PNC Clinical Procedures & Protocols 3 — Questions and Answers
Question 1: A parish nurse is teaching proper hand hygiene. According to CDC guidelines, how long should alcohol-based hand rub be rubbed into the hands?
- Until hands feel slightly wet
- Until the product has evaporated and hands are dry (Correct answer)
- For exactly 5 seconds
- Until a lather is produced
Correct answer: Until the product has evaporated and hands are dry
The CDC recommends rubbing alcohol-based hand rub over all hand surfaces until the product has completely evaporated, which typically takes 20–30 seconds.
Question 2: During a community health screening, a parish nurse finds a client with a total cholesterol of 215 mg/dL. How should this result be classified?
- Desirable
- Borderline high (Correct answer)
- High
- Optimal
Correct answer: Borderline high
According to NCEP/AHA guidelines, a total cholesterol of 200–239 mg/dL is classified as borderline high and warrants lifestyle counseling and follow-up.
Question 3: A parish nurse is assisting a congregation member who reports chest pain. After calling 911, which action is appropriate while waiting for EMS?
- Offer the client a glass of water and have them walk slowly
- Have the client chew one adult aspirin (325 mg) if not allergic and no contraindications (Correct answer)
- Apply heat to the chest to relieve discomfort
- Ask the client to perform deep breathing exercises
Correct answer: Have the client chew one adult aspirin (325 mg) if not allergic and no contraindications
Chewing aspirin immediately during a suspected heart attack inhibits platelet aggregation and may reduce myocardial damage; this is recommended unless allergic or contraindicated.
Question 4: When applying a topical medication during a home visit, the parish nurse should:
- Apply with bare hands to assess skin texture
- Wear gloves to prevent absorption of the medication (Correct answer)
- Use the client's bare hand to spread the medication
- Apply with a dry cotton swab only if the skin is broken
Correct answer: Wear gloves to prevent absorption of the medication
Gloves must be worn when applying topical medications to prevent accidental absorption of the drug through the nurse's skin.
Question 5: A parish nurse is educating a client with hypertension about the DASH diet. Which food group should be significantly increased?
- Red meats and full-fat dairy
- Fruits, vegetables, and low-fat dairy (Correct answer)
- Refined grains and sweets
- High-sodium canned soups
Correct answer: Fruits, vegetables, and low-fat dairy
The DASH diet emphasizes increased intake of fruits, vegetables, whole grains, and low-fat dairy, and is proven to lower blood pressure.
Question 6: A congregation member reports they have been taking ibuprofen daily for 3 weeks for knee pain. The parish nurse should counsel them about which primary risk?
- Increased risk of hypoglycemia
- Gastrointestinal bleeding and renal impairment with prolonged NSAID use (Correct answer)
- Risk of allergic reaction to aspirin cross-reactivity
- Increased risk of muscle weakness
Correct answer: Gastrointestinal bleeding and renal impairment with prolonged NSAID use
Prolonged NSAID use such as ibuprofen significantly increases the risk of gastrointestinal ulceration, bleeding, and renal impairment, especially in older adults.
Question 7: A parish nurse is teaching a client how to correctly use a metered-dose inhaler (MDI) without a spacer. What is the correct sequence for step 3 after removing the cap and shaking the inhaler?
- Exhale fully, hold inhaler 1–2 inches from the open mouth, inhale slowly while pressing canister, hold breath 10 seconds (Correct answer)
- Inhale forcefully before pressing the canister to prime it
- Press the canister first, then place in mouth and inhale
- Inhale normally and press the canister midway through inhalation
Correct answer: Exhale fully, hold inhaler 1–2 inches from the open mouth, inhale slowly while pressing canister, hold breath 10 seconds
Correct MDI technique requires exhaling fully, positioning the inhaler 1–2 inches from the open mouth, pressing the canister while inhaling slowly, and holding the breath for 10 seconds to maximize drug deposition.
PNC Clinical Procedures & Protocols 3
A parish nurse is teaching proper hand hygiene.
According to CDC guidelines, how long should alcohol-based hand rub be rubbed into the hands?