Safe and Effective Care
Environment
1. The correct answer is B.
Question: What are the needs
of the patient with acute lymphocytic leukemia and
thrombocytopenia?
Needed Info: Lymphocytic leukemia, disease characterized by
proliferation of immature WBCs. Immature cells unable to fight
infection as competently as mature white cells. Treatment:
chemotherapy, antibiotics, blood transfusions, bone marrow
transplantation. Nursing responsibilities: private room, no raw
fruits or vegs, small frequent meals, O2, good skin
care.
(A) to a private room so she will not infect other patients
and health care workers — poses little or no threat
(B) to a private room so she will not be infected by other
patients and health care workers — CORRECT: protects patient
from exogenous bacteria, risk for developing infection from
others due to depressed WBC count, alters ability to fight
infection
(C) to a semiprivate room so she will have stimulation during her
hospitalization — should be placed in a room alone
(D) to a semiprivate room so she will have the opportunity to
express her feelings about her illness — ensure that patient
is provided with opportunities to express feelings about
illness
2. The correct answer is A.
Question: What is the BEST
way to prevent accidental poisoning in children?
Strategy: Picture toddlers at play.
(A) Lock all medications in a cabinet — CORRECT: improper
storage most common cause of poisoning; highest incidence in
two-year-olds
(B) Child proof all the caps to medication bottles — children
can open
(C) Store medications on the highest shelf in a cupboard —
toddlers climb
(D) Place medications in different containers — keep in
original container
3. The correct answer is C.
Question: What is the correct
universal precaution?
Strategy: Think about each answer choice. How is each measure
protecting the nurse?
Needed Info: Mask, eye protection, face shield protect mucous
membrane exposure; used if activities are likely to generate
splash or sprays. Gowns used if activities are likely to generate
splashes or sprays.
(A) Gloves, gown, goggles, and surgical cap — surgical caps
offer protection to hair but aren't required.
(B) Sterile gloves, mask, plastic bags, and gown — plastic
bags provide no direct protection and aren't part of universal
precautions
(C) Gloves, gown, mask, and goggles — CORRECT: must use
universal precautions on ALL patients; prevent skin and mucous
membrane exposure when contact with blood or other body fluids is
anticipated
(D) Double gloves, goggles, mask, and surgical cap — surgical
cap not required; unnecessary to double glove
4. The correct answer is B.
Question: What is the best
position after tonsillectomy to help with drainage of oral
secretions?
Strategy: Picture the patient as described.
(A) Sims' — on side with top knee flexed and thigh drawn up
to chest and lower knee less sharply flexed: used for vaginal or
rectal examination
(B) Side-lying — CORRECT: most effective to facilitate
drainage of secretions from the mouth and pharynx; reduces
possibility of airway obstruction.
(C) Supine — increased risk for aspiration, would not
facilitate drainage of oral secretions
(D) Prone — risk for airway obstruction and aspiration, unable
to observe the child for signs of bleeding such as increased
swallowing
5. The correct answer is A.
Question: Which patient is an
appropriate assignment for the LPN/LVN?
Strategy: Think about the skill level involved in each
patient's care.
Needed Info: LPN/LVN: assists with implementation of care;
performs procedures; differentiates normal from abnormal; cares
for stable patients with predictable conditions; has knowledge of
asepsis and dressing changes; administers medications (varies
with educational background and state nurse practice act).
(A) A 72-year-old patient with diabetes who requires a
dressing change for a stasis ulcer — CORRECT: stable patient
with an expected outcome
(B) A 42-year-old patient with cancer of the bone complaining of
pain — requires assessment; RN is the appropriate
caregiver
(C) A 55-year-old patient with terminal cancer being transferred
to hospice home care — requires nursing judgement; RN is the
appropriate caregiver
(D) A 23-year-old patient with a fracture of the right leg who
asks to use the urinal — standard unchanging procedure; assign
to the nursing assistant
Other PracticeQs:
