A nurse is conducting a Romberg test as part of a patient’s physical assessment. Which of the following methods should the nurse employ?
Touch the patient’s face with a cotton ball.
Apply a vibrating tuning fork to the patient’s forehead.
Have the patient stand with their arms at their sides and their feet together.
Perform direct percussion over the area of the kidneys.
The Correct Answer is C
Choice A rationale
Touching the patient’s face with a cotton ball is not part of the Romberg test. This action is more commonly associated with tests of facial sensation.
Choice B rationale
Applying a vibrating tuning fork to the patient’s forehead is not part of the Romberg test. This action is more commonly associated with tests of vibratory sensation.
Choice C rationale
Having the patient stand with their arms at their sides and their feet together is the correct method for conducting a Romberg test.
Choice D rationale
Performing direct percussion over the area of the kidneys is not part of the Romberg test. This action is more commonly associated with tests of kidney function or the presence of kidney disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["8"]
Explanation
Step 1 is: Calculate the total units of heparin in the bag, which is 25,000 units.
Step 2 is: Divide the total units by the total volume to find the units per mL, which is (25,000 units ÷ 250 mL) = 100 units/mL.
Step 3 is: Divide the desired units per hour by the units per mL to find the mL/hr, which is (800 units/hr ÷ 100 units/mL) = 8 mL/hr. So, the infusion pump rate should be set at 8 mL/hr.
Correct Answer is D
Explanation
Choice A rationale
While showering frequency can vary depending on the specific isolation precautions, it does not indicate understanding of the protective isolation precautions.
Choice B rationale
Informing friends and family to visit when feeling well does not indicate understanding of protective isolation precautions. Protective isolation precautions are designed to protect the patient from infections, not based on how the patient is feeling.
Choice C rationale
Taking a plane to visit grandchildren does not indicate understanding of protective isolation precautions. Travel restrictions would depend on the specific condition and doctor’s advice.
Choice D rationale
Wearing a face mask when leaving the hospital room is a common requirement in protective isolation precautions to prevent the spread of infections.
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