

Nursing Practice I Textbook Exam
Questions
Course Introduction
Nursing Practice I introduces students to the foundational concepts and skills essential for safe and effective nursing care across diverse healthcare settings. Emphasizing the nursing process, this course provides hands-on experience in basic clinical procedures, patient assessment, therapeutic communication, and documentation. Students will develop critical thinking, cultural competence, and professional behaviors while working with individuals and families under supervision. Clinical laboratory and simulation experiences prepare students to apply theoretical knowledge, prioritize patient needs, and collaborate as part of an interprofessional healthcare team.
Recommended Textbook
Concepts for Nursing Practice 2nd Edition by Giddens
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58 Chapters
459 Verified Questions
459 Flashcards
Source URL: https://quizplus.com/study-set/174

Page 2
Chapter 1: Development
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8 Verified Questions
8 Flashcards
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Sample Questions
Q1) 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
Q2) The \(\bold{most}\) appropriate response of the nurse when a mother asks what the Denver II does is that it
A) can diagnose developmental disabilities.
B) identifies a need for physical therapy.
C) is a developmental screening tool.
D) provides a framework for health teaching.
Answer: C
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3
Chapter 2: Functional Ability
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) Cleans the house
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: A
Q2) Uses a cane
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: B
Q3) The nurse is assessing a patient with a mobility dysfunction and wants to gain insight into the patient's functional ability. What question would be the most appropriate?
A) "Are you able to shop for yourself?"
B) "Do you use a cane, walker, or wheelchair to ambulate?"
C) "Do you know what today's date is?"
D) "Were you sad or depressed more than once in the last 3 days?"
Answer: B
Q4) Balances the checkbook
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: A

Page 4
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Chapter 3: Family Dynamics
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7 Verified Questions
7 Flashcards
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Sample Questions
Q1) When reviewing the purposes of a family assessment, the nurse educator would identify a need for further teaching if the student responded that family assessment is used to gain an understanding of which aspect of the family?
A) Development
B) Function
C) Political views
D) Structure
Answer: C
Q2) Two women have an established long-term relationship and are attending parenting classes in anticipation of finalizing adoption of a baby. The nurse identifies them as which type of family?
A) Cohabiting
B) Nuclear
C) Same-sex
D) Single parent
Answer: C
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Chapter 4: Culture
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Sample Questions
Q1) 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
Q2) 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.
Q3) The emphasis on understanding cultural influence on health care is important because of
A) disability entitlements.
B) HIPAA requirements.
C) increasing global diversity.
D) litigious society.
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Chapter 5: Spirituality
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7 Flashcards
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Sample Questions
Q1) 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
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) 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
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Page 7

Chapter 6: Adherence
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10 Flashcards
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Sample Questions
Q1) The nurse is assessing a newly diagnosed diabetic, and the patient's readiness to learn about glucose monitoring. Before planning teaching activities, which approach would be most effective?
A) Assist the patient with long-term goals and plan teaching according to these goals.
B) Provide the patient with all the latest research from the Internet on glucose monitoring.
C) Refer the patient to the diabetic specialist who can assist the patient with the glucometer.
D) Assist the patient in developing realistic short-term goals.
Q2) When assessing a 22-year-old male patient, the nurse learns that he smokes a pack of cigarettes daily. The patient tells the nurse, "I enjoy smoking and have no plans to quit." Which nursing diagnosis is most appropriate?
A) Health Seeking Behaviors related to cigarette use
B) Ineffective Health Maintenance related to tobacco use
C) Readiness for Enhanced Self-Health Management related to smoking
D) Deficient Knowledge related to long-term effects of cigarette smoking
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Chapter 7: Self-Management
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Sample Questions
Q1) 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
Q2) The nurse is developing a teaching plan for a patient diagnosed with congestive heart failure. Which are the most appropriate teaching points to include that will assist in self-management of the disease? (Select all that apply.)
A) Side effects of medications
B) Activity restrictions
C) Daily weights
D) Increased sodium intake
E) Blood pressure monitoring
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9

Chapter 8: Fluid and Electrolyte Balance
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9 Flashcards
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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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7 Flashcards
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Sample Questions
Q1) The patient has type B chronic obstructive pulmonary disease (COPD) exacerbated by an acute upper respiratory infection. Which blood gas values should the nurse expect to see?
A) pH high, PaCO<sub>2</sub> high, HCO<sub>3</sub>- high
B) pH low, PaCO<sub>2</sub> low, HCO<sub>3</sub>- low
C) pH low, PaCO<sub>2</sub> high, HCO<sub>3</sub>- high
D) pH low, PaCO<sub>2</sub> high, HCO<sub>3</sub>- normal
Q2) The nurse is making a home visit to a child who has a chronic disease. Which finding has the greatest implication for acid-base aspects of this patient's care?
A) Urine output is very small today.
B) Whites of the eyes appear more yellow.
C) Skin around the mouth is very chapped.
D) Skin is sweaty under three blankets.
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Chapter 10: Thermoregulation
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8 Flashcards
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Sample Questions
Q1) What is the priority nursing action for a patient suspected to be hypothermic?
A) Assess vital signs.
B) Hydrate with intravenous (IV) fluids.
C) Provide a warm blanket.
D) Remove wet clothes.
Q2) The nurse planning care for a patient with hypothermia should consider what similar exemplar?
A) Heat exhaustion
B) Heat stroke
C) Infection
D) Prematurity
Q3) The nurse admitting a patient to the emergency department on a very hot summer day would suspect hyperthermia when the patient demonstrates which assessment finding?
A) Decreased respirations
B) Low pulse rate
C) Red, sweaty skin
D) Slow capillary refill
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12

Chapter 11: Sleep
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7 Flashcards
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Sample Questions
Q1) A mother tells the nurse she is concerned because her 8 month old infant sleeps all day and night and is only awake about 2-3 hours per day. What is the nurse's best response?
A) "This sleep pattern is very normal for an infant at this age."
B) "Adding an additional feeding will keep the child awake more."
C) "I recommend that you notify the child's pediatrician."
D) "Be sure you are laying the child on his back to sleep at night."
Q2) The nurse is caring for a child with tonsillar enlargement. What is the nurse's priority concern?
A) Low oxygen saturation
B) Daytime fatigue
C) Increased temperature
D) Antibiotic administration
Q3) The nurse must awaken a patient from Stage 4 non-rapid eye movement sleep in order to prepare the patient for a procedure. The patient is disoriented. What is the nurse's best action?
A) Notify the healthcare provider
B) Re-assess the patient's orientation
C) Administer an anti-anxiety medication
D) Cancel the patient's procedure
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Chapter 12: Cellular Regulation
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) A patient is not certain whether she and her family should participate in a genetic screening plan. She asks the nurse why the X-linked recessive disorder that has been noted in some of her family members is expressed in males more frequently than in females. What is the nurse's best response?
A) "The disease tends to show up in males because they do not have a second X chromosome to balance the expression of the gene."
B) "One X chromosome of a pair is always inactive in females. This inactivity effectively negates the effects of the gene."
C) "Females are known to have more effective DNA repair mechanisms than males, thus negating the damage caused by the recessive gene."
D) "Expression of genes from the male's Y chromosome does not occur in females, so they are essentially immune to the effects of the gene."
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14

Chapter 13: Intracranial Regulation
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Sample Questions
Q1) The nurse should teach a patient that which is a primary prevention strategy to reduce the occurrence of head injuries?
A) Blood pressure control
B) Smoking cessation
C) Maintaining a healthy weight
D) Violence prevention
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) 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
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15

Chapter 14: Hormonal Regulation
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Sample Questions
Q1) A patient presents to the emergency room complaining of vomiting with severe back and leg pain. The patient's home medications include daily oral corticosteroids. Vital signs reveal a low blood pressure and there are peaked T waves on the electrocardiogram. What is the nurse's priority intervention?
A) Start an intravenous line
B) Collect urine specimen
C) Administer antiemetic
D) Administer narcotic analgesia
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
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Chapter 15: Glucose Regulation
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7 Flashcards
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Sample Questions
Q1) When a diabetic patient asks about maintaining adequate blood glucose levels, which of the following statements by the nurse relates most directly to the necessity of maintaining blood glucose levels no lower than about 74 mg/dL?
A) "Glucose is the only type of fuel used by body cells to produce the energy needed for physiologic activity."
B) "The central nervous system cannot store glucose and needs a continuous supply of glucose for fuel."
C) "Without a minimum level of glucose circulating in the blood, erythrocytes cannot produce ATP."
D) "The presence of glucose in the blood counteracts the formation of lactic acid and prevents acidosis."
Q2) The nurse recognizes which patient as having the greatest risk for undiagnosed diabetes mellitus?
A) Young white man
B) Middle-aged African-American man
C) Young African-American woman
D) Middle-aged Native American woman
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Chapter 16: Nutrition
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Sample Questions
Q1) An African American is at an increased risk for which of the following? (Select all that apply.)
A) Vitamin D deficiency
B) Type 1 diabetes
C) Celiac disease
D) Type 2 diabetes
E) Hypertension
F) Metabolic syndrome
Q2) During a physical examination, the nurse notes that the patient's skin is dry and flaking, with patches of eczema. Which nutritional deficiency might be present?
A) Vitamin C
B) Vitamin B
C) Essential fatty acid
D) Protein
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Chapter 17: Elimination
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Sample Questions
Q1) A patient who was diagnosed with senile dementia has become incontinent of urine. The patient's daughter asks the nurse why this is happening. What is the nurse's best response?
A) "The patient is angry about the dementia diagnosis."
B) "The patient is losing sphincter control due to the dementia."
C) "The patient forgets where the bathroom is located due to the dementia."
D) "The patient wants to leave the hospital."
Q2) 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."
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Page 19

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 patient's serum electrolytes are being monitored. The nurse notices that the potassium level is low. What should the nurse monitor for in this patient?
A) Tissue ischemia
B) Brain malformations
C) Intestinal blockage
D) Cardiac dysrhythmia
Q3) The nurse is explaining to a student nurse about impaired central perfusion. The nurse knows the student understands this problem when the student makes which statement?
A) "Central perfusion is monitored only by the physician."
B) "Central perfusion involves the entire body."
C) "Central perfusion is decreased with hypertension."
D) "Central perfusion is toxic to the cardiac system."
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Page 20
Chapter 19: Gas Exchange
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Sample Questions
Q1) The nurse is assessing a patient's differential white blood cell count. What implications would this test have on evaluating the adequacy of a patient's gas exchange?
A) An elevation of the total white cell count indicates generalized inflammation.
B) Eosinophil count will assist to identify the presence of a respiratory infection.
C) White cell count will differentiate types of respiratory bacteria.
D) Level of neutrophils provides guidelines to monitor a chronic infection.
Q2) Which patient finding would the nurse identify as being a risk factor for altered transport of oxygen?
A) Hemoglobin level of 8.0
B) Bronchoconstriction and mucus
C) Peripheral arterial disease
D) Decreased thoracic expansion
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21

Chapter 20: Clotting
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Sample Questions
Q1) The nurse would expect to administer an anticoagulant to a patient following which surgery?
A) Hip replacement
B) Hysterectomy
C) Abdominal aorta aneurism (AAA) repair
D) Appendectomy
Q2) 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
Q3) The nurse would anticipate that which of the following patient conditions will be treated with the collaborative treatment of regular phlebotomies?
A) Hemophilia
B) Thrombocytopenia
C) Eosinophilia
D) Polycythemia
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22

Chapter 21: Reproduction
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Sample Questions
Q1) The nurse is admitting a prenatal patient for diagnostic testing. While eliciting the psychosocial history, the nurse learns the patient smokes a pack of cigarettes daily, drinks a cup of cappuccino with breakfast, has smoked marijuana in the remote past, and is a social drinker. Which action should the nurse first take?
A) Strongly advise immediate tobacco cessation
B) Elimination of all caffeinated beverages
C) Serum and urine testing for drug use and alcohol use
D) Referral to a 12-step program
Q2) A female infertility patient is found to be hypoestrogenic at the preChapterual clinic visit. She asks the nurse why she has never been able to get pregnant. Which response is best?
A) Circulating estrogen contributes to secondary sex characteristics.
B) Estrogen deficiency prevents the ovum from reaching the uterus and may be a factor in infertility.
C) Hyperestrogen may be preventing the zona pellucida from forming an ovum protective layer.
D) The corona radiata is preventing fertilization of the ovum.
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Chapter 22: Sexuality
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Sample Questions
Q1) When assessing high-risk behaviors, which question specifically identifies a blood-related risk for a sexually transmitted infection?
A) "Have you ever received donor semen, eggs, or transplanted tissue?"
B) "Have you ever exchanged sex for drugs, money, or shelter?"
C) "How do you protect yourself from HIV and sexually transmitted infections?"
D) "Have you ever injected drugs using shared equipment?"
Q2) A 55-year-old male patient post-myocardial infarction (MI) asks the nurse whether he will be healthy enough for sexual activity after discharge from the hospital. The patient has been prescribed anti-hypertensives and beta-blockers. During health teaching, the nurse understands that the three phases of the four-stage model of the human sexual response cycle that are of concern for this patient include which phases?
A) Excitement, plateau, and orgasmic
B) Plateau, orgasmic, and resolution
C) Excitement, orgasmic, and resolution
D) Arousal, excitement, and plateau
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24
Chapter 23: Immunity
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Sample Questions
Q1) 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
Q2) The nurse is caring for a patient who is being discharged home after a splenectomy. What information on immune function needs to be included in this patient's discharge planning?
A) The mechanisms of the inflammatory response
B) Basic infection control techniques
C) The importance of wearing a face mask in public
D) Limiting contact with the general population
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25

Chapter 24: Inflammation
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Sample Questions
Q1) 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."
Q2) A patient is diagnosed with a sprain to her right ankle after a fall. The patient asks the nurse about using ice on her injured ankle. What is the nurse's best response?
A) "Use ice only when the ankle hurts."
B) "Ice should be applied for 15 to 20 minutes every 2 to 3 hours over the next 1 to 2 days."
C) "Wrap an ice pack around the injured ankle for the next 24 to 48 hours."
D) "Ice is not recommended for use on the sprain because it would inhibit the inflammatory response."
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Chapter 25: Infection
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Sample Questions
Q1) 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
Q2) Which set of assessment data is consistent for a patient with severe infection that could lead to system failure?
A) Blood pressure (BP) 92/52, pulse (P) 56 beats/min, respiratory rate (RR) 10 breaths/min, urine output 1200 mL in past 24 hours
B) BP 90/48, P 112 beats/min, RR 26 breaths/min, urine output 240 mL in past 24 hours
C) BP 112/64, P 98 beats/min, RR 18 breaths/min, urine output 2400 mL in past 24 hours
D) BP 152/90, P 52 beats/min, RR 12 breaths/min, urine output 4800 mL in past 24 hours
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Chapter 26: Mobility
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Sample Questions
Q1) What percentage of hip fractures is the result of falls?
A) 50%
B) 80%
C) 90%
D) 100%
Q2) The nurse is talking to the unlicensed assistive personnel about moving a patient in bed. The nurse knows the unlicensed assistive personnel understands the Chapter of mobility and proper moving techniques when making which statement?
A) "Patients must have a trapeze over the bed to move properly."
B) "Patients should move themselves in bed to prevent immobility."
C) "Patients should always have a two-person assist to move in bed."
D) "Patients must be moved correctly in bed to prevent shearing."
Q3) 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
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Chapter 27: Tissue Integrity
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Sample Questions
Q1) A nurse is conducting community education classes on skin cancer. One participant says to the nurse: "I read that most melanomas occur on the face and arms in fair-skinned women. Is this true?" The nurse's most helpful response would be which of the following?
A) "That is not correct. Melanoma is more commonly found on the torso or the lower legs of women."
B) "That is correct, because the face and arms are exposed more often to the sun."
C) "That is not correct. Melanoma occurs on the top of the head in men but is rare in women."
D) "That is incorrect. Melanoma is most commonly seen in dark-skinned individuals."
Q2) A patient asks the nurse what the purpose of the Wood's light is. Which response by the nurse is accurate?
A) "We will put an anesthetic on your skin to prevent pain."
B) "The lamp can help detect skin cancers."
C) "Some patients feel a pressure-like sensation."
D) "It is used to identify the presence of infectious organisms and proteins associated with specific skin conditions."
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Chapter 28: Sensory Perception
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Sample Questions
Q1) A 75-year-old woman walks into the emergency department with complaints of "not feeling well." Her blood pressure is 145/95, pulse 85 beats/min, respirations 24 breaths/min, and blood sugar 300. Upon inspection, the nurse notices that the woman has an open wound on the bottom of her foot, but the patient states she is not aware of this. How should the nurse interpret these findings?
A) Normal in the older adult
B) A need for the patient to be evaluated for cognitive impairment
C) A side effect of anti-hypertensive medication
D) Pathologic impairment of sensory responses
Q2) An 80-year-old patient is being discharged after he was diagnosed with diabetes mellitus and retinopathy. His daughter has been part of the discharge instruction process. Understanding of the instructions is evident when the daughter says which of the following?
A) "I will make sure that Dad always wears warm socks."
B) "Dad needs to wear his glasses so he can delay the onset of macular degeneration."
C) "I will ask the home health aide to carefully inspect Dad's feet every day when she helps him bathe."
D) "We will give him only warm foods, so that he doesn't burn his mouth."
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Page 30

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 70-year-old retired nurse is interested in nondrug, mind-body therapies, self-management, and alternative strategies to deal with joint discomfort from rheumatoid arthritis. What options should you consider in her plan of care considering her expressed wishes?
A) Stationary exercise bicycle, free weights, and spinning class
B) Mind-body therapies such as music therapy, distraction techniques, meditation, prayer, hypnosis, guided imagery, relaxation techniques, and pet therapy
C) Chamomile tea and IcyHot gel
D) Acupuncture and attending church services
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Chapter 30: Fatigue
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Q1) The nurse is caring for a patient diagnosed with amyotrophic lateral sclerosis. The nurse should assess for which priority problem?
A) Fatigue
B) Bradypnea
C) Hypertension
D) Fall risk
Q2) A patient with chronic kidney disease is most likely to complain of which symptom?
A) Fatigue
B) Thirst
C) Constipation
D) Excess bleeding
Q3) Which are treatment related causes of fatigue? (Select all that apply.)
A) Blood transfusion
B) Chemotherapy
C) Radiation therapy
D) Surgery
E) Side effects of medications
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Page 32
Chapter 31: Stress

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Sample Questions
Q1) An older patient presents to the outpatient clinic with a chief complaint of headache and insomnia. In gathering the history, the nurse notes which factors as contributing to this patient's chief complaint?
A) The patient is responsible for caring for two school-age grandchildren.
B) The patient's daughter works to support the family.
C) The patient is being treated for hypertension and is overweight.
D) The patient has recently lost her spouse and needed to move in with her daughter.
Q2) A patient has not been sleeping well because he is worried about losing his job and not being able to support his family. The nurse takes the patient's vital signs and notes a pulse rate of 112 beats/min, respirations are 26 breaths/min, and his blood pressure is 166/88 instead his usual 110-120/76-84 range. Which nursing intervention or recommendation should be used first?
A) Go to sleep 30 to 60 minutes earlier each night to increase rest.
B) Relax by spending more time playing with his pet dog.
C) Slow and deepen breathing via use of a positive, repeated word.
D) Consider that a new job might be better than his present one.
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Chapter 32: Coping
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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) An older adult has experienced severe depression for many years and is unable to tolerate most antidepressant medications due to adverse effects of the medications. He is scheduled for electroconvulsive therapy (ECT) as a treatment for his depression. What teaching should the nurse give the patient regarding this treatment?
A) There are no special preparations needed before this treatment.
B) Common side effects include headache and short-term memory loss.
C) One treatment will be needed to cure the depression.
D) This treatment will leave you unconscious for several hours.
Q2) A nurse is developing a plan of care for a patient admitted with a diagnosis of bipolar disorder, manic phase. Which nursing diagnoses address priority needs for the patient? (Select all that apply.)
A) Risk for caregiver strain
B) Impaired verbal communication
C) Risk for injury
D) Imbalanced nutrition, less than body requirements
E) Ineffective coping
F) Sleep deprivation
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Chapter 34: Anxiety
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Q1) The nurse knows that which of the following medical conditions are most commonly associated with anxiety? (Select all that apply.)
A) Cancer
B) Pancreatitis
C) Hypothyroidism
D) Dysrhythmias
E) Encephalitis
F) Hyperthyroidism
Q2) A patient complains of insomnia during his stay in the hospital. Which nursing diagnosis would be a top priority for this patient?
A) Anxiety related to hospitalization
B) Ineffective Coping related to hospitalization
C) Denial related to hospitalization
D) High Risk for Insomnia related to hospitalization
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36

Chapter 35: Cognition
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Q1) The nurse is reviewing new medication orders for several patients in a long-term care facility. Which patient does the nurse recognize as being at the highest risk for having cognitive impairment related to prescribed medications?
A) The patient prescribed an antibiotic for a urinary tract infection.
B) The patient prescribed a cholinesterase inhibitor for early Alzheimer's disease.
C) The patient prescribed a beta-blocker for hypertension.
D) The patient prescribed a bisphosphonate for osteoporosis.
Q2) A cognitively impaired patient newly admitted to the hospital is experiencing signs of sundown syndrome. Which intervention is best for the nurse to implement?
A) Leave a night light on in the room at all times.
B) Leave the television on at night with the volume up.
C) Restrain the patient to maintain safety during the confusion.
D) Administer a sleeping medication to help the patient sleep.
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Chapter 36: Psychosis
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Q1) In discussing disease prevention with a 15-year-old boy and his mother, the nurse identifies which of the following as risk factors for psychosis? (Select all that apply.)
A) Father diagnosed with paranoid schizophrenia
B) Rural residence
C) Recent immigration from Ecuador
D) Occasional cannabis use
E) January birth date
F) Physical abuse by the father
Q2) 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
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Chapter 37: Addiction
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Q1) To prevent Wernicke's encephalopathy from heavy alcohol use, the nurse anticipates an order for which medications?
A) Benzodiazepine
B) Thiamine and B complex
C) Vitamins C and D<sub>3</sub>
D) Klonopin
Q2) The nurse recognizes a potential health threat to an alcoholic patient who is using the drug disulfiram when the nurse reads in the health record that the patient is also taking which of the following? (Select all that apply.)
A) Blood thinners
B) Diphenhydramine
C) Alcohol
D) Penicillin
E) Mouthwash
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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 reviewing case files for children at risk for injury resulting in brain injury. Which child is at most risk for experiencing this type of violence?
A) A Caucasian, 6-month-old infant living with a single mother
B) An African-American, 24-month-old child living with her grandmother
C) A Mexican, 3-year-old child living in an inner city apartment
D) A Japanese, 8-year-old child living in a home with three generations of family
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Chapter 39: Professional Identity
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Q1) Components of a professional identity in nursing include which attributes? (Select all that apply.)
A) Accountability
B) Advocacy
C) Autonomy
D) Competence
E) Culture
Q2) The scope of professional nursing practice is determined by the rules promulgated by which organization?
A) American Nurses' Association (ANA)
B) Institute of Medicine (IOM)
C) State Board of Nursing
D) State Nursing Association
Q3) Nursing demonstrates dedication to improving public health through which avenue?
A) Changing health care standards
B) Legal regulations
C) Scope of practice
D) Technology
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Chapter 40: Clinical Judgment
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Q1) A nurse has committed a serious medication error and has reported the error to the hospital's adverse medication error hotline as well as to the unit manager. The manager is a firm believer in developing critical thinking skills. From this standpoint, what action by the manager would best nurture this ability in the nurse who made the error?
A) Have the nurse present an in-service related to the cause of the error.
B) Instruct the nurse to write a paper on how to avoid this type of error.
C) Let the nurse work with more experienced nurses when giving medications.
D) Send the nurse to refresher courses on medication administration.
Q2) A new graduate nurse is working with an experienced nurse to chart assessment findings. The new nurse notes that the physical therapist wrote on the chart that the patient is lazy and did not want to participate in assigned therapies this AM. The experienced nurse asks the new nurse what may be going on here. What is the best explanation for this statement?
A) Data on the chart can sometimes be documented in a biased manner.
B) Data on the chart changes as the patient's condition changes.
C) Data on the chart is usually accurate and can be verified from the patient.
D) Reading the chart is not a wise use of time as this can be time consuming and tedious.
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Chapter 41: Leadership
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Q1) The hospital must reduce the number of readmissions from 11% to 8% in the next year. Which of the following best represents the transformational leadership style in accomplishing this goal?
A) The director communicates the goal of reducing readmissions to the hospital operations team and tells them to submit their action plan by the end of the week.
B) The organization charters three work teams to identify solutions for the top three causes for readmissions. These teams are given full authority to implement their solution.
C) The director of quality develops a vision statement and action plan to achieve the goal. The director works directly with the involved departments to implement the action plan.
D) The CEO communicates the goal to the organizational directors and managers and states that they are entrusted to solve the problem.
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Chapter 42: Ethics
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Q1) A nurse on the unit makes an error in the calculation of the dose of medication for a critically ill patient. The patient suffered no ill consequences from the administration. The nurse decides not to report the error or file an incident report. The nurse is violating which principle of ethics?
A) Fidelity
B) Individuality
C) Justice
D) Values clarification
Q2) A 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
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Chapter 43: Patient Education
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Q1) 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
Q2) What is the most appropriate resource to include when planning to provide patient education related to a goal in the psychomotor domain?
A) Diagnosis-related support groups
B) Internet resources
C) Manikin practice sessions
D) Self-directed learning modules
Q3) 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
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Page 45

Chapter 44: Health Promotion
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Q1) 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.
Q2) 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
Q3) 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
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Page 46

Chapter 45: Communication
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Q1) A nurse is conducting a therapeutic session with a patient in the inpatient psychiatric facility. Which remark by the nurse would be an appropriate way to begin an interview session?
A) "How shall we start today?"
B) "Shall we talk about losing your privileges yesterday?"
C) "Let's get started discussing your marital relationship."
D) "What happened when your family visited yesterday?"
Q2) 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."
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Chapter 46: Collaboration
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Q1) The nurse is caring for a patient with a progressive, degenerative muscle illness. The patient states that she would like to remain in her home with her daughter as long as possible. What action should the nurse take?
A) Teach the patient muscle strengthening and stretching exercises.
B) Tell the patient to make plans to move to an assisted-living facility.
C) Discuss resources to help the patient and make appropriate referrals.
D) Ask the patient to come in for daily physical therapy.
Q2) A nurse manager has recently overheard several negative comments made by nurses on the unit about other nurses on the unit. The manager recognizes that the nurses are exhibiting what type of behavior that is detrimental to collaboration?
A) Vertical violence
B) Lateral violence
C) Descending violence
D) Personal violence
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Chapter 47: Safety
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Q1) A sentinel event refers to which situation?
A) An event that could have harmed a patient, but serious harm didn't occur because of chance.
B) An event that harms a patient as a result of underlying disease or condition.
C) An event that harms a patient by omission or commission, not an underlying disease or condition.
D) An event that signals the need for immediate investigation and response.
Q2) The strategy to avoid medication errors endorsed by the Institute for Safe Medication Practices (ISMP) to differentiate products with look-alike names is referred to as which term?
A) Automatic alerts
B) Bar coding
C) Computer order entry
D) Tallman lettering
Q3) 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
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Page 49

Chapter 48: Technology and Informatics
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Q1) 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.
Q2) The nurse manager of a medical/surgical unit wants to increase the use of health care technology on the unit and is working with an ANA-certified informatics nurse to reduce which barriers to health information exchange?
A) Basic informatics knowledge and skills
B) Offering the best set of tools
C) Privacy and security policies
D) Unit-specific terminology
Q3) 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
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Page 50

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 administrator is doing a study that entails gathering data about new employees over a 10-year period. Which research method would be the best one to use for this type of study?
A) Quantitative longitude cohort
B) Qualitative longitudinal
C) Qualitative interview
D) Qualitative case study
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Chapter 50: Health Care Quality
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Q1) A student nurse is talking with his instructor. The student asks how quality of care is evaluated. What is the best response by the instructor?
A) "Quality of care is evaluated by the patient getting well."
B) "Quality of care is evaluated on the basis of process and outcomes."
C) "Quality of care is evaluated by the physician's assessment."
D) "Quality of care is evaluated by the patient's satisfaction."
Q2) What are two major foci of The Joint Commission (TJC) in the delivery of health care?
A) Cost containment; safety
B) Safety; quality
C) Quality; assessment
D) Assessment; evaluation
Q3) What are the major attributes of health care quality? (Select all that apply.)
A) Conforms to standards
B) Sound decision making
C) High acuity patients
D) Low health care costs
E) Identifies adverse events
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Chapter 51: Care Coordination
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Q1) Medical models coordinate medical services and were traditionally designed fulfill which function?
A) Be patient specific.
B) Be nursing oriented.
C) Be diagnosis specific.
D) Be community oriented.
Q2) The nurse is discussing care coordination with a patient. The patient asks the nurse to explain care coordination. What is the nurse's best response?
A) "Care coordination is a cost effective method created by the community."
B) "Care coordination forces the health care facilities in the community to work together."
C) "Care coordination exists for the children and uninsured in the community."
D) "Care coordination allows health care services to work together in the community."
Q3) For children and teens, which model includes school-based services?
A) Social
B) Integrated
C) Medically-Oriented
D) Nurse-Oriented
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Chapter 52: Caregiving
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Q1) The nurse is counseling a woman who is caring for her 83-year-old father. The father has had mental changes and is becoming more confused. The father lives with the daughter in her home. The nurse knows the daughter understands the father's care needs when she states which of the following?
A) "Dad will only need my help for a short time, and then he will get better."
B) "I can leave dad alone during the day; I'll just deadbolt the door."
C) "I can send dad to the adult daycare; that way I can work and care for him at night."
D) "Dad misses mom since she passed; he will be okay in a few weeks."
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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Q1) What is the most prominent goal of palliative care?
A) Integrate into chronic disease management sooner rather than later.
B) Enroll the patient into the Medicare Hospice Benefit.
C) Ensure that the patient has a 6-month prognosis.
D) Reserve this type of care until the patient is actively dying.
Q2) When considering the trajectory of a specific disease, what is the most important Chapter?
A) Hospital admissions
B) Physical functioning
C) Quality of life
D) Symptom management
Q3) 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.
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Chapter 54: Health Disparities
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Q1) Which type of health disparities are most frequently encountered by nurses in clinical and community settings?
A) Avoidable and acceptable
B) Avoidable and unacceptable
C) Unavoidable and acceptable
D) Unavoidable and unacceptable
Q2) An experienced nurse tells the student nurse, "I have found that most Hispanic immigrants live in unsanitary conditions but are hard workers." How should the student nurse best classify this statement?
A) Stereotyping
B) Prejudice
C) Discrimination
D) Misinformed
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 manager recognizes that systems theory identifies that there is a social component within an organization that affects the overall functioning of the system. What indicator would demonstrate to the nurse manager that the social needs of an organization are being met?
A) Most employees from the organization attend an annual holiday celebration.
B) Separate eating areas for each discipline are set up in the cafeteria.
C) Nurse managers are planning to move to a centralized area away from the care units.
D) The summer softball teams are canceled due to lack of interest.
Q2) A nurse is reported for taking prescribed patient medications for their personal use. Who has direct authority over deciding if the nurse may keep their professional license to continue practicing as a nurse?
A) The hospital where the nurse is currently employed
B) The American Nurses Association
C) The National League for Nursing
D) The State Board of Nursing who issued the license
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Chapter 56: Health Care Economics
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Q1) 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."
Q2) What do the economics of health care include?
A) Medicare and Medicaid dollars
B) Patients' rights
C) Equal distribution of health care
D) Nurse salaries
Q3) Two nurses are discussing health care in the past and the present. The two nurses know which to be true about health care in the present?
A) Health care in the present is mostly provided by nurses.
B) Health care in the present is controlled by third party payers.
C) Health care in the present is controlled by physicians.
D) Health care in the present is dictated by the patient.
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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 is the intent of HIPAA?
A) Release of patient information for purposes of insurance reimbursement.
B) Prevent health care providers from billing for procedures done for the insured person.
C) Protect patients from reviewing their own medical records.
D) Limit the ability of health care providers to sell patient information to outside sources.
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Chapter 58: Health Care Law
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Q1) The new nurse correctly defines a law when stating which information?
A) "Law is a fundamental concept for health care professionals."
B) "Law's rule is developed by the employee's organization."
C) "Law's rule is enacted by a government agency that defines what must be done in a given circumstance."
D) "Law is a mandate from the Joint Commission or other accrediting agency."
Q2) Which of the following is true about health care legislation?
A) The US Constitution addresses health care law specifically to give the federal government the ability to license professionals and institutions.
B) The power of the US Constitution does not have a direct relationship to health care and reserves most of the power to the states.
C) State laws are considered the highest source of health care law and trump the federal laws.
D) The federal government asserts its power over health care legislation through the US Constitution.
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