N3025 Fall Comprehensive Exam
20% skill
Critical Elements
Using a Nasal Cannulae--Perform skill beginning on page 891 of Smith using correct technique and paying particular attention to:
1. Explaining use of oxygen to client--4 points.
2. Connecting and administers oxygen from wall to patient correctly--8 points.
3. Providing safety measures when handling and administering oxygen—4 points.
4. Providing comfort measures--4 points.
20% skill
Critical Elements
Removing Sutures and Staples--Perform skills beginning on page 828 and 829 of Smith using correct technique and paying particular attention to:
1. Maintaining standard precautions--5 points.
2. Removing sutures and staples using correct technique and according to hospital policy--10 points.
3. Cleansing suture/staple site in an appropriate manner--5 points.
20% skill
Critical Elements
Providing Catheter Care and Removing a Retention Catheter--Perform skills on pages 722 and 723 of Smith using correct technique and paying particular attention to:
1. Maintaining privacy and comfort of patient--2 points.
2. Providing instruction to patient--5 points.
3. Using standard precautions--3 points.
4. Cleansing catheter and perineal area in correct manner--5 points.
5. Removing catheter in correct manner—5 points.
20% skill
Critical Elements
Collecting a Urinary Specimen from a Closed System--Perform skill beginning on page 736 using correct technique and paying particular attention to:
1. Maintaining sterile technique and follows standard precautions--5 points.
2. Explaining procedure/rationale to patient prior to collection--5 points.
3. Collecting urinary specimen using correct technique and labeling specimen correctly--5 points.
4. Ensuring catheter is flowing correctly after obtaining specimen--5 points.
20% skill
Critical Elements
PO Temp--Digital Thermometer; AX Temp—Digital Thermometer & Tympanic Temp—Infrared Thermometer--Perform skills on pages 244 and 247 of Smith using correct technique and paying particular attention to:
1. Following standard precautions--5 points
2. Providing appropriate assessment and instruction to ensure accuracy of reading--5 points
3. Placing thermometer correctly stating rationale—5 points
4. Accurately reading and documenting temperature including route using medical terminology--5 points
20% skill
Critical Elements
Handwashing--Perform skill beginning on page 391 of Smith using correct technique and paying particular attention to:
1. Preventing contamination of hands, uniform or other objects during handwashing--10 points.
2. Performing procedure to facilitate removal of pathogens—10 points
20% skill
Critical Elements
Respiratory Rate and Radial Pulse--Perform skills beginning on pages 251 and 259 of Smith using correct technique and paying particular attention to:
1. Preparing patient for procedure and assessing activity level of patient before taking measurement--5 points.
2. Employing and describing methods to assist with palpation in correct location. Noting relationship of inspiration: expiration. Noting depth and effort of breathing--5 points.
3. Counting pulse and respiration for sufficient amount of time depending on rhythm and respiratory pattern--5 points.
4. Documenting rhythm, rate and strength of pulse and rate, rhythm and depth of respiration accurately--5 points.
20% skill
Critical Elements
Apical pulse--Perform skill beginning on page 252 of Smith using correct technique and paying particular attention to:
1. Preparing patient for procedure and assessing activity level of patient before taking measurement--5 points.
2. Positioning stethoscope correctly noting landmarks--5 points.
3. Counting for sufficient amount of time-5 points.
4. Documenting rhythm, rate and intensity accurately--5 points.
30% skills
Critical Elements
Converting from a continuous IV to a "Lock", changing the IV dressing and discontinuing the IV--Perform skills beginning on page 1015, 1016 and 1018 of Smith (using correct technique as well as classroom techniques for converting IV to a lock and dressing IV) and paying particular attention to:
1. Providing instruction to patient--5 points.
2. Maintaining sterile technique and standard precautions--10 points.
3. Applying transparent dressing in an appropriate manner--10 points.
4. Performing procedures appropriately--5 points.
30% skill
Critical Elements
Administering an Enema--Perform skill beginning on page 769 of Smith using correct technique and paying particular attention to:
1. Maintaining privacy and comfort of patient--5 points.
2. Providing instruction to patient--5 points.
3. Using standard precautions--5 points.
4. Taking measures to ensure decreased complications from enema administration--5 points.
5. Administering enema in correct manner--10 points.
30% skill
Critical Elements
Managing the IV Site and Administering Medications by IV Line Injection "Push"--Perform skills beginning on page 1014 & 1030 of Smith using correct technique and paying particular attention to:
1. Evaluating for site-related complications and stating ways in which to maintain integrity of IV site--10 points.
2. Applying all medication safety checks to ensure client is receiving correct, appropriate medications--5 points.
3. Performing correct dosage calculation--5 points.
4. Performing measures to ensure compatibility of medications--5 points.
5. Giving medication in appropriate manner--5 points.
30% skill
Critical Elements
Preparing IV Primary and Secondary Infusion, Regulating Infusion Flow Rate--Perform skills beginning on page 999 & 1011 & 1027 of Smith using correct technique and paying particular attention to:
1. Applying all medication safety checks to ensure client is receiving correct, appropriate medications--5 points.
2. Performing measures to ensure compatibility of IV solution--5 points.
3. Performing correct IV dosage calculation--5 points
4. Removing all air from entire line in an appropriate manner--5 points.
5. Maintaining sterile technique--10 points.
30% skill
Critical Elements
Entering Isolation Room, Removing linens, & Removing specimen--Perform skills beginning on page 403, 405, 406, 408 of Smith using correct technique and paying particular attention to:
1. Following isolation precautions--8 points.
2. Double bagging items removed from isolation room to prevent contamination--8 points.
3. Ensuring that healthcare worker outside the room helping with double bagging does not become contaminated. Taking measures to protect other healthcare workers when items are taken out of room--8 points.
4. Preventing contamination of your body while discarding gown, gloves, and mask--6 points.
30% skill
Critical Elements
Oral Meds--Perform skill beginning on page 521, 523, 526 of Smith using correct technique and paying particular attention to:
1. Providing assessment of lab values, vitals signs, and other patient data before administration of pills--10 points.
2. Applying all medication safety checks to ensure patient is receiving correct medications--20 points.
30% skill
Critical Elements
Blood Pressure Assessment--Perform skill beginning on page 262 of Smith using the correct technique and paying particular attention to:
1. Ensuring cuff is correct size for patient--5 points.
2. Preparing patient for procedure--5 points.
3. Palpating brachial artery and placing cuff appropriately--5 points.
4. Auscultating systolic and diastolic blood pressure--10 points
5. Documenting blood pressure findings—5 points
50% skills
Critical Elements
Tube Feeding--Intermittent--Perform skill beginning on page 611 and 604 (“Method of Determining Gastric pH”), 601 step 14 and 14a, using correct technique and paying particular attention to:
1. Following standard precautions—5 points
2. Preparing patient for procedure--5 points
3. Ensuring patient is able to receive feeding--15 points.
4. Ensuring tube is placed in stomach correctly--15 points.
5. Administering procedure such as to provide comfort and decrease potential complications for patient--10 points.
50% skill
Critical Elements
Changing a Dry Sterile Dressing and Assessing a Wound-- Perform skills beginning on page 827 and 832 of Smith using correct technique and paying particular attention to:
1. Provides privacy and comfort for patient—4 points
2. Follows sterile principles when opening and maintaining sterile field and
performing dressing change—20 points.
3. Drops sterile item on sterile field without contaminating field--10 points.
4. Pours liquid into container on sterile field using sterile principles--10 points.
5. Provides appropriate assessment of wound—6 points
50% skill
Critical Elements
Intradermal Meds--Perform skill beginning on page 554 (also refer to page 551) of Smith using the correct technique and paying particular attention to:
1. Applying standard precautions—5 points.
2. Maintaining sterile technique--15 points. points
3. Providing instruction to patient both before and after procedure—10 points.
4. Describing appropriate sites and administering injection by noting landmarks--10 points.
5. Administering medication using correct technique--10 points.
50% skill
Critical Elements
Suctioning Using Separate Catheter and Gloves (Oropharnygeal or Nasopharyngeal suctioning)--Perform skill beginning on page 904 of Smith as well as taught by lab instructors in lab using correct technique and paying particular attention to:
1. Applying standard precautions and follows sterile technique--10 points
2. Assessing patient's need for suctioning--5 points
3. Providing for safety and comfort of patient during procedure--15 points
4. Suctioning using correct technique--10 points
5. Noting effectiveness of suctioning--10 points
50% skill
Critical Elements
Subcutaneous Meds--Perform skill beginning on page 555 of Smith using the correct technique and paying particular attention to:
1. Applying standard precautions and following sterile technique--10 points.
2. Explaining reason for injection and procedure to client--10 points.
3. Describing appropriate sites for injection and using appropriate site for injection by noting landmarks--10 points.
4. Administering medication using correct technique--20 points.
50% skill
Critical Elements
Intramuscular Meds--Perform skill beginning on page 563 of Smith using the correct technique and paying particular attention to:
1. Applying standard precautions and following sterile technique--10 points.
2. Explaining reason for injection and procedure to client--10 points.
3. Describing appropriate sites for injection and using appropriate site for injection by noting landmarks--10 points.
4. Administering medication using correct technique--20 points.
Updated: September 11, 2006/DBY