NR 224 | NR224 EXAM 1 | FUNDAMENTALS
EXAM 1 | CORRECTLY ANSWERED &
GRADED A+ | 2025/2026 GUIDE
Nursing Assessment: Infection
- Correct Answer –
•Review of systems
•History
>Travel history
>immunizations and vaccinations
>Medication history
>Medical history
•Risk factors
•Status of defense mechanisms
•i.e breaks in the skin; recent invasive procedure; etc.
•Clinical appearance (see additional slide)
•Signs and symptoms of infection
Laboratory data
Infection risk factors
- Correct Answer –
,Break of alteration in defensive systems
host
lifestyle
occupation
developmental stage
chronic disease
hospitalization
Examples of nursing diagnosis
- Correct Answer –
Here are some examples:
•Risk for infection
•Imbalanced nutrition: less than body requirements
•Impaired oral mucous membrane
•Risk for impaired skin integrity
•Social isolation
•Impaired tissue integrity
•Readiness for enhanced immunization status
•Any others you can think of?
Common goals for clients with infection
- Correct Answer –
•Preventing exposure to infectious organisms
•Controlling or reducing the extent of infection
•Maintaining resistance to infection
,•Verbalizing understanding of infection prevention and control
techniques (e.g., hand hygiene)
How do we reduce infection?
- Correct Answer - Health promotion
Preventing an infection from developing or spreading
•Nutrition
•Hygiene
•Immunizations
•Rest
•Exercise
The mnemonic S.M.A.R.T is used for which portion of the nursing
diagnosis
- Correct Answer - Planning
SMART goals
Specific, Measurable, Attainable, Realistic, Timely
Infectious Process Signs and Symptoms/ Clinical appearance
, Localized:
•Common in areas of skin or mucous membrane breakdown
•common symptoms= pain, tenderness, redness, warmth, swelling
(edema)
Systemic:
•Symptoms often more generalized
•entire body is affected, fever & chills, N, V, D, fatigue, malaise
•Localized infection may develop or progress to systematic
•Symptoms may not always be present right away, i.e.: some older
adults have an advanced infection before it is identified
Vitals:
•Temperature may increase
•BP may decrease, HR & RR may increase.
•Specific system involvement may impact vitals
Other signs- confusion, agitation (especially in elderly)
T or F
WBC decrease if there is a infection
F ; •Increased in acute infection
You are caring for a client who underwent surgery 48 hours ago. On
physical assessment, you notice that the incision looks red and swollen.
The client is complaining of tenderness. Temp is 101.2 F orally. The
client's WBCs are elevated at 14,867. What should you do?
EXAM 1 | CORRECTLY ANSWERED &
GRADED A+ | 2025/2026 GUIDE
Nursing Assessment: Infection
- Correct Answer –
•Review of systems
•History
>Travel history
>immunizations and vaccinations
>Medication history
>Medical history
•Risk factors
•Status of defense mechanisms
•i.e breaks in the skin; recent invasive procedure; etc.
•Clinical appearance (see additional slide)
•Signs and symptoms of infection
Laboratory data
Infection risk factors
- Correct Answer –
,Break of alteration in defensive systems
host
lifestyle
occupation
developmental stage
chronic disease
hospitalization
Examples of nursing diagnosis
- Correct Answer –
Here are some examples:
•Risk for infection
•Imbalanced nutrition: less than body requirements
•Impaired oral mucous membrane
•Risk for impaired skin integrity
•Social isolation
•Impaired tissue integrity
•Readiness for enhanced immunization status
•Any others you can think of?
Common goals for clients with infection
- Correct Answer –
•Preventing exposure to infectious organisms
•Controlling or reducing the extent of infection
•Maintaining resistance to infection
,•Verbalizing understanding of infection prevention and control
techniques (e.g., hand hygiene)
How do we reduce infection?
- Correct Answer - Health promotion
Preventing an infection from developing or spreading
•Nutrition
•Hygiene
•Immunizations
•Rest
•Exercise
The mnemonic S.M.A.R.T is used for which portion of the nursing
diagnosis
- Correct Answer - Planning
SMART goals
Specific, Measurable, Attainable, Realistic, Timely
Infectious Process Signs and Symptoms/ Clinical appearance
, Localized:
•Common in areas of skin or mucous membrane breakdown
•common symptoms= pain, tenderness, redness, warmth, swelling
(edema)
Systemic:
•Symptoms often more generalized
•entire body is affected, fever & chills, N, V, D, fatigue, malaise
•Localized infection may develop or progress to systematic
•Symptoms may not always be present right away, i.e.: some older
adults have an advanced infection before it is identified
Vitals:
•Temperature may increase
•BP may decrease, HR & RR may increase.
•Specific system involvement may impact vitals
Other signs- confusion, agitation (especially in elderly)
T or F
WBC decrease if there is a infection
F ; •Increased in acute infection
You are caring for a client who underwent surgery 48 hours ago. On
physical assessment, you notice that the incision looks red and swollen.
The client is complaining of tenderness. Temp is 101.2 F orally. The
client's WBCs are elevated at 14,867. What should you do?
