Foundations of Nursing Study Guide Questions
Course
Introduction
Foundations of Nursing introduces students to the core principles, theories, and practices that form the basis of the nursing profession. This course covers the historical evolution of nursing, the role and responsibilities of nurses within the healthcare system, and fundamental concepts such as patient safety, ethical and legal considerations, communication, and evidence-based care. Emphasis is placed on the development of critical thinking, clinical judgment, and professional values, preparing students to provide compassionate and effective care to individuals across the lifespan in diverse healthcare settings.
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) The nurse manager of a pediatric clinic could confirm that the new nurse recognized the purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it is used to assess for needs related to A) anticipatory guidance.
B) low-risk adolescents.
C) physical development.
D) sexual development.
Answer: A
Q2) 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
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Chapter 2: Functional Ability
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Sample Questions
Q1) Use A for instrumental activities of daily living (IADLs)and use B for basic activities of daily living (BADLs).
(Your answer should appear as letters separated by commas and spaces [e.g.,A,A,A,A,A,A].)
A) Uses a cane
B) Bathes daily
C) Takes medications as prescribed
D) Dresses self
E) Balances the checkbook
F) Cleans the house
Answer: B,B,A,B,A,A
Functional impairment,disability,or handicap refers to varying degrees of an individual's inability to perform the tasks required to complete normal life activities without assistance.IADLs are more complex skills that are essential to living in the community.
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4
Chapter 3: Family Dynamics
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Q1) 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
Q2) 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
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Chapter 4: Culture
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Q1) Understanding cultural differences in health care is important because it will help the nurse to understand the manner in which people decide on obtaining treatments and medical care.In independent cultures an individual will
A) put himself first.
B) consult family members for advice.
C) ask for a second opinion.
D) travel great distances to receive the best care.
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) 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
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Page 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 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."
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Chapter 6: Adherence
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Q1) When assessing a 22-year-old male patient,the nurse learns that he smokes a pack of cigarettes daily.The patient tells the nurse,"I enjoy smoking and have no plans to quit." Which nursing diagnosis is most appropriate?
A) Health Seeking Behaviors related to cigarette use
B) Ineffective Health Maintenance related to tobacco use
C) Readiness for Enhanced Self-Health Management related to smoking
D) Deficient Knowledge related to long-term effects of cigarette smoking
Q2) The nurse is evaluating the need to refer a patient with osteoarthritis for a home care visit to be sure the patient can function in accomplishing daily activities independently.What is the nurse's first priority?
A) Determine if the patient has had home visits before and if the experience was positive.
B) Check the patient's ability to bathe without any assistance the next day.
C) Have the patient demonstrate the learned skills at the end of the teaching session.
D) Arrange a physical therapy visit before the patient is discharged from the hospital.
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8
Chapter 7: Fluid and Electrolyte Balance
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Sample Questions
Q1) 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
Q2) 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
Q3) 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
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Chapter 8: Acid-Base Balance
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Q1) The patient has severe hyperthyroidism and will have surgery tomorrow.What assessment is most important for the nurse to assess in order to detect development of the acid-base imbalance for which the patient has highest risk?
A) Urine output and color
B) Level of consciousness
C) Heart rate and blood pressure
D) Lung sounds in lung bases
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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10
Chapter 9: Thermoregulation
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Sample Questions
Q1) 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.
Q2) The nursery nurse identifies a newborn at significant risk for hypothermic alteration in thermoregulation because the patient is
A) large for gestational age.
B) low birth weight.
C) born at term.
D) well nourished.
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) 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) The nurse would incorporate which of the following into the plan of care as a primary prevention strategy for reduction of the risk for cancer?
A) Yearly mammography for women aged 40 years and older
B) Using skin protection during sun exposure while at the beach
C) Colonoscopy at age 50 and every 10 years as follow-up
D) Yearly prostate specific antigen (PSA) and digital rectal exam for men aged 50 and over
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Chapter 11: Intracranial Regulation
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Sample Questions
Q1) 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.
Q2) 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.
Q3) The earliest and most sensitive assessment finding that would indicate an alteration in intracranial regulation would be A) change in level of consciousness.
B) inability to focus visually.
C) loss of primitive reflexes.
D) unequal pupil size.
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13
Chapter 12: Glucose Regulation
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Q1) 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
Q2) 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
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14
Chapter 13: Nutrition
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Q1) 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
Q2) 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.
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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) 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.
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 conducting a patient assessment.The patient tells the nurse that he has smoked two packs of cigarettes per day for 27 years.The nurse may find which data upon assessment?
A) Blood pressure above the normal range
B) Bounding pedal pulses
C) Night blindness
D) Reflux disease
Q2) The patient is brought to the emergency department after a motor vehicle accident.The patient is diagnosed with internal bleeding.The nurse's primary concern is to monitor for
A) mental alertness.
B) perfusion.
C) pain.
D) reaction to medications.
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Chapter 16: Gas Exchange
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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) Which patient would the nurse identify as being at an increased risk for altered transport of oxygen? A patient with A) hemoglobin level of 8.0
B) bronchoconstriction and mucus
C) peripheral arterial disease
D) decreased thoracic expansion
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Chapter 17: Clotting
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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) The nurse is making a home visit to a patient who was discharged from the hospital on Lovenox and warfarin following replacement of the patient's pacemaker.Which observation indicates excessive bleeding? (Select all that apply.)
A) New ecchymosis on the abdomen
B) A nosebleed that does not stop with pressure
C) Pain of the lower extremity with flexion
D) Extreme fatigue
E) Pallor
F) Sudden onset of severe headache
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Chapter 18: Reproduction
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Q1) A female patient comes to the clinic after missing one menstrual period.She lives in a house beneath electrical power lines which is located near an oil field.She drinks two caffeinated beverages a day,is a daily beer drinker,and has not stopped eating sweets.She takes a multivitamin and exercises daily.She denies drug use.Which finding in the history has the greatest implication for this patient's plan of care?
A) Electrical power lines are a potential hazard to the woman and her fetus.
B) Living near an oil field may mean the water supply is polluted.
C) Alcohol exposure should be avoided during pregnancy due to teratogenicity.
D) Eating sweets may cause gestational diabetes or miscarriage.
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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Page 20
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) 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
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Page 21
Chapter 20: Immunity
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Q1) 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.
Q2) The parents of a newborn question the nurse about the need for vaccinations: "Why does our baby need all those shots? He's so small,and they have to cause him pain." The nurse can explain to the parents that which of the following are true about vaccinations?
(Select all that apply.)
A) Are only required for infants
B) Are part of primary prevention for system disorders
C) Prevent the child from getting childhood diseases
D) Help protect individuals and communities
E) Are risk free
F) Are recommended by the Centers for Disease Control and Prevention (CDC)
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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) The nurse assesses the patient and notes all of the following.Select all of the findings that indicate the systemic manifestations of inflammation.
A) Oral temperature 38.6° C/101.5° F
B) Thick, green nasal discharge
C) Patient complaint of pain at 6 on a 0 to 10 scale on palpation of frontal and maxillary sinuses
D) WBC 20 ´ 109/L
E) Patient reports, "I'm tired all the time. I haven't felt like myself in days."
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Chapter 22: Infection
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Q1) 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.
Q2) While reviewing the complete blood count (CBC)of a patient on her unit,the nurse notes elevated basophil and eosinophil readings.The nurse realizes that this is most indicative of a _____ infection.
A) bacterial
B) fungal
C) parasitic
D) viral
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Chapter 23: Mobility
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Q1) 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."
Q2) A patient is talking with the nurse about hip fractures.The patient would like to know the best approach to strengthen the bones.The nurse's best response is which of the following?
A) "Walk at least 5 miles every day for exercise."
B) "Wear proper fitting shoes to prevent tripping."
C) "Talk with your physician about a calcium supplement."
D) "Stand up slowly so you don't feel faint."
Q3) What percentage of hip fractures are the result of falls?
A) 50%
B) 80%
C) 90%
D) 100%
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Page 25
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) A patient asks the nurse what the purpose of the Wood's light is.Which response by the nurse is accurate?
A) "We will put an anesthetic on your skin to prevent pain."
B) "The lamp can help detect skin cancers."
C) "Some patients feel a pressure-like sensation."
D) "It is used to identify the presence of infectious organisms and proteins associated with specific skin conditions."
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Chapter 25: Sensory Perception
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Q1) The nurse requests that a mother give permission for a hearing test in a newborn infant.The mother questions the importance of such a test.The nurse correctly responds with which of the following statements?
A) "This will help us to identify your baby's risk for ear infections the first year of life."
B) "Hearing is important so your baby hears and responds to your voice, which makes you feel like a mother."
C) "Socialization skills include the need to hear in order to interpret the emotional aspect of the words that are spoken to your child."
D) "Imitation of sounds is the first step in language development, and it is important to identify alterations early."
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) 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) A patient has not been sleeping well because he is worried about losing his job and not being able to support his family.The nurse takes the patient's vital signs and notes a pulse rate of 112 beats/min,respirations are 26 breaths/min,and his blood pressure is 166/88 instead his usual 110-120/76-84 range.Which nursing intervention or recommendation should be used first?
A) Go to sleep 30 to 60 minutes earlier each night to increase rest.
B) Relax by spending more time playing with his pet dog.
C) Slow and deepen breathing via use of a positive, repeated word.
D) Consider that a new job might be better than his present one.
Q2) 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.
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Chapter 28: Coping
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Q1) 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
Q2) The nurse is assessing the coping patterns of a newly admitted patient.What will the nurse include in this assessment? (Select all that apply.)
A) Current stressors as perceived by the patient
B) Use of drugs or alcohol
C) Recent weight changes
D) Age and height
E) Temperature
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Chapter 29: Mood and Affect
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Q1) 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.
Q2) A patient with a diagnosis of depression and suicidal ideation was started on an antidepressant 1 month ago.When the patient comes to the community health clinic for a follow-up appointment he is cheerful and talkative.What priority assessment must the nurse consider for this patient?
A) The medication dose needs to be decreased.
B) Treatment is successful, and medication can be stopped.
C) The patient is ready to return to work.
D) Specific assessment for suicide plan must be evaluated.
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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 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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Chapter 31: Cognition
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Q1) The nurse is teaching primary prevention of cognitive impairment at a community health fair.Which topics would be included in the presentation? (Select all that apply.)
A) Do not use substances such as cannabis (marijuana) and alcohol.
B) Wear helmets when riding bicycles and motorcycles.
C) Complete a Mini Mental Status Exam (MMSE) yearly.
D) Correct acid-base imbalances related to underlying disease processes.
E) Wear a seat belt whenever riding in a motorized vehicle.
F) Complete a Confusion Assessment Method (CAM) scale yearly.
Q2) The nurse is reviewing new medication orders for several patients in a long-term care facility.Which patient does the nurse recognize as being at the highest risk for having cognitive impairment related to prescribed medications?
A) The patient prescribed an antibiotic for a urinary tract infection
B) The patient prescribed a cholinesterase inhibitor for early Alzheimer's disease
C) The patient prescribed a beta-blocker for hypertension
D) The patient prescribed a bisphosphonate for osteoporosis
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Chapter 32: Psychosis
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Q1) The nurse is caring for a 32-year-old woman diagnosed with schizophrenia.The woman tells the nurse,"The news on TV last night was all about me." This is an example of what kind of thought content?
A) Thought insertion
B) Thought broadcasting
C) Magical thinking
D) Ideas of reference
Q2) A 23-year-old male veteran of the war in Iraq is admitted with a diagnosis of posttraumatic stress disorder (PTSD)following his arrest for destroying his girlfriend's apartment.This is not his first angry outburst resulting in destruction of property.Which interventions by the nurse will be most helpful to this patient? (Select all that apply.)
A) Allow opportunities for him to express his anger.
B) Provide patient and family teaching regarding PTSD.
C) Tell the patient that hurting himself will solve nothing.
D) Report him to the authorities.
E) Exhibit a nonjudgmental attitude.
F) Reassure him that everything will be all right.
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Page 34
Chapter 33: Addiction
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Q1) 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.
Q2) During history-taking,a patient tells the nurse that he is addicted to alprazolam (Xanax)and that he takes six 1 mg tablets a day.He quit cold turkey yesterday and now presents with extreme agitation,increased heart rate,and panic.The nurse suspects which disorder?
A) Stress reaction
B) DTs
C) Overdose
D) Relapse
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Chapter 34: Interpersonal Violence
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Q1) 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?"
Q2) A nurse is caring for a patient in the emergency department who has been a victim of intimate partner violence.What is most important for the nurse to include in the plan of care?
A) Medication to calm the perpetrator of the violence
B) A list of community resources
C) A referral for self-defense training
D) A referral to the victim's religious advisor
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Page 36
Chapter 35: Professionalism
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Q1) The qualities of leadership,clinical expertise and judgment,mentorship,and lifelong learning would describe a nurse who is a(n)
A) administrator.
B) certified nurse specialist.
C) practitioner.
D) professional.
Q2) The ANA outlines expectations of the nursing profession in the
A) Gallup poll.
B) Goldman report.
C) Social Policy Statement.
D) social identity theory.
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 home care nurse receives a physician order for a medication that the patient does not want to take because the patient has a history of side effects from this medication.The nurse carefully listens to the patient,considers it in light of the patient's condition,questions its appropriateness,and examines alternative treatments.This nurse would most likely
A) call the physician, explain rationale, and suggest a different medication.
B) consult an experienced nurse on whether there are other similar treatments.
C) hold the drug until the physician returns to the unit and can be questioned.
D) question other staff as to the physician's acceptance of nursing input.
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Page 38
Chapter 37: Leadership
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Q1) The hospital must reduce the number of readmissions from 11% to 8% in the next year.Which of the following best represents the transformational leadership style in accomplishing this goal?
A) The director communicates the goal of reducing readmissions to the hospital operations team and tells them to submit their action plan by the end of the week.
B) The organization charters three work teams to identify solutions for the top three causes for readmissions. These teams are given full authority to implement their solution.
C) The director of quality develops a vision statement and action plan to achieve the goal. The director works directly with the involved departments to implement the action plan.
D) The CEO communicates the goal to the organizational directors and managers and states that they are entrusted to solve the problem.
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Chapter 38: Ethics
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Q1) A nurse on the unit makes a error in the calculation of the dose of medication for a critically ill patient.The patient suffered no ill consequences from the administration.The nurse decides not to report the error or file an incident report.The nurse is violating which principle of ethics?
A) Fidelity
B) Individuality
C) Justice
D) Values clarification
Q2) A nursing student is doing a survey of fellow nursing students.Which ethical concept is the student following when calculating the risk-to-benefit ratio and concluding that no harmful effects were associated with a survey?
A) Beneficence
B) Human dignity
C) Justice
D) Human rights
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Chapter 39: Patient Education
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Q1) When describing patient education approaches,the nurse educator would explain that informal teaching is an approach that A) addresses group needs.
B) follows formalized plans.
C) has standardized content.
D) often occurs one-to-one.
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) Interrelated concepts to the professional nursing role a nurse manager would consider when addressing concerns about the quality of patient education include A) adherence.
B) developmental level.
C) motivation.
D) technology.
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Chapter 40: Health Promotion
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Q1) 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.
Q2) At the well-child clinic,the nurse teaching a mother about health promotion activities describes immunizations as
A) unique for children.
B) primary prevention.
C) secondary prevention.
D) tertiary prevention.
Q3) The nurse in a newly opened community health clinic is developing a program for the individuals considered at greatest risk for poor health outcomes.The group is considered the
A) global community.
B) sedentary society.
C) unmotivated population.
D) vulnerable populations.
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Page 42
Chapter 41: Communication
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Q1) Critical Thinking: A patient states,"I had a bad nightmare.When I woke up,I felt emotionally drained,as though I hadn't rested well." Which response by the nurse would be an example of interpersonal therapeutic communication?
A) "It sounds as though you were uncomfortable with the content of your dream."
B) "I understand what you're saying. Bad dreams leave me feeling tired, too."
C) "So, all in all, you feel as though you had a rather poor night's sleep?"
D) "Can you give me an example of what you mean by a 'bad nightmare'?"
Q2) A patient states that everything has been going great; however,the nurse observe the patient biting his nails and fidgeting.What assessment can the nurse make? The patient's communication type is
A) linguistic.
B) paralinguistic.
C) explicit.
D) inadequate.
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Chapter 42: Collaboration
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Sample Questions
Q1) Which activities are appropriate for the nurse to collaborate with a patient? (Select all that apply.)
A) Prescribing a new medication dose
B) Health promotion activities
C) End-of-life comfort decisions
D) Interpreting laboratory results
E) Lifestyle changes to improve health
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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44
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) A staff nurse reports a medication error,failure to administer a medication at the scheduled time.An appropriate response of the charge nurse would be
A) "We'll do a root cause analysis."
B) "That means you'll have to do continuing education."
C) "Why did you let that happen?"
D) "You'll need to tell the patient and family."
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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Sample Questions
Q1) The staff nurse who uses informatics in promoting quality patient care is most likely to access data in the domain of
A) certified clinical information systems (CIS).
B) clinical health care informatics.
C) public health/population informatics.
D) translational bioinformatics.
Q2) 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.
Q3) 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.
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Page 46
Chapter 45: Evidence
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Q1) The nurse in the psychiatric unit is involved in a research study for a depression medication.In the study,patients are randomly assigned to one depression medication and the other group is receiving no medication to treat the depression.What method of research are the patients involved with?
A) Descriptive
B) Correlational
C) Quasi-experimental
D) Experimental
Q2) How does the Iowa model transcend mere nursing care? (Select all that apply.)
A) It includes formalized internal feedback loops.
B) Its triggers can have their origins practically anywhere.
C) It generates change in practice solely through research.
D) It implies a layer of policy development.
E) It addresses multiple disciplines' impacts on quality.
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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) The focus of quality health care should be on which of the following items? (Select all that apply.)
A) Excellent services
B) Comprehensive communication
C) Private hospital rooms
D) Health team collaboration
E) Culturally competent care
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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Page 48
Chapter 47: Care Coordination
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Q1) For children and teens,the model that includes school-based services is the _____ Model
A) Social
B) Integrated
C) Medically-Oriented
Q2) A nursing instructor is talking about care coordination with nursing students.The instructor stresses which of the following to the students concerning care coordination?
A) "A patient must ask for what they need in order to coordinate care."
B) "The nurse does most of the work in care coordination."
C) "Medical diagnoses are an integral part of care coordination."
D) "Collaboration is a big part of care coordination."
Q3) 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) The community health nurse is assessing a family who has a chronically ill child.The child needs special care,and the nurse has to coordinate the care for the home setting.What behavior will the nurse assess for to know that the family can care for the child?
A) The family is willing to learn about the care and share the caregiving needs.
B) The mother is going to care for the child and the family herself.
C) The older siblings are going to care for the child while the parents are at work.
D) An outside agency will be coming to the home three times a week to give care.
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) Palliative care does everything except
A) promote comfort.
B) reduce disease exacerbations.
C) decrease acute care hospital admissions.
D) promote a cure for chronic disease.
Q2) 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
Q3) 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.
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Chapter 50: Health Care Organizations
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Q1) A quality improvement committee is reviewing discharge surveys.Results show that patients and their families have difficulty finding departments and areas of the hospital.What action by the committee would best address this concern for the organization?
A) Continue to review future surveys to monitor the situation.
B) Give additional training to the receptionists and switchboard personnel to give better directions.
C) Form a multidisciplinary committee to identify options to help travel through the hospital.
D) Send a work order to the maintenance department requesting that brighter lights be installed.
Q2) 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
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Chapter 51: Health Care Economics
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Q1) 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.
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) A student asks the instructor about health care economics.The instructor knows the student understands when the student states which of the following?
A) "The elderly population uses most of the health care services."
B) "Everyone should have health insurance to obtain services."
C) "Health care dollars should be partitioned by the government."
D) "Resources will be needed to serve health care issues."
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Page 53
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) A nursing student is preparing a care plan for an assigned patient.When accessing the electronic medical record,what is acceptable information to view? (Select all that apply.)
A) Laboratory data of the assigned patient
B) Admission diagnosis for a patient who is a former neighbor
C) The patient's age, date of birth, and gender
D) The history and physical of the assigned patient
E) A classmate's brother's chest x-ray report
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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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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