Foundations of Nursing Practice Questions
Course Introduction
Foundations of Nursing introduces students to the essential principles, knowledge, and skills required to begin a professional career in nursing. The course covers the history and evolution of nursing, ethical and legal aspects, communication techniques, and roles of the nurse within the healthcare system. Emphasis is placed on fundamental concepts such as patient safety, infection control, health assessment, and the nursing process. Students will also learn basic care procedures, critical thinking, and problem-solving skills necessary for providing safe, effective, and compassionate care to individuals across the lifespan.
Recommended Textbook
Concepts for Nursing Practice 1st Edition by
Jean Foret Giddens
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406 Verified Questions
406 Flashcards
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Page 2
Chapter 1: Development
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Sample Questions
Q1) 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
Q2) To plan early intervention and care for an infant with Down syndrome,the nurse considers knowledge of other physical development exemplars such as A) cerebral palsy.
B) failure to thrive.
C) fetal alcohol syndrome.
D) hydrocephaly.
Answer: D
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Page 3
Chapter 2: Functional Ability
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Sample Questions
Q1) A 65-year-old female patient has been admitted to the medical/surgical unit.The nurse is assessing the patient's risk for falls so that falls prevention can be implemented if necessary.Select all the risk factors that apply from this patient's history and physical. (Select all that apply.)
A) Being a woman
B) Taking more than six medications
C) Having hypertension
D) Having cataracts
E) Muscle strength 3/5 bilaterally
F) Incontinence
Answer: B,D,E,F
Q2) The home care nurse is trying to determine the necessary services for a 65-year-old patient who was admitted to the home care service status after left knee replacement.Which tool(s)will assist with this determination?
A) Minimum Data Set (MDS)
B) Functional Status Scale (FSS)
C) 24-Hour Functional Ability Questionnaire (24hFAQ)
D) The Edmonton Functional Assessment Tool
Answer: C
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Chapter 3: Family Dynamics
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Sample Questions
Q1) Factors which would alert the nurse to negative/dysfunctional family dynamics include
A) aging of family members.
B) chronic illness of a family member.
C) disability of a family member.
D) intimate partner violence.
Answer: D
Q2) The nurse caring for a patient would identify a need for additional interventions related to family dynamics when
A) extended family offers to help.
B) family members express concern.
C) the ill member demands attention.
D) memories are shared.
Answer: C
Q3) The nurse planning to assess the structure of a family would which question?
A) "Who lives with you?"
B) "Who does the grocery shopping?"
C) "Who provides support in your family?"
D) "How old are the members of your family?"
Answer: A
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Chapter 4: Culture
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Sample Questions
Q1) 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.
Q2) 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.
Q3) The emphasis on understanding cultural influence on health care is important because of
A) disability entitlements.
B) HIPAA requirements.
C) increasing global diversity.
D) litigious society.
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Page 6
Chapter 5: Motivation
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Sample Questions
Q1) The nurse is developing a plan of care for a newly diagnosed hypertensive patient who is being discharged on medications and given the Dietary Approaches to Stop Hypertension (DASH)diet to follow.What statement by the patient signals to the nurse that the patient is motivated to learn?
A) "I am sure the medications will help to bring down my blood pressure."
B) "I can't wait to try the new recipes, and I'm hopeful I will lose weight."
C) "Do I really need to follow the diet and take medications?"
D) "I have my parents to blame for this. They both have high blood pressure."
Q2) The nurse is assessing intrinsic motivational levels of a patient who just had knee replacement surgery.Which behaviors would indicate that the patient is intrinsically motivated?
A) Agrees to take blood thinners as prescribed because that is what the doctor prescribed
B) Verbalizes an understanding of taking blood thinners postop to reduce risk of clotting
C) Knows that exercise and physical therapy (PT) will help speed recovery
D) Enjoys exercise and PT, asks for pamphlets to learn about rehab techniques
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Chapter 6: Adherence
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Sample Questions
Q1) A diabetic patient presents to the diabetes clinic with A?c levels of 7.5%.The nurse has met this patient for the first time.When applying principles of Theory of Planned Behavior (TPB),which teaching strategy by the nurse is most likely to be effective?
A) Provide information on the importance of blood glucose control in maintenance of long-term health and evaluate how the patient has been following the prescribed regime.
B) Establish a rapport with the patient by complimenting them on what they did correctly, and ask what strategies they have tried thus far.
C) Refer the patient to a certified diabetic educator, because the educator is an expert on management of diabetes complications.
D) Have the patient explain what medications they are on and what diet they should be following.
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8
Chapter 7: Fluid and Electrolyte Balance
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Sample Questions
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's laboratory report today indicates severe hypokalemia,and the nurse has notified the physician.Nursing assessment indicates that heart rhythm is regular.What is the most important nursing intervention for this patient now?
A) Raise bed side rails due to potential decreased level of consciousness and confusion.
B) Examine sacral area and patient's heels for skin breakdown due to potential edema.
C) Establish seizure precautions due to potential muscle twitching, cramps, and seizures.
D) Institute fall precautions due to potential postural hypotension and weak leg muscles.
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Chapter 8: Acid-Base Balance
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Sample Questions
Q1) The nurse is making a home visit to a child who has a chronic disease.Which finding has the greatest implication for acid-base aspects of this patient's care?
A) Urine output is very small today.
B) Whites of the eyes appear more yellow.
C) Skin around the mouth is very chapped.
D) Skin is sweaty under three blankets.
Q2) The patient had diarrhea for 5 days and developed an acid-base imbalance.Which statement would indicate that the nurse's teaching about the acid-base imbalance has been effective?
A) "To prevent another problem, I should eat less sodium during diarrhea."
B) "My blood became too acid because I lost some base in the diarrhea fluid."
C) "Diarrhea removes fluid from the body, so I should drink more ice water."
D) "I should try to slow my breathing so my acids and bases will be balanced."
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Chapter 9: Thermoregulation
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Sample Questions
Q1) The nurse planning care for a patient with hypothermia would consider knowledge of similar exemplars including
A) heat exhaustion.
B) heat stroke.
C) infection.
D) prematurity.
Q2) The priority nursing intervention for a patient suspected to be hypothermic would be to
A) assess vital signs.
B) hydrate with intravenous (IV) fluids.
C) provide a warm blanket.
D) remove wet clothes.
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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Page 11
Chapter 10: Cellular Regulation
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Sample Questions
Q1) A female patient complains of a "scab that just won't heal" under her left breast.During your conversation,she also mentions chronic fatigue,loss of appetite,and slight cough,attributed to allergies.What are the nurse's next steps?
A) Continue to conduct a symptom analysis to better understand the patient's symptoms and concerns.
B) End the appointment and tell the patient to use skin protection during sun exposure.
C) Suggest further testing with a cancer specialist and provide the appropriate literature.
D) Tell her to put a bandage on the scab and set a follow-up appointment in one week.
Q2) 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
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12
Chapter 11: Intracranial Regulation
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Sample Questions
Q1) The nurse preparing to care for a patient after a suspected stroke would question an order for a(n)
A) antihypertensive.
B) antipyretic.
C) osmotic diuretic.
D) sedative.
Q2) 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.
Q3) When caring for the patient after a head injury,the nurse would be most concerned with assessment findings which included respiratory changes,
A) hypertension, and bradycardia.
B) hypertension, and tachycardia.
C) hypotension, and bradycardia.
D) hypotension, and tachycardia.
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Chapter 12: Glucose Regulation
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Sample Questions
Q1) The nurse recognizes which patient as having the greatest risk for undiagnosed diabetes mellitus?
A) Young white man
B) Middle-aged African-American man
C) Young African-American woman
D) Middle-aged Native American woman
Q2) Which of the following would be included in the assessment of a patient with diabetes mellitus who is experiencing a hypoglycemic reaction? (Select all that apply.)
A) Tremors
B) Nervousness
C) Extreme thirst
D) Flushed skin
E) Profuse perspiration
F) Constricted pupils
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Chapter 13: Nutrition
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Sample Questions
Q1) During a nutritional assessment,the nurse calculates that a female patient's BMI is 27.The nurse would advise the patient to follow which of these recommendations?
A) This measurement indicates that the patient is overweight and should follow a plan of diet and exercise to lose weight.
B) This measurement indicates that the patient is underweight and will need to take measures to gain weight.
C) This measurement indicates that the patient is morbidly obese and may be a candidate for bariatric surgery.
D) This measurement indicates that the patient is of normal weight and should continue with current lifestyle.
Q2) 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
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Chapter 14: Elimination
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Sample Questions
Q1) 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.
Q2) When conducting a health history assessment,the nurse would want to know what important information about the patient's elimination status? (Select all that apply.)
A) Recent changes in elimination patterns
B) Changes in color, consistency, or odor of stool or urine
C) Time of day patient defecates
D) Discomfort or pain with elimination
E) List of medications taken by patient
F) Patient's preferences for toileting
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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 patient's serum electrolytes are being monitored.The nurse notices that the potassium level Is low.The nurse knows that the patient should be observed for A) tissue ischemia.
B) brain malformations.
C) intestinal blockage.
D) cardiac dysthymia.
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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Page 17
Chapter 16: Gas Exchange
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Sample Questions
Q1) The nurse is reviewing the patient's arterial blood gas results.The PaO<sub>2</sub> is 96 mm Hg,pH is 7.20,PaCO<sub>2</sub> is 55 mm Hg,and HCO<sub>3</sub> is 25 mEq/L.What would the nurse expect to observe on assessment of this patient?
A) Disorientation and tremors
B) Tachycardia and decreased blood pressure
C) Increased anxiety and irritability
D) Hyperventilation and lethargy
Q2) The nurse would identify which patient as having a problem of impaired gas exchange secondary to a perfusion problem? A patient with
A) peripheral arterial disease of the lower extremities
B) chronic obstructive pulmonary disease (COPD)
C) chronic asthma
D) severe anemia secondary to chemotherapy
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Chapter 17: Clotting
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Sample Questions
Q1) 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
Q2) 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.
Q3) Which of the following patients would the nurse anticipate the collaborative treatment of regular phlebotomies?
A) Hemophilia
B) Thrombocytopenia
C) Eosinophilia
D) Polycythemia
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19
Chapter 18: Reproduction
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Sample Questions
Q1) A female college student is planning to become sexually active.She is considering birth control options and desires a method in which ovulation will be prevented.To prevent ovulation while reaching 99% effectiveness in preventing pregnancy,which option should be given the strongest consideration?
A) Intrauterine device
B) Coitus interruptus
C) Natural family planning
D) Oral contraceptive pills
Q2) A female infertility patient is found to be hypoestrogenic at the preconceptual clinic visit.She asks the nurse why she has never been able to get pregnant.Which response is best?
A) Circulating estrogen contributes to secondary sex characteristics.
B) Estrogen deficiency prevents the ovum from reaching the uterus and may be a factor in infertility.
C) Hyperestrogen may be preventing the zona pellucida from forming an ovum protective layer.
D) The corona radiata is preventing fertilization of the ovum.
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Chapter 19: Sexuality
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Q1) Symptoms of sexual dysfunction and altered body image often coexist with prolapse of the female reproductive organs.Nursing care requires a great deal of sensitivity,because many women are embarrassed by their condition.Your patient is a 44-year-old married woman who is complaining of painful intercourse and incontinence.Clinical evaluation reveals that the patient has a cystocele.Which treatment option is most appropriate for this patient?
A) Pelvic floor training
B) Vaginal pessaries
C) Surgical correction
D) Lifestyle changes
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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Page 21
Chapter 20: Immunity
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Sample Questions
Q1) While caring for a patient preparing for a kidney transplant,the nurse knows that the patient understands teaching on immunosuppression when she states which of the following?
A) "My body will treat the new kidney like my original kidney."
B) "I will have to make sure that I avoid being around people."
C) "The medications that I take will help prevent my body from attacking my new kidney."
D) "My body will only have a problem with my new kidney if the donor is not directly related to me."
Q2) An 18-month-old female patient is diagnosed with her fifth ear infection in the past 10 months.The physician notes that the child's growth rate has decreased from the 60th percentile for height and weight to the 15th percentile over that same time period.The child has been treated for thrush consistently since the third ear infection.The nurse understands that the patient is at risk for A) primary immunodeficiency.
B) secondary immunodeficiency.
C) cancer.
D) autoimmunity.
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Page 22
Chapter 21: Inflammation
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Q1) The nurse reviews the patient's complete blood count (CBC)results and notes that the neutrophil levels are elevated,but monocytes are still within normal limits.This indicates _____ inflammatory response.
A) chronic
B) resolved
C) early stage acute
D) late stage acute
Q2) On admission to the clinic,the nurse notes a moderate amount of serous exudate leaking from the patient's wound.The nurse realizes that this fluid
A) contains the materials used by the body in the initial inflammatory response.
B) indicates that the patient has an infection at the site of the wound.
C) is destroying healthy tissue.
D) results from ineffective cleansing of the wound area.
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Chapter 22: Infection
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Q1) The nurse is caring for a patient with a diagnosed case of Clostridium difficile.The nurse expects to implement which of the following interventions? (Select all that apply.)
A) Administration of protease inhibitors
B) Use of personal protective equipment
C) Patient teaching on methods to inhibit transmission
D) Preventing visitors from entering the room
E) Administration of intravenous fluids
F) Strict monitoring of intake and output
Q2) Which set of assessment data is consistent for a patient with severe infection that could lead to system failure?
A) Blood pressure (BP) 92/52, pulse (P) 56 beats/min, respiratory rate (RR) 10 breaths/min, urine output 1200 mL in past 24 hours
B) BP 90/48, P 112 beats/min, RR 26 breaths/min, urine output 240 mL in past 24 hours
C) BP 112/64, P 98 beats/min, RR 18 breaths/min, urine output 2400 mL in past 24 hours
D) BP 152/90, P 52 beats/min, RR 12 breaths/min, urine output 4800 mL in past 24 hours
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Chapter 23: Mobility
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Sample Questions
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 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."
Q3) The lack of weight bearing leads to bone _________ and __________ from the skeletal system.
Q4) What percentage of hip fractures are the result of falls?
A) 50%
B) 80%
C) 90%
D) 100%
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Chapter 24: Tissue Integrity
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Q1) A patient is to receive phototherapy for the treatment of psoriasis.What is the nursing priority for this patient?
A) Obtaining a complete blood count (CBC)
B) Protection from excessive heat
C) Protection from excessive UV exposure
D) Instructing the patient to take their multivitamin prior to treatment
Q2) A nurse is conducting community education classes on skin cancer.One participant says to the nurse: "I read that most melanomas occur on the face and arms in fair-skinned women.Is this true?" The nurse's most helpful response would be which of the following?
A) "That is not correct. Melanoma is more commonly found on the torso or the lower legs of women."
B) "That is correct, because the face and arms are exposed more often to the sun."
C) "That is not correct. Melanoma occurs on the top of the head in men but is rare in women."
D) "That is incorrect. Melanoma is most commonly seen in dark-skinned individuals."
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Chapter 25: Sensory Perception
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Q1) An 80-year-old patient has a hearing deficit which he states is getting worse; his hearing aid needs to be replaced.He states he attends church but cannot understand the sermon anymore.He hates to go out to events because his hearing aid makes everything "noisy." He notes "nothing is the same." During the assessment he asks the nurse to repeat the question frequently.Nursing diagnoses would include which of the following? (Select all that apply.)
A) Altered growth and development
B) Social isolation
C) Chronic confusion
D) Activity intolerance
E) Hopelessness
F) Spiritual distress
Q2) The nurse is examining the eyes of a newborn infant.If the nurse notes the absence of the red reflex,she would
A) notify the physician.
B) document the finding in the records.
C) recheck the reflex after several hours.
D) monitor the eye movements and pupil reactions closely.
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Chapter 26: Pain
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Q1) An 80-year-old male patient is in the ICU status fractured femur and MVA.You are making rounds and notice he is somnolent,with no response to verbal or physical stimulation.He has been on round the clock opioids doses q 4 hours.The best immediate course of nursing action is to A) call a Code Blue.
B) stop opioid; consider administering naloxone, call Rapid Response Team (Code Blue); stay with patient, stimulate, and support respiration as indicated by patient status.
C) call the primary hospitalist in charge of patient.
D) call the anesthesia provider on call.
Q2) 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.
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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,"I'm told that I should reduce the stress in my life,but I have no idea where to start." Which would be the best initial nursing response?
A) "Why not start by learning to meditate? That technique will cover everything."
B) "In cases like yours, physical exercise works to elevate mood and reduce anxiety."
C) "Reading about stress and how to manage it might be a good place to start."
D) "Let's talk about what is going on in your life and then look at possible options."
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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 who has been diagnosed with depression is scheduled for cognitive therapy in addition to receiving prescribed antidepressant medication.The nurse understands that the goal of cognitive therapy will be met when what is reported by the patient?
A) "I will tell myself that I am a good person when things don't go well at work."
B) "My medications will make my problems go away."
C) "My family will help take care of my children while I am in the hospital."
D) "This therapy will improve my response to neurotransmitter impulses."
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) A female patient is anxious after receiving the news that she needs a breast biopsy to rule out breast cancer.The nurse is assisting with a breast biopsy.Which relaxation technique will be best to use at this time?
A) Massage
B) Meditation
C) Guided imagery
D) Relaxation breathing
Q2) A patient complains of insomnia while in the hospital.Which nursing diagnosis would be a top priority for this patient?
A) Anxiety related to hospitalization
B) Ineffective Coping related to hospitalization
C) Denial related to hospitalization
D) High Risk for Insomnia related to hospitalization
Q3) The nurse is teaching a hospitalized patient to use mindfulness to reduce anxiety.Which statement by the nurse is appropriate?
A) "How do you feel about what happened to you as a child?
B) "How do you feel about what is going on right now?"
C) "Remember a time when you were calm."
D) "Tap your hands until the feeling goes away."
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Page 32
Chapter 31: Cognition
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Q1) A nurse working in a pediatric clinic recognizes that which child is most at risk for cognitive impairment?
A) An infant who is being fed reconstituted powdered formula
B) A toddler living in an older home that is being remodeled
C) A preschooler who attends a play group 3 days a week
D) A school-age child who rides a school bus 5 days a week
Q2) A cognitively impaired patient newly admitted to the hospital is experiencing signs of sundown syndrome.Which intervention is best for the nurse to implement?
A) Leave a night light on in the room at all times.
B) Leave the television on at night with the volume up.
C) Restrain the patient to maintain safety during the confusion.
D) Administer a sleeping medication to help the patient sleep.
Q3) 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."
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Page 33
Chapter 32: Psychosis
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Q1) A client with schizophrenia has relapsed and has been identified as being in stage four of relapse.Behavior which is most consistent with this stage of relapse would include
A) expressing feelings of anxiety.
B) expressing feelings of being overwhelmed.
C) bizarre behaviors and speech.
D) presence of hallucinations.
Q2) In discussing disease prevention with a 15-year-old boy and his mother,the nurse identifies which of the following as risk factors for psychosis? (Select all that apply.)
A) Father diagnosed with paranoid schizophrenia
B) Rural residence
C) Recent immigration from Ecuador
D) Occasional cannabis use
E) January birth date
F) Physical abuse by the father
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Chapter 33: Addiction
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Q1) A 45-year-old man is brought to the emergency department presenting with a respiratory rate of 6 breaths/min,and cardiac dysrhythmias.The most appropriate question the nurse should ask the patient's friend is
A) "Does he take amphetamines or uppers?"
B) "Has he ever used LSD?"
C) "Have you two been out of the country in the last 2 days?"
D) "Is he using any opioids such as heroin?"
Q2) The nurse assesses the outcomes of a motivational interview on a patient with a dual diagnosis of alcoholism with DTs and determines that the communication was nontherapeutic.What should the nurse's next priority be?
A) Encourage the patient to think of ways to change environmental triggers to abuse substances.
B) Ask the patient what methods they think would work and encourage participating in self-help groups.
C) Notify provider to obtain order for oxazepam (Serax) and vitamin B infusion.
D) Notify provider to obtain order for CT scan and psychologic consult.
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35
Chapter 34: Interpersonal Violence
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Q1) The nurse is reviewing case files for children at risk for injury resulting in brain injury.Which child is at most risk for experiencing this type of violence?
A) A Caucasian, six-month-old infant living with a single mother
B) An African-American, 24-month-old child living with her grandmother
C) A Mexican, three-year-old child living in an inner city apartment
D) A Japanese, eight-year-old child living in a home with three generations of family
Q2) The nurse working at a women's health clinic is seeing a teenage female patient who has come in for a refill on her birth control medication and with a complaint of abdominal pain.When the nurse enters the room,the patient is sitting in the chair with her head down,rocking back and forth,does not make eye contact,and answers questions with no expression on her face.What assessment question would be important for the nurse to ask the patient?
A) "What brings you to the clinic today?"
B) "What can we do to help you today?"
C) "Do you feel safe in your current relationship?"
D) "Have you changed your diet lately?"
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36
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) 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
Q3) 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
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Chapter 36: Clinical Judgment
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Q1) A student nurse is studying clinical judgment theories and is working with Tanner's Model of Clinical Judgment.The student nurse can generalize the process as
A) a reflective process where the nurse notices, interprets, responds, and reflects in action.
B) one conceptual mechanism for critiquing ideas and establishing goal-oriented care. C) researching best practice literature to create care pathways for certain populations. D) assessing, diagnosing, implementing, and evaluating the nursing care plans.
Q2) A patient has been admitted for a skin graft following third degree burns to the bilateral calves.The plan of care involves 3 days inpatient and 6 months outpatient treatment,to include home care and dressing changes.When should the nurse initiate the educational plan?
A) After the operation and the patient is awake
B) On admission, along with the initial assessment
C) The day before the patient is to be discharged
D) When narcotics are no longer needed routinely
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Chapter 37: Leadership
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Q1) To be an effective nursing leader today requires effective collaboration,which is modeled by which answer below?
A) The nursing manager of the observation unit was certain the psychology department would assist the unit with a motivational plan, so she did not request their assistance.
B) The nursing manager of the observation unit worked with the psychology department and physical therapy to develop a motivational plan for patients on the unit.
C) The nursing director of behavioral health services followed the administrative directive to reduce services and refused to provide services for patients on other units.
D) Frustrated by the trend of patients unwilling to work with therapy, the unit manager recommended that these patients be placed on another unit.
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Chapter 38: Ethics
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Q1) A 28-year-old married woman received word that she is pregnant.Sadly,the patient is not able to carry the pregnancy because she suffers from long QT syndrome,which causes an abnormality of the heart,meaning any rush of adrenaline could prove fatal.The pregnant patient states,"I want to have this baby." The nurse realizes that this is a conflict that involves the ethical principle of A) utilitarianism.
B) deontology.
C) autonomy.
D) veracity.
Q2) An unconscious patient is treated in the emergency department for head trauma.The patient is unconscious and on life support for 2 weeks prior to making a full recovery.The initial actions of the medical team are based on which ethical principle?
A) Utilitarianism
B) Deontology
C) Autonomy
D) Veracity
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Chapter 39: Patient Education
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Q1) 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.
Q2) Strategies to include in a teaching plan for an adult who has repeatedly not followed the written discharge instructions would include
A) individualized handout.
B) instructional videos.
C) Internet resources.
D) self-help books.
Q3) The nurse educator would identify a need for further teaching when the student lists the types of learning as
A) affective.
B) cognitive.
C) psychomotor.
D) self-directed.
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Chapter 40: Health Promotion
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Q1) 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.
Q2) 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.
Q3) When there is evidence that supports a screening for an individual patient but not for the general population,the nurse would expect the United States Preventive Services Task Force Grading to be what?
A) No recommendation for or against
B) Recommends
C) Recommends against
D) Strongly recommends
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Page 42
Chapter 41: Communication
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Q1) Critical Thinking: The nurse is seeking clarification of a statement that was made by a patient.What is the best way for the nurse to seek clarification?
A) "What are the common elements here?"
B) "Tell me again about your experiences."
C) "Am I correct in understanding that "
D) "Tell me everything from the beginning."
Q2) A patient does not make eye contact with the nurse and is folding his arms at his chest.Which aspect of communication has the nurse assessed?
A) Nonverbal communication
B) A message filter
C) A cultural barrier
D) Social skills
Q3) 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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Page 43
Chapter 42: Collaboration
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Q1) A nurse manager has recently overheard several negative comments made by nurses on the unit about other nurses on the unit.The manager recognizes that the nurses are exhibiting what type of behavior that is detrimental to collaboration?
A) Vertical violence
B) Lateral violence
C) Descending violence
D) Personal violence
Q2) The nurse is caring for a patient with a progressive,degenerative muscle illness.The patient states that she would like to remain in her home with her daughter as long as possible.What action should the nurse take?
A) Teach the patient muscle strengthening and stretching exercises.
B) Tell the patient to make plans to move to an assisted-living facility.
C) Discuss resources to help the patient and make appropriate referrals.
D) Ask the patient to come in for daily physical therapy.
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Chapter 43: Safety
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Q1) 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.
Q2) To promote a safety culture,the nurse manager preparing the staff schedule considers the anticipated census in planning the number and experience of staff on any given shift.The human factor primarily addressed with this consideration is/are A) available supplies.
B) interdisciplinary communication.
C) interruptions in work.
D) workload fluctuations.
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) To design and implement a decubitus ulcer risk management protocol in the electronic health record,the informatics nurse would first
A) build the screens in the electronic health record.
B) determine evidence supporting decubitus ulcer risk management.
C) develop the training program for staff.
D) select the appropriate standardized language.
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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Chapter 45: Evidence
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Q1) One of the first nurse researchers to document evidence-based practice for nursing was Florence Nightingale.What did Nightingale incorporate into her practice that made her practice different from her colleagues?
A) Nightingale gathered scientific data.
B) Nightingale calculated statistics to report her findings.
C) Nightingale communicated her findings to powerful others.
D) Nightingale based her nursing practice on her findings.
Q2) 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
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Chapter 46: Health Care Quality
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Q1) A student nurse is talking with his instructor.The student asks how quality of care is evaluated.The best response by the instructor is "Quality of care is evaluated
A) by the patient getting well."
B) on the basis of process and outcomes."
C) by the physician's assessment."
D) by the patient's satisfaction."
Q2) The patient's perception of his or her care is not as important as the outcome of the care.
A)True
B)False
Q3) 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
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Chapter 47: Care Coordination
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Q1) Care coordination models should be adopted in health care facilities.If models are not put into practice,the shortcomings of the health care system may display which of the following items? (Select all that apply.)
A) Decrease in patients
B) Fragmented services
C) Low birth weight newborns
D) Cost inefficiencies
E) Poor health outcomes
F) Increased pharmacy costs
Q2) The nurse is discussing care coordination with a patient.The patient asks the nurse to explain care coordination.The nurse's best response would be,"Care coordination
A) is a cost effective method created by the community."
B) forces the health care facilities in the community to work together."
C) exists for the children and uninsured in the community."
D) allows health care services to work together in the community."
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Chapter 48: Caregiving
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Q1) 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."
Q2) A mother is talking with the community-based nurse concerning her adult son.The son is mentally challenged and not able to live on his own.The mother is concerned about her son's welfare when she is no longer able to care for him.The best response by the nurse would be which of the following?
A) "Let's look into the community resources that are available to assist you."
B) "You have raised your son well, and he will be okay on his own."
C) "Contact your distant relatives to see if anyone would take your son."
D) "There are places for mentally challenged adults; let's place him there."
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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) One of the biggest challenges facing current nursing practice is
A) the number of aging Americans living with chronic disease.
B) the number of patients entering into hospice programs.
C) the number of cancer patients receiving supportive care.
D) reduced length of stay in hospice care.
Q3) When considering the trajectory of a specific disease,what is the most important concept?
A) Hospital admissions
B) Physical functioning
C) Quality of life
D) Symptom management
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Chapter 50: Health Care Organizations
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Q1) A nurse is interviewing at an agency owned by a national religious organization that serves homeless and uninsured patients.A large poster display shows a proposed addition that would add 16 beds to the facility that will be funded from profits of the previous 3 years of operation.The nurse recognizes that the agency is most likely what type of agency?
A) For-profit
B) Not-for-profit
C) Publicly-owned
D) Investor-owned
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) Which of the following statements is true about health care in the US?
A) The US spends more money on health care than any other nation.
B) The US provides health care to every citizen.
C) The US relies on government funding to treat most citizens.
D) The US spends less money on pediatric care than other nations.
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Chapter 52: Health Policy
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Q1) Which of the following is the intent of HIPAA?
A) Release of patient information for purposes of insurance reimbursement
B) Prevent health care providers from billing for procedures done for the insured person
C) Protect patients from reviewing their own medical records
D) Limit the ability of health care providers to sell patient information to outside sources
Q2) 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
Q3) Which branch of government is responsible for the execution of laws passed by legislatures?
A) Legislative
B) Judicial
C) Executive
D) Local
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Chapter 53: Health Care Law
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Q1) In which of the following answers is the hospital in compliance with the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA)?
A) The emergency department staff asks a patient to stay in the waiting room until the patients with insurance are treated.
B) The emergency registration personnel explain to a patient that they must have proper identification to receive treatment.
C) A patient with chest pain is triaged directly to a room for evaluation and registration information is obtained after the patient is stabilized.
D) The emergency department physician discharges and instructs a patient who is actively suicidal to go the neighbor facility that has psychiatric services.
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.
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