LVN Safe and Effective Care Environment Test 1

Question 1

A nurse is cleaning the wound of a 33-year-old client.
The nurse cleans the wound from the center of the incision and then outward, followed by lateral motions.
Which of the following best identifies this type of wound cleansing?

Accepted Answer

Horizontal

Answer

Vertical

Answer

Lateral

Answer

Dorsal

Question 2

Which of the following is NOT true of delegation?

Accepted Answer

A nurse should always delegate patient assessments.

Answer

A nurse can delegate tasks such as taking vital signs.

Answer

A nurse should never delegate the task of patient evaluations.

Answer

A nurse should delegate tasks that have expected outcomes.

Question 3

Which of the following best represents the steps of the chain of infection?

Accepted Answer

Etiologic agent, reservoir, portal of exit, method of transmission, portal of entry to the susceptible host, susceptible host

Answer

Bacteria, viruses, local infection, systemic infection

Answer

Acute transmission, chronic transmission, asepsis, and sepsis

Answer

Host, transmission, inflammation, sterilization

Question 4

There are several areas of regulation of nursing practice. Which of the following is NOT an accurate statement regarding the various methods and guidelines that regulate nursing practice?

Accepted Answer

Institutional policies are laws that are recognized by the courts and they detail how nurses are to perform their duties.

Answer

Standards of care are guidelines that identify what the client can expect to receive with nursing care.

Answer

Employee guidelines exist in hospitals and charges of abandonment may be made against nurses who "walk out" when staffing is inadequate.

Answer

The Nurse Practice Act is a series of statutes that have been enacted by state legislature to regulate the practice of nursing in each state.

Question 5

The nurse applies an external electronic fetal monitor (EFM) to assess a client's uterine contractions and evaluate the fetal heart rate (FHR). However, the client is uncomfortable and changes positions frequently, making FHR hard to assess. Consequently, the physician decides to switch to an internal EFM. Before internal monitoring can begin, which of the following must occur?

Accepted Answer

The membranes must rupture

Answer

The client must receive anesthesia

Answer

The cervix must be fully dilated

Answer

The fetus must be at 0 station

Question 6

A 23-year-old female has kidney stones. She is scheduled for an intravenous pyelogram. Which of the following client statements should stand out as a concern to the nurse?

Accepted Answer

”When I eat crab meat, I get short of breath."

Answer

”I feel nauseated when I am injected with the dye used for the procedure."

Answer

”I am afraid of needles."

Answer

”I am allergic to Tetanus shots."

Question 7

The nurse should instruct a client who is self-administering Atropine (Atropisol) to wait how long between instilling the first drop and instilling the second drop:

Accepted Answer

2 to 3 minutes.

Answer

30 seconds.

Answer

1 minute.

Answer

5 minutes.