5 health education for patients with hypothermia?

Answer 8

-Wear extra layers of clothes/ provide more blankets
-Encourage mobilization
-Eat warm food that is high in carbohydrates & drink warm fluids
-Check temperature frequently
-Relief discomfort

Question 9

List all the protective devices

Answer 9

Limbs
Vests
Belts
Mittens

Question 10

The purpose of putting on restrains

Answer 10

Restrain movement of one or more extremities
Restrain the patient’s use of fingers
Restain body movements

Question 11

Health education, when the patient is on, restrains

Answer 11

-Check circulation of restained area
-Educate & explain to the patient the use of restraints
-Ensure self-care needs are met for the patient
-Ensure restraints are only used to protect against self-harm & remove them when safe
-Ensure restrainers are used for safety reasons and not for punishments

Question 12

Potential complications when the patient is on restrains

Answer 12

Strangulation
Dehydration
Fecal impaction
Infection Pneumonia
Bruising
Pressure ulcers
Depression

Question 13

Nursing considerations when collecting sputum for a patient who can expectorate

Answer 13

-Sit the patient up and offer mouth care/ rinse mouth with water
-Ask the patient to start deep breathing & coughing to help facilitate sputum expectoration
-Instruct patient to cough & expectorate 15-30 ml of sputum into a sterile specimen container
-Ensure the container is clearly labeled
-Offer oral hygiene to patients after the procedure to reduce halitosis

Question 14

Purpose of collecting stool specimens?

Answer 14

Monitor the effectiveness of treatment
To screen for colon cancer
Detect any parasites

Question 15

Purpose of obtaining a swab specimen?

Answer 15

Identify the presence of pathogens
MRSA( Methicillin- Resistant Staphylococcus Aureus)
Determine the sensitivity of bacterial calls to antibiotics
Monitor treatment of an infection

Question 16

3 common sites for the collection of swabs

Answer 16

Nasal Cavity
Axellia
Groin

Question 17

Factors of pain?

Answer 17

Age
Gender
Culture
Emotional
Previous experience of pain
Environment

Question 18

Types of patients that require gastric specimen collection

Answer 18

Patient with a history of gastric ulcers
A patient suspected of gastric infections
Patients who consume non-corrosive substances

Question 19

3 purposes of collecting blood specimens for culture & sensitivity

Answer 19

To determine a fungal infection
To determine the type of antibiotics to kill the bacteria/fungi
To assess organ function

Question 20

Nursing considerations for an enrolled nurse role for drug admission

Answer 20

Check expiration date
Ensure 5 Rights
Observe side effects
Calculate the correct amount of drug to administer
Educate patient & family about specific medications

Question 21

Identify potentially hazardous areas within the workplace environment

Answer 21

Toilet
Common areas (corridors/lifts/stairs)
Patient’s room/ward/cubical
Waste disposal room