Introduction to Nursing Midterm Exam
Course Introduction
Introduction to Nursing provides students with a comprehensive overview of the nursing profession, including its historical development, roles and responsibilities of nurses, and core values such as compassion, ethical practice, and patient-centered care. The course introduces foundational concepts in health and wellness, basic healthcare terminology, and the structure of healthcare delivery systems. Emphasis is placed on communication skills, safety protocols, cultural competence, and professional standards that guide nursing practice. Students will also explore the importance of lifelong learning and the impact of evidence-based practice in improving patient outcomes.
Recommended Textbook
Concepts for Nursing Practice 2nd Edition by Giddens
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58 Chapters
459 Verified Questions
459 Flashcards
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Page 2
Chapter 1: Development
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Sample Questions
Q1) The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, the expected stage of development for a preschooler is
A) concrete operational.
B) formal operational.
C) preoperational.
D) sensorimotor.
Answer: C
Q2) To plan early intervention and care for an infant with Down syndrome, the nurse considers knowledge of other physical development exemplars such as A) cerebral palsy.
B) autism.
C) attention deficit hyperactivity disorder (ADHD).
D) failure to thrive.
Answer: D
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Chapter 2: Functional Ability
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Sample Questions
Q1) The home care nurse is trying to determine the necessary services for a 65-year-old patient who was admitted to the home care service after left knee replacement. Which tool is the best for the nurse to utilize?
A) Minimum Data Set (MDS)
B) Functional Status Scale (FSS)
C) 24-Hour Functional Ability Questionnaire (24hFAQ)
D) The Edmonton Functional Assessment Tool
Answer: C
Q2) The nurse is assessing a patient's functional ability. Which patient best demonstrates the definition of functional ability?
A) Considers self as a healthy individual; uses cane for stability
B) College educated; travels frequently; can balance a checkbook
C) Works out daily, reads well, cooks, and cleans house on the weekends
D) Healthy individual, volunteers at church, works part time, takes care of family and house
Answer: D
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Chapter 3: Family Dynamics
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Sample Questions
Q1) Which factors which would alert the nurse to negative/dysfunctional family dynamics?
A) Aging of family members
B) Chronic illness of a family member
C) Disability of a family member
D) Intimate partner violence
Answer: D
Q2) The nurse planning to assess the structure of a family should ask which question?
A) "Who lives with you in this home?"
B) "Who does the grocery shopping?"
C) "Who provides support in your family?"
D) "How old are the members of your family?"
Answer: A
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Chapter 4: Culture
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Sample Questions
Q1) The emphasis on understanding cultural influence on health care is important because of
A) disability entitlements.
B) HIPAA requirements.
C) increasing global diversity.
D) litigious society.
Q2) What interrelated constructs facilitate a nurse to become culturally competent?
A) Cultural diversity, self-awareness, cultural skill, and cultural knowledge
B) Cultural desire, self-awareness, cultural knowledge, and cultural identity
C) Cultural desire, self-awareness, cultural knowledge, and cultural diversity
D) Cultural desire, self-awareness, cultural knowledge, and cultural skill
Q3) The nurse is caring for an older Chinese adult male who is grimacing and appears restless after abdominal surgery. What is the nurse's best action?
A) Ask the patient if he is anxious about his hospital stay.
B) Ask a translator to conduct a FACES pain scale assessment.
C) Ask the patient about pain and assess vital signs.
D) Ask the patient about any history of depression or anxiety.
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Chapter 5: Spirituality
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Sample Questions
Q1) The nurse is assessing a patient's spirituality and observes the patient meditating before any treatments. What is the nurse's best action?
A) Document that the patient is not religious
B) Offer the patient a copy of the bible to read
C) Arrange for quiet time for the patient as needed
D) Limit the time patient can meditate before procedures
Q2) When completing the FICA tool for spiritual assessment, which questions should the nurse ask the patient? (Select all that apply.)
A) What things do you believe in that give meaning to life?
B) Are you connected with a faith center in your community?
C) How has your illness affected your personal beliefs?
D) When was the last time you have been to church?
E) What can I do for you?
Q3) A patient uses rosary beads and attends mass once a week. This expression of spirituality is best described with which term?
A) Religiosity
B) Faith
C) Belief
D) Authenticity
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Page 7
Chapter 6: Adherence
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Sample Questions
Q1) A patient has been newly diagnosed with hypertension. The nurse assesses the need to develop a collaborative plan of care that includes a goal of adhering to the prescribed regimen. When the nurse is planning teaching for the patient, which is the most important initial learning goal?
A) The patient will select the type of learning materials they prefer.
B) The patient will verbalize an understanding of the importance of following the regimen.
C) The patient will demonstrate coping skills needed to manage hypertension.
D) The patient will verbalize the side effects of treatment.
Q2) The nurse is developing a care plan for a patient who has low motivation and nonadherence with blood glucose monitoring. Which statement by the patient would indicate to the nurse that the patient is not motivated and will most likely not comply?
A) "I do not like to test my sugar, but I do it because my wife nags me."
B) "I forget to check my sugar once in a while."
C) "I don't see or feel any different when I do keep my blood sugars under control."
D) "I have no idea what the signs of low blood sugar are."
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Chapter 7: Self-Management
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Sample Questions
Q1) The nurse is developing a plan of care for a newly diagnosed hypertensive patient who is being discharged on medications and given the Dietary Approaches to Stop Hypertension (DASH) diet to follow. What statement by the patient signals to the nurse that the patient is motivated to learn?
A) "I am sure the medications will help to bring down my blood pressure."
B) "I can't wait to try the new recipes, and I'm hopeful I will lose weight."
C) "Do I really need to follow the diet and take medications?"
D) "I have my parents to blame for this. They both have high blood pressure."
Q2) The nurse is assisting an older adult patient, diagnosed with type 2 diabetes, with self-injection of insulin. What is the most appropriate intervention for this patient at discharge?
A) Arrange daily home visits for injections
B) Request an insulin pen prescription
C) Recommend upper arm injection sites
D) Supply patient with 100 unit insulin syringes
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Chapter 8: Fluid and Electrolyte Balance
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Sample Questions
Q1) The nurse is assessing a patient before hanging an IV solution of 0.9% NaCl with KCl in it. Which assessment finding should cause the nurse to hold the IV solution and contact the physician?
A) Weight gain of 2 pounds since last week
B) Dry mucous membranes and skin tenting
C) Urine output 8 mL/hr
D) Blood pressure 98/58
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 nurse assessed four patients at the beginning of the shift. Which finding should the nurse report immediately to the physician?
A) Swollen ankles in patient with compensated heart failure
B) Positive Chvostek's sign in patient with acute pancreatitis
C) Dry mucous membranes in patient taking a new diuretic
D) Constipation in patient who has advanced breast cancer
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Page 10
Chapter 9: Acid-Base Balance
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Sample Questions
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 nurse has telephone messages from four patients who requested information and assistance. Which one should the nurse refer to a social worker or community agency first?
A) "Is there a place that I can dispose of my unused morphine pills?"
B) "I want to lose at least 20 pounds without getting sick this time."
C) "I think I have asthma because I cough when dogs are near."
D) "I ran out of money and am cutting my insulin dose in half."
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Chapter 10: Thermoregulation
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Sample Questions
Q1) 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
Q2) A volunteer at the senior center asks the visiting nurse why the senior citizens always seem to be complaining about the temperature. What is the nurse's best response?
A) Older people have a diminished ability to regulate body temperature because of active sweat glands.
B) Older people have a diminished ability to regulate body temperature because of increased circulation.
C) Older people have a diminished ability to regulate body temperature because of peripheral vasoconstriction.
D) Older people have a diminished ability to regulate body temperature because of slower metabolic rates.
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Chapter 11: Sleep
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Sample Questions
Q1) The nurse enters a patient's room and the patient startles easily and appears to jerk his arms and legs before awakening. Which stage of non-rapid eye movement sleep did the patient most likely awaken from?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
Q2) A patient complains of not being able to fall asleep at night and asks the nurse if there is a safe, non-prescription medication he can try. After consulting the healthcare provider, the nurse should recommend which naturally occurring hormone?
A) Melatonin
B) Cortisol
C) Leutinizing hormone
D) Estrogen
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Chapter 12: Cellular Regulation
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Sample Questions
Q1) A cancer patient's susceptibility to the syndrome of inappropriate antidiuretic hormone (SIADH) can be suspected with which of the following laboratory results?
A) Serum potassium of 5.2 mmol/L
B) Serum sodium of 120 mmol/L
C) Hematocrit of 40%
D) Blood urea nitrogen (BUN) of 10 mg/dL
Q2) In caring for a patient following lobectomy for lung cancer, which of the following should the nurse include in the plan of care?
A) Position the patient on the operative side only.
B) Avoid administering narcotic pain medications.
C) Keep the patient on strict bed rest.
D) Instruct the patient to cough and deep breathe.
Q3) What is the priority nursing diagnosis for a patient experiencing chemotherapy-induced anemia?
A) Risk for injury related to poor blood clotting
B) Fatigue related to decreased cellular oxygenation
C) Disturbed body image related to skin color changes
D) Imbalanced nutrition, less than body requirements related to anorexia
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Chapter 13: Intracranial Regulation
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Sample Questions
Q1) Which assessment finding would be the earliest and most sensitive indicator that there is an alteration in intracranial regulation?
A) Change in level of consciousness
B) Inability to focus visually
C) Loss of primitive reflexes
D) Unequal pupil size
Q2) The nurse is caring for a patient with increased intracranial pressure. Which action is considered unsafe?
A) Aligning the neck with the body
B) Clustering many nursing activities
C) Elevating the head of the bed 30 degrees
D) Providing stool softeners or laxatives as ordered
Q3) The nurse preparing to care for a patient after a suspected stroke would question which order?
A) Antihypertensive
B) Antipyretic
C) Osmotic diuretic
D) Sedative
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15
Chapter 14: Hormonal Regulation
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Sample Questions
Q1) Following a parathyroidectomy, which electrolyte should the nurse most closely monitor?
A) Potassium
B) Sodium
C) Magnesium
D) Calcium
Q2) The nurse is caring for a patient who has undergone a thyroidectomy. Which patient complaint is highest priority requiring further evaluation?
A) Pain at surgical site
B) Thirst
C) Hoarseness
D) Nausea
Q3) The nurse is caring for a patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What is the nurse's best action?
A) Encourage increased fluid and water intake
B) Teach about risk for malignancies
C) Monitor for changes in level of consciousness
D) Assess labwork for potassium level changes
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16
Chapter 15: Glucose Regulation
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Sample Questions
Q1) A diabetic patient is brought into the emergency department unresponsive. The arterial pH is 7.28. Besides the blood pH, which clinical manifestation is seen in uncontrolled diabetes mellitus and ketoacidosis?
A) Decreased hunger sensation
B) Report of no urine output
C) Increased respiratory rate
D) Decreased thirst
Q2) The nurse instructs a patient with type 1 diabetes mellitus to avoid which of the following drugs while taking insulin?
A) Furosemide (Lasix)
B) Dicumarol (Bishydroxycoumarin)
C) Reserpine (Serpasil)
D) Cimetidine (Tagamet)
Q3) 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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Page 17
Chapter 16: Nutrition
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Sample Questions
Q1) During a physical examination, the nurse notes that the patient's skin is dry and flaking. What additional data would the nurse expect to find to confirm the suspicion of a nutritional deficiency?
A) Hair loss and hair that is easily removed from the scalp
B) Inflammation of the tongue and fissured tongue
C) Inflammation of peripheral nerves and numbness and tingling in extremities
D) Fissures and inflammation of the mouth
Q2) An African American is at an increased risk for which of the following? (Select all that apply.)
A) Vitamin D deficiency
B) Type 1 diabetes
C) Celiac disease
D) Type 2 diabetes
E) Hypertension
F) Metabolic syndrome
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18
Chapter 17: Elimination
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Sample Questions
Q1) The nurse is listening for bowel sounds in a postoperative patient. The bowel sounds are slow, as they are heard only every 3 to 4 minutes. The patient asks the nurse why this is happening. What is the nurse's best response?
A) "Anesthesia during surgery and pain medication after surgery may slow peristalsis in the bowel."
B) "Some people have a slower bowel than others, and this is nothing to be concerned about."
C) "The foods you eat contribute to peristalsis, so you should eat more fiber in your diet."
D) "Bowel peristalsis is slow because you are not walking. Get more exercise during the day."
Q2) What is a primary prevention tool used for colon cancer screening?
A) Abdominal x-rays
B) Blood, urea, and nitrogen (BUN) testing
C) Serum electrolytes
D) Occult blood testing
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Chapter 18: Perfusion
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Sample Questions
Q1) The patient asks the nurse to explain the function of the sinoatrial node in the heart. What is the nurse's best response?
A) "The sinoatrial node stimulates the heart to beat in a normal rhythm."
B) "The sinoatrial node protects the heart from atherosclerotic changes."
C) "The sinoatrial node provides the heart with oxygenated blood."
D) "The sinoatrial node protects the heart from infection."
Q2) A nurse is explaining to a student nurse about perfusion. The nurse knows the student understands the Chapter of perfusion when the student makes which statement?
A) "Perfusion is a normal function of the body, and I don't have to be concerned about it."
B) "Perfusion is monitored by the physician."
C) "Perfusion is monitored by vital signs and capillary refill."
D) "Perfusion varies as a person ages, so I would expect changes in the body."
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Chapter 19: Gas Exchange
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Sample Questions
Q1) A 3-month-old infant is at increased risk for developing anemia. The nurse would identify which principle contributing to this risk?
A) The infant is becoming more active.
B) There is an increase in intake of breast milk or formula.
C) The infant is unable to maintain an adequate iron intake.
D) A depletion of fetal hemoglobin occurs.
Q2) Which clinical management prevention Chapter would the nurse identify as representative of secondary prevention?
A) Decreasing venous stasis and risk for pulmonary emboli
B) Implementation of strict hand washing routines
C) Maintaining current vaccination schedules
D) Prevention of pneumonia in patients with chronic lung disease
Q3) The nurse would identify which patient condition as a problem of impaired gas exchange secondary to a perfusion problem?
A) Peripheral arterial disease of the lower extremities
B) Chronic obstructive pulmonary disease (COPD)
C) Chronic asthma
D) Severe anemia secondary to chemotherapy
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21
Chapter 20: Clotting
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Sample Questions
Q1) 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
Q2) Which nursing observation would indicate that the nurse hold the medication warfarin (Coumadin)?
A) An INR (international normalize ratio) of 1.8
B) An INR of 4.8
C) A partial thromboplastin time (APTT) level of 25 seconds
D) An APTT level of 35 seconds
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22
Chapter 21: Reproduction
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Q1) The emergency department nursing assessment of a pregnant female at 35 weeks gestation reveals back pain, blood pressure 150/92, and leaking of clear fluid from the vagina. Which complication of pregnancy does the nurse suspect?
A) Ectopic pregnancy
B) Spontaneous abortion
C) Premature rupture of membranes
D) Supine hypotension
Q2) 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.
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23
Chapter 22: Sexuality
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Sample Questions
Q1) The nurse is caring for a 44-year-old married woman who is complaining of painful intercourse and incontinence due to prolapse of reproductive organs. Clinical evaluation reveals that the patient has a cystocele. Which treatment option is most appropriate for this patient?
A) Pelvic floor training
B) Vaginal pessaries
C) Surgical correction
D) Lifestyle changes
Q2) A 37-year-old heterosexual African-American man has come for his annual health screening. Which test must the nurse ensure is ordered for this patient?
A) Human papilloma virus (HPV)
B) Prostate-specific antigen (PSA)
C) HIV
D) Venereal disease research laboratory (VDRL)
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Chapter 23: Immunity
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Q1) The nurse is preparing to administer medications to a patient with rheumatoid arthritis (RA). The nurse should explain which goal of treatment to the patient?
A) Eradicate the disease
B) Enhance immune response
C) Control inflammation
D) Manage pain
Q2) The nurse is caring for a patient who was started on intravenous antibiotic therapy earlier in the shift. As the second dose is being infused, the patient reports feeling dizzy and having difficulty breathing and talking. The nurse notes that the patient's respirations are 26 breaths/min with a weak pulse of 112 beats/min. The nurse suspects that the patient is experiencing which condition?
A) Suppressed immune response
B) Hyperimmune response
C) Allergic reaction
D) Anaphylactic reaction
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25
Chapter 24: Inflammation
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Q1) On admission to the clinic, the nurse notes a moderate amount of serous exudate leaking from the patient's wound. The nurse realizes what information about this fluid?
A) Contains the materials used by the body in the initial inflammatory response.
B) Indicates that the patient has an infection at the site of the wound.
C) Is destroying healthy tissue.
D) Results from ineffective cleansing of the wound area.
Q2) A patient is being treated with an antibiotic for an infected orthopedic injury. What explanation should the nurse give to the patient about this medication?
A) "Antibiotics will decrease the pain at the site."
B) "An antibiotic helps to kill the infection causing the inflammation."
C) "An antibiotic inhibits cyclooxygenase, an enzyme in the body."
D) "Antibiotics will reduce the patient's fever."
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Chapter 25: Infection
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Q1) Individuals of low socioeconomic status are at an increased risk for infection because of which of the following? (Select all that apply.)
A) Uninsured or underinsured status
B) Easy access to health screenings
C) High cost of medications
D) Inadequate nutrition
E) Mostly female gender
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 which type of infection?
A) Bacterial
B) Fungal
C) Parasitic
D) Viral
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Chapter 26: 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 Chapter of mobility when making which statement?
A) "Patients with impaired bed mobility have an increased risk for pressure ulcers."
B) "Patients with impaired bed mobility like to have extra visitors."
C) "Patients with impaired bed mobility need to have a mechanical soft diet."
D) "Patients with impaired bed mobility are prone to constipation."
Q2) Mobility for the patient changes throughout the life span. What is the term that best describes this process?
A) Aging and illness
B) Illness and disease
C) Health and wellness
D) Growth and development
Q3) The lack of weight bearing leads to what effects on the skeletal system?
A) Demineralization, calcium loss
B) Thickened bones
C) Increased range of motion
D) Increased calcium deposition in the bones
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Chapter 27: Tissue Integrity
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Q1) An older patient has developed age spots and is concerned about skin cancer. How would the nurse instruct the patient to perform skin checks to assess for signs of skin cancer?
A) "Limit the time you spend in the sun."
B) "Monitor for signs of infection."
C) "Monitor spots for color change."
D) "Use skin creams to prevent drying."
Q2) The nurse is instructing the nursing assistant to prevent pressure ulcers in a frail older patient. Which action indicates the nursing assistant has understood the nurse's teaching?
A) Bathing and drying the skin vigorously to stimulate circulation
B) Keeping the head of the bed elevated 30 degrees
C) Limiting intake of fluid and offer frequent snacks
D) Turning the patient at least every 2 hours
Q3) A patient is to receive phototherapy for the treatment of psoriasis. What is the nursing priority for this patient?
A) Obtaining a complete blood count (CBC)
B) Protection from excessive heat
C) Protection from excessive ultraviolet (UV) exposure
D) Instructing the patient to take their multivitamin prior to treatment
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Chapter 28: 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, what is the next best action?
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 29: Pain
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Q1) An elderly Chinese woman is interested in biologically based therapies to relieve osteoarthritis (OA) pain. You are preparing a plan of care for her OA. Options most conducive to her expressed wishes may include which actions or activities?
A) Pilates, breathing exercises, and aloe vera
B) Guided imagery, relaxation breathing, and meditation
C) Herbs, vitamins, and tai chi
D) Alternating ice and heat to relieve pain and inflammation
Q2) A 30-year-old male is admitted to the hospital with acute pancreatitis. He is in acute pain described as a 10/10, which is localized to the abdomen, periumbilical area, and some radiation to his back. The abdomen is grossly distended so it is difficult to assess. He is restless and agitated, with elevated pulse and blood pressure. An appropriate pain management plan of care may include which medication(s)?
A) IV Dilaudid q 4 hours prn, hydrocodone 5/500 PO q 6 hours prn, and acetaminophen
B) Norco 5/500 q 4 hours PO and Benadryl 25 mg PO q 6 hours
C) Phenergan 25 mg IM q 6 hours
D) Tylenol 325 mg q 6 hours
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Chapter 30: Fatigue
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Sample Questions
Q1) Based on the significant effects of chronic idiopathic fatigue, what is the nurse's priority assessment?
A) Cholesterol level and lipid profile
B) Creatinine and BUN levels
C) Memory loss testing
D) Mental health evaluation
Q2) The nurse recognizes that which patients are at highest risk for physiologic fatigue? (Select all that apply.)
A) Parents of a newborn
B) Adolesent with anorexia
C) 25-year-old pregnant female
D)Grandmother who takes 1/2 mile walks
E) Businessman who consumes six cups coffee/day
Q3) The nurse palpates swollen nodes in a patient's neck who presented to the clinic with complaints of fatigue lasting at least 2 weeks. What is the nurse's best action?
A) Advise patient this finding is normal.
B) Review patient's thyroid labwork.
C) Perform deep tendon reflexes.
D) Notify the healthcare provider.
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Page 32
Chapter 31: Stress
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Sample Questions
Q1) The nurse is planning to teach a patient how to use relaxation techniques to prevent elevation of blood pressure and heart rate. The nurse is teaching the patient to control which physiological function?
A) Switch from the sympathetic mode of the autonomic nervous system to the parasympathetic mode.
B) Alter the internal state by modifying electronic signals related to physiologic processes.
C) Replace stress-producing thoughts and activities with daily stress-reducing thoughts and activities.
D) Reduce catecholamine production and promote the production of additional beta-endorphins.
Q2) Which action should the nurse take to monitor the effects of an acute stressor on a hospitalized patient? (Select all that apply.)
A) Assess for bradycardia.
B) Ask about epigastric pain.
C) Observe for increased appetite.
D) Check for elevated blood glucose levels.
E) Monitor for a decrease in respiratory rate.
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Chapter 32: Coping
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Sample Questions
Q1) After a management decision to admit terminal care patients to a medical unit, the nursing manager notes that nursing staff on the unit appear tired and anxious. Staff absences from work are increasing. The nurse manager is concerned that staff may be experiencing stress and burnout at work. What action would be best for the manager to take that will help the staff?
A) Ask administration to require staff to meditate daily for at least 30 minutes.
B) Have a staff psychologist available on the unit once a week for required counseling.
C) Have training sessions to help the staff understand their new responsibilities.
D) Ask support staff from other disciplines to complete some nursing tasks to provide help.
Q2) The nurse is developing a care plan for a patient with ineffective coping skills. Which intervention would be an example of a problem-focused coping strategy?
A) Scheduling a regular exercise program
B) Attending a seminar on treatment options
C) Identifying a confidant to share feelings
D) Attending a support group for families
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Chapter 33: Mood and Affect
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Q1) As a nurse in the emergency department, you are caring for a patient who is exhibiting signs of depression. What is a priority nursing intervention you should perform for this patient?
A) Assess for depression and ask directly about suicide thoughts.
B) Ask the care provider to prescribe blood lab work to assess for depression.
C) Focus on the presenting problems and refer the patient for a mental health evaluation.
D) Interview the patient's family to identify their concerns about the patient's behaviors.
Q2) A patient who has been diagnosed with depression is scheduled for cognitive therapy in addition to receiving prescribed antidepressant medication. The nurse understands that the goal of cognitive therapy will be met when what is reported by the patient?
A) "I will tell myself that I am a good person when things don't go well at work."
B) "My medications will make my problems go away."
C) "My family will help take care of my children while I am in the hospital."
D) "This therapy will improve my response to neurotransmitter impulses."
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Chapter 34: Anxiety
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Sample Questions
Q1) 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."
Q2) A patient is newly diagnosed with anxiety and placed on a selective serotonin reuptake inhibitors (SSRIs). The nurse is developing the plan of care for this patient. How long will it take for this medication to become effective?
A) The medication will become effective immediately.
B) The medication may take up to 12 weeks to become effective.
C) The medication may take up to 6 weeks to become effective.
D) The medication may take up to 4 weeks to become effective.
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Chapter 35: Cognition
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Sample Questions
Q1) A nurse working in a pediatric clinic recognizes that which child is most at risk for cognitive impairment?
A) An infant who is being fed reconstituted powdered formula
B) A toddler living in an older home that is being remodeled
C) A preschooler who attends a play group 3 days a week
D) A school-age child who rides a school bus 5 days a week
Q2) A patient who is dehydrated has been experiencing confusion. The daughter is concerned about taking the patient home in a confused state. What statement by the nurse is correct?
A) "Don't worry; the patient should be fine once they are in a familiar environment."
B) "I can make a referral for a home health aide to assist with the patient."
C) "Once the dehydration is corrected, the patient's confusion should improve."
D) "I can show you how to care for the patient once you return home."
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Chapter 36: Psychosis
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Q1) Which side effect is highest priority for the nurse to assess for when diphenhydramine is administered to a patient also taking antipsychotic medication?
A) Increased pychosis
B) Cognitive impairment
C) Respiratory depression
D) Impaired memory
Q2) Clients who are psychotic because of underlying psychiatric illness are treated with antipsychotic medications. Typical antipsychotic medications can improve positive symptoms in clients with schizophrenia. Positive symptoms include which of the following? (Select all that apply.)
A) Hallucinations
B) Disorganized speech and behavior
C) Anhedonia
D) Delusions
E) Agitation
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Chapter 37: Addiction
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Sample Questions
Q1) During history-taking, a patient tells the nurse that he is addicted to alprazolam 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) Delerium tremens
C) Overdose
D) Relapse
Q2) A 45-year-old man is brought to the emergency department presenting with a respiratory rate of 6 breaths/min, and cardiac dysrhythmias. What is the most appropriate question the nurse should ask the patient's friend?
A) "Does he take amphetamines or uppers?"
B) "Has he ever used LSD?"
C) "Have you two been out of the country in the last 2 days?"
D) "Is he using any opioids such as heroin?"
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Chapter 38: Interpersonal Violence
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Q1) 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
Q2) The nurse is admitting a child with a history of abuse. The nurse understands that the child may exhibit what behaviors that are consequences of being in an abusive environment? (Select all that apply.)
A) Reliving abuse incidents
B) Sleep disturbance
C) Overeating
D) Acting out behaviors
E) Intermittent fever
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Chapter 39: Professional Identity
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Sample Questions
Q1) Nursing demonstrates dedication to improving public health through which avenue?
A) Changing health care standards
B) Legal regulations
C) Scope of practice
D) Technology
Q2) What nursing recommendations are published in the Institute of Medicine (IOM's) report The future of nursing: Leading change, advancing health?
A) Teach, advocate, assess, and nurture.
B) Should have a graduate degree to practice.
C) Diagnose and recommend treatments.
D) Must have continuing education.
Q3) A new registered nurse asks the registered nurse (RN) preceptor what could be done to become more professional. What is the preceptor's best response?
A) "Attend nursing educational meetings."
B) "Listen to other nurses."
C) "Read the agency newsletter."
D) "Pass the licensing exam."
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Chapter 40: Clinical Judgment
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Q1) A new nurse appears to be second-guessing herself and is constantly calling on the other nurses to double-check their plan of care or rehearse what they will say to the doctor before she call on the patient's behalf. This seems to be annoying some of the nurse's coworkers. What is the nurse manager's best response?
A) Explain to coworkers that this is a characteristic of critical thinking and is important for the new nurse to improve reasoning skills.
B) Agree with the staff and have someone follow and work more closely with a preceptor.
C) Have a talk with the nurse and suggest asking fewer questions.
D) Tell the staff that all new nurses go through this phase, and ignore their behavior.
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42
Chapter 41: Leadership
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Sample Questions
Q1) The nursing unit director exhibits the definition of leadership in which of the following responses?
A) The nurse manager refers the concern to the director of the department.
B) The nurse manager corrects the concern with the patient directly and does not communicate her actions to the staff.
C) The nurse manager meets with the staff to discuss the concern and identify solutions.
D) The nurse manager tells the staff that they need to correct the situation by tomorrow and leaves the meeting.
Q2) What are the main features of complex adaptive systems that are relevant to nursing leadership? (Select all that apply.)
A) Focused on creating organizational change and looking at the whole versus individual parts.
B) Defined by efforts of leadership to mandate organizational change.
C) Autocratic in nature with a top-down structure for change.
D) Dependent on employees knowing what change is necessary and acting independently.
E) Non-linear and dynamic in nature, versus a static process.
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Chapter 42: Ethics
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Sample Questions
Q1) A male patient suffered a brain injury from a motor vehicle accident and has no brain activity. The spouse has come up to see the patient every day for the past 2 months. She asks the nurse, "Do you think when he moves his hands he is responding to my voice?" The nurse feels bad because she believes the movements are involuntary, and the prognosis is grim for this patient. She states, "He can hear you, and it appears he did respond to your voice." The nurse is violating which principle of ethics?
A) Autonomy
B) Veracity
C) Utilitarianism
D) Deontology
Q2) A drug-addicted nurse switches a patient's morphine injection with normal saline so that the nurse can use the morphine. The nurse is violating which principles of ethics? (Select all that apply.)
A) Autonomy
B) Utilitarianism
C) Beneficence
D) Dilemmas
E) Veracity
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44
Chapter 43: Patient Education
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Q1) Interrelated Chapters to the professional nursing role a nurse manager would consider when addressing concerns about the quality of patient education include which factor?
A) Adherence
B) Developmental level
C) Motivation
D) Technology
Q2) Strategies to include in a teaching plan for an adult who has repeatedly not followed the written discharge instructions would include which information source?
A) Individualized handout
B) Instructional videos
C) Internet resources
D) Self-help books
Q3) When describing patient education approaches, the nurse educator would explain that informal teaching is an approach that involves which quality?
A) Addresses group needs
B) Follows formalized plans
C) Has standardized content
D) Often occurs one-to-one
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Page 45
Chapter 44: Health Promotion
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Sample Questions
Q1) When teaching a patient with a family history of hypertension about health promotion, the nurse describes blood pressure screening as which type of prevention?
A) Illness
B) Primary
C) Secondary
D) Tertiary
Q2) The primary health care nurse would recommend screening based on known risk factors, because of which action?
A) Eliminate the possibility of developing a condition.
B) Identify appropriate treatment guidelines.
C) Initiate treatment of a condition or disease.
D) Make a substantial difference in morbidity and mortality.
Q3) When there is evidence that supports a screening for an individual patient but not for the general population, the nurse would expect the United States Preventive Services Task Force Grading to be what?
A) No recommendation for or against
B) Recommends
C) Recommends against
D) Strongly recommends
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Page 46
Chapter 45: Communication
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Sample Questions
Q1) The nurse is working with a patient diagnosed with posttraumatic stress disorder related to childhood sexual abuse. The patient is crying and states, "I should be over this by now; this happened years ago." Which response(s) by the nurse will facilitate communication? (Select all that apply.)
A) "Why do you think you are so upset?"
B) "I can see that this situation really bothers you."
C) "The abuse you endured is very painful for you."
D) "Crying is a way of expressing the hurt you're experiencing."
E) "Let's talk about something else, since this subject is upsetting you."
Q2) The nurse is seeking clarification of a statement that was made by a patient. What is the best way for the nurse to seek clarification?
A) "What are the common elements here?"
B) "Tell me again about your experiences."
C) "Am I correct in understanding that "
D) "Tell me everything from the beginning."
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Chapter 46: Collaboration
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Sample Questions
Q1) The nurse and physician are explaining that home care that will be needed by a patient after discharge. The patient's spouse states angrily that it will not be possible to provide the care recommended. What is the best response by the nurse?
A) "Let me review what is needed again."
B) "It is important that you do what the physician has prescribed."
C) "What concerns do you have about the prescribed care?"
D) "I can come back after you talk with your spouse about the care."
Q2) A newly licensed nurse is assigned to an experienced nurse for training on a medical unit of a hospital. What type of nurse-to-nurse collaboration does this assignment demonstrate?
A) Interprofessional
B) Shared governance
C) Interorganizational
D) Mentoring
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Chapter 47: Safety
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Q1) Prior to drug administration the nurse reviews the seven rights, which include right patient, right medication, right time, right dose, right education, right documentation, and what other right?
A) Room
B) Route
C) Physician
D) Manufacturer
Q2) Which is an essential element of a standard order set to verify a medication order?
A) Volume only
B) Number of tablets
C) Metric dose/strength
D) Hour of administration
Q3) Aspects of safety culture that contribute to a culture of safety in a health care organization include which component?
A) Communication
B) Fear of punishment
C) Malpractice implications
D) Team nursing
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Chapter 48: Technology and Informatics
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Q1) The staff nurse who uses informatics in promoting quality patient care is most likely to access data in which domain?
A) Certified clinical information systems (CIS)
B) Clinical health care informatics
C) Public health/population informatics
D) Translational bioinformatics
Q2) Florence Nightingale, the first nurse informatician, sought hospital data for comparison purposes to compete which goal?
A) Allow faster and accurate diagnosis.
B) Better coordinate care.
C) Improve the efficiency of care.
D) Show people how their money was spent.
Q3) Which are exemplars of the health informatics Chapter?
A) Clinical research informatics
B) Hardware and software
C) Privacy and security
D) Standard terminology
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Chapter 49: 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) The nurse in the outpatient setting would like to conduct a research study that compares patients who take tramadol (Ultracet) to patients who take oxycodone hydrochloride and acetaminophen (Percocet) for managing back pain. Which quantitative research method should yield the best results?
A) Longitude study
B) Controlled study
C) Systematic reviews/meta-analysis
D) Survey study
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Chapter 50: Health Care Quality
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Sample Questions
Q1) Two nurses are discussing health care quality. They agree which event contributes to increased health care quality?
A) Magnet status hospitals
B) Fewer adverse events
C) Collaboration of multiple health care agencies
D) Increased patient education
Q2) A student nurse and clinical instructor are discussing quality in health care. The instructor knows the student understands when the student makes which statement?
A) "Quality is apparent in all health care."
B) "Quality is an outcome of health care."
C) "Quality is seen and unseen in health care."
D) "Quality is achieved by collaboration in health care."
Q3) 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
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Page 52
Chapter 51: Care Coordination
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Q1) 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 significant part of care coordination."
Q2) Care coordination models should be adopted in health care facilities. If models are not put into practice, the shortcomings of the health care system may display which of the following items? (Select all that apply.)
A) Decrease in patients
B) Fragmented services
C) Low birth weight newborns
D) Cost inefficiencies
E) Poor health outcomes
F) Increased pharmacy costs
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Chapter 52: Caregiving
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Sample Questions
Q1) Many middle-aged adults are called the "sandwich" generation because they are caring for their children and their aging parents. What is the priority reason for aging parents needing care?
A) Mental clarity
B) Immobility
C) Blindness
D) Multiple chronic illnesses
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. What is the best response by the nurse?
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 53: Palliation
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Sample Questions
Q1) Which is one of the biggest challenges facing current nursing practice?
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.
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) The interprofessional core team includes members from which disciplines?
A) Nursing, medicine, volunteers, and nutrition
B) Medicine, nursing, social work, and clergy
C) Medicine, nursing, physical therapists, and volunteers
D) Nursing, home health aides, volunteers, and clergy
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55
Chapter 54: Health Disparities
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Q1) The nurse is caring for a Chinese patient diagnosed with cancer who is suffering from pain, yet refuses analgesia administration. What type of health disparities is this patient exhibiting?
A) Avoidable and acceptable
B) Avoidable and unacceptable
C) Unavoidable and acceptable
D) Unavoidable and unacceptable
Q2) A new nurse requires further teaching when failing to identify which practice as a health disparity?
A) Annual mammogram
B) Early prenatal care
C) Blood pressure screening
D) Frequent fast food meals
Q3) The nurse is caring for diverse population groups at a health clinic. Which of the following patients demonstrates a potential health disparity group?
A) A 26-year-old woman who is receiving follow-up after a car accident.
B) A 30-year-old immigrant who does not speak English.
C) A 28-year-old man who needs a tetanus booster.
D) A 12-month-old with an appointment for immunizations.
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Page 56
Chapter 55: Health Care Organizations
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Q1) A nurse is interviewing at an agency owned by a national religious organization that serves homeless and uninsured patients. A large poster display shows a proposed addition that would add 16 beds to the facility that will be funded from profits of the previous 3 years of operation. The nurse recognizes that the agency is most likely what type of agency?
A) For-profit
B) Not-for-profit
C) Publicly-owned
D) Investor-owned
Q2) A hospital is experiencing a drop in patient admissions, resulting in the implementation of a hiring freeze. What is a potential critical consequence of this internal organizational decision?
A) A decrease in the availability of future nurses to hire
B) A savings of salaries and benefits
C) Increased scholarships to nursing students from the local high school
D) Increased cross-training of current staff
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Chapter 56: 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) An accountable care organization (ACO) seeks to deliver which of the following aspects of health care? (Select all that apply.)
A) Lessen Medicare payments
B) Integrate care
C) Enhance evidence-based practices
D) Manage acute conditions
E) Support hospice charges
Q3) A student asks the instructor about health care economics. The instructor knows the student understands when the student makes which statement?
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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Chapter 57: Health Policy
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Q1) Nurses can be health advocates in which of the following ways? (Select all that apply.)
A) Supporting their professional nursing organization when discussing upcoming legislation
B) Discussing the upcoming classes with a neighbor
C) Rallying for coverage for childhood immunizations
D) Arranging for a patient to meet with case management for home health care
E) Discussing a patient they are concerned about with a fellow student in the public cafeteria
Q2) 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
Q3) A definition of health policy includes which of the following elements?
A) Funding for public education
B) Appropriation of funds for roadwork
C) Selection of congressional members of committees
D) Public policy made to support health-related goals
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Page 59
Chapter 58: Health Care Law
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Sample Questions
Q1) In which of the following answers is the hospital in compliance with the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA)?
A) The emergency department staff asks a patient to stay in the waiting room until the patients with insurance are treated.
B) The emergency registration personnel explain to a patient that they must have proper identification to receive treatment.
C) A patient with chest pain is triaged directly to a room for evaluation and registration information is obtained after the patient is stabilized.
D) The emergency department physician discharges and instructs a patient who is actively suicidal to go the neighbor facility that has psychiatric services.
Q2) What is one of the major attributes of health care law?
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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