Nursing Foundations
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Course Introduction
Nursing Foundations introduces students to the core principles, concepts, and values underpinning professional nursing practice. The course covers the history and evolution of nursing, the roles and responsibilities of nurses within the healthcare system, ethical and legal principles, and the nursing process as a framework for patient care. Emphasis is placed on effective communication, patient safety, and the development of critical thinking and clinical reasoning skills. Students also gain foundational knowledge in basic nursing procedures, infection control, documentation, and collaborative healthcare practices, providing the essential groundwork for advanced nursing studies and practice.
Recommended Textbook
Fundamentals of Nursing Active Learning for Collaborative Practice 1st Edition by Yoost
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Chapter 1: Nursing, Theory, and Professional Practice
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Q1) The prospective student is considering options for beginning a career in nursing. Which degree would best match the student's desire to conduct research at the university level?
A) Associate Degree in Nursing (ADN)
B) Bachelor of Science in Nursing (BSN)
C) Doctor of Nursing Practice (DNP)
D) Doctor of Philosophy in Nursing (PhD)
Answer: D
Q2) Which nursing theorist described the relationship between the nurse and the patient as an interpersonal and therapeutic process?
A) Virginia Henderson
B) Betty Neuman
C) Imogene King
D) Hildegard Peplau
Answer: D
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Chapter 2: Values, Beliefs, and Caring
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Sample Questions
Q1) The nurse is planning to change a dressing on an anxious patient. The best approach for the nurse is to:
A) ask another staff member to perform the task.
B) tell the patient the dressing change will take 30 minutes.
C) schedule a time in collaboration with the patient.
D) review the physician's order prior to the procedure.
Answer: C
Q2) The nurse is observed sitting at the bedside of a patient discussing the nursing care plan for the shift. Which theory or model most accurately reflects this nurse-patient relationship?
A) Swanson's Theory of Caring
B) Travelbee's Human-to-Human Relationship Model
C) Watson's Theory of Caring
D) Leininger Cultural Care Theory
Answer: A
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4
Chapter 3: Communication
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Sample Questions
Q1) The nurse is performing an abdominal assessment on a postoperative surgical patient. The nurse notes that the dressing needs to be changed twice a day and discusses when the patient would like to have it done. The nurse then plans to change the dressing at that time. In which phase of the nurse-patient helping relationship would this process occur?
A) Introductory phase
B) Orientation phase
C) Working phase
D) Termination phase
Answer: C
Q2) Based on a patient's perception of professional competence and caring, the nurse should wear:
A) large, dangling, hoop earrings
B) bright red, acrylic fingernails
C) a clean, neatly pressed uniform
D) offensive tattoos that cannot be covered
Answer: C
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Page 5
Chapter 4: Critical Thinking in Nursing
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Sample Questions
Q1) The nurse has received advanced orders for a patient that she is expecting to be admitted from the emergency room (ER). The patient's name is Mr. Herman Goldstein. Trying to get ahead on her task, the nurse changes the patient's diet from "Regular" to "Kosher." When the patient reaches the unit, the nurse discovers that the patient is Catholic even though his father is Jewish. The nurse is guilty of giving in to:
A) illogical thinking.
B) a bias.
C) closed-mindedness.
D) an erroneous assumption.
Q2) Professional nursing requires a commitment to lifelong learning because: (Select all that apply.)
A) treatment modalities and technology continue to advance.
B) there are always new things to memorize and store in memory.
C) nurses are expected to update and maintain competency.
D) critical thinking is essential in nursing.
E) nursing school gives the nurse all he/she needs to be competent.
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Chapter 5: Introduction to the Nursing Process
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Q1) The nursing process is the foundation of professional nursing practice. As such, the nursing process can be defined as:
A) The framework that nurses used to provide care.
B) A complex process during which nurses think about their thinking.
C) The process that allows nurses to collect essential data.
D) Thinking like a nurse in developing plans of care.
Q2) The nurse writes a short-term goal for a patient scheduled for surgery in the morning. The goal that contains all of the necessary elements is:
A) The patient will walk to the bathroom within 48 hours after surgery.
B) The patient will walk to the bathroom without experiencing shortness of breath within 48 hours after surgery.
C) The patient will walk to the bathroom without experiencing shortness of breath.
D) The patient will walk to the bathroom without experiencing shortness of breath after surgery.
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Chapter 6: Assessment
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Q1) The morning nurse is assigned to care for a patient admitted during the night with rectal bleeding. When making rounds, the nurse observes that the patient's face is ashen in color and the skin is cool and clammy. The nurse auscultates the patient's heart and lungs. Which category of physical assessment is the basis for the nurse's response?
A) Emergency
B) Focused
C) Complete
D) Initial comprehensive
Q2) 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.
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8
Chapter 7: Nursing Diagnosis
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Q1) The nurse is caring for a complex patient needing physical and emotional support. As the primary care giver, the nurse:
A) is ultimately responsible for assessment of patient needs and progress.
B) delegates to people who know what they are doing and operate independently.
C) provides total care to the patient after getting direction from other disciplines.
D) understands that the patient is ultimately responsible for failure or success.
Q2) The nurse is writing the care plan for a patient admitted to the hospital for complications associated with muscular dystrophy. Which nursing diagnoses written on the care plan indicate a need for further instruction in constructing the diagnostic statement?
A) Constipation related to immobility as manifested by lower extremity weakness.
B) Activity intolerance related to weakness as evidenced by verbal report of fatigue.
C) Feeding self-care deficit related to fatigue as manifested by inability to swallow food.
D) Ineffective airway clearance related to muscle weakness.
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9
Chapter 8: Planning
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Sample Questions
Q1) The nurse is caring for a patient who has undergone abdominal surgery. The patient stated prior to surgery that "I don't think I'll be able to handle this if I get a colostomy. I wouldn't know how to manage it." There is no "next of kin" listed in the patient's record. The patient is complaining of severe surgical pain. The nurse is correct when addressing which nursing diagnosis first?
A) Pain
B) Alteration in body image
C) Knowledge deficit
D) Risk for falls
Q2) The nurse recognizes which of the following as a barrier to achieving goals?
A) The effects of pain and/or clinical depression
B) Patient involvement in setting patient goals
C) Family involvement in setting patient goals
D) Realistic expectations of the patient's capabilities.
Q3) Measurable goals are: (Select all that apply.)
A) specific
B) concrete
C) vague
D) easy to judge
E) non-specific
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Chapter 9: Implementation and Evaluation
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Q1) 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
Q2) The nurse is caring for a patient with blindness. When reviewing the care plan, the nurse notes which of the following goals need to be modified?
A) The patient will report any drainage from the wound with a foul odor to the primary care provider after discharge.
B) The patient will agree to report pain promptly while hospitalized.
C) The patient will obtain no injuries while in the hospital.
D) The patient will report any wound drainage with a purulent appearance to the primary care provider after discharge.
Q3) 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
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11
Chapter 10: Documentation, Electronic Health Records, and Reporting
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Q1) The nurse is charting using the DAR charting system. This form of charting requires documentation about: (Select all that apply.)
A) the patient problems.
B) subjective data.
C) any actions initiated.
D) objective data.
E) the patient's response to interventions.
Q2) 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.
Q3) If a verbal or phone order is necessary in an emergency, the order:
A) must be taken by an RN or LPN.
B) must be repeated verbatim to confirm accuracy.
C) documented as a written order.
D) does not need further verification by the provider.
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Chapter 11: Ethical and Legal Considerations
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Q1) Health care providers are required to supply patients with written information regarding their rights to make medical decisions and implement advance directives, which consist of three documents. Which of the following are considered "advanced directives"? (Select all that apply.)
A) Living will
B) Durable power of attorney
C) Health care proxy
D) Patient's Bill of Rights
E) The Uniform Anatomical Gift Act
Q2) Which law protects health care professionals from charges of negligence when providing emergency care at the scene of an accident?
A) Good Samaritan Act
B) HIPPA
C) Licensure
D) Living wills
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13
Chapter 12: Leadership and Management
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Sample Questions
Q1) The nurse manager is considered a "great communicator." She can be found on the unit talking with staff, keeping them informed and asking their opinions. She believes that her nurses are motivated by internal means and that they want to participate in making decisions about the unit although the final decision always rests with her. This nurse manager is what type of leader?
A) Autocratic
B) Democratic
C) Bureaucratic
D) Laissez-faire
Q2) A patient is found unresponsive and pulseless. The nurse begins cardiopulmonary resuscitation (CPR) and calls for help. When help arrives, the nurse should take on the role of:
A) autocratic leader.
B) democratic leader.
C) laissez-faire leader.
D) bureaucratic leader.
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Chapter 13: Evidence-Based Practice and Nursing Research
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Q1) Nurses use the new information in their practice. In the process of implementing EBP, the nurse: (Select all that apply.)
A) develops clinical questions.
B) creates workshops and in-services.
C) seek answers to support the clinical decision.
D) applies finding to patients.
E) publishes a bulletin.
Q2) A human subject is defined as a living individual about whom an investigator conducting research obtains:
A) data without direct or indirect interaction or intervention.
B) information that is not expected to be made public.
C) no diagnostic information and does not manipulate the subjects environment.
D) information without any communication/contact during the research.
Q3) The nurse is conducting a qualitative research study. Qualitative research:
A) is based on a constructivist philosophy.
B) assumes that reality is the same for everyone.
C) is deductive in nature and approach.
D) proceeds from specific facts to generalizations.
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Chapter 14: Health Literacy and Patient Education
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Q1) During patient teaching led by the nurse with goals established through cooperation of the nurse and patient, the patient asks questions as needed and the nurse answers. This is known as:
A) formal teaching.
B) informal teaching.
C) both formal and informal teaching.
D) psychomotor teaching.
Q2) In determining patient goals, the nurse should:
A) allow patients to identify what is most important to them.
B) take the lead and determine what is best for the patient.
C) should focus on health promotion and staying healthy.
D) explain the importance of avoiding complications.
Q3) The unique ability of the patient to understand and integrate health-related knowledge is known as:
A) health literacy.
B) formal patient education.
C) informal patient education.
D) primary education.
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16
Chapter 15: Nursing Informatics
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Sample Questions
Q1) Nurses working surrounded by computers and mobile IT must develop skills in the use of all available technology. At the same time, it is important to recognize that:
A) the technology in use today will be the same tomorrow.
B) cell phones are not usually allowed in the acute care setting.
C) most forms of mobile technology are in violation of HIPAA guidelines.
D) the technology supports bedside and remote charting.
Q2) When using electronic medical records (EMR), the nurse knows that the EMR:
A) holds the documentation of a single episode of care.
B) is a longitudinal record of care for each patient.
C) is widely used for individual health care encounters.
D) includes progress notes for all disciplines.
Q3) The Technology Informatics Guiding Education Reform (TIGER) initiative identified a set of skills needed by all nurses practicing in the 21st century. The TIGER Vision Pillars include: (Select all that apply.)
A) management and leadership.
B) certification by HIMSS.
C) communication and Collaboration.
D) informatics design.
E) IT policy and culture.
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Page 17
Chapter 16: Health and Wellness
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Sample Questions
Q1) The World Health Organization defines health as
A) the absence of disease.
B) the lack of infirmity.
C) complete well-being.
D) being independent of fiscal responsibility.
Q2) The nurse is discussing immunizations for infants and children with new parents. The nurse should focus on:
A) providing scientific evidence to parents.
B) stressing that non-immunization is a crime.
C) acknowledging that immunizations are not needed.
D) informing the parents that they have no choice.
Q3) Self-concept refers to the way in which individuals perceive unchanging aspects of themselves, such as social character, cognitive abilities, physical appearance, and body image. As such, self-concept:
A) if negative, will allow the patient to compensate for weaknesses.
B) if positive, will cause the patient to see challenges as devastating.
C) is a concept that is derived from the patient internally.
D) depends on relationships with family and friends.
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Chapter 17: Human Development: Conception through Adolescence
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Q1) A preschool-aged child got into the cookie jar and ate several cookies before dinner. When confronted by the parent, the child responds, "My pet horse ate them." What does the nurse teach the parents about this response?
A) It is normal for children to have imaginary friends at this age.
B) This vivid imagination will lead the child to misbehave later on.
C) Lying is disobedient and should be punished consistently.
D) The child is obviously afraid of the parents' response.
Q2) The nurse is asked by the parent of a pediatric patient to explain the difference between growth and development. Which response by the nurse is best?
A) "Growth is physical while development relates to physical, emotional, and cognitive function."
B) "There really is no difference between the two since they occur simultaneously."
C) "Development refers to musculoskeletal and nervous system abilities and growth is a change in height and weight."
D) "Both refer to an increase in abilities and functions of the child that occur sequentially over time."
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Chapter 18: Human Development Young Adult to Older Adult
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Q1) The student of adult development learns that cognitive abilities improve during the young adult stage because of the influence of which experiences? (Select all that apply.)
A) Physical growth of the brain
B) Formal education
C) Occupational training
D) Overall life experiences
E) Specific profession chosen
Q2) A nurse in the family practice clinic is assessing an older adult who has dementia. The adult daughter/caregiver expresses concern that the parent should no longer be left alone while the daughter is at work. What response by the nurse is best?
A) Refer the family to a social worker.
B) Encourage the daughter to look into nursing homes
C) Tell the daughter there are medications for dementia.
D) Help the daughter explore adult day care options.
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Chapter 19: Vital Signs
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Q1) The nurse receives a handoff report on four patients. Which patient should the nurse assess first?
A) Pain rating 4/10 after pain medication
B) Blood pressure 102/62 mm Hg
C) Pulse 42 beats/min
D) Respiratory rate 18 breaths/min
Q2) A nurse assesses a patient's radial pulse rate to be 110 beats/min and regular. What action by the nurse is best?
A) Assess the patient for causes of tachycardia.
B) Take an apical heart rate and compare the two.
C) Document the findings in the patient's chart.
D) Notify the patient's health care provider.
Q3) A nurse observes a student taking an adult patient's tympanic temperature. What action by the student requires the nurse to intervene?
A) Student washes hands prior to patient contact
B) Student pulls the pinna of the patient's ear down and back
C) Student explains the procedure to the patient
D) Student pulls the pinna of the patient's ear up and back
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Chapter 20: Health History and Physical Assessment
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Q1) A nurse is conducting a physical examination using palpation. Which assessments might the nurse note? (Select all that apply.)
A) Rebound tenderness: tenderness long after palpation
B) Crepitation: crackling or rubbing
C) Guarding: holding the nurse's hands away from the body
D) Turgor: tension caused by fluid content
E) Consistency: organ location and size
Q2) The nurse is planning to educate four patients on preventing skin cancer and early warning signs. Which patient is the priority for this education?
A) Adolescent who uses a tanning bed
B) Middle-aged adult who walks for fitness
C) Older woman who sits in the sun for 10 minutes daily
D) Person who works indoors under fluorescent lights
Q3) The nurse is assessing a patient's alcohol intake. What question is most appropriate?
A) "Do you drink alcohol at all?"
B) "You don't drink much do you?"
C) "When was your last drink?"
D) "How much alcohol do you drink daily?"
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22
Chapter 21: Ethnicity and Cultural Assessment
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Q1) The nurse is caring for a patient from a different cultural background. What action by the nurse best demonstrates cultural maintenance?
A) Assist the patient with a healing ritual.
B) Teach the patient a heart healthy diet.
C) Instruct the patient on monitoring blood glucose.
D) Discuss what self-care activities the patient is willing to do.
Q2) The nurse is working with a patient from an unfamiliar culture. After assessing the patient and the patient's cultural beliefs related to health care, what action by the nurse is best?
A) Create a nursing plan of care for the patient.
B) Recheck cultural beliefs with the patient.
C) Use a standard plan of care for consistency.
D) Have an interpreter validate the information.
Q3) The student learns that which item is the most important symbolic aspect of culture?
A) Flags
B) Language
C) Art
D) Music
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Page 23
Chapter 22: Spiritual Health
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Q1) The nurse is caring for four patients. Which one should the nurse assess for spirituality needs as a priority?
A) New mother, older child at home
B) Faces terminal diagnosis
C) Needs to change medications
D) Pleasant but quiet
Q2) A home health care nurse has been working with a patient who has the nursing diagnosis Spiritual Distress. After a few weeks of implementing the care plan, what method is best for the nurse to determine if goals have been met?
A) Ask the patient to what extent he/she feels goals have been met.
B) Ask the patient to rate the distress on a scale of 1-10.
C) Assess for objective data to support goal attainment.
D) Determine if the patient thinks the interventions are helpful.
Q3) 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."
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Page 24
Chapter 23: Public Health, Community Base, and Home Health Care
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Q1) A nurse is a case manager for a home health care agency. The nurse often orders supplies for patients seen by the agency. What action by the nurse is best?
A) Negotiate for cheaper prices from suppliers.
B) Investigate what each patient's insurance will cover.
C) Refer the patient to the closest supply source.
D) Use the same supplier for all patients' needs.
Q2) The home health care nurse educates patients on which goals of hospice care?
(Select all that apply.)
A) Relieve suffering
B) Support the patient and family
C) Provide grief support
D) Keep patients out of the hospital
E) Lower medical expenses
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 patient is recovering from colostomy surgery and states, "I guess I'll never be able to have sex again who would want me?" What nursing diagnosis is most important for this patient?
A) Sexual dysfunction
B) Ineffective sexuality pattern
C) Knowledge deficit
D) Ineffective coping
Q2) A nurse in the emergency department wants to screen a patient for domestic violence, but the woman's partner won't leave. What action by the nurse is best?
A) Ask the questions anyway.
B) Tell the partner to leave.
C) Go with the patient to the bathroom.
D) Skip the abuse assessment.
Q3) A nurse is caring for a victim of domestic violence. What charting by the nurse is most appropriate?
A) Patient allegedly beat up by her boyfriend.
B) Patient has several bruises on the legs.
C) Patient states, "My boyfriend hit me with a hammer."
D) Patient claims she was assaulted last night.
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Page 26
Chapter 25: Safety
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Q1) The nurse is explaining the National Patient Safety Goals (NPSG) to the student nurse. Which of the following answers indicates that the student has a good understanding of these goals? (Select all that apply.)
A) The NPSG's focus on treating all infections quickly
B) The NPGS's focus on improving staff communication
C) The NPGS's focus on using medications safely
D) The NPGS's focus on identifying patients correctly
Q2) 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
Q3) Which statement by the nurse correctly identifies the UAP role in patient restraint use?
A) "The UAP can perform initial assessment."
B) "The UAP can apply a restraint."
C) "The UAP can assist with applying and monitoring of a physical restraint."
D) "The UAP can contact the physician and request an order for restraints."
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Page 27
Chapter 26: Asepsis and Infection Control
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Q1) A disease-causing organism is known as:
A) a pathogen.
B) normal flora.
C) a germ.
D) a microorganism.
Q2) A patient admitted after abdominal surgery has a nursing diagnosis of risk for infection. Which is the most appropriate goal?
A) Patient will ambulate length of hallway this shift.
B) Patient will consume 20% of meals by the end of the week.
C) Patient's incision will be without signs or symptoms of infection at discharge.
D) Patient will verbalize need to stop antibiotics medication when symptom free.
Q3) The nurse recognizes the correct order to remove PPE as:
A) gloves, eyewear, gown, mask.
B) mask, eyewear, gown, gloves.
C) gown, mask, eyewear, gloves.
D) gloves, gown, mask, eyewear.
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Chapter 27: Hygiene and Personal Care
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Q1) The nurse and UAP are making an occupied bed together. Which action by the nurse is incorrect?
A) The nurse asks and assists the patient to turn toward the UAP and loosens the fitted sheet and rolls it in toward the patient.
B) The nurse rolls dirty linens to the side then places the linens on the floor while finishing.
C) The nurse tucks the clean bottom sheet under the cleaner underside of the dirty linens.
D) The nurse wears gloves to remove dirty linens.
Q2) Which tool is used to determine risk for impaired skin integrity?
A) Braden scale
B) Glasgow scale
C) Vanderbilt scale
D) MMSE scale
Q3) Regarding denture care, what action by the nurse is inappropriate?
A) Carrying the dentures to the sink wrapped in a paper towel.
B) Placing a towel in the sink and brushing the dentures over the towel.
C) Brushing the dentures as the nurse would the teeth of a conscious patient.
D) Applying adhesive, then inserting upper and then lower dentures.
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Chapter 28: Activity, Immobility, and Safe Movement
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Q1) The nurse knows active assistive range of motion is:
A) when the patient is able to independently move all joints.
B) when the patient is able to partially move all joints.
C) when the caregiver must move the patient's joints.
D) when the patient is performing isotonic exercises.
Q2) The nurse appropriately delegates care of her patient to the properly trained UAP when she: (Select all that apply.)
A) assigns the UAP to reposition the patient.
B) assigns the UAP to complete the MORSE falls risk scale.
C) assigns the UAP to provide range-of-motion exercises.
D) assigns the UAP to ambulate the patient in the hallway.
Q3) 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."
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Chapter 29: Skin Integrity and Wound Care
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Q1) The nurse knows the following types of wounds heal by tertiary intention:
A) An acute wound in which the patient has sutures placed when it happened
B) A pressure ulcer that was treated with dressing changes and healed
C) An acute wound in which surgical glue was used to close the wound
D) A wound that was left open initially and closed later with sutures
Q2) The nurse is repositioning her patient in the side-lying position. To avoid putting the patient at risk for pressure ulcers, the HOB should be placed at:
A) flat.
B) 90 degrees.
C) 30 degrees.
D) 45 degrees.
Q3) The nurse knows a stage III pressure ulcer is:
A) a pressure ulcer that involves exposure of bone and connective tissue.
B) a pressure ulcer that does not extend through the fascia.
C) a pressure ulcer that does not include tunneling.
D) a partial-thick wound that involves the epidermis.
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Chapter 30: Nutrition
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Q1) The nurse is providing dietary education to her patient to help him include more complex carbohydrates in his diet. Which of the following would be beneficial to include? (Select all that apply.)
A) Green beans
B) Bananas
C) Beans
D) Potatoes
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 knows that patients should consume the following amounts of fiber every day:
A) 25-35 g
B) 20-35 g
C) 25-40 g
D) 20-40 g
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Page 32
Chapter 31: Cognitive and Sensory Alterations
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Sample Questions
Q1) The nurse is caring for a diabetic patient who has had a long history of poor glucose control. For what complications is the patient at risk? (Select all that apply.)
A) Sudden loss of consciousness
B) Diabetic retinopathy
C) Stroke
D) Peripheral neuropathy
E) Memory loss
Q2) The nurse is delegating care to an unlicensed assistive personnel (UAP) to a patient who has sensory overload. Which statement by the UAP indicates a need for further orientation?
A) "I should keep the noise levels low."
B) "I should schedule all the care together."
C) "I should keep the room well lit."
D) "I should allow the family to visit."
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 is educating the patient about alternative therapies. Which statement by the patient indicates a need for more information?
A) Alternative therapies can include relaxation techniques.
B) Alternative therapies are used in conjunction with medical therapies.
C) Alternative therapies can be used when patients are experiencing stress.
D) Some alternative therapists require certification.
Q2) The nurse is measuring her patient's blood glucose levels after an acute myocardial infarction (MI). She knows the rationale for doing this is:
A) damaged muscle tissue releases glucose.
B) corticosteroids increase glucose.
C) myocardial infarctions are often seen in diabetics.
D) all patients should have their blood glucose checked.
Q3) The nurse knows that the coping strategies that are more frequently seen in older adults are: (Select all that apply.)
A) anger.
B) withdrawal.
C) information gathering.
D) avoidance.
E) problem focused.
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Page 34
Chapter 33: Sleep
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Q1) The nurse knows that polysomnograpy is:
A) the recording of brain waves and other variables.
B) the relay of motor impulse to the hypothalamus.
C) the patterns of biological functioning.
D) the recording of seizure activity in the brain.
Q2) The nurse knows an appropriate goal for the nursing diagnosis Disturbed sleep pattern during hospitalization is:
A) the patient will fall asleep within 15 minutes of going to bed.
B) the patient will report an ability to concentrate on tasks.
C) the patient will repeat medication instructions on discharge.
D) the patient will be able to sleep for at least 2 hours at a time.
Q3) The nurse knows that cataplexy includes:
A) an uncontrolled desire to sleep.
B) falling asleep for several minutes.
C) loss of voluntary muscle tone.
D) a sleep cycle that begins with NREM.
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35
Chapter 34: Diagnostic Testing
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Q1) The nurse is caring for a patient with a urinary tract infection. Which test will indicate which antibiotics will be effective to treat the infection?
A) Complete blood count (CBC)
B) Culture and sensitivity (C&S)
C) Renal scan and angiography
D) Radioreceptor assay for HCG
Q2) The nurse is caring for a patient who is to have a noncontrast MRI scan performed. Which assessment finding leads the nurse to report that the patient may not be able to have the test?
A) The patient has an implanted insulin pump.
B) The patient is breastfeeding her newborn infant.
C) The patient is severely allergic to iodine and latex.
D) The patient has profound hearing loss.
Q3) The nurse is caring for a patient who has just undergone paracentesis. For which complication will the nurse carefully monitor?
A) Collapse of the lung with shortness of breath
B) Fecal impaction from retained barium in the colon
C) Cerebrospinal fluid leak resulting in severe headache
D) Perforation of the bowel resulting in abdominal infection
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Page 36
Chapter 35: Medication Administration
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Q1) The nurse begins a shift on a busy medical-surgical unit. The nurse will be caring for multiple patients. Which patient will the nurse assess first?
A) A patient who would like some acetaminophen (Tylenol) for a mild headache
B) A patient who has a question about her daily medications
C) A patient who needs discharge teaching about an antibiotic
D) A patient who just received nitroglycerin for chest pain
Q2) The nurse carefully reviews the patient's medication list. Which observation about the list indicates the highest risk for serious drug-drug interactions?
A) The patient has been taking the same medications for a long time.
B) The patient is taking a large number of medications.
C) Most of the drugs on the list are prescribed at high doses.
D) The patient takes oral, injected, and inhaled medications.
Q3) The nurse suspects that the patient is experiencing a drug toxicity rather than a side effect. Which question will the nurse ask to help confirm this suspicion?
A) "When did you take your last dose of the medication?"
B) "Have you been taking extra doses of the medication?"
C) "Are you taking any other medications?"
D) "Have you ever taken this medication in the past? "
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Chapter 36: Pain Management
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Q1) The nurse is caring for a patient with severe chronic pain. The nurse applied the first 50 mcg transdermal fentanyl (Duragesic) patch 2 hours ago. The patient states that the pain is presently rated at 9 on a 1-10 scale. What is the nurse's best action?
A) Instruct the patient that the Duragesic patch will start to work soon.
B) Administer a short-acting narcotic medication like morphine liquid (Roxanol).
C) Give the patient a gentle back rub and encourage guided imagery.
D) Apply a second 25-mcg transdermal fentanyl (Duragesic) patch now.
Q2) The nurse is caring for a patient who just underwent laparoscopic appendectomy. The patient tells the nurse that she is experiencing severe postoperative pain between her shoulder blades. Which term best describes the pain that this patient is having?
A) Referred pain
B) Phantom pain
C) Neuropathic pain
D) Psychogenic pain
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Chapter 37: Perioperative Nursing Care
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Q1) 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
Q2) The nurse is caring for a postoperative patient who is very sleepy following general anesthesia and administration of pain medication. The nurse notes that the patient is making snoring sounds and his pulse oximetry has dropped to 88%. What is the best action of the nurse?
A) Insert an oral airway and administer oxygen.
B) Call for anesthesia to immediately reintubate the patient.
C) Remove the pillow from behind the patient's head.
D) Elevate the head of the patient's bed.
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Chapter 38: Oxygenation and Tissue Perfusion
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Q1) The nurse is caring for a patient with severe COPD who is becoming increasingly confused and disoriented. What is the priority action of the nurse?
A) Obtain an arterial blood gas to check for carbon dioxide retention.
B) Increase the patient's oxygen until the pulse oximetry is greater than 98%.
C) Lower the head of the patient's bed and insert a nasal airway.
D) Administer a mild sedative and reorient the patient as needed.
Q2) The nurse finds the patient in cardiopulmonary arrest with no pulse or respirations. Which oxygen delivery device will the nurse use for this patient?
A) Non-rebreather mask
B) Bag-valve-mask unit
C) Continuous positive airway pressure (CPAP)
D) High-flow nasal cannula
Q3) Which of the following patients would benefit from postural drainage?
A) A patient with a heart murmur and jugular venous distention
B) A patient with asthma and audible wheezing
C) A patient with right-sided heart failure and pitting edema
D) A patient with chronic bronchitis and congested cough
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Chapter 39: Fluid, Electrolytes, and Acid-Base Balance
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Q1) The nurse is caring for a patient who was brought to the ER after overdosing on narcotic pain medication. The patient was found unresponsive with no respirations. Arterial blood gases were drawn shortly after the patient's arrival to the hospital. Which results will the nurse expect to see?
A) pH 7.56, PaCOS1U1B12S1U1B0 32 mm Hg, HCOS1U1B13S1U1B0 32 mEq/L, PaOS1U1B12S1U1B0
90 mm Hg
B) pH 7.35, PaCOS1U1B12S1U1B0 45 mm Hg, HCOS1U1B13S1U1B0 26 mEq/L, PaOS1U1B12S1U1B0
70 mm Hg
C) pH 7.45, PaCOS1U1B12S1U1B0 38 mm Hg, HCOS1U1B13S1U1B0 28 mEq/L, PaOS1U1B12S1U1B0
80 mm Hg
D) pH 7.27, PaCOS1U1B12S1U1B0 58 mm Hg, HCOS1U1B13S1U1B0 24 mEq/L, PaOS1U1B12S1U1B0
60 mm Hg
Q2) The nurse is reviewing the patient's laboratory results. Which result must be communicated to the physician immediately?
A) Serum chloride level 85 mEq/L
B) Serum sodium level 134 mEq/L
C) Serum potassium level 6.8 mEq/L
D) Serum magnesium level 2.3 mEq/L
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Chapter 40: Bowel Elimination
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Q1) The nurse is caring for a patient who had a colonoscopy earlier that day. The patient states that he still feels very bloated after the procedure. What is the best action of the nurse?
A) Assist the patient to ambulate in the hall.
B) Insert a rectal tube to remove retained flatus.
C) Administer an enema to stimulate peristalsis.
D) Encourage oral intake of fluids and high-fiber foods.
Q2) The nurse is caring for a patient who is constipated and has not had a bowel movement for 3 days. The nurse performs a rectal examination and finds hard dry stool in the rectum. What is the best option to help the patient have a bowel movement?
A) Glass of warmed prune juice
B) Loperamide (Imodium)
C) Oral fiber supplement
D) An oil retention enema
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Chapter 41: Urinary Elimination
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Q1) The nurse is caring for a patient with a history of incontinence and poor perineal hygiene practices. The patient has had four urinary tract infections in the past year. Which is the priority goal for the nursing diagnosis of Ineffective therapeutic regimen management?
A) The patient will be provided with educational materials about risks of urosepsis.
B) The patient will allow family members to assist with daily bathing and perineal care.
C) The patient will clearly state why she refuses to provide adequate care for herself.
D) Regular home care nursing visits and follow-up telephone contact will be arranged.
Q2) The nurse is caring for a patient who has just had an intravenous pyelography (IVP) completed. Which assessment is the nurse's highest priority after the patient returns from the test?
A) Carefully calculate of the patient's intake and output.
B) Monitor for discoloration of the patient's urine.
C) Assess for possible iodine or shellfish allergies.
D) Inquire if the patient has burning or pain with urination.
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43
Chapter 42: Death and Loss
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Q1) The hospice nurse is caring for a terminally ill patient who will probably die within the next hour or two. The patient's daughter is keeping a vigil by the bedside and asks what she can do to help her father at this time. What is the appropriate response of the nurse?
A) "Just let him know you are here, talk to him, and let him know that you love him."
B) "You can try to feed him a few bites of ice cream to keep his mouth from getting dry."
C) "You can take this time to ensure that arrangements are set with the funeral home."
D) "You should let me know when your father's breathing pattern changes."
Q2) The nurse is caring for a patient who suffered a miscarriage at 24 weeks of pregnancy. The patient is devastated by the loss but her husband minimizes her grief by stating, "Quit crying. It's not like you lost a real baby." What term best describes the anguish felt by the patient?
A) Disenfranchised grief
B) Ineffective denial
C) Moral distress
D) Interrupted family processes
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