Foundations of Nursing Flashcards
7 cards from real NACE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Foundations of Nursing flashcards as text
A nurse is assessing a patient's skin turgor. The nurse pinches the skin on the back of the hand and it returns to place in 4 seconds. This finding suggests:
Answer: Dehydration or decreased skin elasticity
Normal skin turgor returns within 2 seconds; a return time of 4 seconds indicates decreased turgor, suggesting dehydration or reduced skin elasticity (common in elderly patients).
Which intervention is the nurse's highest priority when caring for a postoperative patient in the PACU who has a SpO₂ of 89%?
Answer: Apply supplemental oxygen and reposition the airway
Applying supplemental oxygen and opening the airway addresses the immediate physiologic threat of hypoxemia before notifying the provider.
A nurse is caring for a patient on contact precautions. In what order should PPE be removed after leaving the room?
Answer: Gloves, gown, mask/eye protection, hand hygiene
CDC guidelines specify removing gloves first (most contaminated), then gown, then mask/eye protection, followed by hand hygiene.
Which finding in a patient's health history most increases the risk for developing a pressure injury?
Answer: Braden Scale score of 12 and urinary incontinence
A Braden Scale score of 12 indicates high pressure injury risk, and incontinence exposes skin to moisture, further increasing breakdown risk.
A nurse is caring for a patient with a nasogastric tube before administering a tube feeding. Which assessment confirms correct tube placement?
Answer: Aspirating gastric contents and checking pH (pH ≤5.5 confirms gastric placement)
Checking the pH of aspirated contents (pH ≤5.5 indicates gastric placement) is the most reliable bedside method to confirm NG tube placement.
A nurse is preparing to transfer a patient from bed to wheelchair. The patient can bear partial weight. Which action by the nurse is most important for safe transfer?
Answer: Locking the wheelchair brakes and raising the footrests before the transfer
Locking wheelchair brakes and raising footrests prevents the chair from rolling and eliminates a tripping hazard, which are essential safety steps before any transfer.
A nurse is reviewing a patient's advance directive, which designates a healthcare proxy. The patient is now unconscious and the family disagrees with the proxy's decision. The nurse should:
Answer: Honor the decisions of the designated healthcare proxy as per the advance directive
A legally designated healthcare proxy has decision-making authority for an incapacitated patient; the nurse must uphold this advance directive even if family members disagree.