100 Item Exam On Fundamentals Of Nursing : Nursing Process, Physical and Health Assessment and outine Procedures

100 Item Exam On Fundamentals Of Nursing : Nursing Process, Physical and Health Assessment and outine Procedures F!N"A#EN$A%& OF N! &IN' $E&$ I( )y : )ude* htt+:,,---.+inoy/sn.t* 0ontent Outline 1. $he nursing +rocess 1. Physical Assessment 2. Health Assessment 2.a $em+erature 2./ Pulse 2.c es+iration 2.d )lood +ressure 3. outine Procedures 3.a !rinalysis s+ecimen collection 3./ &+utum s+ecimen collection 3.c !rine examination 3.d Positioning +re4+rocedure 3.e &tool s+ecimen collection 1. &he is the first one to coin the term 5N! &IN' P O0E&&6 &he introduced 2 ste+s of nursing +rocess -hich are O/ser7ation, #inistration and (alidation. A. Nightingale ). 8ohnson 0. ogers ". Hall 1. $he American Nurses association formulated an inno7ation of the Nursing +rocess. $oday, ho- many distinct ste+s are there in the nursing +rocess9 A. APIE : 3 ). A"PIE : ; 0. A"OPIE : < ". A"OPIE : = 2. $hey are the first one to suggest a 3 ste+ nursing +rocess -hich are : APIE , or assessment, +lanning, im+lementation and e7aluation. 1. >ura 1. ?alsh 2. oy 3. @no-les A. 1,1 ). 1,2 0. 2,3 ". 1,2 3. ?hich characteristic of nursing +rocess is res+onsi/le for +ro+er utiliAation of human resources, time and cost resources9

A. OrganiAed and &ystematic ). Humanistic 0. Efficient ". Effecti7e ;. ?hich characteristic of nursing +rocess addresses the IN"I(I"!A%IBE" care a client must recei7e9 A. OrganiAed and &ystematic ). Humanistic 0. Efficient ". Effecti7e <. A characteristic of the nursing +rocess that is essential to +romote client satisfaction and +rogress. $he care should also /e rele7ant -ith the clientCs needs. A. OrganiAed and &ystematic ). Humanistic 0. Efficient ". Effecti7e =. hina, -ho has #enieres disease, said that her en7ironment is mo7ing. ?hich of the follo-ing is a 7alid assessment9 1. hina is gi7ing an o/Decti7e data 1. hina is gi7ing a su/Decti7e data 2. $he source of the data is +rimary 3. $he source of the data is secondary A. 1,2 ). 1,2 0. 1.3 ". 1,3 E. Nurse Angela, o/ser7e 8oel -ho is 7ery a++rehensi7e o7er the im+ending o+eration. $he client is ex+eriencing dys+nea, dia+horesis and as*s lots of Fuestions. Angela made a diagnosis of ANGIE$> ,$ IN$ !&I(E P O0E"! E. $his is -hat ty+e of Nursing "iagnosis9 A. Actual ). Pro/a/le 0. Possi/le ". is* H. Nurse Angela diagnosed #rs. "elgado, -ho ha7e undergone a )@A. Her diagnosis is &E%F E&$EE# "I&$! )AN0E ,$ 0HAN'E IN )O"> I#A'E. Although the client has not yet seen her lost leg, Angela already antici+ated the diagnosis. $his is -hat ty+e of "iagnosis9 A. Actual ). Pro/a/le 0. Possi/le ". is* 10. Nurse Angela is a/out to ma*e a diagnosis /ut 7ery unsure /ecause the &,& the client is ex+eriencing is not s+ecific -ith her diagnosis of PO?E %E&&NE&& ,$ "IFFI0!%$> A00EP$IN' %O&& OF %O(E" ONE. &he then focus on gathering data to refute or +ro7e her diagnosis /ut her +lans and inter7entions are already ongoing for the diagnosis. ?hich ty+e of "iagnosis is this9 A. Actual

). Pro/a/le 0. Possi/le ". is* 11. Nurse Angela *ne- that &te+hen %ee #u 0hin, has Dust undergone an o+eration -ith an incision near the dia+hragm. &he *ne- that this -ill contri/ute to some com+lications later on. &he then should de7elo+ -hat ty+e of Nursing diagnosis9 A. Actual ). Pro/a/le 0. Possi/le ". is* 11. ?hich of the follo-ing Nursing diagnosis is IN0O E0$9

A. Fluid 7olume deficit ,$ "iarrhea ). High ris* for inDury ,$ A/sence of side rails 0. Possi/le ineffecti7e co+ing ,$ %oss of lo7ed one ". &elf esteem distur/ance ,$ Effects of surgical remo7al of the leg 12. Among the follo-ing statements, -hich should /e gi7en the HI'HE&$ +riority9 A. 0lient is in extreme +ain ). 0lientCs /lood +ressure is <0,30 0. 0lientCs tem+erature is 30 deg. 0entigrade ". 0lient is cyanotic 13. ?hich of the follo-ing need is gi7en a higher +riority among others9 A. $he client has attem+ted suicide and safety +recaution is needed ). $he client has distur/ance in his /ody image /ecause of the recent o+eration 0. $he client is de+ressed /ecause her /oyfriend left her all alone ". $he client is thirsty and dehydrated 1;. ?hich of the follo-ing is $ !E -ith regards to 0lient 'oals9 A. $hey are s+ecific, measura/le, attaina/le and time /ounded ). $hey are general and /roadly stated 0. $hey should ans-er for ?HO, ?HA$ A0$ION&, ?HA$ 0I 0!#&$AN0E&, HO? ?E%% and ?HEN. ". Exam+le is : After discharge +lanning, 0lient demonstrated the +ro+er +sychomotor s*ills for insulin inDection. 1<. ?hich of the follo-ing is a NO$ a correct statement of an Outcome criteria9 A. Am/ulates 20 feet -ith a cane /efore discharge ). "iscusses fears and concerns regarding the surgical +rocedure 0. "emonstrates +ro+er coughing and /reathing techniFue after a teaching session ". eesta/lishes a normal +attern of elimination 1=. ?hich of the follo-ing is a O)8E0$I(E data9 A. "iAAiness ). 0hest +ain 0. Anxiety ". )lue nails 1E. A +atientCs chart is -hat ty+e of data source9 A. Primary

). &econdary 0. $ertiary ". 0an /e A and ) 1H. All of the follo-ing are characteristic of the Nursing +rocess exce+t A. "ynamic ). 0yclical 0. !ni7ersal ". Intra+ersonal 10. ?hich of the follo-ing is true a/out the N! &IN' 0A E P%AN9 A. It is nursing centered ). ationales are su++orted /y inter7entions 0. (er/al ". Atleast 1 goals are needed for e7ery nursing diagnosis 11. A frame-or* for health assessment that e7aluates the effects of stressors to the mind, /ody and en7ironment in relation -ith the a/ility of the client to +erform A"%. A. Functional health frame-or* ). Head to toe frame-or* 0. )ody system frame-or* ". 0e+halocaudal frame-or* 11. 0lient has undergone !++er 'I and %o-er 'I series. ?hich ty+e of health assessment frame-or* is used in this situation9 A. Functional health frame-or* ). Head to toe frame-or* 0. )ody system frame-or* ". 0e+halocaudal frame-or* 12. ?hich of the follo-ing statement is true regarding tem+erature9 A. Oral tem+erature is more accurate than rectal tem+erature ). $he /ul/ used in ectal tem+erature reading is +ear sha+ed or round 0. $he older the +erson, the higher his )# ". ?hen the client is s-imming, )# "ecreases 13. A ty+e of heat loss that occurs -hen the heat is dissi+ated /y air current A. 0on7ection ). 0onduction 0. adiation ". E7a+oration 1;. ?hich of the follo-ing is $ !E a/out tem+erature9 A. $he highest tem+erature usually occurs later in a day, around E P.# to 11 #.N ). $he lo-est tem+erature is usually in the Afternoon, Around 11 P.# 0. $hyroxin decreases /ody tem+erature ". Elderly +eo+le are ris* for hy+erthermia due to the a/sence of fats, "ecreased thermoregulatory control and sedentary lifestyle. 1<. Hy+er+yrexia is a condition in -hich the tem+erature is greater than A. 30 degree 0elsius

). 2H degree 0elsius 0. 100 degree Fahrenheit ". 10;.E degree Fahrenheit 1=. $ym+anic tem+erature is ta*en from 8ohn, A client -ho -as /rought recently into the E due to freFuent /ar*ing cough. $he tem+erature reads 2=.H "egrees 0elsius. As a nurse, you conclude that this tem+erature is A. High ). %o0. At the lo- end of the normal range ". At the high end of the normal range 1E. 8ohn has a fe7er of 2E.; "eg. 0elsius. It surges at around 30 "egrees and go /ac* to 2E.; degrees < times today in a ty+ical +attern. ?hat *ind of fe7er is 8ohn ha7ing9 A. ela+sing ). Intermittent 0. emittent ". 0onstant 1H. 8ohn has a fe7er of 2H.; degrees 1 days ago, )ut yesterday, he has a normal tem+erature of 2<.; degrees. $oday, his tem+erature surges to 30 degrees. ?hat ty+e of fe7er is 8ohn ha7ing9 A. ela+sing ). Intermittent 0. emittent ". 0onstant 20. 8ohnCs tem+erature 10 hours ago is a normal 2<.; degrees. 3 hours ago, He has a fe7er -ith a tem+erature of 2E.H "egrees. ight no-, his tem+erature is /ac* to normal. ?hich of the follo-ing /est descri/e the fe7er Dohn is ha7ing9 A. ela+sing ). Intermittent 0. emittent ". 0onstant 21. $he characteristic fe7er in "engue (irus is characteriAed as: A. $ricyclic ). )icyclic 0. )i+hasic ". $ri+hasic 21. ?hen 8ohn has /een gi7en +aracetamol, his fe7er -as /rought do-n dramatically from 30 degrees 0elsius to 2<.= degrees in a matter of 10 minutes. $he nurse -ould assess this e7ent as: A. $he goal of reducing DohnCs fe7er has /een met -ith full satisfaction of the outcome criteria ). $he desired goal has /een +artially met 0. $he goal is not com+letely met ". $he goal has /een met /ut not -ith the desired outcome criteria 22. ?hat can you ex+ect from #arianne, -ho is currently at the ON&E$ stage of fe7er9

A. Hot, flushed s*in ). Increase thirst 0. 0on7ulsion ". Pale,cold s*in 23. #arianne is no- at the "efer7escence stage of the fe7er, -hich of the follo-ing is ex+ected9 A. "elirium ). 'oose flesh 0. 0yanotic nail /eds ". &-eating 2;. 0onsidered as the most accessi/le and con7enient method for tem+erature ta*ing A. Oral ). ectal 0. $ym+anic ". Axillary 2<. 0onsidered as &afest and most non in7asi7e method of tem+erature ta*ing A. Oral ). ectal 0. $ym+anic ". Axillary 2=. ?hich of the follo-ing is NO$ a contraindication in ta*ing O A% tem+erature9 A. Iuadri+legic ). Presence of N'$ 0. "ys+nea ". Nausea and (omitting 2E. ?hich of the follo-ing is a contraindication in ta*ing A. !nconscious ). Neutro+enic 0. NPO ". (ery young children 2H. Ho- long should the A. 1 to 1 inches ). .; to 1.; inches 0. 2 to ; inches ". 1 to 2 inches 30. In cleaning the thermometer after use, $he direction of the cleaning to follo- #edical Ase+sis is : A. From /ul/ to stem ). From stem to /ul/ 0. From stem to stem ". From /ul/ to /ul/ 31. Ho- long should the thermometer stay in the 0lientCs Axilla9 A. 2 minutes ectal $hermometer /e inserted to the clients anus9 E0$A% tem+erature9

). 3 minutes 0. = minutes ". 10 minutes 31. ?hich of the follo-ing statement is $ !E a/out +ulse9 A. >oung +erson ha7e higher +ulse than older +ersons ). #ales ha7e higher +ulse rate than females after +u/erty 0. "igitalis has a +ositi7e chronotro+ic effect ". In lying +osition, Pulse rate is higher 32. $he follo-ing are correct actions -hen ta*ing radial +ulse exce+t: A. Put the +alms do-n-ard ). !se the thum/ to +al+ate the artery 0. !se t-o or three fingers to +al+ate the +ulse at the inner -rist ". Assess the +ulse rate, rhythm, 7olume and /ilateral Fuality 33. $he difference /et-een the systolic and diastolic +ressure is termed as A. A+ical rate ). 0ardiac rate 0. Pulse deficit ". Pulse +ressure 3;. ?hich of the follo-ing com+letely descri/es P!%&!& PA A"OGI0!&9 A. A greater4than4normal increase in systolic /lood +ressure -ith ins+iration ). A greater4than4normal decrease in systolic /lood +ressure -ith ins+iration 0. Pulse is +aradoxically lo- -hen client is in standing +osition and high -hen su+ine. ". Pulse is +aradoxically high -hen client is in standing +osition and lo- -hen su+ine. 3<. ?hich of the follo-ing is $ !E a/out res+iration9 A. I:E 1:1 ). I:E : 3:2 0 I:E 1:1 ". I:E 1:1 3=. 0ontains the +neumotaxic and the a+neutic centers A. #edulla o/longata ). Pons 0. 0arotid /odies ". Aortic /odies 3E. ?hich of the follo-ing is res+onsi/le for dee+ and +rolonged ins+iration A. #edulla o/longata ). Pons 0. 0arotid /odies ". Aortic /odies 3H. ?hich of the follo-ing is res+onsi/le for the rhythm and Fuality of /reathing9 A. #edulla o/longata ). Pons 0. 0arotid /odies ". Aortic /odies

;0. $he +rimary res+iratory center A. #edulla o/longata ). Pons 0. 0arotid /odies ". Aortic /odies ;1. ?hich of the follo-ing is $ !E a/out the mechanism of action of the Aortic and 0arotid /odies9 A. If the )P is ele7ated, the increases ). If the )P is ele7ated, the decreases 0. Ele7ated )P leads to #eta/olic al*alosis ". %o- )P leads to #eta/olic acidosis ;1. All of the follo-ing factors correctly influence res+iration exce+t one. ?hich of the follo-ing is incorrect9 A. Hydrocodone decreases ). &tress increases 0. Increase tem+erature of the en7ironment, Increase ". Increase altitude, Increase ;2. ?hen does the heart recei7es /lood from the coronary artery9 A. &ystole ). "iastole 0. ?hen the 7al7es o+ens ". ?hen the 7al7es closes ;3. ?hich of the follo-ing is more life threatening9 A. )P J 1E0,100 ). )P J 1<0,110 0. )P J H0,<0 ". )P J E0,;0 ;;. efers to the +ressure -hen the 7entricles are at rest

A. "iastole ). &ystole 0. Preload ". Pulse +ressure ;<. ?hich of the follo-ing is $ !E a/out the /lood +ressure determinants9 A. Hy+er7olemia lo-ers )P ). Hy+er7olemia increases 'F 0. H0$ of =0K might decrease or increase )P ". E+ine+hrine decreases )P ;=. ?hich of the follo-ing do not correctly correlates the increase )P of #s. Aida, a =0 year old dia/etic9 A. Females, after the age <; tends to ha7e lo-er )P than males ). "isease +rocess li*e "ia/etes increase )P 0. )P is highest in the morning, and lo-est during the night

". Africans, ha7e a greater ris* of hy+ertension than 0aucasian and Asians. ;E. Ho- many minutes are allo-ed to +ass if the client had engaged in strenuous acti7ities, smo*ed or ingested caffeine /efore ta*ing his,her )P9 A. ; ). 10 0. 1; ". 20 ;H. $oo narro- cuff -ill cause -hat change in the 0lientCs )P9 A. $rue high reading ). $rue lo- reading 0. False high reading ". False lo- reading <0. ?hich is a +refera/le arm for )P ta*ing9 A. An arm -ith the most contra+tions ). $he left arm of the client -ith a 0(A affecting the right /rain 0. $he right arm ". $he left arm <1. ?hich of the follo-ing is IN0O E0$ in assessing clientCs )P9

A. ead the mercury at the u++er meniscus, +refera/ly at the eye le7el to +re7ent error of +arallax ). Inflate and deflate slo-ly, 142 mmHg at a time 0. $he sound heard during ta*ing )P is *no-n as @O O$@OFF sound ". If the )P is ta*en on the left leg using the +o+liteal artery +ressure, a )P of 1<0,E0 is normal. <1. ?hich of the follo-ing is the correct inter+retation of the E O OF PA A%%AG

A. If the eye le7el is higher than the le7el of the meniscus, it -ill cause a false high reading ). If the eye le7el is higher than the le7el of the meniscus, it -ill cause a false lo- reading 0. If the eye le7el is lo-er than the le7el of the meniscus, it -ill cause a false lo- reading ". If the eye le7el is eFual to that of the le7el of the u++er meniscus, the reading is accurate <2. Ho- many minute,s is,are allo-ed to +ass /efore ma*ing a re4reading after the first one9 A. 1 ). ; 0. 1; ". 20 <3. ?hich of the follo-ing is $ !E a/out the auscultation of /lood +ressure9 A. Pulse L 3 is considered as F!%% ). $he /ell of the stethosco+e is use in auscultating )P 0. &ound +roduced /y )P is considered as HI'H freFuency sound ". Pulse L1 is considered as NO #A% <;. In assessing the a/domen, ?hich of the follo-ing is the correct seFuence of the +hysical assessment9 A. Ins+ection, Auscultation, Percussion, Pal+ation

). Pal+ation, Auscultation, Percussion, Ins+ection 0. Ins+ection, Pal+ation, Auscultation, Percussion ". Ins+ection, Auscultation, Pal+ation, Percussion <<. $he seFuence in examining the Fuadrants of the a/domen is: A. !I, %I,%!I,%%I ). %I, !I,%%I,%!I 0. !I, %I,%%I,%!I ". %I, !I,%!I,%%I <=. In ins+ecting the a/domen, -hich of the follo-ing is NO$ "ONE9 A. As* the client to 7oid first ). @nees and legs are straighten to relax the a/domen 0. $he /est +osition in assessing the a/domen is "orsal recum/ent ". $he *nees and legs are externally rotated <E. "r. Fa/ian "e %as &antas, is a/out to conduct an o+hthalmosco+e examination. ?hich of the follo-ing, if done /y a nurse, is a 0orrect +re+aration /efore the +rocedure9 A. Pro7ide the necessary dra+ing to ensure +ri7acy ). O+en the -indo-s, curtains and light to allo- /etter illumination 0. Pour -arm -ater o7er the o+hthalmosco+e to ensure comfort ". "ar*en the room to +ro7ide /etter illumination <H. If the client is female, and the doctor is a male and the +atient is a/out to undergo a 7aginal and cer7ical examination, -hy is it necessary to ha7e a female nurse in attendance9 A. $o ensure that the doctor +erforms the +rocedure safely ). $o assist the doctor 0. $o assess the clientCs res+onse to examination ". $o ensure that the +rocedure is done in an ethical manner =0. In +al+ating the clientCs /reast, ?hich of the follo-ing +osition is necessary for the +atient to assume /efore the start of the +rocedure9 A. &u+ine ). "orsal recum/ent 0. &itting ". %ithotomy =1. ?hen is the /est time to collect urine s+ecimen for routine urinalysis and 0,&9 A. Early morning ). %ater afternoon 0. #idnight ". )efore /rea*fast =1. ?hich of the follo-ing is among an ideal -ay of collecting a urine s+ecimen for culture and sensiti7ity9 A. !se a clean container ). "iscard the first flo- of urine to ensure that the urine is not contaminated 0. 0ollect around 204;0 ml of urine ". Add +reser7ati7es, refrigerate the s+ecimen or add ice according to the agencyCs +rotocol =2. In a 13 hour urine s+ecimen started Friday, H:00 A.#, -hich of the follo-ing if done /y a Nurse indicate a NEE" for further +rocedural de/riefing9

A. $he nurse as* the client to urinate at H:00 A.#, Friday and she included the urine in the 13 hour urine s+ecimen ). $he nurse discards the Friday H:00 A # urine of the client 0. $he nurse included the &aturday H:00 A.# urine of the client to the s+ecimen collection ". $he nurse added +reser7ati7es as +er +rotocol and refrigerates the s+ecimen =3. $his s+ecimen is reFuired to assess glucose le7els and for the +resence of al/umin the the urine A. #idstream clean catch urine ). 13 hours urine collection 0. Post+randial urine collection ". &econd 7oided urine =;. ?hen should the client test his /lood sugar le7els for greater accuracy9 A. "uring meals ). In /et-een meals 0. )efore meals ". 1 Hours after meals =<. In collecting a urine from a catheteriAed +atient, ?hich of the follo-ing statement indicates an accurate +erformance of the +rocedure9 A. 0lam+ a/o7e the +ort for 20 to <0 minutes /efore dra-ing the urine from the +ort ). 0lam+ /elo- the +ort for 20 to <0 minutes /efore dra-ing the urine from the +ort 0. 0lam+ a/o7e the +ort for ; to 10 minutes /efore dra-ing the urine from the +ort ". 0lam+ /elo- the +ort for ; to 10 minutes /efore dra-ing the urine from the +ort ==. A community health nurse should /e resourceful and meet the needs of the client. A 7illager as* him, 0an you test my urine for glucose9 ?hich of the follo-ing techniFue allo-s the nurse to test a clientCs urine for glucose -ithout the need for intricate instruments. A. Acetic Acid test ). NitraAine +a+er test 0. )enedictCs test ". %itmus +a+er test =E. A community health nurse is assessing clientCs urine using the Acetic Acid solution. ?hich of the follo-ing, if done /y a nurse, indicates lac* of correct *no-ledge -ith the +rocedure9 A. $he nurse added the !rine as the 1,2 +art of the solution ). $he nurse heats the test tu/e after adding 1,2 +art acetic acid 0. $he nurse heats the test tu/e after adding 1,2 +art of !rine ". $he nurse determines a/normal result if she noticed that the test tu/e /ecomes cloudy =H. ?hich of the follo-ing is incorrect -ith regards to +ro+er urine testing using )enedictCs &olution9 A. Heat around ;ml of )enedictCs solution together -ith the urine in a test tu/e ). Add E to 10 dro+s of urine 0. Heat the )enedictCs solution -ithout the urine to chec* if the solution is contaminated ". If the color remains )%!E, the result is PO&I$I(E E0. LLL Positi7e result after )enedicts test is de+icted /y -hat color9 A. )lue

). 'reen 0. >ello". Orange E1. 0linitest is used in testing the urine of a client for glucose. ?hich of the follo-ing, If committed /y a nurse indicates error9 A. &+ecimen is collected after meals ). $he nurse +uts 1 clinitest ta/let into a test tu/e 0. &he added ; dro+s of urine and 10 dro+s of -ater ". If the color /ecomes orange or red, It is considered +ostiti7e E1. ?hich of the follo-ing nursing inter7ention is im+ortant for a client scheduled to ha7e a 'uaiac $est9 A. A7oid turni+s, radish and horseradish 2 days /efore +rocedure ). 0ontinue iron +re+aration to +re7ent further loss of Iron 0. "o not eat read meat 11 hours /efore +rocedure ". Encourage caffeine and dar* colored foods to +roduce accurate results E2. In collecting a routine s+ecimen for fecalysis, ?hich of the follo-ing, if done /y a nurse, indicates inadeFuate *no-ledge and s*ills a/out the +rocedure9 A. $he nurse scoo+ the s+ecimen s+ecifically at the site -ith /lood and mucus ). &he too* around 1 inch of s+ecimen or a teas+oonful 0. As* the client to call her for the s+ecimen after the client -i+ed off his anus -ith a tissue ". As* the client to defecate in a /ed+an, &ecure a sterile container E3. In a routine s+utum analysis, ?hich of the follo-ing indicates +ro+er nursing action /efore s+utum collection9 A. &ecure a clean container ). "iscard the container if the outside /ecomes contaminated -ith the s+utum 0. inse the clientCs mouth -ith %isterine after collection ". $ell the client that 3 ta/les+oon of s+utum is needed for each s+ecimen for a routine s+utum analysis E;. ?ho collects )lood s+ecimen9 A. $he nurse ). #edical technologist 0. Physician ". Physical thera+ist E<. "a7id, <E year old male client is scheduled for &erum %i+id analysis. ?hich of the follo-ing health teaching is im+ortant to ensure accurate reading9 A. $ell the +atient to eat fatty meals 2 days +rior to the +rocedure ). NPO for 11 hours +re +rocedure 0. As* the client to drin* 1 glass of -ater 1 hour +rior to the +rocedure ". $ell the client that the normal serum li+ase le7el is ;0 to 130 !,% E=. $he +rimary factor res+onsi/le for /ody heat +roduction is the A. #eta/olism ). elease of thyroxin 0. #uscle acti7ity ". &tress

EE. $he heat regulating center is found in the A. #edulla o/longata ). $halamus 0. Hy+othalamus ". Pons EH. A +rocess of heat loss -hich in7ol7es the transfer of heat from one surface to another is A. adiation ). 0onduction 0. 0on7ection ". E7a+oration H0. ?hich of the follo-ing is a +rimary factor that affects the )P9 A. O/esity ). Age 0. &tress ". 'ender H1. $he follo-ing are social data a/out the client exce+t A. PatientCs lifestyle ). eligious +ractices 0. Family home situation ". !sual health status H1. $he /est +osition for any +rocedure that in7ol7es 7aginal and cer7ical examination is A. "orsal recum/ent ). &ide lying 0. &u+ine ". %ithotomy H2. #easure the leg circumference of a client -ith /i+edal edema is /est done in -hat +osition9 A. "orsal recum/ent ). &itting 0. &tanding ". &u+ine H3. In +al+ating the clientCs a/domen, ?hich of the follo-ing is the /est +osition for the client to assume9 A. "orsal recum/ent ). &ide lying 0. &u+ine ". %ithotomy H;. ectal examination is done -ith a client in -hat +osition9

A. "orsal recum/ent ). &ims +osition 0. &u+ine ". %ithotomy H<. ?hich of the follo-ing is a correct nursing action -hen collecting urine s+ecimen from a

client -ith an Ind-elling catheter9 A. 0ollect urine s+ecimen from the drainage /ag ). "etach catheter from the connecting tu/e and dra- the s+ecimen from the +ort 0. !se sterile syringe to as+irate urine s+ecimen from the drainage +ort ". Insert the syringe straight to the +ort to allo- self sealing of the +ort H=. ?hich of the follo-ing is ina++ro+riate in collecting mid stream clean catch urine s+ecimen for urine analysis9 A. 0ollect early in the morning, First 7oided s+ecimen ). "o +erineal care /efore s+ecimen collection 0. 0ollect ; to 10 ml for urine ". "iscard the first flo- of the urine HE. ?hen +al+ating the clientCs nec* for lym+hadeno+athy, -here should the nurse +osition himself9 A. At the clientCs /ac* ). At the clientCs right side 0. At the clientCs left side ". In front of a sitting client HH. ?hich of the follo-ing is the /est +osition for the client to assume if the /ac* is to /e examined /y the nurse9 A. &tanding ). &itting 0. &ide lying ". Prone 100. In assessing the clientCs chest, -hich +osition /est sho- chest ex+ansion as -ell as its mo7ements9 A. &itting ). Prone 0. &idelying ". &u+ine