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Exam 4 Chapters E NNHS NUR 166 NTTRF Concepts of Nursing II P. Emerson

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Exam 4 Chapters 27-28-29 E NNHS NUR 166 NTTRF Concepts of Nursing II P. Emerson/Exam 4 Chapters 27-28-29 E NNHS NUR 166 NTTRF Concepts of Nursing II P. Emerson/Exam 4 Chapters 27-28-29 E NNHS NUR 166 NTTRF Concepts of Nursing II P. Emerson

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6/28/2019 Exam 4 Chapters 27, 28, 29 : 201906E NNHS NUR166 NTTRF Concepts of Nursing II P. Emerson


Exam 4 Chapters 27, 28, 29
Due Jun 29 at 11:59pm Points 100 Questions 100
Available Jun 27 at 12am - Jun 29 at 11:59pm 3 days Time Limit None




Attempt History
Attempt Time Score
LATEST Attempt 1 202 minutes 96.08 out of 100



Score for this quiz: 96.08 out of 100
Submitted Jun 28 at 10:22am
This attempt took 202 minutes.


Question 1 pts


The nurse obtained the above assessment data for a newly admitted client.
The nurse develops a care plan for Risk for Falls. What information in the
client data places the client at risk for falls? Select all that apply.


You Answered Age of 61 years


Correct!
History of a fall

Correct!
Fractured leg


orrect Answer Administration of oxycodone


You Answered Vital signs




https://ecpi.instructure.com/courses/46570/quizzes/208379 1/70

,6/28/2019 Exam 4 Chapters 27, 28, 29 : 201906E NNHS NUR166 NTTRF Concepts of Nursing II P. Emerson




Risk factors for falls include a history of a fall (cause for this
hospitalization), a gait imbalance due to a fractured leg, and the
administration of oxycodone, an opioid analgesic. The client's age
(less than 65 years) and vital signs which are within normal limits are
not risk factors for a fall.




Question 2 0. pts


A mass casualty event has occurred in a community. Many health care
workers have been employed to assist. A nursing student has volunteered
services. With which tasks would the nursing student be asked to assist?
Select all that apply.


Triage clients by severity of injuries.

Correct! Take clients' vital signs.


orrect Answer
Obtain extra supplies, such as intravenous bags and tubing, dressings, and
gloves.



Correct! Hold pressure on a wound that will not stop bleeding.


Administer intravenous pain medication to a client reporting severe pain.




Question 3 pts


An emergency room nurse is assessing a toddler with multiple bruises and
burns. The nurse suspects the toddler has been abused. What is legally
required of the nurse?


Nothing; the nurse has no control over the toddler's home.

https://ecpi.instructure.com/courses/46570/quizzes/208379 2/70

,6/28/2019 Exam 4 Chapters 27, 28, 29 : 201906E NNHS NUR166 NTTRF Concepts of Nursing II P. Emerson


Refer the caregivers of the toddler to a home health nurse.


Verbally confront the caregivers about the suspicions.

Correct!
Report suspicions about the abuse to proper authorities.




Nurses are both legally and ethically obligated to report abuse, either
suspected or confirmed. In many states, the failure to report actual or
suspected abuse is a crime. The role of the nurse does not include
confrontation. Referral is not necessary until the client has been
assessed to need home health care nursing services.




Question 4 pts


An older adult woman in a long-term care facility has fallen and sustained
several injuries. Which of her injuries would be the most serious fall-related
injury?


Correct!
Fractured hip


Fractured ulna


Lacerated lip


Thigh contusion




https://ecpi.instructure.com/courses/46570/quizzes/208379 3/70

, 6/28/2019 Exam 4 Chapters 27, 28, 29 : 201906E NNHS NUR166 NTTRF Concepts of Nursing II P. Emerson




Falls can occur at any age, but a large percentage of older adults in
long-term settings suffer a fall. Hip fractures are among the most
serious fall-related injuries. Fractures can cause pain, permanent
disability, and even death. A fractured ulna may be painful but would
not cause the same potential for complications as a hip fracture.
Lacerations and contusions may be uncomfortable for the client but
will heal with limited risk for further complications.




Question 5 pts


A nurse enters a client's room and finds that the client has fallen on her way
to the bathroom. What is a prudent nursing intervention for this client?



Briefly leave the client in order to call the primary physician to assess the
client's condition.


Order x-rays or CT scans for the client, as needed.

Correct!
Document the incident, assessment, and interventions in the client's medical
record.


Do not file an event report unless the client is seriously injured in the fall.




The nurse is responsible for documenting the incident in the client's
record. Assess the client immediately and provide appropriate care
and interventions based on client status; ensure prompt follow-
through for any physician orders for diagnostic tests. An event report
should be filed in the case of a fall, as per facility policy.




Question 6 pts

https://ecpi.instructure.com/courses/46570/quizzes/208379 4/70

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