Skills Test 1

Question 1

6 factors that contribute to patient accidents and falls:

Answer 1

Advanced Age
Change in Vision
Hearing Loss
Mobility Limitations
Diuretics
Diseases

Question 2

What is semi fowlers position?

Answer 2

Head of bed 45 degrees

Question 3

What is high fowlers?

Answer 3

Head of bed 90 degrees

Question 4

What does “float heels” mean?

Answer 4

Put a pillow under the heals so the feet aren’t touching the bed.

Question 5

Why is a restraint used?

Answer 5

To protect the patient and others

Question 6

What is supine position?

Answer 6

Head of Bed flat

Question 7

What is Prone?

Answer 7

Positioned on belly

Question 8

What are some risk factors for accidents and falls (8)?

Answer 8

Advanced Age
Change in Vision
Hearing Loss
Mobility Limitations
Poor Balance
Mental Status Changes
Diuretics
Diseases

Question 9

How many people does logrolling require?

Answer 9

3

Question 10

What are some steps to preventing falls? (5)

Answer 10

Clear path to the bathroom
Call light with easy access
Grab bars in bathroom to assist with toilet use
Bed in low position
Teaching the patient to use the safety locks on the wheelchair.

Question 11

What type of patient would have to be log-rolled?

Answer 11

Spinal fusion

Question 12

What is a draw sheet?

Answer 12

Sheet under the patient that 2 nurses use to pull a patient up in bed.

Question 13

What is the most common hospital injury for any patient?

Answer 13

Falls

Question 14

The definition of restraint is any physical method that restricts:

Answer 14

Freedom of movement
Physical activity
Normal Movement
(Phil says chemical restraints- haha)

Question 15

Why is a restraint used?

Answer 15

To protect the patient and others

Question 16

What is the type of tie we use to secure restraints?

Answer 16

Quick Release

Question 17

What assessment should be performed when extremity restraints are used?

Answer 17

Pulse and circulation check

Question 18

How often should patients do ROM exercises?

Answer 18

Every 2 hours

Question 19

Finger dexterity can be restrained by the use of:

Answer 19

finger control mitts

Question 20

Four nursing considerations involving monitoring use of restraints: (5)

Answer 20

Monitor for skin irrigation
Check alignment of vest
Check Grip Strength When Using Extremity restraints
Do R.O.M. exercises
Be sensitive to patient needs

Question 21

—Trendelenberg position:

Answer 21

Bed flat with feet elevated and head down

Question 22

Reverse trendelenberg

Answer 22

Bed flat with head elevated and feet down

Question 23

Correct bed position is vital to:

Answer 23

—Promote comfort, prevent injury, and provide sensation

Question 24

Why do we “dangle” a patient?

Answer 24

So they do not get orthostatic hypotension when they stand up

Question 25

Bowel elimination changes with immobility:

Answer 25

Constipation | Impaction

Question 26

What does body alignment refer to?

Answer 26

The position of body parts in relation to each other.

Question 27

Range of motion :

Answer 27

The extent to which a joint can move. Review terms on your own.

Question 28

What are some psychological effects of immobility?

Answer 28

Depression Behavioral changes Changes in sleep-wake cycle Decrease coping abilities

Question 29

What are some urinary elimination changes of immobility?

Answer 29

Urine retention Renal calculi UTI

Question 30

What is a TED?

Answer 30

Thromboembolic devices (hose)

Question 31

What is SCD?

Answer 31

Sequential compression devices (inflatable)

Question 32

What will you document?

Answer 32

Everything. If you don't document it it didn't happen.

Question 33

What is intake

Answer 33

oral fluids, IV fluids and feeding tube content. (Every fluid going in)

Question 34

What is output?

Answer 34

``` Urine Diarrhea Vomitus Gastric Secretions Suction Drainage Sweat Every fluid eliminated from the body ```

Question 35

What is "insensible" loss?

Answer 35

Stuff you can't measure like perspiration

Question 36

What is tachypnic?

Answer 36

Breathing really fast

Question 37

What is strict "I and O's"

Answer 37

Everything: piss, poop you name it. Totaling it

Question 38

How would the nursing diagnosis for dehydration be stated?

Answer 38

Fluid Volume Deficit (FVD)

Question 39

Normal oral fluid intake

Answer 39

>1500 ml/day (2-3 liters)

Question 40

Oral intake should be approximately ______ mls greater than output.

Answer 40

600

Question 41

What is UOP?

Answer 41

Urinary Output

Question 42

What should urinary output be?

Answer 42

>30 ml/hr

Question 43

How do you estimate solid food intake?

Answer 43

Use a percent of what they ate. (Ex: 50% of hamburger steak)

Question 44

What is considered a liquid in intake measurement?

Answer 44

Any substance that becomes a liquid at room temp. (So popsicles, and ice cream would count too)

Question 45

Document ice chips as:

Answer 45

50% of measured volume

Question 46

How do we measure diapers/ incontinence pads?

Answer 46

Weigh them (weigh clean diaper pad first to get the weight of the item).

Question 47

What is the primary energy source of the body?

Answer 47

Glucose

Question 48

Hypoglycemic=

Answer 48

when levels drop too low

Question 49

Normal Glucose =

Answer 49

80-100 (110)

Question 50

Diabetes =

Answer 50

Over 200

Question 51

Polyuria

Answer 51

Peeing a lot

Question 52

Polydypsia =

Answer 52

Super thirsty

Question 53

Anyone who doesn't produce insulin in their pancreas has type ____ diabetes?

Answer 53

1

Question 54

How do you place an unconscious patient for mouth care?

Answer 54

Side-lying position

Question 55

How do you know if a patient's hearing aid is working?

Answer 55

Turn your back or cover your mouth and see if they can hear you.