NR 224 FUNDAMENTALS QUESTIONS AND ANSWERS/ A+ GRADE
A NURSE is preparing to provide hygiene care. Which principle should the
NURSE consider when planning hygiene care?
a.Hygiene care is always routine and expected.
b.No two individuals perform hygiene in the same manner.
c. It is important to standardize a patient's hygienic practices.
d. During hygiene care do not take the time to learn about patient needs.
CORRECT ANSWER: B
No two individuals perform hygiene in the same manner; it is important to individualize
the patient's care based on knowing about the patient's unique hygiene practices and
preferences. Hygiene care is never routine; this care requires intimate contact with the
patient and communication skills to promote the therapeutic relationship. In addition,
during hygiene, the NURSE should take time to learn about the patient's health
promotion practices and needs, emotional needs, and health care education needs.
A patient's hygiene schedule of bathing and brushing teeth is largely influenced
by family customs. For which age group is the NURSE most likely providing
care?
a. Adolescent
b. Preschooler
c. Older adult
d. Adult
CORRECT ANSWER: B
Family customs play a major role during childhood in determining hygiene practices
such as the frequency of bathing, the time of day bathing is performed, and even
whether certain hygiene practices such as brushing of the teeth or flossing are
performed. As children enter adolescence, peer groups and media often influence
hygiene practices. During the adult years involvement with friends and work groups
shape the expectations that people have about personal appearance. Some older
adults' hygiene practices change because of changes in living conditions and available
resources.
The patient has been diagnosed with diabetes. When admitted, the patient is
unkempt and is in need of a bath and foot care. When questioned about hygiene
habits, the NURSE learns the patient takes a bath once a week and a sponge bath
every other day. To provide ultimate care for this patient, which principle should
the NURSE keep in mind?
a.Patients who appear unkempt place little importance on hygiene practices.
b.Personal preferences determine hygiene practices and are unchangeable.
c.The patient's illness may require teaching of new hygiene practices.
d.All cultures value cleanliness with the same degree of importance.
CORRECT ANSWER: C
The NURSE must assist the patient in developing new hygiene practices when
indicated by an illness or condition. For example, the NURSE will need to teach a
patient with diabetes proper foot hygiene. Patients who appear unkempt often need
further assessment regarding their ability to participate in daily hygiene. Patients with
, certain types of physical limitations or disabilities often lack the physical energy and
dexterity to perform hygienic care. Culturally, maintaining cleanliness does not hold the
same importance for some ethnic groups as it does for others.
The NURSE is caring for a patient who refuses to bathe in the morning. When
asked why, the patient says, ―I always bathe in the evening.‖ Which action by
the NURSE is best?
a.Defer the bath until evening and pass on the information to the next shift.
b.Tell the patient that daily morning baths are the ―normal‖ routine.
c.Explain the importance of maintaining morning hygiene practices.
d. Cancel hygiene for the day and attempt again in the morning.
CORRECT ANSWER: A
Allow the patient to follow normal hygiene practices; change the bath to evening.
Patients have individual preferences about when to perform hygiene and grooming
care. Knowing the patient's personal preferences promotes individualized care for the
patient. Hygiene care is never routine. Maintaining individual personal preferences is
important unless new hygiene practices are indicated by an illness or condition.
Cancelling hygiene and trying again is not an option since the NURSE already knows
the reason for refusal. Adapting practices to meet individual needs is required.
A NURSE is completing an assessment of the patient. Which principle is a
priority?
a.Foot care will always be important.
b.Daily bathing will always be important.
c.Hygiene needs will always be important.
d.Critical thinking will always be important.
CORRECT ANSWER: D
A patient's condition is always changing, requiring ongoing critical thinking and changing
of nursing diagnoses. Apply the elements of critical thinking as you use the nursing
process to meet patients' hygiene needs. Critical thinking will help you determine when
foot care, daily bathing, and hygiene needs are important and when they are not.
When providing hygiene for an older-adult patient, the NURSE closely assesses
the skin. What is the rationale for the NURSE's action?
a.Outer skin layer becomes more resilient.
b.Less frequent bathing may be required.
c.Skin becomes less subject to bruising.
d.Sweat glands become more active.
CORRECT ANSWER: B
In older adults, daily bathing as well as bathing with water that is too hot or soap that is
harsh causes the skin to become excessively dry. As the patient ages, the skin thins
and loses its resiliency and moisture, and lubricating skin glands become less active,
making the skin fragile and prone to bruising and breaking.
The NURSE is bathing a patient and notices movement in the patient's hair.
Which action will the NURSE take?
a.Use gloves to inspect the hair.
b.Apply a lindane-based shampoo immediately.
c.Shave the hair off of the patient's head.
d.Ignore the movement and continue.
A NURSE is preparing to provide hygiene care. Which principle should the
NURSE consider when planning hygiene care?
a.Hygiene care is always routine and expected.
b.No two individuals perform hygiene in the same manner.
c. It is important to standardize a patient's hygienic practices.
d. During hygiene care do not take the time to learn about patient needs.
CORRECT ANSWER: B
No two individuals perform hygiene in the same manner; it is important to individualize
the patient's care based on knowing about the patient's unique hygiene practices and
preferences. Hygiene care is never routine; this care requires intimate contact with the
patient and communication skills to promote the therapeutic relationship. In addition,
during hygiene, the NURSE should take time to learn about the patient's health
promotion practices and needs, emotional needs, and health care education needs.
A patient's hygiene schedule of bathing and brushing teeth is largely influenced
by family customs. For which age group is the NURSE most likely providing
care?
a. Adolescent
b. Preschooler
c. Older adult
d. Adult
CORRECT ANSWER: B
Family customs play a major role during childhood in determining hygiene practices
such as the frequency of bathing, the time of day bathing is performed, and even
whether certain hygiene practices such as brushing of the teeth or flossing are
performed. As children enter adolescence, peer groups and media often influence
hygiene practices. During the adult years involvement with friends and work groups
shape the expectations that people have about personal appearance. Some older
adults' hygiene practices change because of changes in living conditions and available
resources.
The patient has been diagnosed with diabetes. When admitted, the patient is
unkempt and is in need of a bath and foot care. When questioned about hygiene
habits, the NURSE learns the patient takes a bath once a week and a sponge bath
every other day. To provide ultimate care for this patient, which principle should
the NURSE keep in mind?
a.Patients who appear unkempt place little importance on hygiene practices.
b.Personal preferences determine hygiene practices and are unchangeable.
c.The patient's illness may require teaching of new hygiene practices.
d.All cultures value cleanliness with the same degree of importance.
CORRECT ANSWER: C
The NURSE must assist the patient in developing new hygiene practices when
indicated by an illness or condition. For example, the NURSE will need to teach a
patient with diabetes proper foot hygiene. Patients who appear unkempt often need
further assessment regarding their ability to participate in daily hygiene. Patients with
, certain types of physical limitations or disabilities often lack the physical energy and
dexterity to perform hygienic care. Culturally, maintaining cleanliness does not hold the
same importance for some ethnic groups as it does for others.
The NURSE is caring for a patient who refuses to bathe in the morning. When
asked why, the patient says, ―I always bathe in the evening.‖ Which action by
the NURSE is best?
a.Defer the bath until evening and pass on the information to the next shift.
b.Tell the patient that daily morning baths are the ―normal‖ routine.
c.Explain the importance of maintaining morning hygiene practices.
d. Cancel hygiene for the day and attempt again in the morning.
CORRECT ANSWER: A
Allow the patient to follow normal hygiene practices; change the bath to evening.
Patients have individual preferences about when to perform hygiene and grooming
care. Knowing the patient's personal preferences promotes individualized care for the
patient. Hygiene care is never routine. Maintaining individual personal preferences is
important unless new hygiene practices are indicated by an illness or condition.
Cancelling hygiene and trying again is not an option since the NURSE already knows
the reason for refusal. Adapting practices to meet individual needs is required.
A NURSE is completing an assessment of the patient. Which principle is a
priority?
a.Foot care will always be important.
b.Daily bathing will always be important.
c.Hygiene needs will always be important.
d.Critical thinking will always be important.
CORRECT ANSWER: D
A patient's condition is always changing, requiring ongoing critical thinking and changing
of nursing diagnoses. Apply the elements of critical thinking as you use the nursing
process to meet patients' hygiene needs. Critical thinking will help you determine when
foot care, daily bathing, and hygiene needs are important and when they are not.
When providing hygiene for an older-adult patient, the NURSE closely assesses
the skin. What is the rationale for the NURSE's action?
a.Outer skin layer becomes more resilient.
b.Less frequent bathing may be required.
c.Skin becomes less subject to bruising.
d.Sweat glands become more active.
CORRECT ANSWER: B
In older adults, daily bathing as well as bathing with water that is too hot or soap that is
harsh causes the skin to become excessively dry. As the patient ages, the skin thins
and loses its resiliency and moisture, and lubricating skin glands become less active,
making the skin fragile and prone to bruising and breaking.
The NURSE is bathing a patient and notices movement in the patient's hair.
Which action will the NURSE take?
a.Use gloves to inspect the hair.
b.Apply a lindane-based shampoo immediately.
c.Shave the hair off of the patient's head.
d.Ignore the movement and continue.
