Saudi Prometric Nursing Fundamentals of Nursing 4

Question 1

The nurse is preparing to perform a sterile dressing change. Which action breaks sterile technique?

Accepted Answer

Reaching across the sterile field

Answer

Reaching across a sterile field introduces contamination because the arm (non-sterile) passes over sterile items. Items must always be passed around, never over, a sterile field.

Question 2

A patient develops a stage 2 pressure injury. Which description best matches this stage?

Accepted Answer

Partial-thickness skin loss with exposed dermis

Answer

Stage 2 pressure injuries involve partial-thickness loss of skin with exposed dermis. The wound bed is viable and may appear as a shallow open ulcer or intact/ruptured seroma. Stage 1 shows intact skin with non-blanchable redness.

Question 3

Which blood pressure reading would be classified as hypertension stage 1 according to current guidelines?

Accepted Answer

130–139/80–89 mmHg

Answer

According to updated cardiovascular guidelines, hypertension stage 1 is defined as systolic 130–139 mmHg or diastolic 80–89 mmHg. Elevated blood pressure is 120–129/<80, and stage 2 hypertension is ≥140/≥90.

Question 4

The nurse is caring for a post-operative patient with a nasogastric tube. Before administering tube feeding, the nurse should first:

Accepted Answer

Verify tube placement by checking gastric pH and/or X-ray

Answer

Verifying NG tube placement is the critical first step before any feeding to prevent aspiration. pH testing (gastric pH <5) and chest X-ray are the most reliable methods. Auscultation alone is no longer considered reliable.

Question 5

Which of the following is a NANDA-approved nursing diagnostic statement format?

Accepted Answer

Risk for infection related to impaired skin integrity

Answer

NANDA nursing diagnoses follow the PES format (Problem + Etiology + Signs/Symptoms) or PE format for risk diagnoses. 'Risk for infection related to impaired skin integrity' correctly identifies a potential problem and its related factor.

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Fundamentals of Nursing 4