Health Assessment for Nurses
Exam Answer Key
Course Introduction
Health Assessment for Nurses is a foundational course designed to equip nursing students with the essential skills and knowledge required to conduct comprehensive and focused health assessments across the lifespan. The course covers systematic approaches to physical, psychological, social, and cultural assessment, with an emphasis on the collection and interpretation of subjective and objective data. Students learn techniques for interviewing, taking health histories, and performing physical examinations, as well as recognizing normal and abnormal findings. The integration of critical thinking and clinical reasoning skills enables students to effectively identify health needs, prioritize care, and communicate findings within the multidisciplinary healthcare team.
Recommended Textbook
Fundamentals of Nursing Active Learning for Collaborative Practice 1st Edition by Yoost
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1050 Verified Questions
1050 Flashcards
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Chapter 1: Nursing, Theory, and Professional Practice
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Sample Questions
Q1) A nursing class volunteers to serve hot meals at a local homeless shelter on a Saturday afternoon. This focus on serving the community is called:
A) Altruism.
B) Accountability.
C) Autonomy.
D) Advocate.
Answer: A
Q2) The nurse is caring for a patient who refuses two units of packed red blood cells. The nurse notifies the health care provider of the patient's decision. The nurse is acting in the role of the:
A) Manager.
B) Change agent.
C) Advocate.
D) Educator.
Answer: C
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Chapter 2: Values, Beliefs, and Caring
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Sample Questions
Q1) The nurse is caring for a patient scheduled for heart surgery. Which statement made by the patient requires further discussion?
A) "My friend died on the operating table several months ago."
B) "The surgeon has a great reputation in the community."
C) "I believe that this surgery is going to make me better."
D) "Yesterday I asked my pastor to visit me after the procedure."
Answer: A
Q2) The nurse is caring for a patient who is under arrest for murder. She is attempting to perform her duties while, at the same time, feeling a sense of repugnance toward the patient. The nurse is undergoing:
A) value clarification
B) value conflict
C) first-order beliefs
D) higher-order beliefs
Answer: B
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Chapter 3: Communication
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Sample Questions
Q1) The nurse is caring for an adult patient with a recent below-the-knee amputation. During shift report, the nurse reports that the patient has urinated in the bed multiple times since the surgery. Which defense mechanism best describes this behavior?
A) compensation
B) denial
C) rationalization
D) regression
Answer: D
Q2) The nurse is admitting a patient with a foul smelling leg wound. Which behavior by the nurse indicates an understanding of appropriate body language?
A) Using hand gestures to enhance verbal communication
B) Standing at the end of the bed with arms crossed
C) Facial grimacing at the sight of the wound
D) Gentle touching of the patient's shoulder
Answer: D
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5
Chapter 4: Critical Thinking in Nursing
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Sample Questions
Q1) The nurse is reviewing the last 3 days of a patient's pain history and notes that the pain level has remained constant. The nurse validates the pain level with the patient and decides to contact the physician for further orders. In this scenario the nurse is using the process of:
A) decision making.
B) reasoning.
C) problem solving.
D) judgment.
Q2) To develop critical thinking, the nurse needs to develop a critical-thinking character that includes:
A) developing honesty and confidence.
B) learning from experiences.
C) enhancing self-reliance.
D) growing a "thick skin" to withstand criticism.
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Chapter 5: Introduction to the Nursing Process
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Sample Questions
Q1) Establishing short- and long-term goals to address nursing diagnoses involves: (Select all that apply.)
A) discussion with the patient.
B) exclusion of family with making patient decisions.
C) collaboration with other members of health care team.
D) making the health care provider as the central figure.
E) coordination of care as collaborative care.
Q2) In which step of the nursing process does the nurse prioritize the nursing diagnoses and identify interventions to address the patient goals?
A) Assessment
B) Planning
C) Implementation
D) Evaluation
Q3) The nurse is gathering data on a patient with acute bacterial pneumonia. This is an example of which step of the nursing process?
A) Assessment
B) Planning
C) Implementation
D) Evaluation
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Chapter 6: Assessment
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Q1) The nurse is performing an assessment of a patient's right kidney. The nurse bluntly strikes the area of the costovertebral angle while observing the patient's reaction. The physical assessment technique being used is:
A) inspection.
B) percussion.
C) palpation.
D) auscultation.
Q2) After the patient's data are collected, validated, and interpreted, the nurse organizes the information in a framework (format) that facilitates access by all members of the health care team. The framework that provides the most holistic view of the patient's condition is:
A) the head-to-toe pattern
B) Marjory Gordon's Functional Health Patterns.
C) the cephalic-caudal pattern.
D) the body systems model.
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Chapter 7: Nursing Diagnosis
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Sample Questions
Q1) The nurse is reviewing data obtained through the health history interview and physical assessment of an assigned patient. Data collected include dry skin, brittle nails, weight gain, thinning hair, constipation, prolonged menstruation, and the patient's complaints of feeling tired and cold. Which statement represents an appropriate data cluster?
A) Prolonged menstruation, constipation
B) Dry skin, brittle nails, weight gain
C) Tired, cold, thinning hair
D) Constipation, weight gain
Q2) The nurse in an outpatient clinic obtains a blood pressure of 190/88 mm Hg on a patient diagnosed with high blood pressure. The patient tells the nurse, "My blood pressure medicine is really expensive. Do you think I really need it?" The nurse assumes the patient is not taking the medication based on the blood pressure result and the patient's statement and chooses noncompliance as a diagnostic label. The action by the nurse is an example of:
A) clustering unrelated data in the diagnostic statement.
B) selecting erroneous data for use in the diagnostic statement.
C) using medical diagnoses in the diagnostic statement.
D) identifying multiple problems within one diagnostic statement.
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Page 9
Chapter 8: Planning
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Sample Questions
Q1) Which goal is written correctly for the nursing diagnosis of activity intolerance related to imbalance between oxygen supply and demand?
A) Patient will walk 1 mile without shortness of breath.
B) Patient will ambulate 100 feet with no shortness of breath on third day after treatment.
C) Patient will climb stairs without shortness of breath by day 2 of hospital stay
D) Patient will tolerate activity.
Q2) Dependent nursing interventions include:
A) ordering heel protectors.
B) preadmission teaching.
C) medication reconciliation.
D) administer antipyretic medications as appropriate.
Q3) Which statement is correct regarding diversity considerations?
A) The male gender may struggle less with health care terminology.
B) High numbers of minority populations do not understand health teachings.
C) Older adults have an easier time understanding health teachings because of life experience.
D) Disabilities have no impact on the development of patient care goals.
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Chapter 9: Implementation and Evaluation
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Sample Questions
Q1) Which of the following is a direct care intervention?
A) Administration of an injection
B) Making the change-of-shift report
C) Collaborating with members of the health care team
D) Ensuring availability of needed equipment
Q2) In implementing research-based interventions, the nurse realizes that:
A) implementation of evidence-based care is unique to the nursing profession.
B) evidence-based practice is based entirely in nursing research.
C) evidence-based care is focused on practices and not outcomes.
D) nurses must read recent literature and remain current in practice
Q3) Which of the following cannot be delegated?
A) Obtaining vital signs
B) Assessment of lung sounds
C) Bathing a patient
D) Ambulating a patient
Q4) Documentation is a vital nursing role since the patient's health record:
A) should be completed accurately and in a timely manner.
B) should not be computerized (EHR) because of disclosure risks.
C) is not a legal document although they can be helpful in lawsuits.
D) cannot be used in determining billing and reimbursement issues.
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Chapter 10: Documentation, Electronic Health Records, and Reporting
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Sample Questions
Q1) Expected nursing documentation includes: (Select all that apply.)
A) nursing assessment.
B) the care plan.
C) critique of the physician's care.
D) interventions.
E) patient responses to care.
Q2) The process of making a change-of-shift report (handoff):
A) is an uncommon occurrence of little importance.
B) occurs only at change of shift and only to oncoming nurses.
C) can lead to patient death if done incorrectly.
D) does not allow for collaboration or problem solving.
Q3) The nurse is admitting a patient who has had several previous admissions. In order to obtain a knowledge base about the patient's medical history, the nurse may use the:
A) electronic medical record (EMR).
B) the computerized provider order entry (CPOE).
C) electronic health record (EHR).
D) American Recovery and Reinvestment Act.
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Page 12
Chapter 11: Ethical and Legal Considerations
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Sample Questions
Q1) The nurse is caring for a patient whose family does not want the patient to be told about the new diagnosis of cancer because of the poor prognosis. Keeping this secret from the patient is in direct conflict with the ethical concepts of:
A) autonomy and veracity.
B) veracity and advocacy.
C) justice and nonmaleficence.
D) confidentiality and justice.
Q2) The Code of Ethics for Nurses is:
A) like the Constitution and not revisable.
B) a succinct statement of ethical obligations.
C) required by entry level nurses only.
D) a negotiable document dependent on individual conscience.
Q3) State legislatures give authority to administrative bodies, such as state boards of nursing, to:
A) create statutory laws.
B) establish regulatory laws.
C) try case law cases.
D) create laws based on social mores.
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13
Chapter 12: Leadership and Management
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Sample Questions
Q1) Hiscock and Shuldham state that, in order to deliver quality care, it is important for nurse leaders to be focused on the:
A) patient.
B) self.
C) staff.
D) physician.
Q2) Which of the following has been done improperly?
A) The UAP re-delegates vital signs to the student nurse.
B) The RN delegates assistance with bathing to the student nurse.
C) The RN delegates monitoring of intake and output to the UAP.
D) The RN delegates assistance with mobility to the UAP.
Q3) The manager of the intensive care unit is accepting an award for excellence and efficiency in the provision of patient care. The manager accepts the award for the unit and cites the contributions of her staff since, without their expertise and dedication, the award may not have been achieved. The manager is demonstrating the quality of:
A) dedication.
B) openness.
C) magnanimity.
D) creativity.
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Page 14
Chapter 13: Evidence-Based Practice and Nursing Research
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Q1) Barriers to the use of evidence-based practice (EBP) include: (Select all that apply.)
A) nurses critiquing research.
B) difficulty communicating how to conduct EBP.
C) the copious amount of literature available.
D) the short time between research and practice.
E) the reluctance of organizations to fund research.
Q2) The nurse is preparing to conduct a research study and is interested in exploring the lived experiences of nurses responsible for approaching patients and family members about the donation of organs. This type of research would be considered:
A) grounded theory.
B) ethnography.
C) historical.
D) phenomenologic.
Q3) When applying research to practice, the nurse finds that:
A) it is usually easy to access information at the bedside.
B) research articles are clear in defining nursing practice.
C) bedside care is not directly related to research.
D) nursing research should be used to improve care.
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Chapter 14: Health Literacy and Patient Education
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Sample Questions
Q1) The nurse is admitting a patient who has cystic fibrosis. During the admission interview, it is apparent that the patient is well versed in most aspects of his illness. When asked about where he learned so much, the patient responds, "I learned most of it myself. I looked things up on the Internet and read books. You have to know what's wrong with you to be sure that you're being treated right." This is an example of:
A) formal education.
B) psychomotor learning.
C) informal education.
D) affective learning.
Q2) As the health care community explores the concept of health literacy, many organizations recognize that:
A) consumers need to understand has no governmental support.
B) improvements are dependent on developing operational definitions.
C) low literacy and low health literacy are interchangeable terms.
D) interest in effective patient education is unique to the United States.
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Chapter 15: Nursing Informatics
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Sample Questions
Q1) Computerized provider order entry (CPOE):
A) allows orders to be communicated to the appropriate department.
B) creates an intermediary for order transcription.
C) slows documentation and provider communication.
D) may lead to increased ordering and transcription errors.
Q2) Computerized provider order entry (CPOE) allows orders to be directly communicated to the appropriate department. Other advantages of CPOE include:
A) decrease in number of transcribing errors.
B) enhanced provider acceptance because of new technology.
C) decreased work flow issues in general.
D) less dependence on technology and computers.
Q3) The Health Insurance Portability and Accountability Act (HIPAA) of 1996: (Select all that apply.)
A) requires the user to have verification codes.
B) ensures access to information without fear of audits.
C) sets the standards on how information is maintained.
D) sets the penalties for any breach in security of health data.
E) has no legal authority relative to security issues.
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Chapter 16: Health and Wellness
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Q1) The patient is asking about using the Internet for resources regarding lifestyle behaviors and benefits of modification. The nurse's should tell the patient that:
A) information on lifestyle behaviors is not available on the Internet.
B) the patient should use websites that are easy to understand.
C) ,most websites are designed for health care providers only.
D) only negative outcomes are evaluated on the Internet.
Q2) A 40-year-old patient presents to her provider for a yearly physical. The provider notes a family history of breast cancer in the patient's mother. The provider schedules the patient for a mammogram. The nurse recognizes this as what level of prevention?
A) Tertiary
B) Primary
C) Secondary
D) Holistic
Q3) The use of seatbelts and airbags in automobiles is an example of:
A) secondary prevention.
B) tertiary prevention.
C) holistic care model.
D) primary prevention.
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Chapter 17: Human Development: Conception through Adolescence
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Q1) A high-school nurse is planning an educational presentation for juniors. What activities are most appropriate for the nurse plan to include? (Select all that apply.)
A) Video showing the aftermath of a drunk driving car crash
B) Confidential depression and suicide risk assessment
C) Same-age speaker sharing her story about the impact of HIV disease
D) Charts and graphs showing the physical changes of puberty
E) Bicycle helmet fitting station to see if child has outgrown the helmet
Q2) The nurse is teaching parents about actions to assist in developing a critical skill in the concrete operations phase of Piaget's developmental theory. What activities does the nurse suggest the parents participate with their child in? (Select all that apply.)
A) Separating a collection of toy horses into functions each type performs.
B) Exploring a space and astronomy museum and planetarium together.
C) Making a scrapbook of leaves sorted by color or type of tree.
D) Having the child explore how common objects can be used for different purposes.
E) Asking the child to describe an event from several different points of view.
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Page 19
Chapter 18: Human Development Young Adult to Older Adult
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Q1) A nurse reads on a patient's chart that she has sarcopenia. What assessment does the nurse perform to confirm this?
A) Mini-mental state exam
B) Tests of muscle strength
C) Gait and balance
D) Vision and hearing
Q2) A nurse is assessing a middle-aged adult for cognitive skills. The patient has difficulty with seriation tests. What action by the nurse is most appropriate?
A) Document the findings and continue the assessment.
B) Perform another test for fluid intelligence.
C) Consult with the provider about dementia screening.
D) Ask the patient about family medical history.
Q3) A young nursing student is assessing an older patient. The nurse questions whether or not to take a sexual history. What response by the faculty is best?
A) Since procreation is not an issue, you do not need to discuss this.
B) Only discuss this topic if you are comfortable in doing so.
C) Ask the patient if he or she wants to talk about sexuality.
D) Sexuality is a basic human need and needs to be assessed.
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Chapter 19: Vital Signs
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Q1) The nurse understands that which factors can increase blood pressure? (Select all that apply.)
A) Head injury
B) Decreased fluid volume
C) Increasing age
D) Recent food intake
E) Pain
Q2) The student nurse is assessing a patient's pulses. What action by the student requires the nurse to intervene?
A) Assessing apical pulse between the fifth and sixth intercostal spaces
B) Assessing the doralis pedis pulse by palpating behind the patient's knee
C) Assessing the radial pulse on the patient's wrist
D) Assessing the brachial pulse on the patient's inner elbow
Q3) A nurse is caring for a patient who has a high temperature. The nurse plans to help the patient regain a normal temperature through conduction. What technique does the nurse use?
A) Placing a cooling fan in the patient's room
B) Putting ice packs in the patient's axillae
C) Spraying the patient with a fine mist of water
D) Turning the temperature down in the room
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Chapter 20: Health History and Physical Assessment
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Q1) The nurse examining a patient's skin correlates which conditions with which underlying pathology? (Select all that apply.)
A) Albinism: Full-thickness burns
B) Peripheral cyanosis: poor circulation
C) Purpura: clotting disorders
D) Jaundice: liver disease
E) Vitiligo: skin infestation
Q2) A nurse is educating women on breast cancer risk reduction. What topics does the nurse include in the presentation? (Select all that apply.)
A) Exercise
B) Limiting alcohol
C) Low-fat diet
D) Breast self exams
E) Milk intake
Q3) The nurse is assessing a patient's cranial nerve III. What technique is best?
A) Have patient identify a common scent with closed eyes.
B) Shine a light into the patient's eyes to assess pupil response.
C) Have the patient read a newspaper or use the Snellen chart.
D) Assess if patient can hear both spoken and whispered words.
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Page 22
Chapter 21: Ethnicity and Cultural Assessment
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Q1) A nursing student wants to observe enculturation practices of an ethnic minority community. What action by the student is best?
A) Attend a community dance.
B) Learn to cook an ethnic meal.
C) Visit the group's worship service.
D) Observe a grandmother teaching a child.
Q2) A new graduate nurse tells the manager that she does not believe she needs more in-service training on culturally congruent care because she already recognizes that there are significant differences among cultures to take into account when providing care. What response by the manager is best?
A) "You have done a great job becoming culturally competent."
B) "Providing culturally congruent care takes ongoing work and effort."
C) "That is a great start, but be sure to sign up for the in-service."
D) "Cultural sensitivity and cultural competence are not the same."
Q3) What does the nursing student learn about race?
A) It is biologically based.
B) It is a social construct.
C) It is chosen by the person.
D) It helps establish superiority.
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Page 23
Chapter 22: Spiritual Health
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Q1) A patient died suddenly in the emergency department. Which action by the nurse best provides the family connection with others?
A) Offering the family written information on grief support groups.
B) Asking the family if there is someone the nurse can call for them.
C) Having the hospital social worker or chaplain sit with the family.
D) Offering to stay with the family during this difficult time.
Q2) The student nurse asks why spirituality is important in health care. What response by the registered nurse is best?
A) "All people have a spiritual aspect to their beings."
B) "Spirituality affects behavior, which also affects health."
C) "Knowledge of it is needed to understand a patient holistically."
D) "People who are less spiritual have worse outcomes."
Q3) A patient who claims to be very involved in church is near death. What action by the nurse is best?
A) Get permission to contact the religious leader.
B) Allow the family to stay at the patient's bedside.
C) Call the hospital chaplain to come to the bedside.
D) Ask if the patient and family want to pray.
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Chapter 23: Public Health, Community Base, and Home Health Care
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Q1) A nurse wants to volunteer for a community group providing secondary prevention. What activity would the nurse attend?
A) Stroke rehabilitation support group
B) Blood pressure screening at the mall
C) Bicycle safety class at the elementary school
D) Drop by nutrition station at the grocery store
Q2) A nurse is orienting to a new job in a home health care agency and is told that most of her patients need tertiary prevention. What activity does the nurse plan to include in the daily routine?
A) Household safety checks
B) Well-baby checkups
C) Antibiotic administration
D) Monthly blood pressure assessments
Q3) A nurse is completing an OASIS assessment on a patient. What data would be most important for the nurse to assess?
A) Presence of grocery stores nearby
B) Safety concerns within the home
C) Number and kind of pets
D) Proximity to a health care facility
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Chapter 24: Human Sexuality
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Q1) A parent confides to the nurse that the parent's 3-year-old son seems to be touching his genitals frequently. What response by the nurse is best?
A) "This is normal behavior at his age."
B) "Why do you think he is doing that?"
C) "Does he complain of burning with urination?"
D) "I'd ignore that behavior; it's attention-seeking."
Q2) The nurse is working with a patient who has a sexual dysfunction. What statement by the patient indicates progress toward an important goal?
A) "I am beginning to enjoy sex more these days."
B) "I'm glad my partner is understanding of the lack of sex."
C) "I wish I didn't need these pills but I know they are important."
D) "I hope one day to have a sexual partner again."
Q3) A male patient takes a medication known to cause erectile dysfunction. What action by the nurse is best?
A) State, "If this medication has bad side effects, talk to your doctor."
B) Ask, "Are you having any sexual problems in your life right now?"
C) Give the patient written information on the side effects of the drug.
D) State, "Many men have erectile dysfunction on this drug."
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Chapter 25: Safety
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Q1) The nurse displays an understanding of high-risk populations for MRSA when identifying which group as the lowest risk?
A) Prison inmates
B) College dorm residents
C) Team athletes
D) Food service workers
Q2) The ER nurse is triaging a patient with suspected poisoning. Who should the nurse anticipate contacting first?
A) Family services
B) Radiology
C) Poison Control Center
D) Respiratory
Q3) The nurse is concerned about helping the patient find resources to obtain assistive equipment to be used in the home. Which team member should the nurse contact first?
A) Occupational therapist
B) Physical therapist
C) Physician
D) Social worker
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Chapter 26: Asepsis and Infection Control
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Q1) The nurse's stethoscope most correctly represents which possible link in the chain of infection?
A) Source
B) Portal of exit
C) Portal of entry
D) Mode of transmission
Q2) A disease-causing organism is known as:
A) a pathogen.
B) normal flora.
C) a germ.
D) a microorganism.
Q3) The nurse is explaining to the patient why she is receiving antibiotics. Her answer would be correct if she stated antibiotics are effective against which microorganism?
A) Viruses
B) Fungi
C) Parasites
D) Bacteria
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Chapter 27: Hygiene and Personal Care
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Q1) Excessively dry skin can lead to cracks and openings in the integumentary system. Based on this, what is the most applicable nursing diagnosis for a patient with excessively dry skin?
A) Imbalanced Nutrition: Less than body requirements
B) Deficient fluid volume
C) Risk for infection
D) Acute pain
Q2) The nurse is assisting her patients with hygiene care. She knows that this includes the following: (Select all that apply.)
A) Bathing
B) Oral care
C) Perineal care
D) Foot care
E) Patient communication
F) None of the above
Q3) Which tool is used to determine risk for impaired skin integrity?
A) Braden scale
B) Glasgow scale
C) Vanderbilt scale
D) MMSE scale
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Chapter 28: Activity, Immobility, and Safe Movement
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Sample Questions
Q1) The nurse correctly selects which intervention to avoid causing shear or friction when moving a patient in bed?
A) Using an airflow bed
B) Using a slide board
C) Using a trochanter roll
D) Using a gel mattress
Q2) The nurse is teaching a patient about ways to decrease her risk of bone fractures. The following statements by the patient indicate a good understanding. (Select all that apply.)
A) "I should do weight-bearing exercises."
B) "I should get adequate intake of calcium and vitamin D."
C) "I should exercise regularly."
D) "I need to do yoga exercises."
Q3) The nurse appropriately delegates care to the UAP when she:
A) instructs the UAP to assess the patient's skin during a bath.
B) instructs the UAP to reposition the patient using the trapeze.
C) instructs the UAP to assess the patient's ability to perform range-of-motion exercises.
D) instructs the UAP to notify the health care provider of any changes.
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Chapter 29: Skin Integrity and Wound Care
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Q1) The nurse is educating the patient about the signs and symptoms of a wound infection. Which statement indicates a need for further education?
A) "The wound will be red."
B) "The wound will have pus."
C) "The wound will be warm."
D) "The wound will need to be treated."
Q2) The nurse knows the following wound would be classified as a closed wound:
A) A large bruise on the side of the face
B) A surgical incision that is sutured closed
C) A puncture wound that is healing
D) An abrasion on the leg
Q3) The nurse is caring for a patient with a Penrose drain. She knows the patient will require the following care:
A) The drain must be compressed after emptying to work properly.
B) The drain must be connected to suction if ordered.
C) The drain is not sutured in place so care is taken to not dislodge it.
D) The suction pulls drainage away from the wound as it re-expands.
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Chapter 30: Nutrition
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Sample Questions
Q1) The nurse knows that initial verification of a nasogastric placement is important. Which method is considered the only reliable method to determine enteral tube placement?
A) Auscultation of air bolus
B) Measurement of pH of the aspirate
C) Radiographic image
D) Aspirate contents to visually inspect appearance
Q2) The nurse is educating a patient about including more omega-3 fatty acids in her diet. Which of the following food sources should be included? (Select all that apply.)
A) Salmon
B) Flaxseed
C) Mackerel
D) Steak
Q3) The nurse is caring for a patient who is receiving total parenteral nutrition (TPN). The nurse knows she should change the tubing every:
A) 72 hours.
B) 48 hours.
C) 24 hours.
D) 12 hours.
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Chapter 31: Cognitive and Sensory Alterations
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Q1) The nurse is providing discharge instructions to an older adult who is being discharged with orthostatic hypotension. Which of the following responses by the patient indicates a need for further education?
A) "I should take my blood pressure once a day at home."
B) "I should get up quickly to avoid my blood pressure dropping."
C) "I should drink plenty of water during the day."
D) "I should get up slowly and carefully."
Q2) The nurse is caring for a patient with receptive aphasia. Which interventions will assist the nurse in communicating with the patient? (Select all that apply.)
A) Use simple phrases.
B) Speak softly.
C) Stand in front of the patient.
D) Use a picture board.
E) Be patient and unrushed.
Q3) An appropriate goal for a patient with a diagnosis of social isolation is:
A) the patient will participate in cognitive exercises.
B) the patient will interact with other residents during activities.
C) the patient will communicate basic needs through use of photos.
D) the patient will remain within the unit while in long-term care.
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Page 33
Chapter 32: Stress and Coping
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Q1) The nurse knows that when patients are experiencing stress, the following change can be seen in their signs and symptoms: (Select all that apply.)
A) Increase in heart rate
B) Increase in gastric motility
C) Pupil dilation
D) Decrease in blood pressure
E) Increase in respiratory rate
Q2) The nurse knows that an appropriate goal for Readiness for enhanced coping would be:
A) The patient will report an ability to focus on discharge instructions.
B) The patient will attend a coping skills class on a weekly basis.
C) The patient will discuss possible coping strategies during weekly office visits.
D) The patient will discuss strategies for coping with relationship violence within 24 hours.
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34
Chapter 33: Sleep
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Sample Questions
Q1) The nurse knows the following information about sudden infant death syndrome (SIDS): (Select all that apply.)
A) SIDS is the most common cause of death among infants (1-12 months).
B) The etiology remains largely unknown.
C) The most modifiable risk factor is sleeping supine.
D) Risk factors include being exposed to cigarette smoke.
E) It is defined as sudden unexpected death.
Q2) The nurse knows that with the onset of darkness and in preparation for sleep:
A) cortisol levels peak.
B) cortisol levels increase.
C) core body temperature increases.
D) melatonin levels increase.
Q3) The nurse is providing discharge instructions for the patient with sleep pattern disturbances. Which statement by the patient indicates a need for further education?
A) "It is a good idea to have a bedtime routine."
B) "My bedtime routine can include watching TV in bed until I fall asleep"
C) "I should keep my regular sleep pattern on the weekend."
D) "If I can't fall asleep, I should get out of bed and do something relaxing."
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Chapter 34: Diagnostic Testing
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Sample Questions
Q1) The nurse is caring for a patient who has been having abdominal pain. The doctor suspects that the patient may have an abdominal aortic aneurysm. Which tests would confirm the doctor's suspicion? (Select all that apply.)
A) Magnetic resonance imaging (MRI) scan
B) Needle aspiration with biopsy
C) Fiberoptic endoscopy
D) Computed tomography (CT) scan
E) Flexible sigmoidoscopy
F) Thoracentesis
Q2) The nurse is caring for a patient who needs to collect a 24-hour urine specimen at home. Which steps of specimen collection may be delegated to the assistant? (Select all that apply.)
A) Label the urine container and lab slips with the patient's name and information.
B) Assess the patient's ability to collect the specimen as required.
C) Explain the procedure to the patient.
D) Obtain the urine container from the utility room or laboratory.
E) Transport the specimen to the laboratory once it is collected.
F) Ensure that the correct test is ordered and collected.
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Chapter 35: Medication Administration
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Sample Questions
Q1) During discharge teaching, the nurse is to give the patient a signed, dated, and timed prescription from the physician for medications to be taken at home. Which prescription drug order needs to be corrected before it is given to the patient?
A) Warfarin (Coumadin) 5 mg PO daily before dinner
B) Methotrexate (Trexall) 8 tablets PO once weekly on Saturdays
C) Levothyroxine (Synthroid) 137 mcg PO daily before breakfast
D) Zolpidem (Ambien) 5 mg PO at bedtime as needed for sleep
Q2) The nurse is caring for a patient who is receiving vancomycin (Vancocin) to treat a severe infection. The next vancomycin dose is due to be administered at 10:00 A.M. What time will the nurse draw the vancomycin serum trough level?
A) 7:30 A.M.
B) 9:30 A.M.
C) 11:30 A.M.
D) 1:30 P.M.
Q3) Which of the following medication orders is to be administered PRN?
A) Zolpidem (Ambien) 10 mg PO tonight if the patient cannot sleep
B) Prednisone 10 mg PO today, then taper down 1 mg each day for the next 10 days
C) Humulin R 10 units subcutaneously before each meal and at bedtime
D) Kefzol (Ancef) 1 g IVPB 30 minutes prior to surgery
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Chapter 36: Pain Management
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Q1) The nurse is caring for a patient who only speaks a foreign language. What is the best method for the nurse to assess the patient's pain level?
A) Perform a pain assessment using a translator.
B) Check the patient's vital signs and pulse oximetry.
C) Check the patient's respiratory rate, depth, and rhythm.
D) Look to see if the patient appears to be resting comfortably.
Q2) The nurse is caring for a patient who has a PCA pump following total hysterectomy surgery. The nurse sees the visitor push the PCA button while the patient is sleeping quietly. What is the best response of the nurse?
A) "Thank you for pushing the button for her to help keep her comfortable after surgery."
B) "Please do not push the button for the patient-she could receive more medication than she needs."
C) "You can push the button for her now, but please have her do it herself when she awakens."
D) "PCA pumps are great because she doesn't have to wait for me to administer her pain medication."
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Chapter 37: Perioperative Nursing Care
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Q1) The nurse is caring for a patient who requires emergency surgery for injuries sustained in a motor vehicle accident. The patient was on his way back to work after having lunch with colleagues when the accident happened. What is the highest priority nursing diagnosis for this patient?
A) Risk for imbalanced body temperature
B) Risk for aspiration
C) Risk for perioperative positioning injury
D) Risk for delayed surgical recovery
Q2) The nurse is caring for a patient with advanced colon cancer. The patient is to have surgery to relieve a bowel obstruction that has been causing unrelenting vomiting and abdominal pain. What type of surgery will this patient undergo?
A) Palliative
B) Reconstructive
C) Diagnostic
D) Ablative
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Chapter 38: Oxygenation and Tissue Perfusion
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Q1) The nurse notes the following findings when assessing a patient with COPD. Which require prompt nursing intervention? (Select all that apply.)
A) The patient is unable to count out loud past 15 after a deep breath.
B) The patient's nails are noticeably clubbed.
C) The patient's sputum has turned from yellow to greenish-brown.
D) The patient has stridor with wheezes heard in all lung fields.
E) The patient's forced vital capacity has increased from 2.8 to 3.4 L.
F) The patient has become confused and mildly disoriented.
Q2) The nurse is caring for a patient who developed a pulmonary embolism after surgery. Which goal statement is the highest priority for the nurse to include in the patient's care plan for the diagnosis Impaired gas exchange r/t impaired pulmonary blood flow from embolus?
A) The patient will maintain pulse oximetry values of at least 95% on room air.
B) The patient will verbalize understanding of ordered anticoagulants.
C) The patient will report chest pain of no greater than 3 on a 1-10 scale.
D) The patient will ambulate 50 feet in hallway without shortness of breath.
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Chapter 39: Fluid, Electrolytes, and Acid-Base Balance
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Sample Questions
Q1) The nurse is caring for a patient who is admitted to the hospital with dehydration and gastroenteritis. The patient attempted to walk to the bathroom and fainted right after getting out of bed. Which is the most likely cause of the patient's collapse?
A) Orthostatic hypotension
B) Circulatory overload
C) Hemolytic reaction
D) Catheter embolism
Q2) The nurse is caring for a patient who is admitted with a serum sodium level of 120 mEq/L. Which is the most important intervention for the nurse to perform?
A) Perform regular neurologic checks and institute seizure precautions.
B) Encourage the patient to eat foods that are high in sodium.
C) Administer hypotonic IV solutions as ordered by the physician.
D) Assess for signs and symptoms of digoxin (Lanoxin) toxicity.
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Chapter 40: Bowel Elimination
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Sample Questions
Q1) The nurse is caring for a patient who is to have a cleansing enema. Which assessment finding by the nurse indicates a need to contact the prescriber and question the order?
A) The patient is recovering from a traumatic brain injury.
B) The patient has not had a bowel movement for 3 days.
C) The patient is to have a lower GI series the following morning.
D) The patient had an upper GI series performed the previous day.
Q2) The nurse is caring for a patient who is recovering after hip surgery. The patient requires assistance to use the bathroom because no weight bearing is allowed on the right leg. Which goal is most important for the nurse to include for the diagnosis of toileting self-care deficit?
A) The patient will demonstrate safe transfer technique between wheelchair and toilet.
B) The call light will be answered promptly when the patient needs to use the toilet.
C) Toileting will be scheduled for the early morning when the patient needs to defecate.
D) Toilet paper and hand-washing items will be kept within easy reach of the patient.
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Chapter 41: Urinary Elimination
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Sample Questions
Q1) The nurse is caring for a postoperative patient whose urinary catheter was removed 8 hours previously. The patient has not been able to void since the catheter was removed and now reports suprapubic pain. What is the priority action of the nurse?
A) Encourage oral fluid intake and administer a diuretic.
B) Obtain a urine sample to test for culture and sensitivity.
C) Carefully calculate the patient's daily intake and output.
D) Obtain an order to straight-catheterize the patient.
Q2) The nurse is caring for a patient who has developed kidney failure. Which test finding leads the nurse to contact the nephrologist and arrange for emergency hemodialysis?
A) Serum potassium level 7.4 mEq/L
B) Serum creatinine level of 2.8 mg/dL
C) Large amounts of protein in the urine
D) 1500 mL of retained urine in the bladder
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Chapter 42: Death and Loss
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Q1) The home care nurse is caring for a terminally ill patient who states that he wants to set up a scholarship in his name at the local university before he dies. What is the best action of the nurse?
A) Suggest that the patient think it over and wait a few days before contacting the school.
B) Direct the patient to ask his family about the possibility of starting a scholarship.
C) Assess the patient's mental status to ensure that he is competent to make the decision.
D) Assist the patient to find the necessary information about endowed scholarships.
Q2) The hospice nurse is caring for a terminally ill patient. The patient's son is distraught because the patient will probably die within the next few days and there is nothing he can do about it. What is the most appropriate nursing diagnosis for the patient's son at this time?
A) Chronic sorrow r/t impending death of mother
B) Impaired religiosity r/t difficulty adhering to religious beliefs
C) Powerlessness r/t progression of mother's terminal illness
D) Complicated grieving r/t desired avoidance of mourning
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