EVISNEHERPMOC • 2 MAXE
Nursing Fundamentals
NURS School of Nursing — Exam 2 Review
W O U N D C A R E · M E D I C AT I O N S · M O B I L I T Y · S E N S O R Y · CO M M U N I C AT I O N
EXAM 2
Fundamentals Exam 2 — Comprehensive Review
W O U N D C A R E , M E D I C AT I O N A D M I N I ST R AT I O N , M O B I L I TY, S E N S O R Y A SS E SS M E N T &
CO M M U N I C AT I O N
INSTITUTION School of Nursing COURSE CODE NURS-FUND-EXAM2
PROGRAM Nursing — ADN / BSN Pathway ACADEMIC YEAR
EXAM TITLE Fundamentals Exam 2 TOTAL QUESTIONS 60+ Comprehensive Questions
COURSE TITLE Nursing Fundamentals FORMAT Multiple Choice / Definition / Select All
That Apply
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise indicated.
▸ Questions cover EHR security, wound care (pressure injuries, debridement, drains), medication administration (routes, angles,
ear drops), mobility (positions, devices, body mechanics), sensory changes with aging, infection control precautions, and
therapeutic communication.
▸ Verified answers with detailed rationales are provided for comprehensive exam preparation.
▸ Pay close attention to pressure injury staging, debridement types, and the differences between droplet/contact/airborne
precautions.
WOUNDS, MEDICATIONS, MOBILITY, SENSORY & INFECTION CONTROL Questions 1 – 60+
1. What are the practices to maintain security and confidentiality of electronic health records (EHR)?
A. Share passwords with colleagues for efficiency.
B. Use secure login, log out when done, do not share passwords, follow HIPAA, access only need-to-know information.
C. Leave the computer screen open for the next nurse.
D. Access any patient record for learning purposes.
CORRECT ANSWER B — Secure login, log out, no password sharing, HIPAA compliance, need-to-know access only
RATIONALE EHR security is a legal and ethical obligation under HIPAA. Key practices: Use unique, secure login credentials;
log out immediately when leaving the computer station (never leave a screen open with patient data visible);
NEVER share passwords with anyone; access ONLY patient records for whom you are providing direct care —
reviewing records of patients not assigned to you is a HIPAA violation, even for educational purposes; follow
your facility's specific policies on information security; report any suspected breaches immediately. Example:
A nurse closes the computer screen when leaving the station to prevent unauthorized viewing of patient
information.
, 2. What is orthostatic hypotension and what are the diagnostic criteria?
A. A rise in blood pressure when standing.
B. A drop in systolic BP ≥20 mmHg or diastolic BP ≥10 mmHg within 3 minutes of moving from lying to standing,
causing dizziness and potential syncope.
C. Normal blood pressure variation with position changes.
D. Hypertension that occurs only when lying down.
CORRECT ANSWER B — Drop ≥20 mmHg systolic or ≥10 mmHg diastolic within 3 minutes of standing; causes dizziness,
possible syncope
RATIONALE Orthostatic (postural) hypotension is defined as a decrease in systolic BP of ≥20 mmHg OR diastolic BP of ≥10
mmHg within 3 minutes of transitioning from supine to standing. When standing, gravity pools approximately
500-700 mL of blood in the lower extremities; normally, baroreceptors trigger compensatory vasoconstriction
and increased heart rate. In orthostatic hypotension, this reflex is impaired. Causes: prolonged immobility
(baroreceptor deconditioning), dehydration, blood loss, medications (antihypertensives, diuretics,
vasodilators), and autonomic neuropathy (diabetes, Parkinson's). Symptoms: dizziness, lightheadedness,
blurred vision, weakness, and syncope (fainting). Nursing assessment: measure BP supine, sitting, and
standing (after 1-3 minutes each); document orthostatic changes. Prevention: gradual position changes,
dangling at bedside before standing, antiembolism stockings, adequate hydration.
3. What are the four types of wound debridement and how do they differ?
A. All types use the same method — scalpel removal.
B. Mechanical (wet-to-dry dressings, irrigation), Autolytic (body's own enzymes/moisture), Chemical/Enzymatic (topical
enzyme agents), Surgical/Sharp (scalpel excision).
C. Only surgical debridement is effective.
D. Debridement is only performed by physicians.
CORRECT ANSWER B — Mechanical (wet-to-dry, irrigation), Autolytic (body's enzymes), Enzymatic (topical agents),
Surgical/Sharp (scalpel)
RATIONALE Debridement removes necrotic tissue, slough, and eschar to promote healing. Four types: Mechanical —
physical force removes debris; wet-to-dry saline dressings placed in wound, allowed to dry, then removed
(non-selective — removes healthy tissue too); wound irrigation with pulsatile lavage. Autolytic — uses the
body's endogenous enzymes and moisture to liquefy necrotic tissue; slow, selective, minimal pain; achieved
with occlusive/hydrocolloid dressings maintaining a moist environment. Chemical/Enzymatic — topical
enzyme preparations (collagenase) applied directly to wound to digest necrotic tissue; selective.
Surgical/Sharp — scalpel or scissors excision of necrotic tissue by trained provider; fastest method, used for
extensive necrosis or advancing cellulitis/osteomyelitis. Selection depends on wound characteristics, patient
condition, and care setting.
Nursing Fundamentals
NURS School of Nursing — Exam 2 Review
W O U N D C A R E · M E D I C AT I O N S · M O B I L I T Y · S E N S O R Y · CO M M U N I C AT I O N
EXAM 2
Fundamentals Exam 2 — Comprehensive Review
W O U N D C A R E , M E D I C AT I O N A D M I N I ST R AT I O N , M O B I L I TY, S E N S O R Y A SS E SS M E N T &
CO M M U N I C AT I O N
INSTITUTION School of Nursing COURSE CODE NURS-FUND-EXAM2
PROGRAM Nursing — ADN / BSN Pathway ACADEMIC YEAR
EXAM TITLE Fundamentals Exam 2 TOTAL QUESTIONS 60+ Comprehensive Questions
COURSE TITLE Nursing Fundamentals FORMAT Multiple Choice / Definition / Select All
That Apply
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise indicated.
▸ Questions cover EHR security, wound care (pressure injuries, debridement, drains), medication administration (routes, angles,
ear drops), mobility (positions, devices, body mechanics), sensory changes with aging, infection control precautions, and
therapeutic communication.
▸ Verified answers with detailed rationales are provided for comprehensive exam preparation.
▸ Pay close attention to pressure injury staging, debridement types, and the differences between droplet/contact/airborne
precautions.
WOUNDS, MEDICATIONS, MOBILITY, SENSORY & INFECTION CONTROL Questions 1 – 60+
1. What are the practices to maintain security and confidentiality of electronic health records (EHR)?
A. Share passwords with colleagues for efficiency.
B. Use secure login, log out when done, do not share passwords, follow HIPAA, access only need-to-know information.
C. Leave the computer screen open for the next nurse.
D. Access any patient record for learning purposes.
CORRECT ANSWER B — Secure login, log out, no password sharing, HIPAA compliance, need-to-know access only
RATIONALE EHR security is a legal and ethical obligation under HIPAA. Key practices: Use unique, secure login credentials;
log out immediately when leaving the computer station (never leave a screen open with patient data visible);
NEVER share passwords with anyone; access ONLY patient records for whom you are providing direct care —
reviewing records of patients not assigned to you is a HIPAA violation, even for educational purposes; follow
your facility's specific policies on information security; report any suspected breaches immediately. Example:
A nurse closes the computer screen when leaving the station to prevent unauthorized viewing of patient
information.
, 2. What is orthostatic hypotension and what are the diagnostic criteria?
A. A rise in blood pressure when standing.
B. A drop in systolic BP ≥20 mmHg or diastolic BP ≥10 mmHg within 3 minutes of moving from lying to standing,
causing dizziness and potential syncope.
C. Normal blood pressure variation with position changes.
D. Hypertension that occurs only when lying down.
CORRECT ANSWER B — Drop ≥20 mmHg systolic or ≥10 mmHg diastolic within 3 minutes of standing; causes dizziness,
possible syncope
RATIONALE Orthostatic (postural) hypotension is defined as a decrease in systolic BP of ≥20 mmHg OR diastolic BP of ≥10
mmHg within 3 minutes of transitioning from supine to standing. When standing, gravity pools approximately
500-700 mL of blood in the lower extremities; normally, baroreceptors trigger compensatory vasoconstriction
and increased heart rate. In orthostatic hypotension, this reflex is impaired. Causes: prolonged immobility
(baroreceptor deconditioning), dehydration, blood loss, medications (antihypertensives, diuretics,
vasodilators), and autonomic neuropathy (diabetes, Parkinson's). Symptoms: dizziness, lightheadedness,
blurred vision, weakness, and syncope (fainting). Nursing assessment: measure BP supine, sitting, and
standing (after 1-3 minutes each); document orthostatic changes. Prevention: gradual position changes,
dangling at bedside before standing, antiembolism stockings, adequate hydration.
3. What are the four types of wound debridement and how do they differ?
A. All types use the same method — scalpel removal.
B. Mechanical (wet-to-dry dressings, irrigation), Autolytic (body's own enzymes/moisture), Chemical/Enzymatic (topical
enzyme agents), Surgical/Sharp (scalpel excision).
C. Only surgical debridement is effective.
D. Debridement is only performed by physicians.
CORRECT ANSWER B — Mechanical (wet-to-dry, irrigation), Autolytic (body's enzymes), Enzymatic (topical agents),
Surgical/Sharp (scalpel)
RATIONALE Debridement removes necrotic tissue, slough, and eschar to promote healing. Four types: Mechanical —
physical force removes debris; wet-to-dry saline dressings placed in wound, allowed to dry, then removed
(non-selective — removes healthy tissue too); wound irrigation with pulsatile lavage. Autolytic — uses the
body's endogenous enzymes and moisture to liquefy necrotic tissue; slow, selective, minimal pain; achieved
with occlusive/hydrocolloid dressings maintaining a moist environment. Chemical/Enzymatic — topical
enzyme preparations (collagenase) applied directly to wound to digest necrotic tissue; selective.
Surgical/Sharp — scalpel or scissors excision of necrotic tissue by trained provider; fastest method, used for
extensive necrosis or advancing cellulitis/osteomyelitis. Selection depends on wound characteristics, patient
condition, and care setting.
