BSN Nightingale

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Sample questions from BSN Nightingale

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 78-year-old patient with pneumonia is admitted to a medical-surgical unit. Temperature is 38.2 C, respiratory rate 26/min, and oxygen saturation is 92% on room air. The room is stuffy, the curtains are closed, and the patient says the overhead light makes it hard to rest. Which nursing action best reflects Nightingale's environmental theory while addressing the immediate clinical cues?

   • A.Assess respiratory status, improve ventilation as tolerated, and adjust lighting to support rest
   • B.Open the window fully and leave the patient unattended to obtain fresh air
   • C.Dim all lights and postpone respiratory reassessment so the patient can sleep
   • D.Move the patient to a brighter room without assessing oxygenation

   Rationale: Option A combines clinical assessment with attention to ventilation, light, and rest, key environmental concepts associated with Nightingale. Option B risks temperature exposure and neglects reassessment, while C delays evaluation of tachypnea and hypoxemia. Option D changes the environment without addressing the patient's immediate respiratory needs. The exam takeaway is to improve surroundings without substituting environmental measures for assessment and treatment.

2. 2.A 64-year-old patient recovering from abdominal surgery is on a surgical unit. Temperature is 37.1 C, pulse 88/min, and the patient reports poor sleep because of repeated hallway noise. Which intervention best applies Nightingale's emphasis on the healing environment?

   • A.Cluster nonurgent care, reduce unnecessary noise, and reassess the patient's comfort
   • B.Ask the patient to tolerate noise because hospital activity cannot be changed
   • C.Administer a sedative without first exploring nonpharmacologic approaches
   • D.Keep the door open and turn on the television to distract the patient

   Rationale: Option A reduces avoidable disturbance while preserving needed care and includes reassessment. Option B dismisses a modifiable environmental factor, and C jumps to medication without assessing causes or safety. Option D is likely to add noise rather than promote rest. Nightingale's environmental approach supports quiet and restorative sleep, balanced with necessary monitoring.

3. 3.A 52-year-old patient with type 2 diabetes is admitted with a draining foot ulcer. Temperature is 38.0 C, blood glucose is 246 mg/dL, and the dressing is damp. Which action best reflects Nightingale's sanitation principles and current infection prevention?

   • A.Perform hand hygiene, assess the wound, and replace the dressing using the prescribed aseptic technique
   • B.Change the dressing with clean gloves only and reuse the scissors from the prior dressing
   • C.Leave the damp dressing in place until the next scheduled change
   • D.Ask the patient to keep the wound uncovered so air can reach it

   Rationale: Option A supports cleanliness, wound assessment, and aseptic practice, reducing contamination risk. Option B can transfer organisms because hand hygiene and clean equipment are not assured. Option C leaves moisture and drainage against the wound, while D disregards the prescribed wound plan. The exam takeaway is that cleanliness and fresh air do not replace evidence-based wound care.

4. 4.A 70-year-old patient with heart failure is on a medical unit. The patient has new dyspnea, crackles, oxygen saturation 88% on room air, and respiratory rate 30/min. The room is warm and poorly ventilated. What should the nurse do first?

   • A.Raise the head of the bed, apply oxygen per protocol, and promptly reassess and escalate care
   • B.Open a window and wait 15 minutes to see if breathing improves
   • C.Offer a fan and document the environmental adjustment
   • D.Ask the nursing assistant to obtain a blanket while the nurse finishes routine charting

   Answer and rationale are in the full material.

5. 5.A 31-year-old patient with influenza is hospitalized on a medical unit. Temperature is 38.4 C and cough is frequent; the patient has been walking into the shared hallway without a mask. Which nursing action best combines infection control with Nightingale's focus on the environment?

   • A.Initiate the indicated respiratory precautions, provide source-control teaching, and maintain adequate room ventilation per facility policy
   • B.Close the room vents and keep the door open so staff can observe the patient
   • C.Tell the patient to remain in the room but do not explain why
   • D.Place a surgical mask on the patient only when visitors arrive

   Answer and rationale are in the full material.