Nursing Fundamentals Quiz

Blood Glucose Levels

• Reference range: 70 to 110 mg/dL

Potassium Levels

• Reference range: 3.5 to 5.1 mEq/L

Hematocrit Levels

• Male: 42% to 52%
• Female: 36% to 45%

Hemoglobin Levels

• Male: 15 to 17 g/dL
• Female: 12 to 16 g/dL

Newborn Screening

• Collection time frame: 24 to 48 hours after birth

CPOE (Computerized Provider Order Entry)

• Required for entering hospital orders

Pap Test Specimen Collection

• Method: Cytobrush

EKG Baseline Issues

• Wandering baseline: Poorly attached electrodes
• Interrupted baseline: Electrical disconnection or detached electrode

Ancillary Services

• Provide diagnostic confirmation (e.g., pathology, radiology)

Patient Ledger Adjustments

• Post adjustments concurrently with payment postings

Urine Specimen Handling

• Send urine specimen and requisition to the lab on the same day
• Record specimen temperature within 4 minutes of collection

Weber Test Procedure

• Instruct the patient to report if one ear hears the vibration louder.
• Used to assess hearing lateralization

Rinne Test Procedure

• Place the tuning fork on the mastoid until the sound is no longer heard. Raise tuning fork.

Cultural Differences

• Patient distrust of healthcare workers can be a cultural difference

Bandaging Procedure

• Observe site for 5-10 seconds after bandaging to check for leakage

Orthostatic Vital Signs

• Order: Lying, sitting, then standing to take orthostatic vital signs

Medical Billing Processes

• Abstracting: Reviews medical records to determine billing codes.
• Auditing: Checks claims for completeness.
• Reviewing: Verifies correct diagnosis and procedure codes for reimbursement.

Health Records

• Complete medical history and physical examination = patient health record

Cancer Screening Guidelines

• Females (65+): Bone density screenings every 2 years.
• Patients (55-80): Lung cancer screenings (based on criteria).
• Patients (45-75): Colonoscopies every 3 years.
• Males (50+): Prostate cancer screenings.

Eye Ointment Application

• Apply from inner to outer canthus (not above the eye)

Specimen Labeling

• Manually record time and initials on the specimen after venipuncture

Child's Heart Rate

• Expected range: 75 to 120 bpm (6-year-old child)

Body Systems

• Endocrine and nervous systems work together to maintain homeostasis

Personal Protective Equipment (PPE)

• Donning order: Gown, mask, goggles, gloves (CDC guidelines)

Fracture Types

• Comminuted fracture: Multiple bone fragments

Anesthetic Use

• Epinephrine use: Reduces bleeding and prolongs anesthetic effect (important for laceration repair)

Injection Procedures

• Intradermal: 25-gauge needle, 15° angle, anterior forearm (not for influenza)
• Subcutaneous: 27-gauge needle, 45° angle, abdominal region (not for influenza)
• Intramuscular: 18-gauge needle, 90° angle

Medication Vials

• Multidose vials: Good for 28 days after opening (unless manufacturer states otherwise)

Eye Instillation

• Patient instruction: Look towards ceiling while keeping both eyes open

Insulin Injection

• Subcutaneous insulin: 45° angle into adipose tissue

Sterility Maintenance

• Mayo stand: At least 12 inches from body to maintain sterility.
• Sterile instrument packet: 1-inch edge is nonsterile

Sutures

• Absorbable: Attach tissues beneath the skin (5-0/6-0 for face/neck)
• Nonabsorbable: Used on skin surfaces, easily removable (5-0/6-0 for face/neck)

Wound Complications

• Dehiscence: Wound edges separate
• Evisceration: Wound edges separate, organs protrude

Wound Healing Phases

• Proliferative (3-21 days): Fibrin threads pull edges together
• Maturation (21 days-2 years): Tissue strengthening, scar formation

Colposcopy

• Examine vagina and cervix following an abnormal Pap smear

Staple Removal

• Hold the staple remover's lower tip under the staple and squeeze handles together to bend and remove staples.

Complete Blood Count (CBC) Ranges

• White blood cell count: 4,500 to 11,000/mm³
• Red blood cell count (Male): 4.5 to 5.9 million/mm³
• Red blood cell count (Female): 4 to 5.5 million/mm³
• Platelet count: 150,000 to 400,000/mm³
• Granulocyte ratio: 50% to 70% (of all white blood cells)
• MCV: 80 to 95
• Hemoglobin (HGB):
  • Male: 13.5 to 17.5 g/dL
  • Female: 12 to 16 g/dL
• Hematocrit (HCT)
  • Male: 41% to 53%
  • Female: 36% to 46%
• Glucose (fasting): 70 to 100 mg/dL
• Hemoglobin A1c: Below 5.7%
• Total Cholesterol: 130 to 200 mg/dL
• LDL: Less than 100 mg/dL
• HDL: Greater than 60 mg/dL
• Triglycerides: 40 to 150 mg/dL

Hearing Tests

• Adults with normal hearing can hear tones at 25 decibels.
• Abnormal tympanograms appear as flat lines on a graph.

Skin Testing

• Discontinue antihistamines 3 days before skin testing.

Medication Scheduling

• Schedule II: No refills
• Schedule III: 5 refills within 6 months
• Schedule IV: 5 refills within 6 months
• Schedule V: Yearly refills

Medication Administration Routes

• Lozenges: Oral administration

Medication Terminology

• Contraindication: Makes treatment inadvisable or dangerous
• Adverse effect: Unintended, harmful effect
• Adverse reaction: Unexpected, harmful, potentially dangerous or fatal effect
• Side effect: Unintended, undesirable, but typically harmless

Patient Care Models

• PCMH: PCP coordinates patient care
• Managed care: Umbrella term for plans that provide care for preset payments.
• Home health: Specific types of care provided in the home

Dietary Restrictions

• Celiac disease: Avoid gluten
• Chronic kidney disease: Limit phosphorus/potassium intake, sodium to < 2,300 mg/day

Anorexia Signs

• Significant (at least 15%) weight loss

COPD Symptoms

• Tachycardia
• Weight gain
• Orthopnea
• Hypertension

Patient Verification

• Verify patient address at each visit

Neurological Disorders

• ALS: Lou Gehrig's disease
• Transient ischemic attack: Mini-strokes
• Trendelenburg position: Used in surgical and critical care (shock/hypotension)

DMEPOS Items

• CMS establishes a list of DMEPOS items on the Master List

Infection Control

• Healthcare worker must be fever-free for 24 hours without fever-reducing medications and facilities must train staff annually and on hiring.
• Exposure control plans must be updated annually and when exposure procedures change.
• Sterilization: Submerge instruments in chemical bath for 8 hours (closed lid)

Handwashing Technique

• Rub hands together vigorously for 15-20 seconds.

Antiseptic/Disinfectant Use

• Disinfection: Kills pathogenic organisms
• Sanitization: Reduces microorganisms to safe levels

Disinfection Levels

• Low-level: Hydrogen peroxide
• Intermediate-level: Isopropyl alcohol
• High-level: Cidex OPA

Autoclave Procedure

• Recommended temperature: 250°-270°F
• Unwrapped items: 20 minutes
• Wrapped items: 30 minutes

Sharps Disposal

• Used/unsterile needles: Dispose in sharps container immediately.

Specimen Handling/Storage

• Serum specimens: Allow to clot 30 minutes before centrifuging
• EDTA tubes: Invert 8-10 times
• Serum separator gel: Tiger-top tubes
• Clot activator: Red-top tubes
• Lithium heparin: Green-top tubes

Arrhythmias

• Atrial fibrillation: Irregular rhythm, absence of P waves, narrow QRS complexes
• Ventricular fibrillation: No discernable waves

EKG Interference

• 60-cycle interference: Regular spikes in tracing (caused by nearby electrical equipment)

Eye Exam Color-Plate Test

• Ishihara test: Identifies color deficiencies (red-green/blue-yellow most common)

Cancer Screening (additional)

• Cervical cancer screening (Pap test) for women (21-29) every 3 years.
• Cervical cancer screening (Pap test) for women (30-65) every 3 years, or every 5 years with HPV test.

Hearing Tests (cont)

• Adults: Normal hearing thresholds below 25 decibels
• Children: Normal hearing thresholds below 15 decibels

Peak Flow Meter Use

• 80% or better = well-controlled respiratory condition.

Scheduling & Patient Encounters

• Cluster scheduling: Groups patients with common medical needs
• Encounter form (superbill): Includes visit reasons and actions performed.
• Referrals: Requested in writing, by phone, or on third-party payer website

Health Information Technology (IT)

• Interoperability: Enables access to patient records for timely care.
• Directed exchange: Sends and receives health information electronically.
• Query-based exchange: Finds or requests information from other providers.
• Consumer-mediated exchange: Patients control the use of their health information.

Medicare/Medicaid/Insurance and Billing

• CMS: Federal agency overseeing Medicare and Medicaid programs
• Clearinghouses: Accept claim data, edit, and submit to third-party payers.
• Cycle billing: Bills accounts in segments throughout the month.

Medical Supplies

• Par level: Appropriate stock levels determined by the health care team.

Additional Patient Information to Record

• Allergies, names and dosage of the medication, route, when it should be administered and the name of the prescriber ( MAR)

Health Care Delivery Services

• PCMH: PCP coordinates treatment for patients
• Managed care: Insurers coordinate care.
• Value-based insurance: Reimbursement depends on patient outcomes and service quality.
• Capitation: Monthly payments to providers based on patient enrollment numbers.
• HMOs: Provide coverage for health care services for a set fee and typically requires referral from a PCP.
• PPO (Preferred Provider Organization): Network of physicians, etc., offering contracted/discounted health care. A PPO member doesn't need a PCP and can see any provider in their network or out-of-network.
• POS (Point of Service): POS plans allow patient flexibility, with referrals to specialists without a PCP.
• Fee-for-service models: Paid for services performed
• Value-based models: Focused on value to the patient

Types of Providers

• GPs General practitioners

Types of Health Care Services

• Ancillary services
  • Urgent care
  • Lab service
  • Diagnostic imaging
  • Occupational therapy
  • Physical therapy
• Complementary therapies:
  • Energy therapy
  • Chiropractic care
  • Dietary counseling
  • Acupuncture

Medication Classification

• Classification of medications
• Analgesics
• Antacids/Anti-ulcer
• Antibiotics
• Anticholinergics
• Anticoagulants
• Anticonvulsants
• Antidepressants
• Antidiarrheals
• Antiemetics
• Antifungals
• Antihistamines
• Antihypertensives
• Anti-inflammatories
• Antilipemics
• Antimigraine agents
• Anti-osteoporosis agents
• Antipsychotics
• Antipyretics
• Skeletal/muscle relaxants
• Antitussives/expectorants
• Antivirals
• Anxiolytics (anti-anxiety)
• Bronchodilators
• Contraceptives
• Decongestants
• Diuretics
• Hormone replacement
• Laxatives/stool softeners
• Oral hypoglycemics
• Sedative-hypnotics

Controlled Substances

• Schedule I: High potential for abuse (e.g., heroin, LSD, marijuana)
• Schedule II: High potential for abuse (e.g., opioids, amphetamines)
• Schedule III: Moderate to low potential for abuse (e.g., anabolic steroids, acetaminophen with codeine)
• Schedule IV: Low potential for abuse (e.g., benzodiazepines, tramadol)
• Schedule V: Limited quantities of narcotics (e.g., cough medicine with codeine)

Medication Interactions/Contraindications

• Medications toxic to the liver:
  • Acetaminophen
  • Phenytoin
  • Fluconazole
  • Bupropion
  • Penicillin
  • Erythromycin
  • Rifampin
  • Ritonavir
  • Lisinopril
  • Losartan
• MAOIs (Monoamine Oxidase Inhibitors): Interact dangerously with tyramine-containing foods and other antidepressants.

Medication Administration Forms

• Elixirs
• Emulsions
• Foams
• Liniments
• Lozenges
• Patches
• Powders
• Solutions
• Sprays
• Steam
• Suppositories
• Suspensions
• Syrups
• Tinctures

Medication Administration/Storage

• Check the medication and prescription before administering.
• Check the medication and prescription when preparing.
• Recheck medication before re-stocking bottle.
• Liver and kidney function influence medication metabolism and excretion.
• Medication dosages may need to be adjusted for infants and older adults.
• Half-lives of medications must be known so medication is not given too late.
• Store refrigerated medications between 2-8°C (35°F – 46°F)

Medication Dosing Intervals

• Half-lives help determine dosing intervals
• Therapeutic level must be maintained to ensure medication effectiveness.

Body Composition

• Human body: 50-80% water.
• Recommended daily water intake: 2 to 3 liters (64 to 96 fluid ounces)

Amino Acids

• Types of amino acids:
  • Essential: Body cannot produce
  • Nonessential: Body makes from essential amino acids
  • Conditional: Not usually essential, become essential during stress or illness

Carbohydrates

• Organic compounds made of carbon, oxygen, and hydrogen (sugars).
• Types of carbohydrates:
  • Simple sugars
  • Complex carbohydrates
• Digestion converts carbohydrates into glucose stored as glycogen.

Fats (Lipids)

• Use as energy source when glucose is low.
• Types of fats:
  • Unsaturated (monounsaturated, polyunsaturated): Less dense, less likely to raise cholesterol.
  • Saturated: Solid at room temperature, raise LDL cholesterol.
  • Trans fat: Byproduct of hydrogenation, raises LDL cholesterol

Vitamins

• Body cannot produce/doesn't make enough of Vitamin D, A, and B3. So must be included in your diet.
• Types of vitamins:
  • Fat-soluble: Vitamins A, D, E, K
  • Water-soluble: Vitamins B1, B2, B3, B6, folate, B12, pantothenic acid, biotin, C
• Vitamin functions and potential toxicity

Herbal Supplements

• Examples of herbal supplements, their uses, and potential side effects (St. John's wort, black cohosh, melatonin, willow bark, glucosamine sulfate, ginkgo biloba)

Chronic Kidney Disease (CKD)

• CKD is a gradual decline in kidney function.
• Diet restrictions for CKD: Limit sodium and phosphorus intake.

Celiac Disease

• Celiac disease: Autoimmune disorder, patients cannot consume gluten from wheat, barley, or rye.

Cell Structure and Components

• Plasma membrane: Separates internal cell components from the environment.
• Cytoplasm: Gel-like fluid
• Nucleus: Genetic material (DNA), regulates cell activity
• Nuclear membrane: Surrounds and protects nucleus.
• Nucleolus: Creates RNA and ribosomes
• Mitochondria: Produces energy (ATP)
• Ribosomes: Protein synthesis
• Endoplasmic reticulum (rough and smooth): Transport and synthesis of materials
• Golgi apparatus: Modifies and packages proteins/lipids
• Lysosomes: Digestive sacs
• Cytoskeleton: Maintains cell shape and structure.
• Centrioles: Cell reproduction
• Cilia: Movement of materials on cell surface
• Flagella: Movement of the cell

Anatomy and Physiology

• Adult skeleton: Axial (80 bones) and appendicular (126 bones)
• Ligaments: Connect bone to bone.
• Tendons: Connect muscle to bone
• Connective tissue/cartilage: Supports, protects, and forms tissues/organs
• Types of bones: Long, short, flat, irregular, sesamoid.
• Bone Marrow: Red(blood cell development), and Yellow.
• Skeletal muscle: Voluntary muscle
• Smooth muscle: Involuntary muscle

Mental Health Conditions

• Common mental health disorders -Apathy, Compensation, Conversion, Displacement, Intellectualization, Introjection, Reaction formation, Regression, Repression, Sublimation, Suppression.
• Stages of grief: Denial, Anger, Bargaining, Depression, Acceptance

Medical Record Verification

• Verify name, address, and other identifiers to ensure accuracy.
• Medication reconciliation: Matching current medications to the patient's medical record
• Two methods of identification used to verify patient identity

Vital Sign Measurement

• Auscultation: Listening with a stethoscope
• Blood pressure measurement: Correct cuff size, position, and patient posture
• Factors affecting blood pressure results (e.g., arm position, leg crossing).
• Peripheral resistance and blood volume effects on blood pressure
• Pulse rates in different age groups (adolescents, children, toddlers, infants)

Respiratory Assessment

• Sounds: Rales (crackles), rhonchi (wheezing) - causes associated with conditions
• Respiratory rates in different age groups

Temperature Measurement

• Temperature measurements in different age groups (newborns, 1 year, 6 to adult, older adults)
• Measurement units
• Conversions between Fahrenheit and Celsius

Pulse Measurement

• Pulse rate in different age groups

Ear Drop Administration

• Technique for administration to infants and children vs adults

Injection Techniques

• Subcutaneous injections (45°)
• Intradermal injections (10-15°)

Medication Storage Practices

• Refrigerator and freezer maintenance( temperature needs to be checked daily and logged.)
• Medications in different temperatures for storage

Medication Administration Record (MAR)

• Requirements for recording medication administration
• Initialing or signing the MAR after administration.

Electronic Prescription Transmission

• State and federal regulations for e-prescribing.
• DEA Electronic Prescription for Controlled Substances (EPCS)

Specialty Pharmacy

• Role and services provided.

Computerized Provider Order Entry (CPOE)

• Role and benefits of the electronic order entry system
• Clinical decision support system (CDSS)

Telehealth/Telemedicine

• Scope of telehealth services, including non-clinical services
• Use of draping materials and ensuring sterility.

Sterile Field Techniques

• Opening sterile packaging: Proper procedure for opening sterile packages.
• Sterile field: Identifying sterile and non-sterile surfaces

Sutures

• Absorbable sutures: Used to attach tissues beneath the skin, generally reabsorb in 5-20 days
• Nonabsorbable sutures: Used on skin surfaces (removed after healing, used for face/neck 5-0, 6-0 sutures. Heavier sutures for chest/abdomen)

Wound Closure

• Surgical staples: Close wounds under high tension (trunk, extremities, scalp)

Medical Emergencies & Treatments

• Emergencies kits: Checked regularly.
• Epinephrine auto-injector: Anaphylactic shock
• Naloxone: Opioid overdose
• Morphine: Pain
• Nitroglycerin: Chest pain
• Albuterol: Breathing difficulty
• Lidocaine: Local pain relief
• Atropine: Bradycardia
• Saline IV: Dehydration
• Prochlorperazine: Nausea/vomiting

Durable Medical Equipment (DME)

• Items considered DMEPOS: Durable, home use, life expectancy is at least 3 years.
• Prior authorization process for DMEPOS items.

Disease Transmission

• Chain of infection: Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host.
• Exposure categorization: Tasks (minor procedures, CPR, vital signs, etc.)

Instrument Cleaning and Sterilization

• Procedures for sanitizing and disinfecting equipment.
• Different disinfectant levels
• Autoclave procedures: Temperatures and times for sterilization.

Quality Control and Quality Assurance

• Measures performed for proper lab and other health care services.

Patient Assessment (additional)

• Near and far vision screening: Use of Jaeger eye charts
• Color deficiency test: Ishihara test

###Patient Registration and Scheduling

• New Patient check-in forms: Contain patient's demographic information
• Cluster scheduling: Grouping patients with similar medical needs.
• Encounter forms/Superbills: Include reason for visit and actions performed.

Test your knowledge on essential nursing practices and protocols, including blood glucose levels, patient screenings, and wound care. This quiz covers critical topics like medication refills, personal protective equipment, and cultural differences in healthcare. Perfect for nursing students and professionals looking to refresh their skills.