Test Bank Contemporary Medical Surgical Nursing 2nd Edition, Daniels
Chapter 1–The Health Care System and Contemporary Nursing
1.The nurse ensures that a client’s bedspace is neat and clean with the call light within easy reach. The
nurse is focusing on which nursing theorist who realized the importance of the environment for care?
1. Florence Nightingale
2. Sister Callista Roy
3. Dorothea Orem
4. Martha Rogers
2.The nurse is instructing a client on self-administration of insulin so that the client will not need a
health care provider to do this activity. The nurse is implementing which of the following aspects of
Virginia Henderson’s theory of nursing?
1. A caring relationship
2. Helping the client achieve independence from the nurse’s assistance as quickly as possible
3. Integration of objective and subjective data
4. Application of critical thinking
3.A client tells the nurse that he has an HMO for his health insurance. The nurse understands that the
purpose of this type of health plan is to:
1. ensure payment is made to Medicare for services rendered.
2. maximize the utilization of health care resources.
3. efficiently manage costs while providing quality care.
4. focus on the illness when providing care.
4.A client tells the nurse that he does not have a primary care physician but rather makes an
appointment with a doctor who specializes in the area in which he is experiencing a problem. The nurse
realizes this client is at risk for which of the following?
1. Fragmented care
2. Overpayment of services
3. Inability to sustain health
4. Finding an appropriate general practitioner
5.The nurse is attending a master’s degree program in efforts to be educationally prepared to serve as a
hospital leader. The nurse realizes that this educational preparation will:
1. hinder the nurse’s ability to work with physicians.
2. be viewed as not supporting the profession of nursing by other nurses.
3. ensure the nurse is biased towards clinicians’ interests.
4. prepare the nurse to serve as strong clinical support with the ability to integrate business and caring.
6.A client tells the nurse that all hospitals care about is doing the minimum for a client regardless of the
outcome. Which of the following should the nurse respond to this client?
1. “It does feel like that sometimes.”
2. “Health insurance companies have caused this problem.”
3. “The doctors will get paid regardless of the clients’ outcomes.”
4. “There are quality programs in place to make sure clients receive the best quality of care regardless of the cost.”
7.The nurse is providing care at a time that is the most beneficial to the client. The nurse is
implementing which of the following Joint Commission Dimensions of Quality Performance?
8.The nurse is providing care while adhering to safety as a Joint Commission Dimension of Quality
Performance. Which of the following did the nurse provide to the client?
1. Using a needleless device when providing intravenous medications
2. Keeping the siderails of the bed in the down position after providing a pain medication to a client
3. Having the client sit in a wheelchair with the wheels in the unlocked position
4. Placing cloth towels over a spill in the room of an ambulatory client
9.The nurse is planning and providing care while adhering to the American Nurses Association
definition of professional nursing. Which of the following does the nurse include when implementing
1. Follows the NANDA nursing diagnoses process
2. Integrates objective and subjective data
3. Respects cultural diversity of peers
4. Acknowledges the experience and training of physicians
10.The nurse has shifted her practice from an illness focus to a health focus. Which of the following has
this nurse implemented?
1. Standardized care plans
2. Critical pathways
3. Instructing a client on relaxation techniques to aid with sleep
4. Holding around-the-clock medication when a client is asleep
Chapter 2–Clinical Decision Making and Evidence-Based Practice
1.The nurse is implementing evidence-based practice. Which of the following is not a component of this
1. Patient preference
2. Clinical expertise
3. Research evidence
4. Leader practice
2.The nurse is planning the care for a client using an unstructured approach. Which of the following
approaches did the nurse most likely use?
2. Trial and error
3. Nursing theory
4. Validated order
3.The nurse is participating in an activity that is the first step of the ACE Star Model of Knowledge
Transformation. Which of the following is the nurse doing?
1. Creating evidence summaries
2. Evaluating outcomes
3. Integrating findings into practice
4. Participating in research
4.A committee has been developed to implement knowledge transformation when providing client care.
The members realize that the purpose of knowledge transformation is to:
1. reduce length of stay.
2. convert research findings to impact health outcomes.
3. reduce the cost of care.
4. increase the number of patients with health insurance.
5.An advance practice nurse is being consulted to participate during the translation phase of the ACE
Star Model of Knowledge Transformation. During this phase, which of the following will the nurse
1. Standardized care plans
2. Critical pathways
3. Clinical practice guidelines
4. Checklists to streamline documentation
6.The nurse leaders of a health care organization are creating plans to change clinical and
organizational practices to support evidence-based practice. Which phase of the ACE Star Model of
Knowledge Transformation are the leaders implementing?
4. Evidence summaries
7.The advance practice nurse is writing clinical practice guidelines. Prior to writing these guidelines
which of the following will the nurse need?
1. Current client census
2. Evidence summaries
3. Nursing department budget
4. Staffing ratios
8.The nurse is writing a systematic review. After the nurse formulates questions and locates relevant
studies, the nurse thing the nurse will do is:
1. update the reviews.
2. interpret the findings.
3. summarize and synthesize results.
4. select and appraise the studies.
9.The nurse is using the scale for rating the strength of research evidence for one research article for
potential inclusion in a clinical practice guideline. Which of the following is considered the strongest
1. Individual cohort study
2. Meta-analysis of randomized clinical trials
3. Expert opinion
4. Case studies
10.The nurse is considering a research study for inclusion in a clinical practice guideline that has been
identified as being sufficient to determine effects on health outcomes. This research study would be
considered as being:
Chapter 3–Health Education and Promotion
1.A client is reviewing a videotape without the assistance of the nurse for instruction. The type of
teaching strategy this client is using is considered:
3. programmed instruction.
2.The nurse is instructing a client regarding food safety, injury prevention, and occupational health.
Which of the following Healthy People 2010 objectives is the nurse instructing the client?
1. Promote healthy behaviors
2. Promote healthy and safe communities
3. Improve systems for personal health and public health
4. Prevent and reduce diseases and disorders
3.A client has inadequate resources and impairment of personal support systems. Which nursing
diagnosis would apply to this patient?
2. Deficient knowledge
3. Ineffective health maintenance
4. Health-seeking behavior
4.While planning care for a client, the nurse identifies content that would address the client’s diagnosis
of Deficient Knowledge. The nurse will ensure time is allocated for client instruction because:
1. the client cannot be discharged without it.
2. it is a legal component of the nursing process.
3. it is a nice thing to do for a client.
4. the physician has written an order for instruction.
5.The nurse is engaged in an information teaching session with a client. Which of the following would be
appropriate to instruct during an informal teaching session?
1. Expected effects of a new medication
2. Instruction on leg exercises to be used after surgery
3. How to use an incentive spirometer
4. Diet and medications to manage a new diagnosis of diabetes mellitus
6.The nurse is planning a presentation to a group of senior citizens as part of a wellness program.
Which of the following topics would be appropriate for the nurse to instruct this client population?
1. Importance of taking medications as prescribed
2. Ways to follow a physician’s treatment plan
3. Ease of changing an abdominal dressing
4. Strategies to reduce salt in the diet and increase activity
7.A client is considering several changes in personal habits to improve his health. Which of the following
critical thinking strategies can the nurse use to help this client?
1. Ask the client to identify his goals to improve his health.
2. Remind the client that the physician has to approve all changes in his health improvement plan.
3. Suggest the client wait until he is discharged before planning to make personal habit changes.
4. Recommend that immediate changes are made to confuse the body’s responses.
8.A client has several identified learning needs. Which of the following should the nurse assess prior to
planning instruction for this client?
1. Home address
2. Client’s learning style
3. Living arrangements
4. Financial resources
9.Which of the following teaching strategy would best support a client who needs to learn how to self-administer insulin injections?
4. Programmed instruction
10.A client tells the nurse that she uses audio CDs in her vehicle when driving to and from work to keep
current with educational requirements for her job. The nurse would assess this client as preferring
which type of learning style?
Chapter 4–Culturally Sensitive Care
1.A client from a different culture is having difficulty adjusting to living in the United States. The nurse
realizes this client is experiencing:
1. an expected reaction.
2. culture shock.
2.A client from the Japanese culture tells the nurse that she is a member of an organization for Japanese
information technology professionals. The nurse realizes this client is describing:
1. an ethnic group.
2. cultural norms.
3. a subculture.
4. personal preferences.
3.The nurse is providing care to a client from the Native American ethnic group. The nurse realizes that
which of the following would be a health belief for this client?
1. Illness is punishment from God.
2. The body must be intact upon death.
3. Hospitals are a place to die.
4. Illness is a price to be paid from a past or future event.
4.While assessing a client from a different culture, the nurse passes over several sections because of
previous experience with other clients from the same culture. Which of the following is this nurse
3. Cultural sensitivity
4. Time management
5.The nurse, using an interpreter to communicate with a client from a different culture, is concerned
that the client’s body language does not match the content the interpreter provides. Which of the
following communication issues does this situation describe?
2. Intrinsic distortion
4. Extrinsic distortion
6.An interpreter who will assist in communicating with a client from a different culture will not arrive for
several hours. The client has many questions and the only person available to assist with translating is
the client’s adult daughter. Which of the following situations can occur with using this family member as
1. The daughter may alter information to protect the client.
2. The nurse will not have to wait for the interpreter to arrive.
3. The client’s care can begin sooner if the daughter is used to interpret.
4. The client will understand everything that is occurring with his health.
7.The nurse is frustrated with a client from a different culture who is not adhering to the prescribed
medication regime. Which of the following should the nurse assess in this client?
8.An elderly client’s daughter tells the nurse that she has done all that she can do to help her mother,
and she needs to return home to care for her own family. The nurse realizes this client is a member of
which type of family structure?
9.The nurse is planning care for a client from a different culture. Which of the following should the
nurse use when planning care for this client?
1. Plan care using the same approaches as any other client.
2. Communicate to the client that culture cannot be taken into consideration with care.
3. Accept cultural practices that could be negative for the client.
4. Preserve the cultural beliefs and practices of the client.
10.The nurse is providing care to a client from a different culture. Which of the following behaviors
should the nurse demonstrate while providing this care?
4. Judgmental attitude
Chapter 5–Legal and Ethical Aspects of Health Care
1.The nurse is providing care for a client who is 18 years old. Which of the following ethical principles
should be implemented for this client?
2.A client, being treated with chemotherapy and radiation for terminal cancer, decides to stop any
further treatment and enter the hospice program. The nurse realizes this client’s decision is supported
by the ethical principle of:
3.The care a nurse provides to clients is considered as being a benefit to their health and recovery. The
principle that supports the nurse’s behavior is considered:
4.A client recovering from surgery does not want to move out of bed because of pain. The nurse
explains the long-term effects of staying in bed and the benefits of movement. The client agrees and is
assisted out of bed. This is an example of:
5.The nurse who bases client care actions on the principle of “greatest good” is implementing which
6.The nurse is preparing a consent form for a client to sign before a procedure. Which of the following
statements explains a characteristic of informed consent?
1. The client does not need autonomy to give consent.
2. Minors are permitted to give consent.
3. The client does not need to give consent if the situation is an emergency.
4. If the client is of legal age, he or she does not need the cognitive ability to understand.
7.When the nurse obtains a client’s signature for informed consent, the nurse’s responsibility is the
1. the client understands everything about the procedure.
2. a family member witnesses the signature.
3. the client was not coerced into signing the form.
4. the client has asked questions.
8.The health care team is addressing an ethical issue regarding one client’s continuing care. The nurse
wants to ensure that the principle of justice is taken into consideration. Which of the following ethical
decision-making modules would support this principle?
1. Medical indications
2. Patient preferences
3. Quality of life
4. Contextual features
9.The nurse, caring for an elderly client recovering from a fractured coccyx, wants to discuss palliative
care. The client becomes alarmed and asks “is there something you aren’t telling me? Am I dying?”
Which of the following should the nurse respond?
1. “We are all dying.”
2. “It’s an approach to care to help relieve pain and provide you with support.”
3. “It’s care provided to all elderly patients.”
4. “Since it is covered by Medicare, you are entitled to it.”
10.The nurse provides a terminally ill client with dose of a newly prescribed pain medication. Shortly
afterwards, the client experiences respiratory arrest and dies. Which of the following describes this
2. Assisted suicide
3. Intended effect
4. Double effect
Chapter 6–Nursing of Adults across the Life Span
1.The nurse is reviewing the number of elderly adult clients who were admitted during the previous 3month period with complications from the seasonal flu. The nurse is reviewing which of the following
4. Mortality rate
2.An elderly client is admitted with worsening dementia. Which of the following health problems should
the nurse consider as causing this client’s dementia?
2. Alzheimer’s disease
3. Memory impairment
4. Alcohol withdrawal
3.The nurse is instructing a client on ways to reduce the risk of developing coronary heart disease.
Which of the following should be included in these instructions?
1. Limit smoking.
2. Exercise when able.
3. Keep BMI at or above 30.
4. Reduce cholesterol level.
4.When planning instruction for a client diagnosed with coronary artery disease, the nurse should
identify which of the following risk factors that cannot be modified for the client?
3. Sedentary lifestyle
5.A client tells the nurse that he is planning to retire and plans to become involved with charitable
organizations. The nurse realizes this client is within which of the following stages of Levinson’s Theory
of Adult Development?
1. Middle Age
2. Late Adulthood
3. Old Age
4. The Thirties
6.A client tells the nurse that she began having a particular health problem around the onset of the Iraqi
War. The nurse determines that the client is utilizing which of the following perceptions of time?
1. Life time
2. Social time
3. Historic time
4. Actual time
7.The nurse is instructing a 55-year-old client on ways to reduce the development of illnesses that are
the leading cause of death for persons in the same age group. Which of the following is the nurse
instructing this client?
1. Need to wear seat belts when operating a motor vehicle
2. Reduction of alcohol intake
3. Need for a annual mammogram, Pap smear, and colonoscopy every 10 years
4. Weight reduction
8.A middle-aged client tells the nurse that she is scheduled for a treatment to reduce facial wrinkles and
the cost is much less than a plastic surgeon. Which of the following should the nurse respond to this
1. “I would like to schedule the same procedure for myself.”
2. “Did you research why the cost is less than a plastic surgeon’s?”
3. “It is so much better to avoid surgery if possible.”
4. “I am sure you will feel much better afterwards.”
9.The nurse is assessing a client who experienced bariatric surgery 5 years ago. The nurse would
consider the client’s surgery as successful when which of the following is assessed?
1. Current weight is 100 lbs less than the starting weight of 600 lbs.
2. Current weight is 300 lbs with a starting weight of 450 lbs.
3. Current weight is 200 lbs with a starting weight of 400 lbs.
4. Current weight is 50 lbs less than the starting weight of 400 lbs.
10.A 35-year-old female client tells the nurse that she is having difficulty managing her job, family, and
the needs of her aging parents. To help this client avoid chronic illnesses later in life, which of the
following should the nurse instruct?
1. Plan to change jobs to reduce stress.
2. Do not smoke; keep weight within normal limits; exercise.
3. Enlist the help of her children to aid with the aging parents’ care.
4. Consider not working until the children are raised.
Chapter 7–Palliative Care
1.The nurse believes that a client is eligible as a participant for The National Hospice Reimbursement
Act of 1986. This act mandated that:
1. clients with terminal illnesses are reimbursed.
2. a physician must order hospice to be reimbursed.
3. to receive reimbursement that client must be eligible for Medicare.
4. to receive benefits, the physician must certify that the client has a limited life expectancy of 6 months or less.
2.After a Native American client has died, the family begins the practice of purifying the body. The nurse
realizes that the deceased client may stay with the family for what period of time?
1. 12 hours
2. 24 hours
3. 36 hours
4. 48 hours
3.A client is receiving care for symptoms; however, the treatment will not alter the course of the
disease. This client is receiving which type of care?
4.A client diagnosed with a terminal illness is receiving an opioid/acetaminophen combination for pain
control. The nurse realizes this client is being managed at which step of the World Health Organization
approach to pain management?
1. Step 1
2. Step 2
3. Step 3
4. Step 4
5.A dying client is surrounded by family and friends at home. The hospice nurse talks with the spouse of
the dying client to ensure that everything the family needs during this time is being done. The nurse is
providing support to:
1. the client.
2. the bereaved.
3. ensure compliance with the hospice rules and regulations.
4. determine if the spouse understands that the client is dying.
6.A client of the Hispanic culture is nearing death and the family requests that the client be prepared for
discharge. The nurse realizes that the reason the family and client want to return home is because:
1. individuals within this culture do not trust hospital caregivers.
2. the family wants to have a spiritual healer care for the client.
3. it is bad luck to die in the hospital.
4. the spirit may get lost if the client dies in the hospital, and it will not be able to find its way home.
7.During the period of time when a client diagnosed with a terminal illness became comatose, a health
care proxy made decisions about the client’s care. When the client regained consciousness a few days
later, the nurse consulted whom regarding the client’s ongoing care decisions?
1. The client
2. The health care proxy
3. The client’s family
4. The client’s physician
8.The nurse is concerned that the spouse of a terminally ill client is experiencing Anticipatory Grieving
when which of the following is assessed?
1. Confidence the ability to care for the ill client at home
2. Expressing anger about the client’s pending death and crying throughout the day
3. Large social support system
4. Knowledge of equipment function
9.The nurse administers additional intravenous medication to a hospice client with uncontrollable pain.
After receiving the additional medication, the client demonstrates apneic periods and bradycardia.
Which of the following does this nurse’s actions suggest?
2. Assisted suicide
3. Double effect
10.A client with a terminal illness was ingesting morphine sulfate 10 mg by mouth every 6 hours for
pain. To ensure that the client receives the same degree of pain control when delivering the same
medication through the intravenous route, which of the following should the nurse do?
1. Provide morphine sulfate 10 mg intravenous every 6 hours.
2. Provide morphine sulfate 20 mg intravenous every 4 hours.
3. Provide a different medication since morphine sulfate cannot be given through the intravenous route.
4. Consult a dose equivalent table to determine the dose of morphine sulfate the client will need through the intravenous route.
Chapter 8–Health Assessment
1.A client is brought to the emergency department with injuries sustained from a motor vehicle
accident. The nurse will conduct which of the following types of health assessments?
2.The nurse is collecting data for a comprehensive assessment. Data that can be seen, heard, or felt by
someone other than the person experiencing them are called:
3.A recently admitted client answers all health assessment questions clearly and provides the necessary
information. The nurse realizes that this assessment data is considered:
4.A client is complaining of a headache and an upset stomach. The nurse realizes that this type of data
5.The nurse is beginning the introductory portion of the health interview process. This part of the
assessment is considered the:
1. orientation phase.
2. initiation phase.
3. working phase.
4. closure phase.
6.The nurse completes a comprehensive health assessment with a client. This assessment is completed
so that when future assessments are made they can be:
1. incorporated into the initial assessment.
2. considered a new baseline.
3. compared to the initial assessment.
7.The nurse is assessing a client for a cardiac thrill. To best assess this thrill, the nurse should do which
of the following?
1. Use the ulnar surface of the hand.
2. Use the dorsal aspect of the hand.
3. Use the fingertips.
4. Use a stethoscope.
8.The nurse is using percussion to assess a client’s lung region. Which of the following would be
considered a normal assessment finding?
9.A 17-year-old male client tells the nurse that he hopes he stops growing since he is already over 6 feet
tall. Which of the following should the nurse respond to this client?
1. “You have reached your full adult stature by age 17.”
2. “You have until age 21 to reach your full adult height.”
3. “You won’t reach your full height until age 25.”
4. “You have reached your full height and will begin to lose height every year.”
10.The nurse is assessing a week-old male client. Which of the following will the nurse assess as a
common variation because of the client’s gender?
1. Physiologically more mature
2. More motor activity
3. Responsive to tactile stimulation
4. Smaller in size
Chapter 9–Genetics and the Multiple Determinants of Health
1.A client is found to be heterozygous for a normal gene and an abnormal gene. The nurse realizes this
client would be considered a(n):
1. affected individual.
3. genetically defective.
4. mutated individual.
2.A client is diagnosed with a chromosomal abnormality that occurred during cell division and resulted
in the formation of two cells, each with the same chromosome complement as the parent cell. The
nurse realizes that the abnormality occurred during:
3.From genetic testing, a client is found to have the correct number of chromosomes within cells. The
nurse would document this finding as being:
4.From genetic testing, a fetus is determined to have genetic trisomy. The nurse realizes that the most
common trisomy condition is:
1. Down syndrome.
2. Edward syndrome.
3. Marfan syndrome.
4. Patau syndrome.
5.A pregnant client is scheduled for a procedure to harvest stem cells from the fetus’s umbilical cord.
Which of the following must occur before this procedure can be conducted?
2. Umbilical cord is visualized upon ultrasound.
3. Chorionic villus sampling test has been completed.
4. Placental biopsy is completed.
6.The nurse is concerned that a pregnant client may deliver an infant with a teratogenic condition when
which of the following is assessed?
1. Client ingests two alcoholic drinks every night during pregnancy.
2. Client exercises 3 days each week for 30 minutes.
3. Client works 40 hours a week.
4. Client eats six servings of fruits and vegetables each day.
7.An adolescent female client being treated for cystic fibrosis is asking the nurse about birth control.
Which of the following should the nurse include in these instructions?
1. The chances that the client will become pregnant are small.
2. Women with cystic fibrosis can transmit this disorder to their children.
3. Pregnancy will cause the disease to go into remission.
4. The client has a good chance of having children without the disorder.
8.After genetic testing, a client is found to have the apolipoprotein E genotype. The nurse realizes that
this genotype predisposes the client to developing:
1. diabetes mellitus.
3. cystic fibrosis.
4. cardiovascular disease.
9.A client with a family history of cancer asks the nurse what he can do to prevent developing the
disease. Which of the following should the nurse respond to this client?
1. “Everyone develops cancer sometime in his life.”
2. “There are lifestyle changes that you can make to avert the development of cancer.”
3. “If you have cancer in your family, you will also develop the disease.”
4. “Cancer cannot be prevented.”
10.The nurse caring for a client diagnosed with sickle-cell anemia realizes that which of the following
interventions has been shown to increase clients’ life expectancy?
1. Low-fat diet
2. Moderate exercise
3. Prophylactic antibiotic therapy
4. Vitamin D therapy
Chapter 10–Stress, Coping, and Adaptation
1.A client tells the nurse that he feels “stressed out.” The nurse realizes which of the following regarding
1. Stress can be caused by a variety of situations.
2. Stressors do not cause a need for change.
3. Positive events do not increase stress.
4. All events are regarded as threatening to self.
2.A client’s symptoms are consistent with those seen in the first stage of the general adaptation
syndrome (GAS). Which of the following symptoms did the nurse most likely assess in this client?
1. Mental exhaustion, cool skin, and decreased senses
2. Elevation of blood pressure, dilated pupils, and tachycardia
3. Hyperventilation, nausea, and vomiting
4. Physical illness, hypertension, and shortness of breath
3.The nurse is concerned that a client is in the third stage of the general adaptation syndrome (GAS)
when which of the following is assessed?
1. Increased energy
2. Fluid retention
3. Prolonged stress
4. Numbing effect
4.The nurse determines that a client is utilizing a maladaptive method to cope with a new illness. Which
of the following is the client most likely demonstrating?
5.A client diagnosed with heart failure is experiencing feeling of helplessness and is uncertain about
how her heart failure has been progressing. These feelings are referred to as:
6.A client tells the nurse that he believes he will learn to manage his illness and will continue to live a
productive life. The nurse realizes that this client’s positive self-esteem is evidence of:
1. external locus of control.
7.A client tells the nurse that she uses herbal remedies to help control the symptoms of a chronic illness
but does not want her physician to know. Which of the following should the nurse respond to this
1. “I would not tell my doctor either.”
2. “Herbal remedies don’t work anyway.”
3. “Some herbal remedies could interact with prescribed medications. Be sure to let your doctor know what you are taking.”
4. “Your doctor doesn’t believe in herbal remedies so don’t tell him.”
8.A client diagnosed with a terminal illness tells the nurse that he will do whatever it takes to work
through the illness and be as healthy as he can. The nurse recognizes this client’s inner strength is a
1. emotion-focused coping.
9.The nurse is planning interventions for a client with a chronic illness who is experiencing stress. Which
of the following would be appropriate for this client?
1. Inform the client that others have the responsibility for addressing her stress.
2. Inform the client about diet, exercise, and medications to help with her stress.
3. Remind the client that keeping a journal is not a good use of time.
4. Encourage the client to remain isolated until the stress passes.
10.A client from a non-English-speaking culture refuses to accept one prescribed treatment for an acute
illness. Which of the following should the nurse do to support this client’s refusal of care?
1. Suggest the client be discharged since care is being refused.
2. Talk with the client about the treatment and why it is not being accepted.
3. Ask the physician to prescribe an equally effective treatment so that the client may agree.
4. Transfer the client to another care area.
Chapter 11– Inflammation and Infection Management
1.The nurse, assessing a client’s leukocyte level, determines the amount to be within normal limits. Which of the following would indicate a normal level of leukocytes in the client’s blood?
1. 14 to 18 g/dL
2. 4.6 to 6.2 million/mm3
3. 4500 to 11,000 mm3
4. 50 to 60 percent
2.A client’s complete blood count reveals a large amount of phagocytic cells present. The nurse realizes that this type of cell is most likely:
3.According to assessment findings, the nurse determines that a client is experiencing an inflammatory process. Which of the following did the nurse assess in this client?
1. Redness, swelling, heat, and pain
2. Reduced urine output
4. Elevated blood pressure and slow heart rate
4.A client is diagnosed with a bacterial infection. Which of the following is an example of this type of infection?
3. Urinary tract infection
5.A client is diagnosed with gastroenteritis. The nurse realizes that this illness occurs from which type of disease-causing organism?
6.A client has been diagnosed with Rocky Mountain spotted fever. The causative organism for this disease process is:
7.Which of the following will the nurse most likely assess in a client diagnosed with asthma?
1. Wheezing and anxiety
2. Barking cough and increased blood pressure
3. Bradycardia and restlessness
4. Anemia and hypoxia
8.The nurse would expect that a client diagnosed with arthritis will be prescribed which of the following medications?
9.A client is being admitted to a health care facility. Which type of precautions will the nurse implement at this time?
10.A client diagnosed with tuberculosis is scheduled for a chest x-ray to be completed in the radiology department. Which of the following devices should be utilized when transporting this client?
1. Face shield with mask and gown
2. N-95 mask
3. Surgical mask
4. Patient does not need to wear a device
Chapter 12–Fluid, Electrolyte, and Acid-Base Imbalances
1.The nurse is concerned that a client can become dehydrated when which of the following is assessed?
1. History of arthritis
2. Appendicitis diagnosis 3 years ago
3. Age 30
4. Obese female
2.A client has lost a significant amount of blood. The nurse realizes that the fluid compartment most effected with the blood loss will be:
3.A client is diagnosed with chronic renal failure. Which of the following electrolytes should the nurse monitor for this client?
4. Vitamin D
4.A client had a 2 kg weight loss in one day. The nurse realizes this change in weight is due to:
1. fluid loss.
2. poor appetite.
4. bed rest.
5.A client has a serum sodium level of 129 mEq/L. The nurse should prepare to administer which of the following intravenous solutions?
1. Dextrose 5% and Lactated Ringer
2. Dextrose 5% and 0.45% Normal Saline
3. 0.9% Normal Saline
4. Dextrose 5% and 0.9% Normal Saline
6.A client is diagnosed with fluid volume excess. Which of the following will the nurse most likely assess in this client?
1. Poor skin turgor
2. Jugular vein distention
3. Dry mouth
4. Increased heart rate
7.A client is demonstrating dizziness and lightheadedness upon standing. The nurse is concerned the client is experiencing postural hypotension when which of the following is assessed?
1. Lying BP 120/70 mmHg, P 70; standing BP 116/78 mmHg, P 78
2. Lying BP 116/64 mmHg, P 62; standing BP 94/58 mmHg, P 78
3. Lying BP 130/80 mmHg, P 84; standing BP 118/72 mmHg, P 90
4. Lying BP 126/74 mmHg, P 74; standing BP 108/62 mmHg, P 84
8.The nurse assesses a client to have mild pitting edema of the lower extremities. The nurse would document this finding as being:
9.An elderly client is demonstrating new signs of confusion. Which of the following should the nurse consider when caring for this client?
1. Assess for signs of elevated sodium level.
2. Restrict fluids.
3. Administer prescribed diuretic medication.
4. Monitor daily weights.
10.A client diagnosed with hypokalemia should have which of the following electrolytes also assessed?
Chapter 13–Infusion Therapy
1.A client is scheduled for a peripherally inserted central catheter in a few days. However, the client needs intravenous fluids infused immediately. Which of the following veins should the nurse avoid when starting the intravenous infusion now?
1. Accessory cephalic vein
2. Basilic vein
3. Cephalic vein
4. Median vein
2.The tubing on a client’s intravenous infusion administration set is not long enough to support the client’s ambulation needs. Which of the following can the nurse do to assist this client?
1. Apply a stopcock.
2. Add an extension set.
3. Use a filter.
4. Attach a needleless access device.
3.An intravenous catheter has been inserted over a client’s antecubital joint. Which of the following should the nurse do to ensure the client’s comfort and the usefulness of the catheter?
1. Use an arm board to keep the arm straight.
2. Wrap gauze around the insertion site.
3. Place a gauze dressing over the insertion site.
4. Apply a wrist restraint to keep the arm straight.
4.After preparing a client’s skin for insertion of an intravenous catheter, the nurse accidentally touches the skin site with an uncovered finger. Which of the following should the nurse do?
1. Cleanse the skin again.
2. Apply clean gloves and continue.
3. Locate another vein to access.
4. Continue with the insertion of the catheter.
5.Which of the following should the nurse assess to determine if a client’s intravenous infusion has infiltrated?
1. A blood return
2. Size of extremity
3. Presence of pain
4. Presence of a temperature
6.A client is diagnosed with an extravasation of a intravenous medication. Which of the following should the nurse do to assist this client?
1. Remove the catheter and apply heat.
2. Place the extremity lower than the level of the heart.
3. Keep the catheter intact until an antidote is administered.
4. Apply ice over the site until the swelling subsides.
7.A client is complaining of numbness and tingling around the intravenous infusion catheter. Which of the following should the nurse do?
1. Apply heat.
2. Remove the cannula.
3. Elevate the extremity.
4. Slow the intravenous infusion rate.
8.A client is prescribed to receive a medication diluted in 50 mL of 0.9% Normal Saline four times a day. The nurse realizes that this type of administration is considered:
2. direct injection.
9.A client has an implanted port for medication administration. Which of the following should the nurse use when administering medications through this port?
1. Use a noncoring needle.
2. Use an 18 gauge needle.
3. Apply heat to the site prior to administering medication.
4. Flush the port after administering medications.
10.A client is receiving total parenteral nutrition. Which of the following interventions are appropriate for this client?
1. Provide the infusion at the maximum rate.
2. Do not use a pump for infusing.
3. Measure weights daily.
4. Assess blood glucose levels every week.
Chapter 14–Complementary and Alternative Therapies
1.A client from the Asian culture tells the nurse that he has blockages in his life force that are causing him to have a disease. The nurse realizes that within this culture, the life force is considered:
2.The nurse is planning to learn Reiki to become a master practitioner. Which level of learning will the nurse need to achieve in order to become a Reiki master?
1. Level I
2. Level II
3. Level III
4. Level IV
3.A client tells the nurse that she utilizes biofeedback to combat chronic back pain. The nurse identifies this type of complementary alternative medicine as being:
1. biological therapy.
2. mind-body therapy.
3. body-based therapy.
4. energy therapy.
4.A client tells the nurse that his health has improved since he starting practicing tai chi. The nurse realizes this alternative medicine approach:
1. is a modern form of yoga.
2. uses breathing, movement, and posture.
3. enhances the flow of prana.
4. improves the flow of chi through the meridians of the body.
5.After an assessment, the nurse believes a client would benefit form the care of a chiropractor. Which of the following health problems could be addressed with this form of alternative therapy?
4. Kidney stones
6.When asked about an armband that a pregnant client is wearing, the client tells the nurse that it helps reduce morning sickness. The nurse realizes this client is utilizing which form of alternative medicine?
4. Guided imager
7.A client tells the nurse that she is having a series of massages to break up scar tissue created from back surgery which have caused uneven hip and shoulder height. The nurse realizes the type of massages the client is receiving would be:
8.A client tells the nurse that he believes watching old comedy movies has helped him achieve a quick recovery from orthopedic surgery. The nurse realizes this client has been using which of the following forms of complementary alternative medicine?
9.A client tells the nurse that she is not concerned about recovering from an acute illness since she has several people from her church praying for her health. The nurse realizes this client is utilizing which form of complementary alternative medicine?
2. Wishful thinking
3. Intercessory prayer
4. Positive thinking
10.A client tells the nurse that he ingests only herbal preparations and not medications prescribed from a physician. Which of the following should the nurse respond to this client?
1. “How long have you been using herbal preparations?”
2. “Are you aware of the side effects of using herbal preparations?”
3. “They must be working.”
4. “They are probably less expensive than other medications.”
Chapter 15–Cancer Management
1.The nurse realizes that for a cell to become cancer, it needs to progress through four stages. Which of the following is not a stage of this process?
2.A client’s most recent prostate-specific antigen level has decreased since starting treatment for prostate cancer. The nurse realizes this level would indicate that the client:
1. no longer has the disease.
2. has an increase in the severity of the disease process.
3. is responding to treatment.
4. should be retested.
3.A client’s tumor was staged using the TNM system. The tumor was staged as T4,N1,Mx. The nurse realizes that this staging means:
1. tumor in situ, minimal node involvement, no presence of metastasis.
2. large tumor, no node involvement, presence of metastasis.
3. medium tumor, multiple nodes involvement, no presence of metastasis.
4. large tumor, single node involvement, unable to assess metastasis.
4.Which of the following statements made by a client after receiving instruction regarding internal radiation would indicate that teaching has been successful?
1. “My children can come visit me after school.”
2. “Individuals will need to keep at least 3 feet away when possible.”
3. “I will be sharing a room near the nursing station.”
4. “The hospital staff will limit the amount of time in my room.”
5.A client, prescribed to begin chemotherapy, asks the nurse “How does chemotherapy work?” Which of the following should the nurse respond to this client?
1. It prevents the process of cell growth and replication.
2. It kills only cancer cells.
3. It treats the exposed area only with high-energy rays.
4. Agents are implanted in an area to inhibit cancer growth.
6.A client is prescribed interferon as part of treatment for cancer. Which of the following should the nurse instruct the client regarding this medication?
1. Flu-like symptoms should be reported to the physician.
2. General fatigue while receiving this medication is common.
3. Seek emergency care with a high fever.
4. Side effects are short term and will resolve in a few days.
7.A client recovering from bone marrow transplantation is experiencing vomiting, fatigue, and skin reactions. Which of the following should the nurse do to help this client?
1. Prepare to administer platelets as prescribed.
2. Prepare to administer red blood cells as prescribed.
3. Limit fluids.
4. Explain that the client is experiencing expected short-term side effects.
8.A client receiving chemotherapy for cancer has a hemoglobin level of 9.7 g/dL. Which of the following should the nurse anticipate as treatment for this client?
1. Place client in reverse isolation.
2. Administer antibiotics as prescribed.
3. Administer epoetin alfa as prescribed.
4. Administer filgrastim as prescribed.
9.A client receiving chemotherapy has a platelet count of 85,000. Which of the following should the nurse do to assist this client?
1. Assess for bruising and frank bleeding.
2. Provide a razor for shaving.
3. Remind the client to floss before brushing the teeth each day.
4. Provide NSAIDs as prescribed.
10.A client receiving chemotherapy tells the nurse that he is concerned that he may be developing Alzheimer’s disease since he is having a new onset of memory loss. Which of the following should the nurse do to help this client?
1. Discuss the client’s memory issues with the physician.
2. Suggest the client use a journal to aid with short-term chemo fog problems.
3. Assess for signs of pending stroke.
4. Notify the physician and plan for transferring the client to an intensive care area.
Chapter 16–Pain Management
1.A client tells the nurse that she rarely experiences pain, but when she does, she seeks medical attention. The nurse realizes this client understands that pain is important because it:
1. is a protective system.
2. includes the automatic withdrawal reflex.
3. creates sensitivity to pain.
4. helps with healing.
2.A client complains that the bed sheets touching his skin are extremely painful. The nurse realizes this client is experiencing:
3.A client is complaining of severe abdomen pain. The nurse realizes this client is experiencing which type of pain?
4.A client, diagnosed with acute appendicitis, is experiencing abdominal pain. The best way for the nurse to describe this client’s pain would be:
5.A client is observed holding a pillow over the abdominal region with both knees flexed in a side-lying position. Vital signs assessment reveals an elevated blood pressure and heart rate. Which of the following should the nurse say to this client?
1. “Can I get you anything?”
2. “Would you like something for pain?”
3. “You look comfortable.”
4. “Your blood pressure is up.”
6.A client experiencing chronic pain asks the nurse why she is not prescribed Demerol like she received when she had a total knee replacement. Which of the following should the nurse respond to this client?
1. “You don’t need something that strong.”
2. “That medication does not exist anymore.”
3. “That medication does not last very long.”
4. “It can cause you have high blood pressure.”
7.A client is informed that a tricyclic antidepressant medication is going to help control his chronic pain. The nurse would expect the physician to prescribe:
8.A client receiving around-the-clock medication for terminal cancer experiences additional pain when performing activities of daily living. The nurse realizes this client is experiencing:
1. breakthrough pain.
2. intractable pain.
3. psychosomatic pain.
4. acute pain.
9.A client recovering from surgery tells the nurse that she is nauseated and is experiencing an increase in pain. Which of the following does this client’s symptoms suggest to the nurse?
1. The client is becoming dependent upon the pain medication.
2. The client’s pain threshold is lower when experiencing nausea.
3. The client is experiencing withdrawal symptoms from pain medication.
4. The client is experiencing referred pain.
10.A client with a history of malingering pain tells the nurse that he needs a prescription for pain medication. Which of the following should the nurse do first to assist this client?
1. Ask the physician for a pain medication prescription for the client.
2. Remind the client that he does not have pain but just wants the medication.
3. Thoroughly assess the client for pain.
4. Suggest the client seek counseling for his pain medication-seeking behavior.
Chapter 17–Pharmacology: Nursing Management
1.A client is prescribed a medication that takes several doses to achieve a therapeutic level; however, the effects of the medication are needed immediately. Which of the following can the nurse anticipate to implement in order to achieve this desired effect?
1. Administer the medication intravenously.
2. Administer the medication at hour of sleep.
3. Administer the medication before breakfast.
4. Administer a loading dose of the medication.
2.A client is prescribed tetracycline. Which of the following should the nurse instruct the client about this medication?
1. Ingest the medication with milk products.
2. This medication does not interact with other medications.
3. Avoid exposure to the sun while ingesting this medication.
4. Blood in the urine is a common side effect.
3.When providing nitroglycerin paste to a client, the nurse should wear gloves because:
1. putting on the paste is a sterile procedure.
2. this medication is absorbed through the skin.
3. it is part of the six rights of medication administration.
4. it is necessary for infection control.
4.The nurse would report which of the following laboratory values as being within the range of toxicity for a client who is prescribed digoxin?
1. 0.5 mcg/mL
2. 0.2 mcg/mL
3. 1.5 mcg/mL
4. 2.7 mcg/mL
5.When instructing a client regarding the correct method to utilize nitroglycerin tablets, the nurse tells the client if the pain persists after three tablets are used at 5 minute intervals, the client should:
1. call 911 and go to the hospital.
2. sleep for 1 hour and see if the pain is resolved.
3. take a fourth tablet and the pain will go away.
4. drink an extra glass of water to help with digestion.
6.When instructing a client diagnosed with hypertension on the purpose of a diuretic, the nurse should explain the mechanism of action to be:
1. promoting sodium and water loss.
2. retention of sodium and water.
3. working on the heart vessels.
4. decreasing heart rate.
7.Before administering a furosemide (Lasix) to a client, which of the following laboratory values should the nurse assess?
1. White blood cell count
2. K+ (potassium)
8.The nurse is reviewing the laboratory values for a client prescribed theophylline (Theo-Dur). Which of the following would indicate a therapeutic level of this medication?
1. 2.0 mcg/mL
2. 5.0 mcg/mL
3. 15 mcg/mL
4. 25 mcg/mL
9.The nurse should monitor which laboratory test for a client who is prescribed valproic acid (Depakote) for a seizure disorder?
1. Complete blood count
2. Serum sodium level
3. Liver function studies
4. Sedimentation rate
10.A client is diagnosed with duodenal ulcers. Which of the following medications should the nurse prepare to administer to this client?
Chapter 18–Health Care Agencies
1.A client is being admitted to a restorative care facility. The nurse realizes the goal of restorative care is to:
1. help the client die.
2. help the family cope.
3. regain an optimal level of functioning.
4. increase health care costs.
2.A client is relocating to a facility that will provide personal care services, 24-hour supervision, social activities, and health care services. The nurse realizes the client is relocating to:
1. adult day care.
2. long-term care
4. assisted living.
3.A client tells the nurse that he is a veteran of a foreign war and utilizes those benefits. The nurse realizes that the client most likely is receiving benefits for:
1. health care.
4.A client tells the nurse that someone telephones her at home to ask how she is doing, if she is following her physician’s treatment plan, and then provides instruction on ways to improve her health with the diagnosis of type 2 diabetes mellitus. The nurse realizes this client is experiencing which of the following care delivery systems?
5.A client tells the nurse that he has a place to go to receive current information and the annual flu vaccination, and he has a small gym and outdoor walking track. The nurse realizes this client is utilizing which type of health care service?
1. Preventive care
2. Primary care
3. Secondary care
4. Tertiary care
6.A client goes to a free-standing clinic to be seen by a doctor for a mild stomach ailment. The client has utilized which of the following types of health care services?
1. Preventive care
2. Primary care
3. Secondary care
4. Tertiary care
7.A client is admitted to a secondary care service facility. Which of the following types of care will this client most likely receive in this facility?
1. Education for a healthy lifestyle
2. Complex treatment
3. Emergent care
4. Physical therapy
8.A client who is on a waiting list for a liver transplant has been notified to report to the hospital within 2 hours. The type of facility equipped to perform a liver transplant would be considered:
9.When assessing a client’s financial and health care insurance coverage information, the client says that since she does not have any income, she gets health care insurance through the state. The nurse realizes the client most likely is receiving:
1. Veteran’s benefits.
10.A client is receiving continuing care for a health care problem. Which of the following types of agencies will this client most likely receive care?
1. Acute care hospital
2. Adult daycare
3. Specialty care hospital
4. Physician’s office
Chapter 19–Critical Care
1.The nurse determines that a client’s cardiac output is normal. Which of the following values would be considered normal?
1. 1 L/min.
2. 3 L/min.
3. 6 L/min.
4. 15 L/min.
2.A client’s cardiac index is calculated to be 3.1 L/minute/m2. Which of the following could explain this client’s cardiac index value?
1. Acute myocardial infarction
2. Cardiogenic shock
3. This is a normal value
3.A client with an elevated cardiac index has received diuretic medication as prescribed. The nurse realizes that this medication will affect which cardiac parameter?
4. Stroke volume
4.The nurse is caring for a client who is experiencing an increase in cardiac contractility. Which of the following will decrease contractility and reduce myocardial oxygen demand for this client?
1. Administer Primacor as prescribed.
2. Administer Digoxin as prescribed.
3. Administer beta-blocker as prescribed.
4. Administer potassium chloride as prescribed.
5.Which of the following interventions would ensure the accuracy of hemodynamic parameters and ensure an air-free system?
1. Slowly flush the system after taking a blood sample.
2. Loosen connections.
3. Keep pressure bag inflated to 300 mmHg.
4. Add extensions to the line.
6.A client is prescribed a vasoactive intravenous medication to maintain a normal blood pressure. Which of the following is not a vasoactive medication?
2. Dopamine hydrochloride
3. Nitroprusside sodium
7.A client’s right atrial pressure is measured as being 6 mmHg. The nurse would document which of the following regarding this client’s pressure?
1. Right arterial pressure within normal limits
2. Right arterial pressure below normal limits
3. Right arterial pressure above normal limits
4. Right arterial pressure unable to obtain
8.A client has an intraparenchymal probe inserted into his brain tissue. The nurse realizes an advantage of this type of intracranial monitoring device would be:
1. low risk of intracerebral bleeding.
2. low risk of infection.
3. sturdy and will not break.
4. an inexpensive method to monitor.
9.A client is diagnosed with increased intracranial pressure. Which of the following interventions can be used to reduce this pressure?
1. Administer hypotonic intravenous fluids.
2. Administer Mannitol.
3. Keep head of the bed flat.
4. Keep PaCO2 level above normal.
10.A client who has an endotracheal tube is being considered for a tracheostomy. Which of the following criteria would support the placement of a tracheostomy in this client?
1. Client is unable to maintain airway when extubated.
2. Client has a history of diabetes mellitus.
3. Client has been diagnosed with hypertension.
4. Client is coughing and bucking the endotracheal tube.
Chapter 20–Preoperative Nursing Management
1.The nurse is identifying diagnoses appropriate for a client scheduled for a surgical procedure. Which of the following is a diagnosis commonly used for preoperative client?
2. Sleep deprivation
3. Excess fluid volume
4. Disturbed body image
2.The preoperative nurse cares for the client until the client progresses into the intraoperative phase of care which begins when the client:
1. signs the surgical consent form.
2. arrives at the surgical suite doors.
3. is transferred to the postanesthesia care unit.
4. accepts that surgery is pending.
3.The nurse is ensuring that a client is able to make knowledgeable decisions regarding an upcoming surgery and can provide informed consent. What is the responsibility of the nurse regarding informed consent?
1. Explain the surgical options
2. Explain the operative risks
3. Describe the operative procedure to be done
4. Witness a patient’s signature
4.A client being prepared for surgery has a pulse oximeter placed on one digit of his hand. The nurse is applying this device to monitor the client’s:
1. oxygen level.
2. heart rate.
3. blood pressure.
4. urine output.
5.A client is scheduled for surgery in 2 weeks. Which of the following should the nurse instruct the client regarding healthy lifestyle behaviors?
1. Eat nutritious meals.
2. If obese, cut calories before the surgery.
3. If sedentary, exercise more before the surgery.
4. Stop all prescribed medications.
6.The nurse wants to reduce the stress level for a preoperative client. Which of the following communication techniques can the nurse use to achieve this result?
1. Allow the client to be alone before the surgery.
2. Observe and ask the client if there is anything that can be done to help reduce her anxiety.
3. Refer to the client by her first name.
4. Make tasteful jokes or comments to help the client laugh.
7.Which of the following can the nurse do to help an elderly client scheduled for a surgical procedure?
1. Work at a slower pace.
2. Speed up the pace so the client has time to rest.
3. Talk to family members and leave the client alone.
4. Send them to the surgical holding area in advance.
8.The nurse is concerned that a client scheduled for surgery will be at risk for hypothermia. Which of the following did the nurse assess in this client to determine the risk?
1. Client is a vegetarian.
2. Client exercises 5 days a week for 30 minutes.
3. Client has a history of congestive heart failure.
4. Clint is 48 years old.
9.The nurse is concerned that a client may have an undocumented allergy to latex when which of the following is assessed?
1. Recent episode of appendicitis
2. Recovered from bronchitis 3 months ago
3. Allergy to specific foods
4. Does not like to wear wool clothing
10.The nurse is providing a medication to reduce the preoperative client’s anxiety. Which of the following medications is the nurse most likely providing to the client?
1. Hydrogen ion antagonist
3. Calcium channel blocker
AND MUCH MORE