Foundations of Nursing Final Exam
Course Introduction
Foundations of Nursing introduces students to the essential principles and practices that form the basis of professional nursing. The course covers the history and evolution of nursing, ethical and legal aspects of care, communication skills, patient safety, and health assessment techniques. Emphasis is placed on understanding the nursing process, critical thinking, and evidence-based practice in various healthcare settings. Students will also learn about cultural competence, patient advocacy, health promotion, and the role of the nurse within interdisciplinary healthcare teams, providing a solid platform for further study and clinical experience.
Recommended Textbook
Concepts for Nursing Practice 1st Edition by
Jean Foret Giddens
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53 Chapters
406 Verified Questions
406 Flashcards
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Page 2
Chapter 1: Development
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Sample Questions
Q1) The school nurse talking with a high school class about the difference between growth and development would best describe growth as
A) processes by which early cells specialize.
B) psychosocial and cognitive changes.
C) qualitative changes associated with aging.
D) quantitative changes in size or weight.
Answer: D
Q2) To plan early intervention and care for a child with a developmental delay,the nurse would consider knowledge of the concepts most significantly impacted by development,including A) culture.
B) environment.
C) functional status.
D) nutrition.
Answer: C
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Chapter 2: Functional Ability
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Q1) The nurse is assessing a patient with a mobility dysfunction and wants to gain insight into the patient's functional ability.What question would be the most appropriate?
A) "Are you able to shop for yourself?"
B) "Do you use a cane, walker, or wheelchair to ambulate?"
C) "Do you know what today's date is?"
D) "Were you sad or depressed more than once in the last 3 days?"
Answer: B
Q2) The nurse is assessing a patient's functional ability.Which activities most closely match the definition of functional ability?
A) Healthy individual, works outside the home, uses a cane, well groomed
B) Healthy individual, college educated, travels frequently, can balance a checkbook
C) Healthy individual, works out, reads well, cooks and cleans house
D) Healthy individual, volunteers at church, works part time, takes care of family and house
Answer: D
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Chapter 3: Family Dynamics
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Sample Questions
Q1) Jane and Janet have an established long-term relationship and are attending parenting classes in anticipation of finalizing adoption of baby Joan.Jane and Janet would be considered which type of family?
A) Cohabiting
B) Nuclear
C) Same-sex
D) Single parent
Answer: C
Q2) Critical Thinking: The nurse identifies the family with a child graduating from college as being in the family life cycle of
A) single young adult leaving home.
B) new couple joins their families through marriage or living together.
C) families with young children.
D) launching children and moving on.
Answer: D
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Chapter 4: Culture
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Sample Questions
Q1) When teaching an Asian patient with newly diagnosed diabetes,the nurse notes the patient nodding yes to everything that is being said.With a better understanding of cultural interdependence in self-concept,a nurse should immediately
A) write everything down for the patient to refer to later.
B) prompt further to elicit additional questions or concerns.
C) call the recognized elder for this patient.
D) call the oldest male relative for help with decision making.
Q2) What interrelated constructs facilitate a nurse to become culturally competent?
A) Cultural diversity, self-awareness, cultural skill, and cultural knowledge
B) Cultural desire, self-awareness, cultural knowledge, and cultural identity
C) Cultural desire, self-awareness, cultural knowledge, and cultural diversity
D) Cultural desire, self-awareness, cultural knowledge, and cultural skill
Q3) Women who are given the job of caretaker for aging relatives are subject to caregiver strain due to A) feminine attributes.
B) unequal gender.
C) fixed gender roles.
D) female inequality.
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6
Chapter 5: Motivation
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Q1) The nurse is assessing a patient's readiness to be discharged.What is the most appropriate question for the nurse to ask to determine the patient's learning needs before planning teaching activities?
A) "What are your hobbies and occupation?"
B) "What do you need to know before you go home from the hospital?"
C) "Do you have any cultural or religious beliefs that you would like incorporated into your plan of care?"
D) "What were your grades and learning style when you were in school?"
Q2) The nurse is trying to help an obese diabetic patient who has 30 pounds to lose.The nurse is setting weight loss goals that the patient will attain.Which goals would most likely cause an increase in motivation in this patient?
A) Follow American Diabetic Diet, lose 2 pounds a week, and 20 pounds in 2 months.
B) Follow American Diabetic Diet, lose .5 pounds a week, and 5 pounds in 2 months.
C) Follow American Diabetic Diet, lose 1 pound a week, and 10 pounds in 2 months.
D) Follow American Diabetic Diet, lose 3 pounds a week, and 30 pounds in 2 months.
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Chapter 6: Adherence
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Q1) The nurse is doing discharge teaching on a patient who has peripheral vascular disease and has poor circulation to the feet.Which learning goal should the nurse include in the teaching plan?
A) The nurse will demonstrate the proper technique for trimming toenails.
B) The patient will understand the rationale for proper foot care after instruction.
C) The nurse will instruct the patient on appropriate foot care before discharge.
D) The patient will post reminder stickers on their calendar to check feet every day and record scheduled appointments with podiatrist.
Q2) A patient has been newly diagnosed with hypertension.The nurse assesses the need to develop a collaborative plan of care that includes a goal of adhering to the prescribed regimen.When the nurse is planning teaching for the patient,which is the most important initial learning goal?
A) The patient will select the type of learning materials they prefer.
B) The patient will verbalize an understanding of the importance of following the regimen.
C) The patient will demonstrate coping skills needed to manage hypertension.
D) The patient will verbalize the side effects of treatment.
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Page 8
Chapter 7: Fluid and Electrolyte Balance
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Q1) The patient with which diagnosis should have the highest priority for teaching regarding foods that are high in magnesium?
A) Severe hemorrhage
B) Diabetes insipidus
C) Oliguric renal disease
D) Adrenal insufficiency
Q2) The patient is receiving tube feedings due to a jaw surgery.What change in assessment findings should prompt the nurse to request an order for serum sodium concentration?
A) Development of ankle or sacral edema
B) Increased skin tenting and dry mouth
C) Postural hypotension and tachycardia
D) Decreased level of consciousness
Q3) At change-of-shift report,the nurse learns the medical diagnoses for four patients.Which patient should the nurse assess most carefully for development of hyponatremia?
A) Vomiting all day and not replacing any fluid
B) Tumor that secretes excessive antidiuretic hormone (ADH)
C) Tumor that secretes excessive aldosterone
D) Tumor that destroyed the posterior pituitary gland
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Chapter 8: Acid-Base Balance
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Sample Questions
Q1) The patient is hyperventilating from anxiety and abdominal pain.Which assessment findings should the nurse attribute to respiratory alkalosis? (Select all that apply.)
A) Skin pale and cold
B) Tingling of fingertips
C) Heart rate of 102
D) Numbness around mouth
E) Cramping in feet
Q2) Which statements said by patients indicate that the nurse's teaching regarding prevention of acid-base imbalances is successful? (Select all that apply.)
A) "Baking soda is an effective inexpensive antacid."
B) "I shall take my insulin on time every day."
C) "My aspirin is on a high shelf away from children."
D) "I have reliable transportation to dialysis sessions."
E) "Fasting is a great way to lose weight rapidly."
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Chapter 9: Thermoregulation
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Sample Questions
Q1) The nurse admitting a patient to the emergency department on a very hot summer day would suspect hyperthermia when the patient demonstrates
A) decreased respirations.
B) low pulse rate.
C) red, sweaty skin.
D) slow capillary refill.
Q2) The most appropriate measure for a nurse to use in assessing core body temperature when there are suspected problems with thermoregulation is a(n)
A) oral thermometer.
B) rectal thermometer.
C) temporal thermometer scan.
D) tympanic membrane sensor.
Q3) During orientation to an emergency department,the nurse educator would be concerned if the new nurse listed which of the following as a risk factor for impaired thermoregulation?
A) Impaired cognition
B) Occupational exposure
C) Physical agility
D) Temperature extremes
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Chapter 10: Cellular Regulation
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Sample Questions
Q1) While the nurse is obtaining the health history of a 75-year-old female patient,which of the following has the greatest implication for the development of cancer?
A) Being a 75-year-old woman
B) Family history of hypertension
C) Cigarette smoking as a teenager
D) Advancing age
Q2) While collecting a health history on a patient admitted for colon cancer,which of the following questions would be a priority to ask this patient?
A) "Have you noticed any blood in your stool?"
B) "Have you been experiencing nausea?"
C) "Do you have back pain?"
D) "Have you noticed any swelling in your abdomen?"
Q3) In caring for a patient following lobectomy for lung cancer,which of the following should the nurse include in the plan of care?
A) Position the patient on the operative side only.
B) Avoid administering narcotic pain medications.
C) Keep the patient on strict bed rest.
D) Instruct the patient to cough and deep breathe.
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Chapter 11: Intracranial Regulation
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Sample Questions
Q1) The nurse is caring for a patient with increased intracranial pressure.Which action is considered unsafe?
A) Aligning the neck with the body
B) Clustering many nursing activities
C) Elevating the head of the bed 30 degrees
D) Providing stool softeners or laxatives as ordered
Q2) After shunt procedure,the nurse would monitor the patient's neurologic status by using the
A) electroencephalogram.
B) GCS.
C) National Institutes of Health Stroke Scale.
D) Monro-Kellie doctrine.
Q3) Primary prevention strategies to reduce the occurrence of head injuries would include
A) blood pressure control.
B) smoking cessation.
C) maintaining a healthy weight.
D) violence prevention.
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Chapter 12: Glucose Regulation
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Sample Questions
Q1) When a diabetic patient asks about maintaining adequate blood glucose levels,which of the following statements by the nurse relates most directly to the necessity of maintaining blood glucose levels no lower than about 74 mg/dl?
A) "Glucose is the only type of fuel used by body cells to produce the energy needed for physiologic activity."
B) "The central nervous system cannot store glucose and needs a continuous supply of glucose for fuel."
C) "Without a minimum level of glucose circulating in the blood, erythrocytes cannot produce ATP."
D) "The presence of glucose in the blood counteracts the formation of lactic acid and prevents acidosis."
Q2) A diabetic patient is brought into the emergency department unresponsive.The arterial pH is 7.28.Besides the blood pH,which clinical manifestation is seen in uncontrolled diabetes mellitus and ketoacidosis?
A) Oral temperature of 38.9° Celsius
B) Severe orthostatic hypotension
C) Increased rate and depth of respiration
D) Extremity tremors followed by seizure activity
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Chapter 13: Nutrition
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Q1) Critical Thinking: During a physical examination,the nurse notes that the patient's skin is dry and flaking,with patches of eczema.Which nutritional deficiency might be present?
A) Vitamin C
B) Vitamin B
C) Essential fatty acid
D) Protein
Q2) An African American is at an increased risk for which of the following? (Select all that apply.)
A) Vitamin D deficiency
B) Type 1 diabetes
C) Celiac disease
D) Type 2 diabetes
E) Hypertension
F) Metabolic syndrome
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Page 15
Chapter 14: Elimination
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Sample Questions
Q1) A primary prevention tool used for colon cancer screening is
A) abdominal x-rays.
B) blood, urea, and nitrogen (BUN) testing.
C) serum electrolytes.
D) occult blood testing.
Q2) You are caring for a patient who has suffered a spinal cord injury.You are concerned about the patient's elimination status.As the nurse,your primary concern is to
A) speak with the patient's family about food choices.
B) establish a bowel and bladder program for the patient.
C) speak with the patient about past elimination habits.
D) establish a bedtime ritual for the patient.
Q3) A patient who was diagnosed with senile dementia has become incontinent of urine.The patient's daughter asks the nurse why this is happening.The best response by the nurse is:
A) "The patient is angry about the dementia diagnosis."
B) "The patient is losing sphincter control due to the dementia."
C) "The patient forgets where the bathroom is located due to the dementia."
D) "The patient wants to leave the hospital."
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Page 16
Chapter 15: Perfusion
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Sample Questions
Q1) The nurse is explaining to a student nurse about impaired central perfusion.The nurse knows the student understands this problem when the student states,"Central perfusion
A) is monitored only by the physician."
B) involves the entire body."
C) is decreased with hypertension."
D) is toxic to the cardiac system."
Q2) A nurse is explaining to a student nurse about perfusion.The nurse knows the student understands the concept of perfusion when the student states,"Perfusion
A) is a normal function of the body, and I don't have to be concerned about it."
B) is monitored by the physician, and I just follow orders."
C) is monitored by vital signs and capillary refill."
D) varies as a person ages, so I would expect changes in the body."
Q3) The patient asks the nurse to explain the sinoatrial node in the heart.The nurse's best response would be,"The sinoatrial node
A) provides the heart with the stimulation to beat in a normal rhythm."
B) protects the heart from atherosclerotic changes."
C) provides the heart with oxygenated blood."
D) protects the heart from infection."
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Chapter 16: Gas Exchange
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Sample Questions
Q1) A 3-month-old infant is at increased risk for developing anemia.The nurse would identify which principle contributing to this risk?
A) The infant is becoming more active.
B) There is an increase in intake of breast milk or formula.
C) The infant is unable to maintain an adequate iron intake.
D) A depletion of fetal hemoglobin occurs.
Q2) Which clinical management prevention concept would the nurse identify as representative of secondary prevention?
A) Decreasing venous stasis and risk for pulmonary emboli
B) Implementation of strict hand washing routines
C) Maintaining current vaccination schedules
D) Prevention of pneumonia in patients with chronic lung disease
Q3) The nurse is assigned a group of patients.Which patient would the nurse identify as being at increased risk for impaired gas exchange? A patient
A) with a blood glucose of 350 mg/dL
B) who has been on anticoagulants for 10 days
C) with a hemoglobin of 8.5 g/dL
D) with a heart rate of 100 beats/min and blood pressure of 100/60
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Chapter 17: Clotting
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Q1) A patient on a medical surgical unit has a platelet count of 90,000 per mm³.The nurse knows to include which of the following precautions in discharge instructions?
A) Use a standard safety razor for shaving.
B) Use a soft bristle toothbrush.
C) Have aggressive dental care immediately to prevent dental caries.
D) Do not eat fresh fruit.
Q2) The nurse would expect to administer an anticoagulant to a patient following which surgery?
A) Hip replacement
B) Hysterectomy
C) Abdominal aorta aneurism (AAA) repair
D) Appendectomy
Q3) Which nursing observation would indicate that the nurse hold the medication warfarin (Coumadin)?
A) An INR (international normalize ratio) of 1.8
B) An INR of 4.8
C) A partial thromboplastin time (APTT) level of 25 seconds
D) An APTT level of 35 seconds
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Chapter 18: Reproduction
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Q1) The nurse is admitting a prenatal patient for diagnostic testing.While eliciting the psychosocial history,the nurse learns the patient smokes a pack of cigarettes daily,drinks a cup of cappuccino with breakfast,has smoked weed in the remote past,and is a social drinker.Which action should the nurse first take?
A) Strongly advise immediate tobacco cessation
B) Elimination of all caffeinated beverages
C) Serum and urine testing for drug use and alcohol use
D) Referral to a 12-step program
Q2) An obstetric multipara with triplets is placed on bed rest at 24 weeks' gestation.Her perinatologist is managing intrauterine growth restriction with serial ultrasounds.This is an example of
A) antenatal diagnostics.
B) primary prevention.
C) secondary prevention.
D) tertiary prevention.
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Chapter 19: Sexuality
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Q1) A 55-year-old male patient post-myocardial infarction (MI)queries the nurse caring for him whether he will be healthy enough for sexual activity after discharge from the hospital.The patient has been prescribed anti-hypertensives and beta-blockers.While health teaching,the nurse understands that the three phases of the four-stage model of the human sexual response cycle that are of concern for this patient include
A) excitement, plateau, and orgasmic.
B) plateau, orgasmic, and resolution.
C) excitement, orgasmic, and resolution.
D) arousal, excitement, and plateau.
Q2) Sexual dysfunction is a negative consequence of human sexuality manifested by any disturbance to the psycho-physiologic changes that occur during the sexual response cycle.Which statements related to sexual dysfunction are correct? (Select all that apply.)
A) Biological factors play a more significant role than psychologic factors.
B) Sexual dysfunction is more prevalent among men than women.
C) The best predictor of sexual health is emotional well-being.
D) The patient with sexual dysfunction is at risk for anxiety and depression.
E) Sexual dysfunction remains uncommon.
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Chapter 20: Immunity
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Q1) The nurse is caring for a patient who was started on intravenous antibiotic therapy earlier in the shift.As the second dose is being infused,the patient reports feeling dizzy and having difficulty breathing and talking.The nurse notes that the patient's respirations are 26 breaths/min with pulse 112 beats/min and weak.The nurse suspects that the patient is experiencing a(n)
A) suppressed immune response.
B) hyperimmune response.
C) allergic reaction.
D) anaphylactic reaction.
Q2) The nurse is caring for a postoperative patient who had an open appendectomy.The nurse understands that this patient should have some erythema and edema at the incision site 12 to 24 hours post operation if
A) his immune system is functioning properly.
B) he is properly vaccinated.
C) he has an infection.
D) the suppressor T-cells in his body are activated.
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Chapter 21: Inflammation
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Q1) A nurse is instructing her patient with ulcerative colitis regarding the need to avoid enteric coated medications.The nurse knows that the patient understands the reason for this teaching when he states which of the following?
A) "The coating on these medications is irritating to my intestines."
B) "I need a more immediate response from my medications than can be obtained from enteric coated medications."
C) "Enteric coated medications are absorbed lower in the digestive tract and can be irritating to my intestines or inadequately absorbed by my inflamed tissue."
D) "I don't need to use these medications because they cause diarrhea, and I have had enough trouble with diarrhea and rectal bleeding over the past weeks."
Q2) A patient is being treated with an antibiotic.The nurse explains to the patient that this medication is required for the reduction of inflammation at the injury site because this medication
A) will decrease the pain at the site.
B) helps to kill the infection causing the inflammation.
C) inhibits cyclooxygenase.
D) will reduce the patient's fever.
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Chapter 22: Infection
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Q1) Individuals of low socioeconomic status are at an increased risk for infection because of which of the following? (Select all that apply.)
A) Uninsured or underinsured status
B) Easy access to health screenings
C) High cost of medications
D) Inadequate nutrition
Q2) The nurse is working on a plan of care with her patient which includes turning and positioning and adequate nutrition to help the patient maintain intact skin integrity.The nurse helps the patient to realize that this breaks the chain of infection by eliminating a A) host.
B) mode of transmission.
C) portal of entry.
D) reservoir.
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Chapter 23: Mobility
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Q1) Mobility for the patient changes throughout the life span; this is known as the process of
A) aging and illness.
B) illness and disease.
C) health and wellness.
D) growth and development.
Q2) The lack of weight bearing leads to bone _________ and __________ from the skeletal system.
Q3) What percentage of hip fractures are the result of falls?
A) 50%
B) 80%
C) 90%
D) 100%
Q4) The nurse and a student nurse are discussing the effects of bed immobility on patients.The nurse knows that the student nurse understands the concept of mobility when she states,"Patients with impaired bed mobility
A) have an increased risk for pressure ulcers."
B) like to have extra visitors."
C) need to have a mechanical soft diet."
D) are prone to constipation."
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Chapter 24: Tissue Integrity
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Q1) A patient was given a patch test to determine what allergen was responsible for their atopic dermatitis.The provider prescribes a steroid cream.What important instructions should the nurse give to the patient?
A) Apply the cream generously to affected areas.
B) Apply a thin coat to affected areas.
C) Apply a thin coat to affected areas; avoid the face and groin.
D) Apply an antihistamine along with applying a thin coat of steroid to affected areas.
Q2) The nurse is instructing the nursing assistant to prevent pressure ulcers in a frail older patient; the nursing assistant understands the instruction when she agrees to
A) bathe and dry the skin vigorously to stimulate circulation.
B) keep the head of the bed elevated 30 degrees.
C) limit intake of fluid and offer frequent snacks.
D) turn the patient at least every 2 hours.
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Chapter 25: Sensory Perception
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Q1) Mr.Smith is complaining of decreased appetite.He states he just finished taking his antibiotics for an episode of pneumonia.The nurse's best response would be which of the following?
A) "Your wife should increase the spices in your food, as the pneumonia changes your sense of smell."
B) "Notify your doctor immediately, because this is a concerning reaction to the medication."
C) "You need to take an appetite stimulant, as your body will need good nutrition to recover from the infection."
D) "You should see an improvement in the next week or so. Call if this continues."
Q2) The patient who had a hip replacement yesterday has a visual acuity of 20/200 after correction.To provide recreational activities during the rehabilitation phase,the nurse should
A) place the television to the left or right of patient's visual field.
B) encourage the patient to learn braille.
C) suggest use of talking books.
D) provide headphones for listening to music.
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Chapter 26: Pain
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Q1) Understanding classifications of pain helps nurses develop a plan of care.A 62-year-old male has fallen while trimming tree branches sustaining tissue injury.He describes his condition as an aching,throbbing back.This is characteristic of A) neuropathic pain.
B) nociceptive pain.
C) chronic pain.
D) mixed pain syndrome.
Q2) Controlling pain is important to promoting wellness.Unrelieved pain has been associated with
A) prolonged stress response and a cascade of harmful effects system-wide.
B) large tidal volumes and decreased lung capacity.
C) decreased tumor growth and longevity.
D) decreased carbohydrate, protein, and fat destruction.
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28
Chapter 27: Stress
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Q1) An older patient presents to the outpatient clinic with a chief complaint of headache and insomnia.In gathering the history,the nurse notes which factors as contributing to this patient's chief complaint?
A) The patient is responsible for caring for two school-age grandchildren.
B) The patient's daughter works to support the family.
C) The patient is being treated for hypertension and is overweight.
D) The patient has recently lost her spouse and needed to move in with her daughter.
Q2) A patient tells the nurse "My doctor thinks my problems with stress relate to the negative way I think about things,and he wants me to learn a new way of thinking." Which response would be in keeping with the doctor's recommendations?
A) Teaching the patient to recognize, reconsider, and reframe irrational thoughts
B) Encouraging the patient to imagine being in calming circumstances
C) Teaching the patient to use instruments that give feedback about bodily functions
D) Provide the patient with a blank journal and guidance about journaling
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Chapter 28: Coping
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Q1) The nurse is developing a care plan for a patient with ineffective coping skills.Which intervention would be an example of a problem-focused coping strategy?
A) Scheduling a regular exercise program
B) Attending a seminar on treatment options
C) Identifying a confidant to share feelings
D) Attending a support group for families
Q2) The school nurse is assessing coping skills of high school students who attend an alternative school for students at high risk to not graduate.What is the priority concern that the nurse has for this student population?
A) Altered vital sign readings
B) Inaccurate perceptions of stressors
C) Increased risk for suicide
D) Decreased access to alcoholic beverages
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Chapter 29: Mood and Affect
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Q1) A patient has been prescribed a selective serotonin reuptake inhibitor (SSRI)antidepressant.After taking the new medication,the patient states,"This medication isn't working.I don't feel any different." What is the best response by the nurse?
A) "I will call your care provider. Perhaps you need a different medication."
B) "Don't worry. You can try taking it at a different time of day to help it work better."
C) "It usually takes a few weeks for you to notice improvement from this medication."
D) "Your life is much better now. You will feel better soon."
Q2) A patient has been resistant to treatment with antidepressant therapy.The care provider prescribes phenelzine (Nardil),a monoamine oxidase inhibitor (MAOI)medication.What teaching is critical for the nurse to give the patient?
A) Serum blood levels must be regularly monitored to assess for toxicity.
B) To prevent side effects, the medication should be administered as an intramuscular injection.
C) Eating foods such as blue cheese or red wine will cause side effects.
D) This medication class may only be used safely for a few days at a time.
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Chapter 30: Anxiety
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Q1) The nurse is assessing the social support of a patient who is recently divorced and has moved from their hometown to the city due to change in jobs.Which response related to social support would be most therapeutic?
A) Encourage the patient to begin dating again, perhaps with members of her church.
B) Discuss how divorce support groups could increase coping and social support.
C) Note that being so particular about potential friends reduces social contact.
D) Discuss using the Internet as a way to find supportive others with similar values.
Q2) The nurse knows that which of the following medical conditions are most commonly associated with anxiety? Select all that apply:
A) Cancer
B) Chronic obstructive pulmonary disease
C) Hypothyroidism
D) Dysrhythmias
E) Encephalitis
F) Hyperthyroidism
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Chapter 31: Cognition
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Q1) The nurse is sitting with the family of a patient who has just received the diagnosis of dementia.The family asks for information on what treatment will be needed to cure the condition.How does the nurse respond?
A) "Hormone therapy will reverse the condition."
B) "Vitamin C and zinc will reverse the condition."
C) "There is no treatment that reverses dementia."
D) "Dementia can be reversed with diet, exercise, and medications."
Q2) The nurse is developing a care plan for a patient newly admitted to a unit that cares for patients with cognitive impairment.What is an important component of care for the patients on this unit?
A) Allow food selections from a menu with several choices.
B) Schedule frequent field trips off the unit for cognitive stimulation.
C) Plan for attendance at activities with several other patients on the unit.
D) Plan for a structured daily routine of events and caregivers.
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Chapter 32: Psychosis
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Q1) The nurse is planning discharge teaching for a patient taking clozapine (Clozaril).Which of the following is essential to include?
A) Caution about sunlight exposure
B) Reminder to call the clinic if fever, sore throat, or malaise develops
C) Instructions regarding dietary restrictions
D) A chart to record patient weight
Q2) A client previously diagnosed as psychotic expresses to the nurse that he is seeing spiders climbing up the walls in his room and he is concerned that they will get into his bed.The nurse's best response to this behavior is to
A) ignore his remarks.
B) express doubt that there are spiders on the wall.
C) ask the client if he also sees spiders in the day room.
D) tell the client there are no spiders and he should stop worrying about it.
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34
Chapter 33: Addiction
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Q1) To prevent Wernicke's encephalopathy from heavy alcohol use,the nurse anticipates an order for which medications?
A) Benzodiazepine
B) Thiamine and B complex IV
C) Vitamins C and D3
D) Klonopin
Q2) A patient who was admitted 24 hours ago has become increasingly irritable and now says there are bugs on his bed.The nurse suspects
A) alcohol-induced psychosis.
B) delirium tremens (DTs).
C) neurologic injury related to a fall.
D) posttraumatic stress reaction.
Q3) The nurse is assessing a patient using the CAGE Questionnaire.The patient answers yes to all of the questions.The nurse suspects alcoholism and feels the patient is in denial when the patient states which of the following?
A) "I go to meetings once a day and still drink."
B) "My family and friends have been avoiding me lately."
C) "I don't have a problem with alcohol. I can quit anytime I want to."
D) "I know it will be hard to quit, but I am willing to try."
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Page 35
Chapter 34: Interpersonal Violence
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Q1) The nurse is counseling women at a crisis shelter about risk factors for increased intimate partner violence.What event is most likely to trigger an increase in abusive behaviors?
A) Moving to a new community
B) Starting a new job
C) Becoming pregnant
D) The death of a grandfather
Q2) The nurse is seeing a patient who has been in the clinic eight times in the past 6 months for injuries from an abusive partner.The patient states,"I don't see any way to get away from my partner,and I can't keep going on like this." What assessment question is most important for the nurse to ask?
A) "Do you have any family in the area that can help?"
B) "Have you thought about hurting yourself or someone else?"
C) "Have you thought about moving to a different city?"
D) "Have you discussed this with anyone else?
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Chapter 35: Professionalism
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Q1) The ANA outlines expectations of the nursing profession in the A) Gallup poll.
B) Goldman report.
C) Social Policy Statement.
D) social identity theory.
Q2) The scope of professional nursing practice is determined by the rules promulgated by which organization?
A) American Nurses' Association (ANA)
B) Institute of Medicine (IOM)
C) State's Board of Nursing
D) State's Nursing Association
Q3) Components of a professional identity in nursing include which of the following? (Select all that apply.)
A) Accountability
B) Advocacy
C) Autonomy
D) Competence
E) Culture
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Chapter 36: Clinical Judgment
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Q1) A new graduate nurse (GN)is working with an experienced nurse to chart assessment findings.The GN notes that the physical therapist wrote on the chart that the patient is lazy and did not want to participate in assigned therapies this AM.The experienced nurse asks the GN what may be going on here.What is the best explanation for this statement?
A) Data on the chart can sometimes be documented in a biased manner.
B) Data on the chart changes as the patient's condition changes.
C) Data on the chart is usually accurate and can be verified from the patient.
D) Reading the chart is not a wise use of time as this can be time consuming and tedious.
Q2) A nurse has committed a serious medication error and has reported their error to the hospital's adverse medication error hotline as well as to the unit manager.The manager is a firm believer in developing critical thinking skills.From this standpoint,what action by the manager would best nurture this ability in the nurse who made the error?
A) Have the nurse present an in-service related to the cause of the error.
B) Instruct the nurse to write a paper on how to avoid this type of error.
C) Let the nurse work with more experienced nurses when giving medications.
D) Send the nurse to refresher courses on medication administration.
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Chapter 37: Leadership
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Q1) The clinical nurse leader needs to identify the staff who must go home due to low census.Which answer below describes a democratic style of decision making?
A) The clinical nurse leader identifies the staff person with the most vacation and asks them to go home.
B) The clinical nurse leader tells the last person to show up for their shift to go home.
C) The clinical nurse leader decides not to send anyone home because it is too difficult to decide who should lose hours.
D) The clinical nurse leader asks the group if any of them would like the opportunity to go home and selects staff who volunteer.
Q2) The nurse who is certified as a Critical Care Registered Nurse (CCRN )represents the unit on the organizational performance improvement team.This is an example of _____ leadership.
A) formal
B) unit
C) organizational
D) informal
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Chapter 38: Ethics
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Q1) A male patient suffered a brain injury from a motor vehicle accident and has no brain activity.The spouse has come up to see the patient every day for the past 2 months.She asks the nurse,"Do you think when he moves his hands he is responding to my voice?" The nurse feels bad because she believes the movements are involuntary,and the prognosis is grim for this patient.She states,"He can hear you,and it appears he did respond to your voice." The nurse is violating which principle of ethics?
A) Autonomy
B) Veracity
C) Utilitarianism
D) Deontology
Q2) The nurse is faced with an ethical issue.When assessing the ethical issue,the nurse must first
A) ask, "What is the issue?"
B) identify all possible alternatives.
C) select the best option from a list of alternatives.
D) justify the choice of action or inaction.
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Chapter 39: Patient Education
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Q1) The most appropriate resources to include when planning to provide patient education related to a goal in the psychomotor domain would be
A) diagnosis-related support groups.
B) Internet resources.
C) manikin practice sessions.
D) self-directed learning modules.
Q2) Barriers to patient education the nurse considers in implementing a teaching plan include
A) family resources.
B) high school education.
C) hunger and pain.
D) need perceived by patient.
Q3) When planning to evaluate a patient's satisfaction with a teaching activity,the most appropriate strategy would be to
A) include a survey instrument.
B) observe for level of skill mastery.
C) present information more than one time.
D) provide for a return demonstration.
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Chapter 40: Health Promotion
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Q1) The plan of care for a patient newly diagnosed with diabetes includes health promotion with the tertiary prevention measure of A) avoiding carcinogens.
B) foot screening techniques.
C) glaucoma screening.
D) seat belt use.
Q2) Interrelated concepts to professional nursing a nurse manager would consider when addressing concerns about the quality of health promotion include A) culture.
B) development.
C) evidence.
D) nutrition.
Q3) The primary health care nurse would recommend screening based on known risk factors,because they can
A) eliminate the possibility of developing a condition.
B) identify appropriate treatment guidelines.
C) initiate treatment of a condition or disease.
D) make a substantial difference in morbidity and mortality.
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Chapter 41: Communication
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Q1) The nurse is admitting a patient to the medical/surgical unit.Which communication technique would be considered appropriate for this interaction?
A) "I've also had traumatic life experiences. Maybe it would help if I told you about them."
B) "Why do you think you had so much difficulty adjusting to this change in your life?"
C) "You will feel better after getting accustomed to how this unit operates."
D) "I'd like to sit with you for a while to help you get comfortable talking to me."
Q2) A nurse is conducting a therapeutic session with a patient in the inpatient psychiatric facility.Which remark by the nurse would be an appropriate way to begin an interview session?
A) "How shall we start today?"
B) "Shall we talk about losing your privileges yesterday?"
C) "Let's get started discussing your marital relationship."
D) "What happened when your family visited yesterday?"
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Chapter 42: Collaboration
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Q1) The management of a community hospital is trying to encourage a more collaborative environment among staff members.Which concept is most important for management to develop first?
A) Post educational posters about how well collaboration is being performed
B) Highlight that no single profession can meet the needs of all patients
C) Provide meetings for each department on how their role affects patients
D) Begin implementing evaluations of collaborative skills on annual performance reviews
Q2) Which patient scenario describes the best example of professional collaboration?
A) The nurse, physician, and physical therapist have all visited separately with the patient.
B) The nurse, physical therapist, and physician have all developed separate care plans for the patient.
C) The nurse mentions to the physical therapist that the patient may benefit from a muscle strengthening evaluation.
D) The nurse and physician discuss the patient's muscle weakness and initiate a referral for physical therapy.
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Chapter 43: Safety
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Q1) The nurse is caring for a patient experiencing an allergic reaction to a bee sting who has an order for BenaDRYL.The only medication in the patient's medication bin is labeled BenaZEPRIL.The nurse contacts the pharmacy for the correct medication to avoid what type of error?
A) Communication
B) Diagnostic
C) Preventive
D) Treatment
Q2) The strategy to avoid medication errors endorsed by the Institute for Safe Medication Practices (ISMP)to differentiate products with look-alike names is referred to as
A) automatic alerts.
B) bar coding.
C) computer order entry.
D) tallman lettering.
Q3) Essential elements of a standard order set to verify a medication order include A) volume only.
B) number of tablets.
C) metric dose/strength.
D) hour of administration.
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Chapter 44: Technology and Informatics
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Q1) When discussing the purposes of health care informatics with a nurse during orientation,the nurse educator would be concerned if the nurse orientee said that one purpose would be to
A) develop a cognitive science.
B) improve disease tracking.
C) improve the health provider's work flow.
D) increase administrative efficiencies.
Q2) Exemplars of the health informatics concept include A) clinical research informatics.
B) hardware and software.
C) privacy and security.
D) standard terminology.
Q3) The nurse manager of a medical/surgical unit wants to increase the use of health care technology on the unit and is working with an ANA-certified informatics nurse to reduce barriers to health information exchange,including A) basic informatics knowledge and skills.
B) offering the best set of tools.
C) privacy and security policies.
D) unit-specific terminology.
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Page 46
Chapter 45: Evidence
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Q1) Critical Thinking: The nurse in the outpatient setting would like to conduct a research study that compares patients who take tramadol (Ultracet)to patients who take oxycodone hydrochloride and acetaminophen (Percocet)for managing back pain.Which quantitative research method should yield the best results?
A) Longitude study
B) Controlled study
C) Systematic reviews/meta-analysis
D) Survey study
Q2) Which statements are true about the Iowa model of EBP? (Select all that apply.)
A) It addresses utilization of research findings at an individual level.
B) It prioritizes pressing items of interest related to quality of care.
C) Individual nurses enact an Iowa decision tree when they examine risk management data.
D) It identifies triggers capable of posing hazard or benefit.
E) It reiterates that innovators embrace change far earlier than laggards.
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Chapter 46: Health Care Quality
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Q1) The focus for The Joint Commission (TJC)is _____ and _____ in the delivery of health care.
A) cost containment; safety
B) safety; quality
C) quality; assessment
D) assessment; evaluation
Q2) What are the major attributes of health care quality? (Select all that apply.)
A) Conforms to standards
B) Sound decision making
C) High acuity patients
D) Low health care costs
E) Identifies adverse events
Q3) Two nurses are discussing health care quality.They agree on the statement that health care quality requires
A) magnet status hospitals.
B) fewer adverse events.
C) collaboration of multiple health care agencies.
D) increased patient education.
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Chapter 47: Care Coordination
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Q1) Nurses work to serve the population,and they know that the priority population who needs to be served by care coordination is the
A) most vulnerable and the frail.
B) uninsured and the very young.
C) underinsured and the elderly population.
D) whole population of the community.
Q2) Student nurses are being questioned by the nursing instructor about the health care coordination system.The instructor knows the students understand health care delivery when they state,"Health care
A) is available for everyone at every time."
B) needs are best met with a collaborative effort."
C) is adequately meeting the needs of the homeless populations."
D) needs are mostly in third world countries."
Q3) Medical models coordinate medical services and were traditionally designed to be A) patient specific.
B) nursing oriented.
C) diagnosis specific.
D) community oriented.
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Chapter 48: Caregiving
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Q1) Many grandparents today are caring for grandchildren in place of a parent.Identify the reasons why this phenomenon is happening.(Select all that apply.)
A) Children prefer living with their grandparents.
B) Parents are incarcerated.
C) Parents are deceased.
D) Grandparents are better caregivers.
E) Parents are mentally ill.
F) Parents are substance abusers.
Q2) A young wife is talking with the nurse about her husband who is returning from the military.The wife confides that her husband is physically okay but is behaving differently.The nurse's best response is which of the following?
A) "He is just trying to adjust to civilian life again; he'll be okay."
B) "You should observe him closely, because he could attack you."
C) "Many times people need care for emotional trauma."
D) "Talk with your physician to get medication, and then put it in his food."
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Chapter 49: Palliation
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Q1) The interprofessional core team includes members from
A) nursing, medicine, pharmacy, and nutrition.
B) medicine, nursing, social work, and clergy.
C) medicine, nursing, physical therapists, and volunteers.
D) nursing, home health aides, volunteers, and clergy.
Q2) The most prominent goal of palliative care is to
A) integrate into chronic disease management sooner rather than later.
B) enroll the patient into the Medicare Hospice Benefit.
C) ensure that the patient has a 6-month prognosis.
D) reserve this type of care until the patient is actively dying.
Q3) Today most patients are living for several years before dying with multiple chronic conditions,such as COPD,congestive heart failure,diabetes,and obesity.These concomitant diseases contribute to multiple symptoms that interfere with the patient's quality of life.What type of care would you consider for this patient?
A) End-of-life care
B) Supportive care
C) Comfort care
D) Palliative care
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Chapter 50: Health Care Organizations
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Q1) The annual report for a hospital shows that external environment factors are affecting the amount of new staff hired.What is a likely factor contributing to this outcome?
A) The recent implementation of becoming a not-for-profit institution
B) The implementation of a hospital electronic medical record system
C) A national recession that has been occurring for 3 years
D) The closure of a hospital-based school of nursing due to lack of funding
Q2) A hospital organization is working to improve a feeling of being valued and respected among all staff members.Which action by administration would reinforce the feeling of being valued?
A) Create professional pathways that require advanced education for any advancement of staff.
B) Seek staff input when planning a remodeling project of patient rooms.
C) Form committees that consist of upper management to plan organizational goals.
D) Consistently schedule required staff meetings at the same time each month.
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Chapter 51: Health Care Economics
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Q1) A student nurse is discussing Medicare coverage with the clinical instructor.The instructor knows the student understands Medicare when the student makes this which statement(s)? (Select all that apply.)
A) Medicare covers all patients while they are in the hospital.
B) Medicare is funded by the federal government.
C) Medicare is for persons 65 years old and older.
D) Medicare is partially funded by private third-party payers.
E) Medicare is for patients who are disabled and/or have end-stage renal disease.
Q2) The US health care system is different from that of other countries in which way?
A) The US charges money from the private sector only.
B) US health care is funded from private organizations.
C) The US health care system is not entirely government funded.
D) The US health care treats the older person first.
Q3) The economics of health care include
A) Medicare and Medicaid dollars.
B) patients' rights.
C) equal distribution of health care.
D) nurse salaries.
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Chapter 52: Health Policy
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Q1) Which of the following components are included in health policy at the state level?
A) Americans with Disabilities Act of 1990
B) Scope of nursing practice
C) Health Insurance Portability and Accountability Act (HIPAA) of 1996
D) Patient Safety and Quality Improvement Act of 2005
Q2) Nurses can be health advocates in which of the following ways? (Select all that apply.)
A) Supporting their professional nursing organization when discussing upcoming legislation
B) Discussing the upcoming classes with a neighbor
C) Rallying for coverage for childhood immunizations
D) Arranging for a patient to meet with case management for home health care
E) Discussing a patient they are concerned about with a fellow student in the public cafeteria
Q3) A definition of health policy includes which of the following elements?
A) Funding for public education
B) Appropriation of funds for roadwork
C) Selection of congressional members of committees
D) Public policy made to support health-related goals
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Page 54
Chapter 53: Health Care Law
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Q1) An example of the regulatory power to make law is the
A) Joint Commission establishing a medication reconciliation standard.
B) Centers for Disease Control and Prevention (CDC) developing recommendations for childhood immunizations.
C) Institute of Medicine (IOM) defining the approximate number of medication errors that result in significant patient harm or death.
D) Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals.
Q2) A law is defined as a
A) fundamental concept for health care professionals.
B) rule developed by the employee's organization.
C) rule enacted by a government agency that defines what must be done in a given circumstance.
D) mandate from the Joint Commission or other accrediting agency.
Q3) One of the major attributes of health care law is
A) it defines the expected behavior of persons in the business of health care.
B) the law or rule is easy to interpret and comply with.
C) it is established by any health care authority.
D) the creator must be an expert in health care.
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Page 55