Deck 87: Hygiene

Question 1

The nurse is providing oral care to an unconscious patient and notes that the patient has extremely bad breath.The term for "bad breath" is

A) Alopecia.
B) Halitosis.
C) Dental caries.
D) Neuropathy.

Answer 1

B
Halitosis is the term for "bad breath." Alopecia indicates hair loss.Dental caries are cavities in the teeth.Neuropathy is a degeneration of peripheral nerves leading to loss of sensation in the extremities.

Question 2

Of the following interventions,which would be the most important for preventing skin impairment in a mobile patient with local nerve damage?

A) Turn the patient every 2 hours.
B) Limit caloric and protein intake.
C) Insert an indwelling urinary catheter.
D) During a bath, assess for pain.

Answer 2

D
During a bath,assess the status of sensory nerve function by checking for pain,tactile sensation,and temperature sensation.When restricted from moving freely,dependent body parts are exposed to pressure that reduces circulation.However,this patient is mobile and therefore is able to change positions.Limiting caloric and protein intake may result in impaired or delayed wound healing.The presence of perspiration,urine,watery fecal material,and wound drainage on the skin results in impaired or delayed wound healing.However,a mobile patient can use bathroom facilities or a urinal.

Question 3

Social groups influence hygiene preferences and practices,including the type of hygienic products used and the nature and frequency of personal care.Which of the following developmental stages is most likely to be influenced by family customs?

A) Adolescent
B) Toddler
C) Adult
D) Older adult

Answer 3

B
During childhood,family customs influence hygiene.As children enter their adolescent years,peer group behavior often influences personal hygiene.During the adult years,involvement with friends and work groups shapes the expectations people have about their personal appearance.Some older adults' hygiene practices change because of living conditions and available resources.

Question 4

When assessing a patient's skin,the nurse needs to know that

A) Restricted movement can increase blood circulation.
B) Paralyzed patients have normal sensory function.
C) Loss of subcutaneous tissue may increase the rate of wound healing.
D) Moisture on the skin can lead to skin maceration.

Question 5

The nurse is caring for a patient who is immobile.The nurse is aware that the patient is at risk for Impaired skin integrity because

A) Pressure reduces circulation to affected tissue.
B) Patients with limited caloric intake develop thicker skin.
C) Inadequate blood flow leads to decreased tissue ischemia.
D) Local nerve damage leads to pain sensation.

Question 6

When providing hygiene for an elderly patient,it is important for the nurse to closely assess the skin.This is because as the patient ages

A) Skin becomes more resilient.
B) Sweat glands become more active.
C) Skin becomes less subject to bruising.
D) Less frequent bathing may be required.

Question 7

The patient has been brought to the emergency department following a motor vehicle accident.The patient is unresponsive.His driver's license states that he needs glasses to operate a motor vehicle,but no glasses were brought in with the patient.The nurse should

A) Assume that the glasses were lost during the accident.
B) Stand to the side of the patient's eye and observe the cornea.
C) Assume that the patient was not wearing glasses while driving.
D) Assume that the ambulance personnel have them.

Question 8

Of the following disorders,which is caused by a virus?

A) Corns
B) Plantar warts
C) Athlete's foot
D) Callus

Question 9

When assessing a patient's feet,the nurse notices that the toenails are thick and separated from the nail bed.The nurse is aware that this condition is caused by

A) Fungi.
B) Nail polish.
C) Friction.
D) Nail polish remover.

Question 10

The nurse is caring for an unresponsive patient who has a nasogastric tube in place for continuous tube feedings.The nurse assesses the patient's oral hygiene because good oral hygiene

A) Helps prevent gingivitis.
B) May cause glossitis.
C) May lead to halitosis.
D) Causes tongue coating.

Question 11

A number of factors influence a patient's personal preferences for hygiene.Because of this,it is important for the nurse to realize that..

A) No two individuals perform hygiene in the same manner.
B) It is important to standardize a patient's hygienic practices.
C) Hygiene care is always routine and expected.
D) Hygiene is not the time to learn about patient needs.

Question 12

Successful critical thinking requires synthesis of knowledge,experience,information gathered from patients,critical thinking attitudes,and intellectual and professional standards.Once the assessment has been done,it is important for the nurse to understand that

A) The nursing diagnoses never change.
B) The patient's condition never changes.
C) Critical thinking is ongoing.
D) Hygiene needs to become a simple routine.

Question 13

The nurse is providing education about the importance of proper foot care to a patient who has diabetes mellitus.The nurses understands that this is important for the patient because

A) Plantar warts can develop from foot fungi.
B) Poor foot care leads to neuropathy.
C) A strong dorsalis pedis pulse indicates poor blood flow.
D) Foot ulcers are the most common precursor to amputation.

Question 14

The patient has been diagnosed with diabetes for the past 12 years.When admitted,the patient is unkempt and is in need of a bath and foot care.When questioned about his hygiene habits,the patient tells the nurse that baths are taken once a week where he comes from,although he takes a sponge bath every other day.To provide ultimate care for this patient,the nurse understands that

A) Personal preferences determine hygiene practices and are unchangeable.
B) Patients who appear unkempt place little importance on hygiene practices.
C) The patient's illness may require teaching of new hygiene practices.
D) All cultures value cleanliness with the same degree of importance.

Question 15

The nurse is caring for a patient who has undergone external fixation of a broken leg and has a cast in place.To prevent skin impairment,the nurse should

A) Not allow the patient to turn in bed because that may lead to redislocation of the leg.
B) Restrict the patient's dietary intake to reduce the number of times on the bedpan.
C) Assess all surfaces exposed to the cast for pressure areas.
D) Keep the patient's blood pressure low to prevent overperfusion of tissue.

Question 16

The nurse is bathing a patient and notices movement in the patient's hair.The nurse should

A) Ignore the movement and continue.
B) Use gloves or a tongue blade to inspect the hair.
C) Examine the hair without gloves to make picking lice easier.
D) Shave the hair off of the patient's head.

Question 17

The patient is diagnosed with athlete's foot (tinea pedis).The patient says that she is relieved because it is only athlete's foot,and it can be treated easily.The nurse explains that athlete's foot is

A) Generally isolated to the feet and never recurs.
B) Contagious and frequently recurs.
C) Caused by the papillomavirus.
D) Treated with salicylic acid or electrodesiccation.

Question 18

The nurse is caring for a patient who refuses "AM care." When asked why,the patient tells the nurse that she always bathes in the evening.The nurse should

A) Defer the bath until evening and pass on the information to the next shift.
B) Tell the patient that she must bathe because that is the "normal" routine.
C) Explain to the patient the importance of maintaining morning hygiene practices.
D) Cancel hygiene for the day and attempt again in the morning.

Question 19

The nurse is caring for a patient who has diabetes mellitus and circulatory insufficiency,with peripheral neuropathy and urinary incontinence.The nurse realizes that patients with these conditions

A) Have decreased pain sensation and increased risk of skin impairment.
B) Are at decreased risk of developing infection due to urinary pH level.
C) Also have decreased caloric intake, which results in accelerated wound healing.
D) Have impaired venous return, allowing for greater circulation and less breakdown.

Question 20

The nurse is caring for a patient who is complaining of severe foot pain due to corns.The patient states that she has been using oval corn pads to self-treat the corns,but they seem to be getting worse.The nurse explains that

A) Corn pads are an adequate treatment and should be continued.
B) The patient should avoid soaking her feet before using a pumice stone.
C) Tighter shoes would help to compress the corns and make them smaller.
D) Depending on severity, surgery may be needed to remove the corns.

Question 21

The nurse is teaching the patient about flossing and oral hygiene.The nurse teaches the patient that

A) Flossing needs to be done at least three times a day.
B) To prevent bleeding, the patient should use waxed floss.
C) Flossing removes plaque and tartar from the teeth.
D) Applying toothpaste to the teeth before flossing is harmful.

Question 22

The nurse is preparing to provide a complete bed bath to an unconscious patient.The nurse decides to use a bag bath.She does this for which of the following reasons?

A) Washbasins can harbor gram-negative organisms.
B) Bag baths use soaps that enhance cleansing.
C) Bag baths do not contain emollients.
D) Bag baths increase skin flaking and scaling.

Question 23

The nurse is caring for an elderly patient with Alzheimer's disease who is ambulatory but requires total assistance with his activities of daily living (ADLs).The nurse notices that his skin is dry and wrinkled.The nurse should

A) Make sure that the patient is receiving daily baths.
B) Reduce the number of baths per week if possible.
C) Be aware that sweat glands become more active with aging.
D) Be sure that the patient is using soap with his bath.

Question 24

The nurse is caring for a patient who has multiple ticks on her legs and body.To rid the patient of ticks,the nurse should

A) Burn the ticks in an ashtray once removed.
B) Use blunt tweezers and pull upward with steady pressure.
C) Allow the ticks to drop off by themselves.
D) Use products containing lindane to kill the ticks.

Question 25

A self-sufficient bedridden patient unable to reach all body parts needs which type of bath?

A) Complete bed bath
B) Bag bath
C) Sponge bath
D) Partial bed bath

Question 26

After the patient's bath,the nurse should

A) Not offer a backrub because it is not therapeutic.
B) Routinely give backrubs of 2 minutes or less.
C) Assume that all patients need backrubs after their bath.
D) Not offer a backrub for 48 hours after coronary artery bypass surgery.

Question 27

In providing oral care to an unconscious patient,it is important for the nurse to

A) Moisten the mouth using lemon-glycerin sponges.
B) Hold the patient's mouth open with his or her fingers.
C) Rinse the mouth and immediately suction the oral cavity.
D) Use foam swabs to help remove plaque.

Question 28

The nurse is providing perineal care to an uncircumcised male patient.When providing such care,the nurse should

A) Leave the foreskin alone because there is little chance of infection.
B) Retract the foreskin for cleansing and allow it to return on its own.
C) Retract the foreskin and keep retracted.
D) Retract the foreskin and return it to its natural position when done.

Question 29

The unconscious patient is resisting attempts by the nurse to provide oral hygiene.To provide the needed care,the nurse may

A) Insert an oral airway upside down.
B) Hold the patient's mouth open with her fingers.
C) Position the patient on his back.
D) Use undiluted hydrogen peroxide as a cleaner.

Question 30

The nurse is providing a complete bed bath to a patient using a commercial bath cleansing pack (bag bath).In doing so,the nurse should

A) Use one towel for the entire bath.
B) Dry the skin with a towel.
C) Allow the skin to air dry.
D) Not use a bath blanket or towel.

Question 31

The patient is diagnosed with pediculosis capitis (head lice)and was treated upon admission and was re-treated 24 hours later,yet the patient is still infested.The nurse should next

A) Re-treat the patient with a medicated shampoo for eliminating lice.
B) Use a product containing lindane to get rid of the lice.
C) Manually remove the lice using a fine-toothed comb.
D) Have the patient bathe or shower thoroughly.

Question 32

The nurse is caring for a patient who has head lice (pediculosis capitis).The nurse knows that in treating this condition,one must understand that

A) Products containing lindane are most effective.
B) Head lice may spread to furniture and other people.
C) Treatment must be repeated in 7 to 10 days.
D) Manual removal is not a realistic option as treatment.

Question 33

When providing the patient with a complete bed bath using soap and water (not a bag bath),it is important to

A) Use alkaline soaps to help prevent infection.
B) Towel dry completely to prevent maceration.
C) Use soap liberally when cleansing the eyes.
D) Cleanse the eye from outer canthus to inner canthus.

Question 34

In examining a patient for pediculosis capitis (head lice),the nurse would expect to find

A) Grayish-white parasites with red legs.
B) Pustules or bites behind ears and at the hairline.
C) Balding patches in periphery of the hairline.
D) Brittle and broken hair.

Question 35

Scaling of the scalp accompanied by itching is known as

A) Dandruff.
B) Pediculosis.
C) Alopecia.
D) Ticks.

Question 36

When providing basic eye care,the nurse

A) Cleanses the eye with soap and water.
B) Applies pressure directly to the eyeball.
C) Cleanses from inner canthus to outer canthus.
D) Provides less frequent care to unconscious patients.

Question 37

The female nurse is caring for a male patient who is uncircumcised but not ambulatory,although he has full function of arms and hands.The nurse is providing the patient with a partial bed bath.Perineal care for this patient

A) Is not necessary because he is not circumcised.
B) Should be postponed because it may cause him embarrassment.
C) Should be done by the patient.
D) Should be done by the nurse.

Question 38

Patients with diabetes mellitus need special foot care to prevent the development of ulcers.Knowing this,the nurse

A) Trims the patient's toenails daily.
B) Has the patient soak his or her feet twice a day.
C) Requests a consult with a nail care specialist.
D) Assesses the brachial artery.

Question 39

In providing perineal care to a female patient,the nurse should wash

A) Upward from rectum to pubic area.
B) From back to front.
C) From pubic area to rectum.
D) In a circular motion.

Question 40

The patient is being treated for cancer with weekly radiation and chemotherapy treatments.The nurse is aware that the patient's oral mucosa needs to be assessed because chemotherapy and radiation can

A) Increase saliva production.
B) Decrease the risk of oral inflammation.
C) Decrease drying of oral mucosa.
D) Lead to oral problems.

Question 41

The use of critical thinking attitudes is necessary to design a plan of care to meet the patient's hygiene needs.Which of the following are considered critical thinking attitudes?

A) Curiosity
B) Communication principles
C) Prior experience
D) Humility
E) Knowledge of cultural variations

Question 42

The nurse is admitting an elderly patient for failure to thrive and weight loss.A nasogastric tube is inserted for supplemental tube feedings.The nurse should become concerned when

A) Bleeding is noted where the tube comes in contact with the nares.
B) Nasal mucosa is pink.
C) No discharge from the nose is noted.
D) Clear, watery discharge is noted.

Question 43

The nurse is teaching a patient about contact lens care.The patient has plastic lenses,so the nurse instructs the patient to

A) Use tap water to clean lenses.
B) Keep the lenses is a cool dry place when not being used.
C) Reuse storage solution for up to a week.
D) Wash and rinse lens storage case daily.

Question 44

The patient complains to the nurse about a perceived decrease in hearing.When the nurse examines the patient's ear,she notices a large amount of cerumen (ear wax)buildup at the entrance to the ear canal.The nurse should

A) Apply gentle, downward retraction of the ear canal.
B) Tell the patient to use a bobby pin to extract earwax.
C) Teach the patient how to use cotton-tipped applicators.
D) Instill hot water into the ear canal to melt the wax.

Question 45

The patient is complaining of an inability to clear his nasal passages.The nurse instructs the patient to

A) Blow his nose forcefully to clear the passage.
B) Insert a cotton-tipped applicator as far as possible.
C) Apply gentle suction using a pediatric bulb suction device.
D) Use a dry washcloth to absorb secretions.

Question 46

Of the following developmental changes,which are most commonly associated with the elderly?

A) Increased eccrine and apocrine gland function
B) Fungal nail infections
C) Less resilient skin and bruising
D) Increased skin lubrication
E) Dry, itchy skin

Question 47

Of the following hearing aids,which interferes the most with wearing eyeglasses and using a phone?

A) In-the-canal hearing aid
B) In- the-ear hearing aid
C) Behind-the-ear hearing aid
D) They are all equally useful.

Question 48

The patient has been forcefully blowing his nose and now has a nosebleed.The nurse is concerned about the patient's condition and assesses the patient for which possible negative issues?

A) Clearance of nasal passages
B) Injury to the tympanic membrane (eardrum)
C) Damage to nasal mucosa
D) Eye injury
E) Decreased nasal passage pressure

Question 49

Of the following patients,which are in need of perineal care?

A) A patient with urinary and fecal incontinence
B) A circumcised male who is ambulatory
C) A patient with rectal and perineal surgical dressings
D) A patient with an indwelling catheter
E) A morbidly obese patient

Question 50

The patient is being fitted with a hearing aid.In teaching the patient how to care for the hearing aid,the nurse instructs the patient to

A) Wear the hearing aid 24 hours per day except when sleeping.
B) Change the battery every day or as needed.
C) Avoid the use of hairspray, but aerosol perfumes are allowed.
D) Adjust the volume for a talking distance of 1 yard.