Test Bank Essentials Nursing Practice 8th Edition, Potter
Chapter 01: The Nursing Profession
1.A nurse uses effective strategies to communicate and handle conflict with nurses and other health care professionals. Which Quality and Safety Education for Nurses (QSEN) competency is the nurse demonstrating?
b. Quality improvement
c. Teamwork and collaboration
d. Evidence-based practice
2.A nurse is employed by a health care agency that provides an informal training session on how to properly use a new vital sign monitor. Which type of education did the nurse receive?
a. In-service education
b. Advanced education
c. Continuing education
d. Registered nurse education
3.A nurse listens to a patient’s lungs and determines that the patient needs to cough and deep breath. The nurse has the patient cough and deep breath. Which concept did the nurse demonstrate?
4.A registered nurse is required to participate in a simulation to learn how to triage patients who are arriving to the hospital after exposure to an unknown gas. This is an example of a response to what type of influence on nursing?
a. Workplace hazards
b. Nursing shortage
d. Emergency preparedness
5.A nurse is an advanced practice registered nurse (APRN) who cares for geriatrics. This nurse is which type of advanced practice nurse?
a. Clinical nurse specialist
b. Nurse practitioner
c. Certified nurse-midwife
d. Certified registered nurse anesthetist
6.A patient does not want the treatment that was prescribed. The nurse helps the patient talk to the primary health care provider and even talks to the primary health care provider when needed. The nurse is acting in which professional role?
d. Provider of care
7.A nurse must follow legal laws that protect public health, safety, and welfare. Which law is the nurse following?
a. Code of Ethics
b. Nurse Practice Act
c. Standards of practice
d. Quality and safety education for nurses
8.A nurse is directing the care and staffing of three cardiac units. The nurse is practicing in which nursing role?
a. Advanced practice registered nurse
b. Nurse researcher
c. Nurse educator
d. Nurse administrator
Chapter 02: Health and Wellness
1.A nurse is assessing a patient’s stage of behavioral change. Which statement by the patient will indicate to the nurse that the patient is in the preparation stage?
a. “I started to exercise regularly, but it didn’t last long. I’ll probably try again in a few weeks.”
b. “I have a problem, and I really think I need to work on it.”
c. “I am really working hard to stop smoking.”
d. “There is nothing that I really need to change.”
2.A patient is depressed after a divorce and is not eating. The nurse is using Maslow to prioritize care. Which patient need should the nurse address first?
b. Emotional safety
d. Love and belonging
3.A nurse is assessing a patient’s risk factors for heart disease and finds that the patient has several risk factors. How should the nurse interpret this finding?
a. The patient needs surgery for heart disease.
b. The patient has a genetic disease.
c. The patient will develop the disease.
d. The patient has an increased chance to develop the disease.
4.To determine a patient’s external variables for health beliefs and practices, which area should the nurse assess?
a. Emotional factors
b. Intellectual background
c. Developmental stage
d. Socioeconomic factors
5.Which nursing action best represents primary prevention?
a. Instructing a healthy individual to get a flu shot on a yearly basis
b. Instructing a patient to take blood pressure medication every day
c. Instructing a patient to live with a known disability
d. Instructing a patient to undergo physical therapy following a cerebrovascular accident
6.A married father of four has recently been diagnosed with emphysema resulting from a long history of smoking. At a family counseling session a nurse helps the family to understand that this diagnosis is classified as a(n):
a. acute illness.
b. tertiary prevention.
c. chronic illness.
d. internal variable.
7.Which information by a patient indicates teaching by the nurse was successful for the best definition of health?
a. State of complete well-being
b. Absence of disease
c. Vital signs within normal range
d. Maintenance of a normal weight
8.A patient with newly diagnosed diabetes is concerned about the risk for developing foot ulcers because the mother had a foot amputated as a result of the disease. This is an example of which of the following?
a. Health promotion
b. Health practices
c. Health beliefs
d. Holistic health
9.A patient with diabetes is diligent about testing blood sugar before meals. Which model is the nurse using when the nurse realizes the patient is taking preventative actions for health and represents the third component of this model?
a. Basic Human Needs
b. Health Belief
c. Holistic Health
d. Tertiary Prevention
10.Which will best assist a nurse in understanding a patient’s use of tying a silver dollar to the stomach of a newborn infant to heal an umbilical hernia?
a. Cultural background
b. Maslow’s Hierarchy of Needs
c. World Health Organization’s definition of “health”
d. Primary prevention
Chapter 03: The Health Care Delivery System
1.A nurse is teaching the importance of breast self-examination to a group of 20-year-old women. The nurse is promoting which type of care?
2.A patient who needs nursing and rehabilitation after a stroke would benefit most by receiving care at which center?
a. Primary care center
b. Restorative care center
c. Assisted living center
d. Respite center
3.A patient states that he or she cannot afford health care insurance for the family because of a low income. What is the best form of insurance available for this patient?
c. Private insurance
d. A managed care organization
4.A nurse is teaching the staff about managed care. Which information should the nurse include?
a. Managed care focuses on long-term care services for skilled nursing.
b. Managed care focuses on hospital admissions and illnesses for a group of people.
c. Managed care focuses on control over primary health services for a defined population.
d. Managed care focuses on decreased access to care while increasing costs.
5.A nurse admits an older adult patient who states that he or she has no living relatives and only two close friends. Upon admission to the hospital, which action should the nurse initiate first?
a. Implement a process of payment.
b. Implement a discharge plan.
c. Implement a visit with the family.
d. Implement a resource utilization group.
6.A nurse is asked the most frequently cited reason for death in the world. How should the nurse reply?
a. Technological advances
b. Old age
7.A nurse is teaching the staff about the Prospective Payment System (PPS). Which information should the nurse include in the teaching session?
a. PPS establishes cost-based reimbursement for health care.
b. PPS provides reimbursement for every service the patient receives.
c. PPS establishes reimbursement rates based upon diagnosis-related groups (DRGs).
d. PPS provides money to the patient for health promotion use.
8.A 74-year-old patient was admitted to the hospital with diabetic ketoacidosis. How will the hospital be reimbursed by Medicare?
a. Based upon the diagnostic-related group
b. Based upon the cost of care
c. Based upon the actual length of stay
d. Based upon the number of medications
9.A patient tells the nurse that he or she does not understand the purpose of capitation. What is the nurse’s best response?
a. To provide high-quality care at the highest cost to the hospital, not the patient
b. To provide the least expensive care for patients regardless of outcomes
c. To build a payment plan that includes the best standards of care at the lowest cost
d. To ensure that all patients receive the same care for the same cost in all hospitals
10.A single mother with three children uses the public health department services in the county to immunize her children. Which level of health care did the mother use?
a. Continuing care
b. Preventative care
c. Secondary acute care
d. Restorative care
Chapter 04: Community-Based Nursing Practice
1.A student nurse is beginning the community-based primary care rotation. The student nurse anticipates that the assignment in community-based health care will most likely be at which organization?
a. An acute care hospital
b. A rehabilitation hospital
c. A nursing home
d. A high school
2.A nurse is practicing as a community health nurse. What is the primary focus of care for this nurse?
a. Providing care to subpopulations
b. Practicing care in existing services
c. Being a specialist in public health science
d. Having a case management certification
3.A community health nurse is using the goals of the Healthy People 2020 to focus care. Which goal is the priority?
a. To increase the life expectancy of people in the United States
b. To increase the health status of people throughout the world
c. To eradicate the human immunodeficiency virus (HIV)
d. To reduce health care costs
4.The teen pregnancy rate in one community significantly increased; as a result, the school system was seeing an increase in the dropout rate of teenage mothers. A nurse recently worked with the local school system to develop a day care program for the children of high school students so that they could return to school. Which technique did the nurse use?
a. Incorporating immunizations for the infants and mothers
b. Responding to changes within the community
c. Influencing chronic environmental factors
d. Managing disease
5.A nurse notices that a particular area of the community had food poisoning. The nurse collected data from the people who were affected, identified a local restaurant that served all the people, and determined it was the chicken dish that caused the poisoning. Which community health nurse competency did the nurse demonstrate?
a. Public health
d. Case manager
6.Upon assessment the nurse finds the following: a 46-year-old immigrant patient from the Czech Republic has diabetes and hypertension and just recently moved in to live with a family member who must travel frequently. The patient speaks English very well. The community health nurse knows that this patient may be vulnerable because of which assessment finding?
b. Immigration status
7.A nurse wants to use the most important competency in community nursing. Which competency should the nurse use?
b. Case manager
8.A community health nurse is assessing the structure of a community. Which component will the nurse assess?
a. Available health systems
b. Available colleges and schools
c. Geographical boundaries
d. Predominant religious groups
Chapter 05: Legal Principles in Nursing
1.Which information indicates the nurse has an accurate understanding of the State Nurse Practice Act?
a. It is a federal senate bill.
b. It is a law enacted by the federal government.
c. It is a statute enacted by state legislature.
d. It is a judicial decision.
2.A student nurse must pass the NCLEX® before practicing as a registered nurse. NCLEX®stands for __________ Examination.
a. Nursing Council of Licensing
b. Nightingale Code of Licensure
c. Nursing Code of Licensure
d. National Council Licensure
3.A registered nurse was accused of patient abandonment when the nurse became angry, quit the job, and left the hospital before the end of the shift. This is an example of violating legal standards/guidelines set by which organization?
a. The State Department of Health
b. The Joint Commission
c. The State Board of Nursing
d. The National League for Nursing
4.An RN suffers from chronic back pain that was the result of an injury suffered when pulling a patient up in bed. The nurse is addicted to pain medication and has recently been accused of stealing narcotics. This is an example of which violation of the law?
5.The nurse is caring for a patient who refuses to cooperate for a dressing change. The nurse tells the patient that he or she will tie the patient down if the patient does not hold still. Which action did the nurse commit?
b. Unintentional tort
6.Which chart entry by a nurse would require follow up?
a. 0815 Patient found on floor.
b. 0816 Patient assessed and helped back to bed.
c. 0818 Physician notified of incident.
d. 0820 Occurrence report completed.
7.To establish the elements of malpractice against a nurse, which must be proved by the patient?
a. The patient must have been harmed as a result of the injury.
b. The patient must have paid for the health care services.
c. The patient must show evidence of malicious intent.
d. The patient must demonstrate personal accountability.
8.Which behavior is the best way for a nurse to avoid being liable for malpractice?
a. Purchasing quality malpractice insurance coverage on a yearly basis
b. Practicing nursing that meets the generally accepted standard of care
c. Not sharing his or her last name with patients and families
d. Not delegating any tasks to unlicensed assistive personnel
9.A nurse wants to follow nursing standards of care. Which document should the nurse follow?
a. World Health Organization guidelines
b. National League for Nursing brochure
c. Health care facility’s written procedure manual
d. Department of Health and Human Services guidelines
10.What is the nurse’s best proof against malpractice?
a. The nurse supervisor’s memory of the event
b. Recorded documentation written carelessly
c. The nurse’s memory of the event
d. Recorded documentation of nursing care
Chapter 06: Ethics
1.A 73-year-old patient with hypertension is awaiting a triple cardiac bypass surgery. The patient is hard of hearing and did not understand what the surgeon said regarding the surgery. The daughter is concerned that the patient does not understand the risks of the surgery. If not clarified, this would be a violation of what principle?
2.A 45-year-old mother of two children has cirrhosis of the liver and is on a waiting list for a liver transplant. She had to meet certain criteria to be eligible to receive a liver. She understands that she is next on the list for a donor liver that matches. This is an example of which ethical principle?
3.A registered nurse who works on an oncology unit discussed pain control options that the primary health care provider had ordered with a patient undergoing treatment for pancreatic cancer. The patient requested that the intravenous (IV) pain medication be given on a regular basis. The nurse agreed to provide the IV pain medication as requested and continued to reevaluate the pain levels. The nurse is following which ethical principle?
4.A registered nurse knows that an oncology patient undergoing a bone marrow transplant will spend weeks in isolation in the hospital. During that time the patient will be at an increased risk for infection and other complications and may not recover. The nurse ensures that the patient has been given information regarding the risks and potential benefits of the procedure. The nurse is following which ethical principle?
5.A registered nurse is working on a pediatric oncology unit and caring for four children undergoing chemotherapy. Today a new nursing assistive personnel (NAP) who has passed a competency examination is assigned to the team. The nurse will delegate a portion of the fundamental nursing tasks to the NAP during the shift, but realizes that he or she is still responsible for his or her own actions and is accountable for the care. The nurse is following which principle of behavior?
a. Ethical dilemma
b. Code of ethics
d. Feminist ethics
6.The mother of a 45-year-old patient is a retired physician and requests to discuss the patient’s plan of care with the nurse caring for the patient. What is the nurse’s best response to this request?
a. “I will need to ask permission from my supervisor before I can share that information.”
b. “I will show you the chart, just follow me and we can discuss your questions and concerns.”
c. “I would suggest that you leave me out of your family problems. I am here to care for the patient.”
d. “I will have to get the patient’s permission before I can share that information.”
7.A nurse bases ethical decisions on the effect, or consequences, an act will have and uses the following guidelines: the greatest good for the greatest number of people. Which ethical system is the nurse using?
d. Ethics of care
8.A registered nurse has recently been reassigned to the gynecology unit at the hospital. The nurse is strongly against abortion because of religious beliefs and contacts the nursing supervisor regarding the assignment because the unit cares for women who are undergoing abortions. The nurse is having a conflict in which area?
c. Social networking
9.A 9-year-old patient was severely burned and has been undergoing whirlpool treatments to debride the wounds. The patient is crying and does not want to go to the physical therapy department for treatment. The registered nurse caring for the patient knows that, even though it is uncomfortable, the patient needs to have the therapy for the wounds to heal properly. The nurse is demonstrating which ethical principle?
10.Although a registered nurse has been working for several years as a staff nurse on an adult oncology unit, the nurse recently transferred to a pediatric unit in the hospital. The nurse will be in orientation for several days to learn about the different systems and will need to demonstrate proficiency in various pediatric areas such as medication administration. Which behavior is the nurse demonstrating?
Chapter 07: Evidence-Based Practice
1.Which organization is preparing future nurses to have the knowledge, skills, and attitudes (KSAs) of evidence-based practices necessary to continuously improve the quality and safety of the health care systems within which they work?
a. The Joint Commission
b. Quality and Safety Education for Nurses’ (QSEN)
c. The National Database of Nursing Quality Improvement (NDNQI)
d. The Agency for Health care Research and Quality (AHRQ)
2.A registered nurse questioned the nurses on the neonatal intensive care unit about the practice of kangaroo care for neonates. The nurse had read literature supporting the practice, but the nurses that work on the neonatal unit stated that they had never done anything like that at their institution. The nurse continued to ask questions and began a literature review. Which behavior was the nurse demonstrating?
b. Peer review
c. Evidence-based practice
d. Process measurement
3.A registered nurse wants to review the latest information regarding prevention of a health care acquired infection. Where is the best place for the nurse to obtain this information?
a. Online information
b. Peer-reviewed nursing journal
c. Latest edition of a nursing textbook
d. Most recent edition of a popular magazine
4.A 15-year-old patient was admitted to the hospital with a bowel obstruction. The patient underwent surgery and was experiencing postoperative pain. The nurse caring for the patient had recently read a research article in which a study had been done with neonatal (infant) patients and the use of therapeutic touch to assist with pain control. Which factor is mostimportant for the nurse to consider in this case when applying research to clinical practice?
a. The patient’s gender
b. The patient’s preference
c. The patient’s allergies
d. The patient’s roommate
5.A nurse is using evidence-based practice (EBP) to provide care. Which action should the nurse take first?
a. Collect the most relevant and best evidence.
b. Integrate evidence with one’s clinical expertise.
c. Critically appraise the evidence gathered.
d. Ask a clinical question.
6.The nurse manager of a 30-bed medical surgical unit has noticed that the fall rate of postoperative patients has increased in the past 2 months. The nurse manager wants to address this situation using evidence-based practice. Which type of trigger did the nurse manager use?
a. Literature-focused trigger
b. Problem-focused trigger
c. Knowledge-focused trigger
d. Expectations-focused trigger
7.A registered nurse who works for a surgical intensive care unit (ICU) has recently read several articles in professional nursing journals about the use of quiet time in the ICU to enhance patient outcomes. The nurse would like to apply the research findings to the unit. How did the nurse formulate the clinical question?
a. Measurement-focused trigger
b. Problem-focused trigger
c. Knowledge-focused trigger
d. Expectations-focused trigger
8.A nurse’s manager has suggested that a nurse formulate a PICO question to clarify the topic before doing a literature review. When the nurse asks what the acronym PICO stands for, how should the nurse manager respond?
a. Policy, information, comparison, outcome
b. Patient, information, collection, outcome
c. Patient, intervention, comparison, outcome
d. Policy, intervention, communication, outcome
9.A nurse working on a PICO question has found a large amount of literature available on the topic with multiple studies that have been published. Which type of study should have the bestevidence?
a. Meta-analysis of randomized control trials
b. Opinion of an expert committee
c. One well-designed randomized control trial
d. Systematic review of descriptive and qualitative studies
10.A registered nurse is concerned about the patients’ perceptions and feelings about the quality of life that they experience after a diagnosis of liver cancer. Which is the most appropriate type of research study the nurse should use to gather information about this situation?
a. Quantitative study
b. Randomized trial
c. Qualitative study
d. Case controlled study
Chapter 08: Critical Thinking
1.A registered nurse is caring for a patient in the trauma unit who had been involved in a motor vehicle accident. Although the patient denied pain, during the nurse’s assessment, the nurse observed that the patient groaned when moving and was protective of the right arm. The nurse believed the patient had pain and reported it to the primary health care provider, who ordered a radiograph (x-ray) of the right arm. The radiograph revealed a fractured arm. Which technique did the nurse use?
b. Critical thinking
2.A registered nurse is caring for a postoperative patient whose systolic blood pressure has dropped 10 points during the shift. The nurse remembers that this was similar to a situation that happened in the past when a patient developed an internal bleed. Based upon the nurse’s thoughts, which skill did the nurse use?
b. Critical thinking
c. Nursing process
3.A nurse is admitting a 73-year-old woman with a fractured ulna and radius to the trauma unit of the hospital. The patient’s daughter and son-in-law are present. The nurse notices that the patient does not make eye contact when answering questions and the nurse senses that something is not right about the situation. Which technique did the nurse use?
b. Critical thinking
c. Nursing process
4.A student nurse is administering an enema with an instructor in the room. The patient states that he or she can no longer hold the enema solution. The student nurse acknowledges the patient’s request and begins to tell the patient to go to the bathroom but asks the instructor if this is OK. The instructor suggests that the patient wait a few minutes to give the enema solution time to be absorbed into the bowel. In this situation the student nurse demonstrates what level of critical thinking according to Kataoka-Yahiro and Saylor’s model?
a. Level 1: Basic
b. Level 2: Complex
c. Level 3: Commitment
d. Level 4: Expert
5.A nurse is describing risk taking, creativity, and integrity in nursing care. What is the nurse explaining?
a. Attitudes of critical thinking
b. Competencies of critical thinking
c. Standards for critical thinking
d. Nursing process for critical thinking
6.A nurse is using the scientific method to solve a patient situation. Which action should the nurse take first?
a. Collect data.
b. Identify a problem.
c. Formulate a question.
d. Evaluate the results.
7.A registered nurse is explaining a procedure to a patient who speaks another language. Which action by the nurse reflects critical thinking?
a. Teach with unfamiliar explanations.
b. Explain using medical jargon.
c. Use vague descriptions.
d. Obtain an interpreter.
8.A patient receiving blood after an abdominal surgery notified the nurse that the IV pump was alarming. The nurse checked the pump and determined that the tubing was kinked. The tubing was straightened out and the nurse left the room. Five minutes later the IV pump again alarmed. The nurse returned to find the tubing was again kinked. On further investigation, the nurse discovered that the IV tubing had become twisted. This is an example of which behavior on the part of the nurse?
a. Effective problem solving
b. Diagnostic reasoning
c. Scientific method
d. Commitment level of critical thinking
9.A patient on a pediatric unit who underwent an appendectomy for a ruptured appendix 3 days ago complains of acute pain and has a high fever. The nurse is concerned that the patient may have an infection and notifies the primary health care provider of the change in the patient’s condition. This concern is based on the nurse’s experience as a pediatric nurse. The nurse’s ability to make a tentative conclusion regarding this patient’s situation based on observed data is known as what?
a. Scientific method
b. Clinical inference
c. Effective problem solving
d. Data collection
10.A patient with cancer is undergoing outpatient chemotherapy. The clinic nurse notes that the patient’s white blood cell count is very low and has little energy. The plan of care is based upon the nursing diagnosis Risk for Infection. The nurse provides patient teaching in order to reduce the risk for infection. The nurse is using which skill in this situation?
a. Medical diagnosis
b. Scientific method
c. Diagnostic reasoning
d. Data collection
Chapter 09: Nursing Process
1.A nurse is collecting data on a patient who is being admitted into hospice care. The nurse collects data from both the patient and the family so that a clear picture of the patient status is obtained. The nurse is currently involved in which step of the nursing process?
2.The nurse is admitting a patient to the unit and asks the patient about the health history. The nurse is engaged in which component of the nursing process?
3.A postoperative patient is continuing to have incisional pain. As part of the nurse’s assessment, the nurse notes that the patient is grimacing when he or she changes position. The patient’s grimace can be useful in the assessment and can be described as which of the following?
d. Health pattern
4.A postoperative patient has denied the need for pain medication. The nurse has noted that the patient describes the pain as a “1” on a 0 to 10 scale. The nurse also notes that the patient grimaces when he or she changes position and guards the incision. The nurse believes that the patient is experiencing pain based on the information gathered in the assessment. What is this phenomenon known as?
d. Health pattern
5.A nurse is collecting data during the assessment of a patient. During the assessment, the nurse collects both subjective and objective data. Which information should the nurse consider as subjective data?
a. Heart rate of 96
b. Incisional erythema
c. Emesis of 150 mL
d. Sharp, burning pain
6.The nurse has just completed an assessment on a patient with a fractured right femur. Which data will the nurse categorize as objective?
a. The patient’s toes of right foot are warm and pink.
b. The patient reports a dull ache in the right hip.
c. The patient says feels tired all the time.
d. The patient is concerned about insurance coverage.
7.A student nurse is responsible for assessing a patient, who is abrupt and requests that the assessment be done later by a nurse. As the student nurse charts the interaction, which statement is the best way to document what happened?
a. Appears to be in pain as evidenced by grouchy behavior
b. Behavior is inappropriate, requests registered nurse do the assessment
c. States, “I want a registered nurse to do my assessment”
d. Is grumpy, registered nurse notified
8.A mother of five children is admitted to the hospital for abdominal pain. The nurse asks a series of questions before performing a physical assessment. The patient answers the questions. When asking the patient some other questions, the patient’s spouse starts to answer. As the admission process progresses and the nurse gathers subjective data, the nurse requests that the patient answer the next questions. What is the rationale for the nurse’s behavior?
a. The patient is exhibiting confusion.
b. The spouse is being obnoxious.
c. The patient is the best source of information.
d. The spouse is too controlling.
9.A 2-year-old patient is being admitted to the outpatient surgery for a tonsillectomy. Which will provide the best primary source of information for what comforts the patient when stressed?
a. Patient chart
10.A nurse is interviewing a patient being admitted to the hospital for surgery. During the interview, the nurse introduces self and explains that will be gathering some information. The nurse is in which phase of the interview?
Chapter 10: Informatics and Documentation
1.A nurse works at a health care organization that is accredited by The Joint Commission. What is the best method for this health care organization to demonstrate that it is providing quality patient care?
a. Cost of care per patient day
b. Number of registered nurses
c. Absence of sentinel events
d. Documentation audits
2.A registered nurse is caring for an older adult patient with lung cancer. The daughter, who is also a nurse, asks to see the chart. What is the nurse’s best response?
a. “Come with me and we will look at it together.”
b. “I’m sorry; this information is confidential.”
c. “Let me ask my supervisor if it is okay.”
d. “You should know better than to ask me that.”
3.A nursing student is working on a clinical assignment. Which information is acceptable for the student to write on the clinical care plan that will be given to the instructor?
a. Patient room number
b. Patient date of birth
c. Patient medical record number
d. Patient nursing diagnosis
4.A nurse is working in an agency with standards that require a nurse’s documentation to be within the context of the nursing process. The nurse is working for which agency?
a. Centers for Disease Control and Prevention accredited hospital
b. World Health Organization hospital
c. The Joint Commission accredited hospital
d. Agency for Healthcare Research and Quality hospital
5.Which information indicates the nurse has a correct understanding of the purpose of a patient’s medical record?
a. To invoice the nurse for reimbursement
b. To protect the patient in case of a malpractice suit
c. To ensure everyone is working toward a common goal of providing safe care
d. To contribute to a worldwide databank for trends in health care
6.A nurse is frustrated about the lack of staffing for the shift. When one of the patients fell and broke a hip, the nurse documented the incident in the patient’s chart. Which entry is the bestway that the nurse should document what happened?
a. “Patient stated that fell while going to the bathroom. Physician notified.”
b. “Nobody available to answer call bell; patient got up on own and fell.”
c. “Patient fell because of unsafe staffing levels on unit.”
d. “Patient waited as long as possible but nobody there to help and fell.”
7.A registered nurse is documenting patient assessments. Which documentation written by the nurse is most clear?
a. “Seems comfortable at this time.”
b. “Is asleep, appears not to be experiencing pain.”
c. “Apparently is not in pain because patient didn’t rate it high on the scale.”
d. “States pain is a 2 on a 0 to 10 scale.”
8.A patient states that he or she is experiencing pain in the lower back. What is the best way for the nurse to document this subjective information?
a. “Seems back is hurting.”
b. “States ‘My lower back hurts.’”
c. “Grimaces when moving; I believe patient has lower back pain.”
d. “Appears to be uncomfortable with lower back pain.”
9.Which documentation by the nurse best describes patient data?
a. “Moderate amount of clear yellow urine voided.”
b. “Voided 220 mL clear yellow urine.”
c. “A small amount of urine voided into absorbent pad.”
d. “Patient incontinent of urine.”
10.Which entry by the nurse demonstrates the most accurate and safe documentation of patient care?
a. “Sm. amt. of emesis.”
b. “150 mL of cloudy dark yellow urine.”
c. “Had a good day.”
d. “Looks bad.”
Chapter 11: Communication
1.A nurse who works for an oncology unit is preparing to bathe a patient who recently underwent surgery to remove an abdominal tumor. Before beginning the bath, the nurse explains the procedure. Which of the following best describes the nurse’s communication role?
2.A patient is being cared for by a nurse. The patient has questions regarding what time the surgery is scheduled. When the nurse responds to the question, the nurse is assuming which communication role?
3.A registered nurse is a new nurse manager who needs to council an employee regarding attendance. Because the nurse manager is new to the position, the nurse is rehearsing what is planning to say to the employee before the meeting. The nurse is using which form of communication?
4.A nurse is working in a busy emergency department of an urban hospital. The family of a patient brought in by ambulance asks the nurse what the doctor meant when he or she said that the patient was coding. In this situation, the word coding is an example of which of the following?
a. Denotative meaning
b. Connotative meaning
5.A patient asked a nurse when the primary health care provider would make rounds. The nurse was taking another patient for a stat test and replied very quickly, “I have no idea.” The patient most likely interpreted the nurse as uncaring because of which factor?
d. Personal appearance
6.A 9-year-old patient who is hospitalized for bowel surgery appears very frightened. To appear less threatening to the child, which action should the nurse take?
a. Stand over the bed when talking to the patient.
b. Sit in a chair next to the bed when talking to the patient.
c. Maintain constant eye contact with the patient at all times.
d. Stay within 12 inches of the patient when talking to the patient.
7.A nurse went into a patient’s room at 0900, shortly after the patient was told that he or she had liver cancer. The patient asked the nurse to stay because he or she did not want to be alone. The nurse stood very close to the patient, held the patient’s hand, and told the patient that he or she had plenty of time. A few minutes later, the nurse thought to check the time on the wristwatch because the nurse was supposed to take another patient for a test at 0945. The patient saw the nurse look at the wrist watch and told the nurse it was now okay to be alone. What was the most likely reason the patient said it was okay for the nurse to leave?
a. Invasion of personal space
b. Verbal communication
c. Nurse’s gesture
8.A registered nurse is caring for a postoperative patient who is experiencing respiratory distress after the administration of pain medication. The nurse called the patient’s primary health care provider immediately. The information regarding the patient was conveyed using the SBAR format. Which information did the nurse convey to the primary health care provider?
a. Situation, background, assessment, recommendation
b. STAT, background, assessment, requirement
c. Status, background, analysis, recommendation
d. Setting, belief, assessment, requirement
9.Which behavior by the nurse would be considered most professional?
a. Addressing a patient by “dear”
b. Wearing small earrings
c. Being task oriented
d. Avoiding troublesome patients
10.When caring for a patient from another culture, what is the best strategy for the nurse to use in communicating with the patient?
a. Using a cultural joke to break the ice
b. Stereotyping the patient within his or her culture
c. Considering the context of the patient’s background
d. Assuming the patient or the family member speaks English
Chapter 12: Patient Education
1.A nurse has been asked to prepare patient education for Spanish-speaking patients regarding diabetes. This information will be available to patients in the diabetes clinic. What is the primarygoal for this patient education?
a. To reduce the legal liability of the clinic
b. To teach Spanish-speaking patients some English
c. To assist Spanish-speaking patients to reach optimal health
d. To provide information so they can make a decision between oral and injectable medications
2.A patient with newly diagnosed diabetes is being discharged from the hospital. The patient will be going to an outpatient diabetic center to learn more about diet, exercise, disease management, and insulin administration. Which statement made by the patient indicates that effective teaching can take place?
a. “I don’t want to get sick again so I will do what is needed.”
b. “I am so happy to be going home so I don’t have to eat hospital food anymore.”
c. “I will be glad when they find a cure for diabetes.”
d. “I don’t think I will need to take insulin for very long because I already feel better.”
3.The parents of a 3-month-old infant are preparing to take their child home from the hospital. Before being discharged, the parents must be educated on infant CPR. What is the mostappropriate learning objective for this situation?
a. The parents will be able to understand CPR skills.
b. The parents will demonstrate infant CPR skills.
c. The infant will not require further hospitalization.
d. The parents will call the hospital for help.
4.Which finding will best indicate to the nurse that the teaching about a dressing change was successful?
a. The patient understands how to change an abdominal dressing.
b. The patient acknowledges the principles of an abdominal dressing change.
c. The patient correctly demonstrates an abdominal dressing change as taught.
d. The patient states, “Yes, I know how to change the dressing.”
5.A patient recently had a stroke and suffered right-sided weakness. The patient is being discharged from a rehabilitation hospital after learning to use a walker. Which learning domain was primarily used to teach the patient to be independent with the walker?
6.Which patient is the most likely to be motivated to learn?
a. A 23-year-old smoker being taught about weight control
b. A 45-year-old man being taught about importance of prostate cancer screening
c. A 63-year-old knee replacement patient being taught postsurgical knee rehabilitation
d. A 15-year-old girl being taught about safe sex
7.A postsurgical patient is being taught about wound care before being discharged from the hospital and is in a semiprivate room with another patient. The other patient is upset with a family member and is crying. The television is on to try to provide some distraction from the roommate. Which action should the nurse take to best facilitate patient education for wound care?
a. Explain to the patient that everything is in the handout.
b. Take the patient to a quiet area to do the patient teaching.
c. Ask the roommate to please be considerate of the patient because patient education is occurring.
d. Request that a home health nurse follow up with the patient at home to teach about wound care.
8.A nurse will be teaching a prepared childbirth class for the first time at a neighborhood church. The nurse has gone to the church to determine which room would be best suited to teach a group of six couples. Which room configurations would be most appropriate for teaching this group?
a. A small carpeted room with no furniture
b. A large auditorium with a stage and theater-style seating
c. A lunchroom with stationary tables and chairs
d. A Sunday-school classroom with tables and chairs
9.A patient who is a migrant farm worker did not graduate from high school and speaks English as a second language. The nurse will be providing discharge teaching after a hysterectomy. The nurse is concerned about the patient’s ability to understand the discharge instructions. Which of the following should be of most concern in this situation?
b. Developmental stage
c. Health literacy
d. Psychomotor learning
10.A patient was recently diagnosed with heart failure. The health care provider has ordered a low-sodium diet. A nurse is planning patient education for diet instruction. Which information should the nurse present first?
a. How much daily intake of sodium is recommended
b. How to read food labels at the grocery store
c. How to understand the metric system of measurement
d. How to cook different meals with low-sodium foods
Chapter 13: Managing Patient Care
1.A registered nurse works as a case manager in the local hospital. What primary role will the nurse be fulfilling?
a. Coordinating care for patients with a specific condition
b. Only working with primary health care providers
c. Directing care of all patients in the hospital setting
d. Providing direct care to specific patients
2.A nurse manager is interested in supporting more involvement of the staff nurses on the unit. What is one approach the nurse manager can take to facilitate this involvement?
a. Inform the staff of decisions made.
b. Use decentralized management.
c. Avoid unit goals.
d. Discourage input from other personnel.
3.A primary nurse caring for a patient with kidney failure develops a plan of care for the patient after consulting with the patient on the best way to manage the patient’s diet. As the staff delivers the plan of care the primary nurse evaluates whether the plan is working. Which attribute is the primary nurse displaying?
b. Interprofessional collaboration
d. Staff involvement
4.A registered nurse delegates vital signs on a patient to the unlicensed assistive personnel (UAP). The nurse reviews the documented vital signs from the UAP to determine if they are within normal parameters for the patient. The nurse in this example is demonstrating which attribute when following up on the vital signs?
a. Interprofessional collaboration
b. Staff education
5.A nurse is using SBAR. Which information will the nurse report for the “B”?
a. The patient had a broken right leg with a cast applied 2 days ago.
b. The toes are cool and pale.
c. The patient is reporting severe pain—10 out of 10—even after pain medication was given.
d. The nurse requests that the primary health care provider examine the patient.
6.A patient admitted to the intensive care unit was placed on ventilator support. The nurse caring for this patient identified on the plan of care that one of the outcomes was that the patient would not develop ventilator-acquired pneumonia (VAP). To achieve this outcome, the nurse delegates the following to the unlicensed assistive personnel: “Please perform oral care on the patient every 2 hours. In this situation oral care would include using the special swabs we have for our patients on VAP precautions so we can prevent pneumonia.” Which of the five rights of delegation did the nurse use?
a. Right route
b. Right direction/communication
c. Right dose
d. Right supervision
7.A patient is admitted to the hospital for hip replacement surgery after falling at home and breaking a hip. The patient has developed pneumonia while in the hospital and has required frequent suctioning from the tracheostomy. The nurse decides to delegate I&O to the unlicensed assistive personnel but does not delegate suctioning. This is an example of which of the five rights of delegation?
a. Right task
b. Right direction/communication
c. Right intervention
d. Right supervision
8.A nurse is in the acute care unit caring for a 67-year-old patient with a varicose ulcer in the right lower leg. The wound has been healing well but will require a dressing change during the shift. What priority level should the nurse classify this problem?
a. High priority
b. Low priority
c. Mid priority
d. Intermediate priority
9.A new nurse would like to work where clinical performance is valued and in an environment that uses evidence-based practice. Given the new nurse’s goals, which organization would be the best for this nurse?
a. Private hospitals
b. Community hospitals
c. Not-for-profit hospitals
d. Magnet-designated hospitals
10.A nurse has worked in a variety of nursing areas and would like to find a unit within the hospital that mirrors the nurse’s own professional values. The best way for the nurse to find a unit that would be a good fit is for the nurse to examine which document?
a. Hospital mission statement
b. Unit policies and procedures
c. Unit philosophy of care
d. Hospital vision statement
Chapter 14: Infection Prevention and Control
1.The nurse has had a nasal culture performed and has been found to be MRSA positive. Because the nurse has not been ill from the bacteria, the nurse’s nasal cavity can best be described as a:
a. susceptible host.
c. portal of entry.
d. mode of transmission.
2.The nursing assistive personnel (NAP) is working on a busy pediatric unit in a hospital. She has a cut on her hand that has not been kept covered. It hurts her to wash her hands or sanitize them, so she has been providing patient care without performing hand hygiene. Several of the patients on the pediatric unit have suffered hospital-associated infections of rotavirus. This was thought to be a result of the NAP’s lack of hand hygiene. This type of disease transmission can best be described as:
b. natural active immunity.
d. natural passive immunity.
3.The nurse is working for a postsurgical unit. He is caring for four postsurgical patients, all of whom have been in the hospital for 3 days or more. Which of the following patients should he be most concerned about regarding a health care–associated infection?
a. An asymptomatic elderly patient with bacteria in his urine
b. A middle-aged woman with a white blood cell count of 10,000/mm3
c. A young adult woman who is 1 day postoperative with redness at incision site
d. A middle-aged man with temperature of 101.3° F and complaints of malaise
4.A patient with a history of poor nutrition and chronic illness is admitted to the medical unit. The nurse caring for this patient is preparing to provide the patient with a bed bath and recalls that normal body flora:
a. are only found on the skin surface.
b. are beneficially aided by the use of antibiotics.
c. are primary sources of infection when balanced.
d. help to maintain health.
5.An emergency department nurse is caring for a patient with a laceration on the lower leg that has become infected. On assessment the nurse realizes that a sign of an inflammatory response consists of:
a. wound blanching.
b. coolness at the site of injury.
c. a vascular reaction that delivers fluid, blood, and nutrients to the area.
d. decreased pain sensation.
6.There was an outbreak of Salmonella poisoning at a nursing home. Several residents were hospitalized as a result of their infections. What is the best term to describe this infection?
a. Exogenous infection
b. Endogenous infection
c. Community-acquired infection
7.A nurse is assigned to multiple patients on a busy surgical unit. To minimize the onset and spread of infection, the nurse should:
a. insert indwelling catheters to prevent incontinence.
b. use aseptic technique when performing procedures.
c. use barriers sparingly to reduce the patient’s sense of isolation.
d. keep mucus membranes dry to prevent maceration.
8.The infection control nurse is presenting an in-service presentation on infection prevention and control. A participating nurse identifies what patient as most susceptible to acquiring an infection?
a. An 81-year-old patient with a fractured hip
b. A 10-month-old patient with a first-degree burned hand
c. A 40-year-old patient with a recent uncomplicated laparoscopic cholecystectomy
d. A 16-year-old athlete with a repair of the medial collateral ligament
9.A senior nursing student is working on a community health project for the local homeless shelter. There are several indigent men who come to the shelter in cold weather to sleep for the night. The student nurse knows that these men do not bathe on a regular basis. One of the men has been sick several times recently with skin infections. Which of the following is the best way for the student nurse to explain the importance of personal hygiene to this individual?
a. “You don’t have to shower every day. You only need to take a shower when you feel like you’re going to be sick.”
b. “Take a shower. If you don’t take a shower, you will continue to get sick.”
c. “Showering regularly will remove germs that cause skin infections. What do you think we should do about these skin infections of yours?”
d. “Showering with warm water is enough to wash away bacteria. Soap is not needed if you don’t like it.”
10.The student nurse who is developing a plan of care for a postoperative patient who underwent abdominal surgery to remove a tumor. The student has chosen Risk for Infection as a nursing diagnosis. Which of the following is the most appropriate goal for this diagnosis?
a. The patient’s wound drainage will decrease in 2 days.
b. The patient will report decrease in incisional pain by discharge.
c. The progression of infection will be controlled or decreased.
d. The patient will describe signs/symptoms of wound infection.
Chapter 15: Vital Signs
1.The nursing student is obtaining the patient’s vital signs. The patient has gone to the clinic seeking help because she is having chest pain. Which of the following vital signs are most important to obtain?
a. Temperature, pulse, respirations
b. Temperature, pulse, respirations, oxygen saturation
c. Temperature, pulse, respirations, blood pressure, oxygen saturation
d. Temperature, pulse, respirations, blood pressure, oxygen saturation, pain
2.Upon a patient’s admission to the nursing unit, the registered nurse delegated to the nursing assistive personnel to take her vital signs. What is the registered nurse’s responsibility regarding delegating this task?
a. This is inappropriate delegation; the nurse should always take the vital signs.
b. Have the NAP repeat the measurement if vital signs appear abnormal.
c. The nurse should review and interpret the vital sign measurements.
d. This task has been delegated so the nurse is not responsible.
3.A 36-year-old African-American patient has been admitted to the hospital with diabetic ketoacidosis. The nurse who is admitting him notes that his blood pressure is 164/98. Which of the following should the nurse do next?
a. Call the health care provider because the patient’s values differ from the standard range.
b. Immediately call the health care provider and request antihypertensive medication.
c. Ask the patient what his blood pressure normally measures for comparison.
d. Do nothing; this is within a normal range for a patient with diabetic ketoacidosis.
4.A nurse is working on a medical unit in an acute care hospital. One of the patients she is caring for has a fever of 100.6° F. Which of the following is the best reason why the patient should not receive an antipyretic at this time?
a. A temperature of 100.3° F is within the normal range.
b. Shivering is a more effective way to dissipate heat energy.
c. Corticosteroids are safer to use than antipyretics.
d. Mild fevers are an important defense mechanism of the body.
5.A nursing assistant asks the nurse why she needs to bathe a febrile patient. The best response is that this intervention increases heat loss through which of the following?
6.A 6-year-old was taken to the hospital after having a seizure at home. The patient’s mother tells the nurse that she has been ill for the past week and has had a fever with nausea and vomiting. The patient’s mother believes that the seizure was caused by a fever of 99.5° F, which the patient had during the course of her illness. What is the nurse’s best response?
a. “With a temperature that high, we can only hope that there is no permanent damage.”
b. “Fevers in this range are part of the body’s natural defense system”
c. “Febrile seizures are common in children Nancy’s age.”
d. “The child will need antibiotics. Does she have any allergies?”
7.A 5-year-old child was admitted for a diagnosis of meningitis with a fever of 104.5° F and nuchal rigidity. She responded to antipyretics that were ordered. In addition, the patient’s mother was asked to help reduce the fever by limiting the number of blankets covering the patient. After interventions, the child’s temperature is 100.5° F. The nurse recognized that the mother has an understanding of the patient’s condition when she states which of the following?
a. “The high temperature is useful in fighting bacteria and viruses as long as it’s not too high.”
b. “You need to get her temperature down quickly. She’s so uncomfortable.”
c. “Her fever is dropping because she is shivering. She must be cold.”
d. “She probably picked up a bacteria. That’s what kids do. That’s why they get infected.”
8.The young mother of an 8-month-old patient brought her daughter to the clinic after taking the little girl’s temperature rectally and obtaining a reading of 100.4° F. The mother was concerned that her daughter might be ill. Which of the following is the best response?
a. “Children usually run lower rather than higher temperatures when ill.”
b. “Because of her age, it is probably a bacterial infection.”
c. “Rectal temperatures are higher than temperatures obtained orally.”
d. “When taking multiple temperatures, the sites should be rotated.”
9.A 6-year-old child was taken to the after-hours pediatric clinic with a fever and a rash. She had been seen by her pediatrician earlier in the day and had been given a prescription for an antibiotic. Later that evening she developed a fever and a rash on her abdomen. The nurse who assesses the child in the clinic suspected the symptoms are associated with which of the following?
b. An allergic response to the prescribed medication
c. Febrile seizures
d. Fever of unknown origin (FUO)
10.A 56-year-old grandmother has been admitted to the hospital with a fever of 103.2° F after caring for her 5-year-old granddaughter who also developed a fever. The health care provider has ordered blood cultures, antibiotics, antipyretics, a clear liquid diet, and a chest radiograph. Which of the orders should the nurse do first?
a. Administer antibiotic.
b. Administer antipyretic.
c. Draw blood cultures.
d. Apply water cooled blankets.
Chapter 16: Health Assessment and Physical Examination
1.While auscultating a patient with pneumonia, a nurse hears low-pitched, rumbling coarse sounds during inspiration and expiration. These sounds can best be described as which of the following?
d. A friction rub
2.The nursing student is performing a physical examination on a 6-year-old patient who is being admitted to the pediatric unit with abdominal pain. When would be the most appropriate time in the examination to palpate the patient’s abdomen?
a. Palpate tender areas last.
b. Palpate tender areas first to get it over.
c. Palpate tender areas before inspection.
d. Palpate before auscultation.
3.The registered nurse is precepting a first-year nursing student. She is demonstrating how to appropriately auscultate. Auscultation is defined as which of the following?
a. Listening with a stethoscope to sounds produced by the body
b. Tapping the body with the fingertips to produce a vibration
c. Becoming familiar with the nature and source of body odors
d. Using the hands to touch body parts to make a sensitive assessment
4.A patient is being seen in the health clinic for abdominal pain. The nurse will be doing a physical assessment. After using light palpation to examine the patient, the nurse uses deep palpation. With deep palpation the nurse does which of the following?
a. Performs a completely safe method of examination
b. Should use two hands only
c. Uses the upper hand to exert an upward pressure
d. Can examine the condition of organs
5.A nurse is preparing to perform a physical examination on a patient who has mobility issues. In preparing for the examination, the nurse should do which of the following?
a. Be sure that a well-equipped examination room is available.
b. Tune the radio to the nurse’s favorite station to relax the patient.
c. Perform thorough hand hygiene before preparing equipment.
d. Instruct the patient on the safest way to transfer onto the examination table.
6.A registered nurse is preparing to perform a physical examination on a 5-year-old child. To make the child feel safer during the examination the nurse should do which of the following?
a. Examine the child’s fingernails before listening to his breath sounds.
b. Question only the child so as to avoid unwanted parental influence.
c. Perform palpation before visual inspection.
d. Calls the parents by their first names to establish a more trusting bond.
7.A nurse is preparing to perform a physical exam on a patient. She has found that it is best to perform the physical with a head-to-toe approach. Why is this important?
a. The head-to-toe format excludes unnecessary body systems.
b. It is a methodical way to include all body systems.
c. It reduces time by allowing examination of only one side.
d. It requires that painful procedures be done first.
8.A nurse is admitting a 79-year-old woman with a fractured hip to the orthopedic unit. Her husband states that she broke her hip when she tripped in her garden. Upon examination, the nurse notes purple, green, and yellow bruises on the back and arms. The patient states that those were received when she fell. The nurse should do which of the following?
a. Ask the husband to wait in the waiting room.
b. Ignore the bruises because the patient has provided an explanation.
c. Realize that the patient may be abused, but that is a family issue.
d. Prepare to discharge the patient home once treatment is complete.
9.The student nurse has been assigned to the pediatric unit for her clinical training this semester. She is assisting with the admission of a 5-month-old infant admitted with pneumonia. The student nurse is responsible for taking the child’s vital signs and weighing and measuring the child. The infant’s mother is very concerned when the student nurse tells her that the baby weighs 14 pounds. The mother states that the baby has lost a significant amount of weight because the previous week she weighed 16 pounds at home. What is the student nurse’s best response to the mother’s concern?
a. “To get an accurate weight, babies are weighed at different times of the day.”
b. “Variations occur because we place our hand firmly on the child.”
c. “Even if we use the same scale, the variation can be 1 to 2 pounds.”
d. “Weight measurements can vary with different scales.”
10.An older adult African-American woman has gone to the clinic where a RN volunteers twice a week. She is a diabetic and has some skin breakdown on the calf of her right leg. Her skin is very darkly pigmented. To best examine the patient’s skin, the nurse should use which of the following?
a. Halogen lighting
b. Artificial warming to increase room temperature
c. Natural sunlight
d. Air conditioning to lower room temperature
Chapter 17: Administering Medications
1.A registered nurse for more than 15 years was concerned when she learned that her hospital was going to let unlicensed nursing assistants start IVs on patients. The nurse knew this was in violation of the scope of nursing practice in her state. Which of the following organizations defines the scope of nursing’s professional functions and responsibilities?
a. The US Food and Drug Administration (FDA)
b. The MedWatch program
c. Employee assistance programs (EAP)
d. State Nurse Practice Acts
2.A 34 year old has been on morphine for 6 months after back surgery and has gone to multiple health care providers to obtain prescriptions. Which term best describes this situation?
a. Medication dependence
b. Medication abuse
c. Medication misuse
d. Medication underuse
3.A patient calls to say that he is unable to pay for the medication from a specific manufacturer that was prescribed. The health care provider gives another name for the medication and suggests the patient look for this name instead. The new name was probably which of the following?
4.A patient is unable to swallow pain medication following oral surgery. What would be the appropriate form of the medication to use to administer the drug using the rectal route?
5.A 12-year-old patient has undergone knee surgery. She has an order for pain medication, which can be given by several different routes. Which of the following routes of administration will provide the fastest pain relief?
6.The nurse is preparing oral medications for a patient. In preparing these medications the nurse is aware of which of the following?
a. Acidic medications are absorbed slowly by the gastric mucosa.
b. Alkaline medications are absorbed rapidly by the gastric mucosa.
c. Solutions and suspensions are more difficult to absorb than capsules.
d. Alkaline medications are absorbed in the small intestine.
7.A nurse is caring for a patient with kidney disease. The nurse needs to make more focused assessments when administering medications to this patient because the patient may experience problems with the process of:
8.The nurse is preparing to give an intramuscular (IM) injection of pain medication. The nurse prepares this medication knowing which of the following?
a. Intramuscular (IM) medications are absorbed faster than subcutaneous medications.
b. Medication absorption is faster with subcutaneous medications.
c. Blood supply to the subcutaneous tissue is richer than to muscle.
d. Muscle tissue has a less developed vascular system than subcutaneous tissue.
9.A nurse is working with the pharmacist to determine when a patient’s medications should be given. Several medications are due to be given in the morning. What is the most important reason to appropriately schedule the patient’s medications?
a. Some medications are absorbed more quickly on an empty stomach.
b. All medications are hindered by the presence of gastric contents.
c. If given at the same time, all medications will be absorbed at the same rate.
d. The nurse must schedule medications to fit the pharmacy’s schedule.
10.A patient is hospitalized with a central nervous system infection that needs to be treated with water-soluble antibiotics. The medications will be instilled into the subarachnoid space via an epidural catheter. Why is this the best route of administration for this patient?
a. Intravenous water-soluble antibiotics cannot pass through the blood-brain barrier.
b. Only water-soluble medications can pass into the brain and cerebrospinal fluid.
c. Older patients better tolerate lipid soluble medications than younger patients.
d. Lipid soluble medications are safer for patients who are pregnant.
Chapter 18: Fluid, Electrolyte, and Acid-Base Balances
1.A nurse is caring for a patient who is suffering from kidney failure and is receiving peritoneal dialysis. The nurse explains that peritoneal dialysis works by instilling a solution into the abdomen that contains dextrose that will pull extra fluid into the abdominal cavity. What is the name of this process?
d. Active transport
2.A patient has been admitted to the postsurgical nursing unit after surgery. The health care provider has ordered the patient to have an IV of 0.9% sodium chloride. The nurse who is caring for the patient recognizes this as what type of solution?
3.The patient is in a coma after a motor vehicle accident. In addition to IV medications, the patient is receiving an isotonic IV fluid. The primary purpose for this fluid infusion is to:
a. cause cells to shrink and reduce swelling.
b. move fluid from intravascular space into cells.
c. pull fluid from cells into the intravascular space.
d. expand the body’s intravascular fluid volume.
4.Two nursing students were having pizza one evening as they were studying. One student remarked that whenever she ate pizza, she was incredibly thirsty. The second student explained that this thirst was caused by:
a. colloid osmotic pressure.
c. oncotic pressure.
d. hydrostatic pressure.
5.A 7-year-old patient was admitted to the hospital with a high fever. The nurse caring for the child knows that the child has increased insensible water loss resulting from the fever and should receive additional water to prevent hypernatremia. Insensible water loss occurs through which organ?
b. GI tract
6.A patient presents to the emergency department complaining of increased urine output. The patient has been drinking alcohol and is still visibly impaired. He is aware of his condition and apologizes, stating that he has never gotten drunk before and if he survives he never will again, but he knows that if he drinks too much he will lose potassium and die. The nurse realizes that the patient is dealing with:
a. antidiuretic hormone (ADH) suppression.
b. ADH stimulation.
c. insensible water loss.
d. angiotensin II release.
7.The body’s fluid and electrolyte balance is maintained partially by hormonal regulation. The nurse conveys an understanding of this mechanism in which statement?
a. “The pituitary gland secretes aldosterone.”
b. “The kidney secretes antidiuretic hormone.”
c. “The adrenal cortex secretes antidiuretic hormone.”
d. “The pituitary gland secretes antidiuretic hormone.”
8.A 15-year-old patient suffered a head injury as the result of a bicycle accident. The nurse is concerned about potential fluid complications caused by the injury. What should the nurse monitor most closely?
a. Aldosterone release
b. Urine output
c. Renin release
d. Body temperature
9.The patient is taking furosemide (Lasix) and has been complaining of muscle weakness. The nurse should be most concerned about which imbalance?
10.The patient is on a ventilator. The health care provider has indicated concern about the patient’s acid-base status. The nurse anticipates that the health care provider will determine the acid-base levels via:
a. PaO2 measurement.
b. SaO2 levels.
c. chloride levels.
d. arterial blood gas analysis.
Chapter 19: Caring in Nursing Practice
1.A nurse is working in a health care clinic. She loves her work because of all the different people she meets. She professes to care for all of them and states that she understands them because she realizes which of the following is true?
a. Basically all patients are the same.
b. Each person has a unique background.
c. Caring for people requires very little experience.
d. There are standard solutions to most health care problems.
2.Madeleine Leininger identifies the concept of care as the essence and unifying domain that sets nursing apart from other health care disciplines. Which of the following is true in her view?
a. Care and cure are synonymous.
b. Care is designed to focus only on individuals.
c. Caring acts are independent of patient values.
d. Caring depends on communication.
3.Nurses care for a variety of patients. What is an activity that best demonstrates the caring role of a nurse?
a. Staying with a patient and developing a plan of care before surgery
b. Performing IV insertion with confidence
c. Assessing the patient’s entire health history
d. Inserting a urinary catheter using aseptic technique
4.Which of the following would indicate that the nurse has established a level of mutual problem solving?
a. The nurse helps the patient develop questions to ask the health care provider.
b. The nurse tells the patient what needs to be done to resolve health problems.
c. The nurse is seen as the authority when it comes to health care issues.
d. The nurse excludes the family from health discussions to protect privacy.
5.The patient was hospitalized with pneumonia. He had always been very healthy and was concerned that now his family would have to take care of him. During one conversation the nurse said to him, “This gives the ones who love you a chance to show you how much they care for you.” The comment that the nurse made best demonstrated which behavior?
a. Human respect
b. Encouraging manner
c. Healing environment
d. Affiliation needs
6.A registered nurse who works for an orthopedic unit of an acute care hospital makes hourly rounds on his patients. He also closes the door and pulls the curtains around the beds of patients in semiprivate rooms before exposing them for treatments. This is an example of which of the following behaviors?
a. Human respect
b. Encouraging manner
c. Healing environment
d. Affiliation needs
7.A registered nurse who worked in an extended care facility could see that a patient was in the process of dying. The lab technician came to draw his blood. The nurse requested that the blood draw be postponed for a while so that the patient’s wife, who was at his bedside, could spend some quiet time with her husband. This is an example of which caring behavior?
a. Providing presence
b. Encouraging manner
c. Healing environment
d. Affiliation needs
8.A female patient has just found a large lump in her breast. The health care provider needs to perform a breast biopsy. The nurse assists the patient into the proper position and offers support during the biopsy. What is the nurse doing?
a. Creating a healing environment
b. Fulfilling affiliation needs
c. Providing a sense of presence
d. Demonstrating an encouraging manner
9.A nurse enters a patient’s room and is very methodical in her assessment skills and in providing a safe environment, but only speaks with the patient when necessary to gather data. This nurse is:
a. uncaring and probably always will be.
b. most likely a product of a less caring environment.
c. probably more caring with other patients.
d. a product of a caring environment.
10.The patient was admitted to the hospital with advanced-stage cancer. As the nurse was admitting her, the patient told her about how her little dog learned a new trick, and could play dead when she said “bang-bang.” Why did the nurse listen attentively to the patient’s story?
a. She knew it was easy to do and she had nothing else to do at that time.
b. It was little more than two people talking back and forth.
c. She knew it was probably not going to affect the patient-nurse relationship.
d. She knew it was a way to know and respond to what matters to the patient.
Chapter 20: Cultural Awareness
1.The nurse is attempting to teach a patient how to perform wound care for when he goes home. Using the “teach back” method the nurse should do which of the following?
a. Repeat the instructions until the patient understands.
b. Present the information and clarify with closed-ended questions.
c. Ask the patient if he understands the instructions.
d. Ask if the patient has any questions about the technique.
2.A student nurse is caring for a patient of Mexican descent. In an attempt to become culturally aware, the student should consciously think about which of the following?
a. What people of Mexican descent believe
b. The relationship between culture and ethnicity
c. The fact that the patient belongs to an isolated social group
d. Where the person is in the intersections of socially constructed categories
3.When dealing with cultural awareness, the nurse realizes that the term oppression involves which of the following?
a. Maintaining advantages based on social group membership
b. Systems that maintain disadvantages aimed purely at individuals
c. Intentional discrepancies alone
d. Issues at institutional levels independent of individual or cultural factors
4.The student nurse has been studying different cultures in relationship to nursing. She understands that transcultural nursing has been developed as a distinct discipline and can be defined as which of the following?
a. Understanding that cultural patterns are generated from predetermined criteria
b. Knowing that culturally congruent care is based on health care system values
c. Understanding cultural similarities and differences among groups of people
d. The realization that illness and disease are the same
5.Cultural competence is the ongoing process in which a health care professional continuously strives to achieve the ability to work effectively within the cultural context. To do this effectively, what must the nurse do?
a. Understand the cultural norms of the patient’s community.
b. See herself or himself as being culturally competent.
c. Face the reality that cultural competence can take up to a year to achieve.
d. View herself or himself as becoming culturally competent.
6.A student nurse assigned to a female, observant Muslim patient noticed her discomfort with several of the male health care providers. She wonders if this discomfort is related to the patient’s religious beliefs. In her preparation for clinical, she learned that Muslims differ in their adherence to tradition, but that modesty is the “overarching Islamic ethic” pertaining to interaction between the sexes (Rabin, 2010). The student nurse states which of the following to the patient?
a. “I’m going to request that you only have female physicians see you. Does having male nurses bother you as well?”
b. “I know that it’s hard to get used to, but you just have to get used to it. That’s how it is in America.”
c. “It must be difficult for people like you to adjust to our ways, but there are limitations for all of us.”
d. “I know that for many of our Muslim patients modesty is very important. Is there some way I can make you more comfortable?’
7.The nurse is caring for a patient of a culture different from her own. To provide culturally competent care for this patient, what does the nurse need to do?
a. Not be curious about other ways of being in the world
b. Understand the forces that influence her own world view
c. Recognize that she must not hold any bias toward the patient
d. Have no predispositions relative toward the patient’s culture
8.The current focus on promoting a culturally competent health care environment is on which of the following?
a. The health care provider’s efforts to become self-aware
b. The health care provider learning about other cultures
c. Avoiding the systematic provision of care
d. Ensuring that cultural competence is integrated into administrative processes
9.The nurse is performing a cultural assessment on a patient. What does the nurse know about cultural assessments?
a. They are intrusive and time consuming.
b. They are not dependent on a trusting relationship.
c. They are rarely plagued by miscommunication.
d. They are based in similarities of behavior.
AND MUCH MORE