1. The nurse delegates a patient's back massage to nursing assistive personnel (NAP). Which statement by the NAP requires the nurse to follow up?

1. "She likes that special lotion her daughter brought. I'll see if she wants me to use it."
2. "The muscles of her lower back twitch when I start to rub it, but they calm down if I keep massaging her.” "
3. "She's been complaining of soreness in her shoulders. I'll give them special attention."
4. "The family usually visits about now. I'll check and see if she wants to wait until later."

2. The nurse is delegating to nursing assistive personnel (NAP) the perineal care of a female patient who is totally dependent and confined to bed. Which statement by the NAP requires the nurse's follow-up?

1. "I'll ask for assistance if I need help positioning her."
2. "I'll see if she's up to the care right now."
3. "I'll let you know if I notice any signs of redness or discharge."
4. "I'll be sure to use hot, soapy water, since she has been incontinent."

3. Which instruction would the nurse give when asking nursing assistive personnel (NAP) to give a complete bed bath to a patient?

1. Do not massage any reddened areas on the patient's skin.
2. Be sure to wash the patient's face with soap.
3. Disconnect the intravenous tubing when changing the gown.
4. Wear gloves if necessary.

4. The nurse would not offer back massage to which of the following patients?

1. Patient with abdominal pain
2. Patient who has a controlled-release transdermal analgesic patch
3. Patient who receives peritoneal dialysis for renal failure
4. Patient who is receiving continuous epidural analgesia

5. The nurse is assisting a patient with a tub bath. After the patient has been safely positioned in the tub, he tells the nurse, "I'll call you when I'm done." What is the nurse's best response?

1. "All right. Just holler when you're ready, and I'll come help you get out of the tub."
2. "Well, I'll check back with you in about 5 minutes to see if you need anything."
3. "That's not safe. I'll wait right outside the door for you to finish."
4. "I'll be back in 15 minutes. That should be enough time for you to finish up."

6. How can the nurse promote infection control while providing perineal care for a female patient who has a catheter?

1. By avoiding the application of tension on the catheter
2. By patting, not rubbing, the skin dry after thoroughly rinsing it
3. By cleansing the patient's labia from the pubic area toward the rectum
4. By using warm water to cleanse the patient's entire perineal area

7. What is the primary reason for performing perineal care on a male patient with incontinence?

1. To provide comfort and a relaxed, refreshed feeling
2. To promote personal hygiene while minimizing perineal odor
3. To remove all microorganisms from the patient's perineal area
4. To reduce the risk of skin breakdown in the patient's genital and perineal area.

8. Which nursing action reduces the risk of falling as a patient is getting into or out of a bathtub?

1. Add 1 oz of bath oil to the tub water before the patient gets into the tub.
2. Place an “Occupied” sign on the bathroom door.
3. Fill the tub half full of water at 110°F-115°F.
4. Place a skidproof disposable bath mat in front of the tub.

9. A patient is being given a bed bath. The nurse realizes that another washcloth is needed to complete the bath. What is one way in which the nurse can ensure the patient's safety?

1. Use the call light to ask someone else to bring a washcloth.
2. Raise all four side rails on the patient's bed.
3. Make sure the call light is within the patient's reach.
4. Raise the bed to its highest position.

10. The nurse has just helped a patient into the bathtub. Before leaving the bathroom, what would the nurse do to help ensure the patient's safety?

1. Show him how to use the call signal.
2. Place an “Occupied” sign on the door.
3. Check the cleanliness of the room.
4. Remove unneeded supplies from the bathroom.

11. The nurse is delegating a female patient's perineal care to nursing assistive personnel (NAP). What instruction would the nurse give to ensure the NAP's safety while performing this care?

1. Wear sterile gloves.
2. Wear clean gloves.
3. Wear an isolation gown.
4. Use hot water.

12. Which patient should not have his or her feet soaked during a complete bed bath?

1. A patient with arthritis
2. A patient who has just complained of shoulder pain
3. A patient with diabetes mellitus
4. A patient who is nauseated

13. The nurse observes the nursing assistive personnel (NAP) providing perineal care to a male patient. Which observation of care requires the nurse's follow-up?

1. Assisting the patient into the supine position in bed
2. Cleansing the tip of the penis with a circular motion, starting at the meatus
3. Reserving the cleansing of the tip of the penis as the final step in perineal care
4. Using a gloved hand to grasp the shaft of the penis in order to retract the foreskin

14. Which of the following interventions directly related to patient safety must the nurse consider when providing perineal care to an elderly male patient with a catheter?

1. Wear clean gloves during care.
2. Assess the patient's ability to provide self-care.
3. Encourage the patient to report any pain originating from the catheter.
4. Monitor the amount of urine in the drainage bag to prevent overflow.

15. After performing back massage for a patient experiencing pain, what is the primary reason the nurse asks her to rate her current pain level on a scale of 1 to 10?

1. To determine how soon the next massage should be offered
2. To evaluate the effectiveness of the massage in relieving pain
3. To determine if it is time to give the patient another dose of analgesic medication
4. To help gauge the patient's level of consciousness

16. When preparing to delegate a patient's back massage to nursing assistive personnel (NAP), the nurse would do what first?

1. Observe the NAP performing the skill
2. Determine if the NAP has enough muscle endurance to give a complete back massage
3. Assess the NAP's understanding of the proper technique for back massage
4. Have the NAP determine whether the patient is interested in a back massage

17. A patient with left-sided muscle weakness is prescribed a bath every other day. Which precaution would help the nurse reduce this patient’s risk of falling?

1. Maintain the water temperature at 104°F.
2. Allow the patient to remain in the bath for 45 minutes.
3. Decline the patient's request to add scented oil to the bathwater.
4. Discuss the patient's level of fatigue after the bath.

18. The nurse is helping a patient get out of a bathtub, and the patient appears to be unsteady on her feet. What should the nurse do to help ensure the patient’s safety?

1. Drape a bath towel over the patient’s shoulders.
2. Demonstrate how to use the call light for assistance.
3. Drain the bathtub before the patient gets out.
4. Apply lotion to the patient's freshly dried skin.

19. The nurse is bathing a patient who is unconscious. What should the nurse do to ensure safe care of the patient’s eyes?

1. Remove eye crusts with soapy water.
2. Avoid closing the patient's eyes.
3. Use eye patches or shields taped in place.
4. Tape the patient's eyelids closed.

20. A patient with difficulty breathing requests a back massage. In which position would the nurse instruct nursing assistive personnel (NAP) to place the patient during the massage?

1. Prone
2. Side-lying
3. Supine
4. Fowler’s

21. A male patient receiving perineal care tells the nurse "It has started to hurt a little down there." What is the nurse's best response?

1. "When did you start experiencing the pain?"
2. "Rate the pain on a scale of 1 to 10."
3. "I'll assess your perineal area for the possible cause of the pain."
4. "Would you like some pain medication before I continue with your care?"

22. The nurse is preparing to provide perineal care for a female patient who is on bed rest. Which patient position should the nurse use for this care?

1. Supine
2. Prone
3. Side-lying
4. Dorsal recumbent

23. As the nurse is preparing to provide perineal care to a female patient with limited mobility, the patient says, "I can do that myself." Which action would be the priority?

1. Provide all the necessary supplies and linen for this task.
2. Assess the patient's ability to perform proper perineal care.
3. Ensure that the patient has privacy while performing perineal care.
4. Document any complaints of irritation or pain in the perineal area.

24. The nurse has washed a patient’s abdomen. Which area should the nurse wash next?

1. Feet
2. Face
3. Chest
4. Legs

25. The nurse has delegated a male patient's perineal care to the nursing assistive personnel (NAP). Which statement made by the NAP requires the nurse's follow-up?

1. "I will check to see if he cleans himself well."
2. "I will let you know if I see any redness or drainage."
3. "I will ask him if he is experiencing any pain in that area"
4. "I will be sure to use hot, soapy water to be sure he's clean."