Nursing Process and Health Assessment
Midterm Exam
Course Introduction
This course introduces students to the foundational concepts of the nursing process and comprehensive health assessment. Emphasizing a systematic approach to patient care, it covers the five key steps of the nursing process: assessment, diagnosis, planning, implementation, and evaluation. Students will learn to collect, analyze, and interpret health data through techniques such as patient interviews, physical examinations, and the use of assessment tools. The course also explores the importance of cultural competence, critical thinking, and effective communication in assessing diverse populations. By combining theoretical knowledge with hands-on practice, students develop the skills necessary to identify health priorities, formulate nursing diagnoses, and contribute to the creation of individualized care plans.
Recommended Textbook
Fundamentals of Nursing 1st Edition by Barbara Yoost
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42 Chapters
1050 Verified Questions
1050 Flashcards
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Page 2
Chapter 1: Nursing, Theory, and Professional Practice
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25 Verified Questions
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Sample Questions
Q1) The nurse administers a medication to the patient and then realizes that the medication had been discontinued.The error is immediately reported to the physician.The nurse is complying with the standards of professional performance known as:
A) Ethics.
B) Socialization.
C) Altruism.
D) Autonomy.
Answer: A
Q2) The nurse is delegating frequent blood pressure (BP)measurements for a patient admitted with a gunshot wound to a licensed practical nurse (LPN).When delegating,the nurse understands that:
A) He/she may assume that the LPN is able to perform this task appropriately.
B) The LPN is ultimately responsible for the patient findings and assessment.
C) The LPN may perform the tasks assigned without further supervision.
D) He/she retains ultimate responsibility for patient care and supervision is needed.
Answer: D
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3
Chapter 2: Values,Beliefs,and Caring
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Sample Questions
Q1) A vital aspect of providing effective and appropriate nursing care is being able to actively listen to a patient.This requires the nurse to:
A) pay attention as if in a social conversation with the patient.
B) practice and develop this skill over many years.
C) focus on what the patient is saying.
D) passively listen with the ears.
Answer: B
Q2) While helping patients with values clarification and care decisions,nurses should:
A) convince the patient to do what the nurse believes is best.
B) give advice about what the nurse would do.
C) tell the patient what the right thing to do is.
D) provide information so that the patient can make informed decisions.
Answer: D
Q3) When developing a nursing practice,it is important for the nurse to:
A) be exposed to negative as well as positive role models.
B) avoid negative role models as much as possible.
C) understand that caring and compassion are taught in class.
D) consider another profession if he/she is not naturally compassionate.
Answer: A
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Page 4
Chapter 3: Communication
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25 Verified Questions
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Sample Questions
Q1) A nurse has been working with a patient for the entire shift.Which action by the nurse is unacceptable?
A) Sharing a personal mobile phone number
B) Touching the patient's hand during a painful procedure
C) Standing 6 feet away from the patient when conversing
D) Using the SBAR method of hand-off communication
Answer: A
Q2) A female patient is admitted to the emergency department after being raped by a neighbor.The patient refuses to discuss the circumstances surrounding the event with the sexual assault nurse examiner.This patient is most likely using the defense mechanism of:
A) suppression
B) sublimation
C) displacement
D) rationalization
Answer: A
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Chapter 4: Critical Thinking in Nursing
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Sample Questions
Q1) The nursing student is admitting a patient with abdominal distention and severe nausea.The physician orders the insertion of a nasogastric tube.The student reviews the procedure,gathers the supplies,and tells the instructor,"I'm ready to begin." Which of the following critical thinking traits suggest that the student is prepared for the task?
A) Risk taking
B) Curiosity
C) Confidence
D) Perseverance
Q2) The nurse completes the health interview and physical exam on a patient admitted with an infection of the gallbladder.The nurse reviews the medical record and compares the abnormal lab results to the normal standards.Which critical thinking skill is the nurse using in this part of the nursing process?
A) Interpretation
B) Analysis
C) Evaluation
D) Inference
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Chapter 5: Introduction to the Nursing Process
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Sample Questions
Q1) The nurse is attempting to develop nursing diagnoses for her patient.The nurse understands that nursing diagnoses: (Select all that apply. )
A) identify actual or potential problems as well as responses to a problem.
B) require naming patient problems using nursing diagnostic labels.
C) utilize objective data since subjective data are often inaccurate.
D) includes unvalidated data to determine an accurate and thorough diagnosis. E) are similar to medical diagnoses since they both are labels for diseases.
Q2) A patient with a congenital heart defect is admitted for further testing.The nurse observes the patient has increased shortness of breath and is restless.The nurse is demonstrating which phase of the nursing process?
A) Assessment
B) Planning
C) Implementation
D) Evaluation
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Chapter 6: Assessment
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Sample Questions
Q1) After the patient's data are collected,validated,and interpreted,the nurse organizes the information in a framework (format)that facilitates access by all members of the health care team.The framework that provides the most holistic view of the patient's condition is:
A) the head-to-toe pattern
B) Marjory Gordon's Functional Health Patterns.
C) the cephalic-caudal pattern.
D) the body systems model.
Q2) 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
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Chapter 7: Nursing Diagnosis
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Sample Questions
Q1) North American Nursing Diagnosis Association International (NANDA-I)is an organization focusing on revising nursing diagnosis taxonomy and evaluates nursing research to validate the diagnostic labels.The NANDA-I taxonomy and new nursing diagnoses are published every:
A) 2 years.
B) 3 years.
C) 4 years.
D) 5 years.
Q2) The nurse is developing a plan of care for a patient who has had a stroke.Assessment findings include weakness in right upper and lower extremities,numbness in face,slurred speech,and headache.Which of the following would best represent the etiology of the patient's gait and balance problems?
A) Lack of muscle motor movement
B) Decreased sensation to touch
C) Inability to speak clearly
D) Pain in back of head
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9
Chapter 8: Planning
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Sample Questions
Q1) The significance of developing organized plans of care for patients cannot be stressed enough.In the planning phase,the nurse must take seriously the responsibility of: (Select all that apply. )
A) prioritizing patient needs.
B) developing mutually agreed-on goals.
C) determining outcome criteria.
D) identifying interventions.
E) implementation of the patient's plan of care.
Q2) Which statement is correct regarding diversity considerations?
A) The male gender may struggle less with health care terminology.
B) High numbers of minority populations do not understand health teachings.
C) Older adults have an easier time understanding health teachings because of life experience.
D) Disabilities have no impact on the development of patient care goals.
Q3) Which should the nurse address first?
A) Pain
B) Hunger
C) Decreased self-esteem
D) Absence of pulse
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Page 10
Chapter 9: Implementation and Evaluation
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Sample Questions
Q1) Repositioning a patient,providing hygiene,and active listening are examples of:
A) dependent interventions.
B) independent nursing interventions.
C) standing orders.
D) counseling.
Q2) The nurse is learning to identify readiness to learn in patients.Which one of the following patients would the nurse identify correctly as ready to learn?
A) The patient requesting pain medication for treatment of severe discomfort
B) The patient with nausea and vomiting
C) The patient who learned 30 minutes ago that she has cancer of the pancreas
D) The patient who was recently diagnosed with diabetes mellitus and is scheduled to be discharged in 2 days
Q3) The nurse is preparing to administer medications to a patient.The patient is complaining of shortness of breath.The nurse should:
A) provide the patient with oxygen since it does not require a provider order.
B) complete at least two checks to ensure that the proper medication is given.
C) check the provider orders for all forms of prescription medications.
D) remember that medication administration is an independent nursing action.
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11
Chapter 10: Documentation, Electronic Health Records, and Reporting
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Sample Questions
Q1) The patient has fallen when trying to climb out of bed.The nurse:
A) needs to complete an incident report as a risk management document.
B) completes an incident report since it is a permanent part of the medical record.
C) must document that an incident report was completed in the medical record.
D) should say nothing about the incident in the medical record.
Q2) The nurse is caring for patients on unit that uses electronic health records (EHRs).In order to protect personal health information,the nurse should:
A) allow only nurses that she knows and trusts to use her verification code.
B) not worry about mistakes since the information cannot be tracked.
C) never share her password with anyone.
D) be aware that the EHR is sophisticated and immune to failure.
Q3) The use of electronic health records:
A) improves patient health status.
B) requires a keyboard to enter data.
C) has not been shown to reduce medication errors.
D) requires increased storage space.
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Page 12
Chapter 11: Ethical and Legal Considerations
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29 Flashcards
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Sample Questions
Q1) Nurses are consistently considered to be honest and ethical professionals by most respondents in an annual Gallup poll.This is because professional nurses understand that ethics are:
A) internal values developed outside the influence of societal norms.
B) influenced by family,friends,and socioeconomics,among other variables.
C) societal in nature and do not involve personal influences.
D) totally independent from a person's character.
Q2) The Code of Ethics for Nurses is:
A) like the Constitution and not revisable.
B) a succinct statement of ethical obligations.
C) required by entry level nurses only.
D) a negotiable document dependent on individual conscience.
Q3) Which of the following nurses has committed a serious documentation error?
A) Susan documents all medications for her patients prior to administration.
B) Jim documents medication administration as the medications are given.
C) Jane documents assessments as they are completed.
D) Jon documents meal intake as he picks up meal trays.
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Chapter 12: Leadership and Management
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Sample Questions
Q1) Which of the following has been done improperly?
A) The UAP re-delegates vital signs to the student nurse.
B) The RN delegates assistance with bathing to the student nurse.
C) The RN delegates monitoring of intake and output to the UAP.
D) The RN delegates assistance with mobility to the UAP.
Q2) The nurse manager of the emergency room believes that efficiency is the expected standard for her department.She also believes that efficiency lies in following established rules,policies,and guidelines.The only way to change procedures is to changes rules,policies,and guidelines.In order to run the emergency room with this philosophy,the nurse manager must take on the role of:
A) laissez-faire leader.
B) democratic leader.
C) bureaucratic leader.
D) autocratic leader.
Q3) Which of the following was delegated inappropriately?
A) Personal hygiene by the UAP
B) Assistance with eating breakfast by the UAP
C) Assistance with toileting by the UAP
D) Interpretation of abnormal vital signs by the UAP
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Page 14
Chapter 13: Evidence-Based Practice and Nursing Research
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Sample Questions
Q1) Testing the application of theories in different situations with different populations is considered to be:
A) applied research.
B) clinical research.
C) basic research.
D) quantitative research.
Q2) In researching the effectiveness of an antihypertensive medication,the nurse knows that the medication would be the _________________ variable and the person's blood pressure would be the ____________________ variable.
A) dependent,independent
B) independent,dependent
C) treatment,controlled
D) controlled,treatment
Q3) An institutional review board (IRB)is a review committee established to:
A) approve research involving animal subjects.
B) approve research that is not government funded.
C) function differently than scholarly journals do.
D) protect the rights of human research subjects.
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Chapter 14: Health Literacy and Patient Education
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Sample Questions
Q1) The nurse is implementing a patient teaching plan regarding diabetes mellitus.One of the short-term goals of the plan is that the patient will be able to verbalize three symptoms of hypoglycemia.This is an example of:
A) psychomotor teaching.
B) cognitive teaching.
C) affective teaching.
D) VARK teaching.
Q2) The nurse is preparing to teach a patient for the first time and needs to evaluate the health literacy of the patient.She uses the VARK assessment to:
A) assess the learning styles of the patient.
B) find the one method that the patient uses to learn.
C) be sure that the patient is a unimodal learner.
D) reduce the need for creating a collaborative learning plan.
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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Page 16
Chapter 15: Nursing Informatics
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) 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.
Q2) The integration of nursing,computers,and information science for the management and communication of data,information,knowledge,and wisdom is:
A) nursing informatics.
B) computer science.
C) medical informatics.
D) informatics.
Q3) Computerized provider order entry (CPOE):
A) allows orders to be communicated to the appropriate department.
B) creates an intermediary for order transcription.
C) slows documentation and provider communication.
D) may lead to increased ordering and transcription errors.
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Page 17
Chapter 16: Health and Wellness
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Sample Questions
Q1) The nurse is developing a plan of care for a patient with a hip fracture.In order to prioritize the patient's care,the nurse should use:
A) the Health Belief Model.
B) Pender's Health Promotion Model.
C) Maslow's hierarchy of needs.
D) the Holistic Health Model.
Q2) The patient is asking about using the Internet for resources regarding lifestyle behaviors and benefits of modification.The nurse's should tell the patient that:
A) information on lifestyle behaviors is not available on the Internet.
B) the patient should use websites that are easy to understand.
C) ,most websites are designed for health care providers only.
D) only negative outcomes are evaluated on the Internet.
Q3) The genetic vulnerability of an organism,or risk of disease expression based on genotype,is
A) involuntarily passed from biologic parents to offspring.
B) totally unrelated to environmental factors.
C) non-responsive to alteration by way of lifestyle modification.
D) not a factor in mental illness because it is behavioral.
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Chapter 17: Human Development: Conception Through
Adolescence
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Q1) The pediatric nurse is treating a patient who has questions about safer sexual practices.The patient states,"I think I should wait until marriage to be sexually active because I'm not sure sex is OK outside of marriage." The nurse understands the student is acting with which component of Freud's theory?
A) Id
B) Ego
C) Superego
D) Anal
Q2) A pregnant woman in her second trimester is scheduled for quad testing.What conditions does the nurse explain are screened for in this assessment? (Select all that apply. )
A) Blood clotting abnormalities
B) Neural tube defects
C) Heart abnormalities
D) Trisomy 18
E) Trisomy 21
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Chapter 18: Human Development Young Adult to Older Adult
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Q1) The nurse tells the student that which disorders are related to the presence of free radicals? (Select all that apply. )
A) Cancer
B) Cataracts
C) Glaucoma
D) Arthritis
E) Liver disease
Q2) A young nursing student is assessing an older patient.The nurse questions whether or not to take a sexual history.What response by the faculty is best?
A) Since procreation is not an issue,you do not need to discuss this.
B) Only discuss this topic if you are comfortable in doing so.
C) Ask the patient if he or she wants to talk about sexuality.
D) Sexuality is a basic human need and needs to be assessed.
Q3) The nurse working with an adult population knows that many age-related declines in function begin occurring at what age?
A) 20
B) 30
C) 50
D) 70
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Chapter 19: Vital Signs
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Q1) A nursing student is caring for a patient with metabolic acidosis.The student asks the registered nurse why the patient's respiratory rate is so high.What response by the nurse is best?
A) "The patient's metabolic rate is increased from being ill."
B) "The lungs are trying to rid the body of extra carbon dioxide."
C) "The patient is trying to reduce his temperature through panting."
D) "Patients who are acutely ill often have abnormal vital signs."
Q2) 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
Q3) The nursing faculty member is observing a student taking a patient's carotid pulse.What action by the student requires intervention by the faculty member?
A) Counts pulse for 30 seconds and multiplies by two.
B) Performs hand hygiene prior to patient contact.
C) Compares pulses in both carotid arteries at the same time.
D) Assesses pulse on one side then assesses the other side.
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Page 21
Chapter 20: Health History and Physical Assessment
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Sample Questions
Q1) A nurse is told in handoff report that a patient opens eye spontaneously,is confused but able to answer questions,and demonstrates purposeful movement to painful stimuli.What does the nurse calculate the patient's Glasgow Coma Scale to be?
A) 7
B) 9
C) 11
D) 13
Q2) A student nurse is preparing to auscultate a patient's lungs.What action by the student leads the instructor to intervene?
A) Student asks to turn the television volume down.
B) Student warms the bell of the stethoscope before use.
C) Student uses the stethoscope bell to listen to bowel sounds.
D) Student places the stethoscope diaphragm on the patient's skin.
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) A nurse has been told he has many obvious stereotypes about a specific cultural group.What action by the nurse is best?
A) Ask to not care for members of this cultural group.
B) Ask to take care of as many members of this group as possible.
C) Begin to educate himself on aspects of this cultural group.
D) Vow to not allow his stereotypes to show when providing care.
Q2) A nurse is caring for a refugee patient who wants the community shaman to perform a healing ritual at the bedside.What action by the nurse is best?
A) Work with the patient to allow the shaman to perform the ritual.
B) Investigate whether the ritual will harm the patient.
C) Check to see if the ritual breaks laws or policies.
D) Offer to call the hospital chaplain instead.
Q3) A patient in the emergency department needs an emergency operation.The patient refuses to consent and wants the nurse to call a respected elder in the community for consent.What action by the nurse is best?
A) Explain that this violates privacy laws.
B) Call the elder to get consent for the operation.
C) Tell the woman she has the right to consent.
D) Arrange for admission without the operation.
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Page 23
Chapter 22: Spiritual Health
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Q1) When does the nurse assess patients' spirituality? (Select all that apply. )
A) Upon admission
B) New diagnosis
C) Life-changing diagnosis
D) When the chaplain makes rounds
E) When facing treatment decisions
Q2) A patient in the hospital is an adherent Muslim.Which of the five pillars of Islam can the nurse assist the patient in meeting?
A) Praying five times a day
B) Having privacy
C) Personal cleanliness
D) Giving alms
E) Maintaining modesty
Q3) A patient is concerned that she will not be able to maintain her dietary restrictions while in the hospital.What nursing diagnosis is most appropriate for this patient?
A) Spiritual distress
B) Impaired religiosity
C) Moral distress
D) Decisional conflict
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Page 24
Chapter 23: Public Health, community Base, and Home
Health Care
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Q1) A nurse is interested in epidemiology.What work activity would best fit this role?
A) Studying census data to determine common causes of death
B) Researching population variables that contribute to disease
C) Developing sanitary measures to prevent foodborne illness
D) Designing research to determine the connection between pollution and cancer
Q2) When planning interventions for a community,what action by the nurse is best?
A) Involve community leaders in planning.
B) Create a plan of action addressing priorities.
C) Determine what resources are available.
D) Attempt to find funding for the plan.
Q3) The community health nurse knows that which are standards of professional performance for home care nurses? (Select all that apply. )
A) Collegiality
B) Performance appraisal
C) Outcome identification
D) Ethics
E) Resource utilization
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Page 25
Chapter 24: Human Sexuality
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Q1) The nurse is working with a patient who has a sexual dysfunction.What statement by the patient indicates progress toward an important goal?
A) "I am beginning to enjoy sex more these days."
B) "I'm glad my partner is understanding of the lack of sex."
C) "I wish I didn't need these pills but I know they are important."
D) "I hope one day to have a sexual partner again."
Q2) The nurse learns that spermatozoa are produced in which sexual organ?
A) Scrotum
B) Testes
C) Glans
D) Prostate
Q3) A nurse is planning sexuality education programs.Which topics are important to each age group? (Select all that apply. )
A) Adolescents: contraception
B) Adolescents: infertility
C) Young adults: conception
D) Middle adulthood: sexual dysfunction
E) Old age: decreased sexuality
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Chapter 25: Safety
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Q1) The nurse recognizes that a patient is using a portable generator in the house as a power source.What source of poisoning does the nurse appropriately identify?
A) Lead
B) Carbon monoxide
C) Antifreeze
D) Pesticide
Q2) The nurse knows that which of the following patients has a teaching need based on statements by the patient or the patient's parents?
A) "My 6-month-old daughter only sleeps with me when she's ill."
B) "I do not put pillows in the bed with my 3-month-old son."
C) "I do not feed popcorn to my 2-year-old."
D) "I have discussed the risks of the 'choking game' with my 16-year-old."
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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Chapter 26: Asepsis and Infection Control
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Q1) The nurse's stethoscope most correctly represents which possible link in the chain of infection?
A) Source
B) Portal of exit
C) Portal of entry
D) Mode of transmission
Q2) The nurse knows that standard precautions are indicated for: (Select all that apply. )
A) all patients.
B) patients with HIV.
C) patients with MRSA.
D) patients with tuberculosis.
E) None of above
Q3) The patient has hepatitis A.Which isolation precaution is correctly implemented?
A) Airborne
B) Contact
C) Droplet
D) Protective
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28
Chapter 27: Hygiene and Personal Care
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Q1) Excessively dry skin can lead to cracks and openings in the integumentary system.Based on this,what is the most applicable nursing diagnosis for a patient with excessively dry skin?
A) Imbalanced Nutrition: Less than body requirements
B) Deficient fluid volume
C) Risk for infection
D) Acute pain
Q2) Which statement by the patient indicates a teaching need?
A) "I use bobby pins to remove excessive ear wax."
B) "I use soap and a warm cloth to clean the outside of my ear."
C) "My doctor sometimes gives me oil drops for my ears."
D) "I never use Q-Tips."
Q3) Which member of the collaborative team is most appropriate to cut the toenails of a diabetic patient?
A) Nurse
B) Physical therapist
C) Occupational therapist
D) Podiatrist
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Chapter 28: Activity, Immobility, and Safe Movement
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Q1) An appropriate goal for the patient who is postoperative day one from a hip fracture with the nursing diagnosis Impaired physical mobility is:
A) the patient will interact with others.
B) the patient will ambulate to the bathroom with assistance.
C) the patient will have no skin breakdown.
D) the patient will have a physical therapy consult.
Q2) The nurse appropriately delegates care to the UAP when she:
A) instructs the UAP to assess the patient's skin during a bath.
B) instructs the UAP to reposition the patient using the trapeze.
C) instructs the UAP to assess the patient's ability to perform range-of-motion exercises.
D) instructs the UAP to notify the health care provider of any changes.
Q3) The nurse correctly selects which intervention to avoid causing shear or friction when moving a patient in bed?
A) Using an airflow bed
B) Using a slide board
C) Using a trochanter roll
D) Using a gel mattress
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Chapter 29: Skin Integrity and Wound Care
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Q1) The nurse knows the most appropriate goal for a patient with a stage III pressure ulcer who has a nursing diagnosis of Impaired skin integrity is:
A) the wound will be completely healed in 72 hours.
B) the wound will show signs of healing within 2 weeks.
C) the patient will develop no new pressure ulcers.
D) the patient will ambulate twice a day.
Q2) The nurse is caring for a postoperative patient who has had abdominal surgery and whose wound has completely eviscerated when she walks into the room.In addition to notifying the physician,what should the nurse do?
A) Cover the wound with a sterile gauze pad.
B) Cover the wound with a transparent dressing.
C) Put pressure on the wound with a sterile gauze pad.
D) Cover the wound with gauze soaked with normal saline.
Q3) The nurse is delegating care of a patient with a chronic nonsterile wound to a UAP.The delegation is inappropriate if:
A) the nurse asks the UAP to assess the wound.
B) the nurse asks the UAP to report increased wound drainage.
C) the nurse asks the UAP to observe changes in dietary intake.
D) the nurse asks the UAP to change the dressing.
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Page 31
Chapter 30: Nutrition
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Q1) The nurse has received an order from the health care provider to discontinue the nasogastric tube.Which of the following actions by the nurse indicates a need for further education?
A) The nurse clears the tube with air prior to discontinuing.
B) The nurse stops the tube feeding.
C) The nurse instructs the patient to cough while pulling out the tube.
D) The nurse clamps the tube while pulling it out.
Q2) The nurse is preparing to insert a nasogastric (NG)tube in her patient.Which of the following steps in the process indicates a need for further education?
A) The nurse lubricates 4 inches of the tube prior to insertion.
B) The nurse marks the length of the tube with a marker for insertion.
C) The nurse measures the length of tube needed using the nose-earlobe-xiphoid process.
D) The nurse applies clean gloves for the procedure.
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Chapter 31: Cognitive and Sensory Alterations
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Q1) The nurse is preparing discharge instructions for a patient who has tactile alterations in his legs.Which instructions should be included? (Select all that apply. )
A) Verify bath water temperature is approximately 39.5° C.
B) Do not use hot or cold therapy on any extremity.
C) Use sturdy shoes when walking outside or on hard surfaces.
D) Report any changes in skin color on your legs to your health care provider.
E) Set your water heater so that scalding is not possible.
Q2) The nurse is providing discharge education to her patient with diabetes regarding foot care.Which of the following statements by the patient indicates a need for further education?
A) "I can go barefoot outside only in the summer."
B) "I should wear good fitting shoes."
C) "I cannot soak my feet in a hot tub."
D) "I can use lotion on my feet."
Q3) An appropriate goal for a patient with a diagnosis of social isolation is:
A) the patient will participate in cognitive exercises.
B) the patient will interact with other residents during activities.
C) the patient will communicate basic needs through use of photos.
D) the patient will remain within the unit while in long-term care.
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Page 33
Chapter 32: Stress and Coping
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Q1) The nurse knows that when coordination between multiple health care disciplines is needed,the following role is used:
A) Pastoral care
B) Case manager
C) Social worker
D) Dietitian
Q2) The nurse is providing education to a patient around anger management strategies.Which statement indicates a need for further education by the patient?
A) "Exercise can help me deal with the anger."
B) "I can use humor."
C) "I can punch things."
D) "I can take a time out."
Q3) The nurse is seeing a patient during a follow-up visit after discharge in which the patient had a nursing diagnosis of Ineffective coping.Which statement by the patient would be a cause for concern?
A) "I am sleeping better most nights."
B) "I feel less anxious."
C) "I do not need to do the relaxation exercises anymore."
D) "I am continuing my exercises every day."
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Page 34
Chapter 33: Sleep
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Q1) The nurse knows that dyssomnias are: (Select all that apply. )
A) difficultly getting to sleep.
B) stages of sleep.
C) inability staying asleep.
D) being excessively sleepy.
E) falling asleep during the day.
Q2) The nurse is admitting a patient to the general medical-surgical unit.What should the nurse assess as part of a routine sleep assessment? (Select all that apply. )
A) Usual sleeping and waking times
B) Bedtime routines
C) Sleeping environment preferences
D) Medications used for sleep
E) Any current life events
F) None of above
Q3) The nurse knows an appropriate goal for the nursing diagnosis Insomnia is:
A) The patient will report an ability to concentrate on tasks.
B) The patient will repeat medication instructions on discharge.
C) The patient will be able to sleep for at least 2 hours at a time.
D) The patient will be able to fall asleep within 15 minutes.
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Page 35
Chapter 34: Diagnostic Testing
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Q1) The nurse is caring for a patient who will be undergoing bone marrow biopsy.Which statement by the patient indicates that additional teaching is needed?
A) "I will count the ceiling tiles when the doctor inserts the numbing medicine."
B) "I will take acetaminophen (Tylenol)later today if the site becomes uncomfortable."
C) "I will squeeze your hand to help calm my fears about the test."
D) "I will keep the biopsy site clean and dry for the next 24 hours."
Q2) The nurse is caring for a patient who is anemic.Which CBC test results demonstrate that the patient's treatment plan is effective and the anemia is resolving? (Select all that apply. )
A) Red blood cell count (RBC)5.8 million/mm<sup>3</sup>
B) Hematocrit (HCT)25%
C) Hemoglobin (HGB)14 g/dL
D) White blood cell count (WBC)4500/mm<sup>3</sup>
E) Platelet count (PLT)255,000/mm<sup>3</sup>
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Page 36
Chapter 35: Medication Administration
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Q1) The nurse is caring for a patient who is receiving vancomycin (Vancocin)to treat a severe infection.The next vancomycin dose is due to be administered at 10:00 A.M.What time will the nurse draw the vancomycin serum trough level?
A) 7:30 A.M.
B) 9:30 A.M.
C) 11:30 A.M.
D) 1:30 P.M.
Q2) The nurse is caring for a patient who is NPO with a new PEG (percutaneous endoscopic gastrostomy)tube.Which of the patient's medications can the nurse administer through the tube? (Select all that apply. )
A) Edluar (zolpidem tartrate)sublingual tablet 5 mg nightly at bedtime
B) Ondansetron (Zofran)oral disintegrating tablet 8 mg q 8 hours PRN nausea
C) Ceclor (cefaclor for oral suspension)250 mg q 6 hours
D) Oxymorphone hydrochloride extended release (Opana ER)40 mg q 12 hours
E) Phenytoin (Dilantin)chewable tablet 100 mg q 12 hours
F) Potassium chloride oral solution 20 mEq daily
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Chapter 36: Pain Management
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Sample Questions
Q1) What is the priority nursing assessment for a patient who his receiving postoperative epidural analgesia with hydromorphone (Dilaudid)?
A) Respiratory rate,depth,and pattern
B) Skin underneath the epidural dressing
C) Bladder scanning to check for urinary retention
D) Itching on the trunk and/or extremities
Q2) The nurse is caring for a patient who will be using a hydromorphone (Dilaudid)PCA analgesia pump following surgery.Which intervention is the highest priority for the nurse to include in the patient's care plan for the diagnosis: Readiness for enhanced knowledge r/t appropriate management of PCA pump?
A) Assess the patient's respiratory status every 30 minutes after PCA pump started.
B) Review patient's medication profile to check for interactions with hydromorphone.
C) Teach the patient how to use PCA pump when awake and aware and pain level is tolerable.
D) Keep naloxone (Narcan)available at the bedside in case of respiratory suppression.
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Chapter 37: Perioperative Nursing Care
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Q1) The nurse is caring for a patient who underwent abdominal surgery the previous day.Which assessment findings indicate to the nurse that the patient may be experiencing serious internal bleeding? (Select all that apply. )
A) The patient's urinary output increased to 40 mL/hr.
B) The patient's pulse has risen from 76 to 112 beats/min.
C) The patient states that his abdominal pain is worse than yesterday.
D) The patient complains of generalized itching.
E) The patient's hematocrit dropped from 14.6 to 11.0 g/dL
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 who is hospitalized for pneumonia.Which nursing diagnosis has the highest priority?
A) Activity intolerance r/t generalized weakness and hypoxemia
B) Imbalanced nutrition r/t poor appetite and increased metabolic needs
C) Ineffective airway clearance r/t thick secretions in trachea and bronchi
D) Knowledge deficit r/t use of nebulizer and inhaled bronchodilators
Q2) The preceptor is working with a new nurse to suction a patient through his new tracheostomy.Which actions by the new nurse indicate need for additional teaching about the procedure? (Select all that apply. )
A) The suction is not applied to the catheter until it is being withdrawn.
B) The patient is placed in the supine position prior to suctioning.
C) The suction catheter is twirled side to side as it is being withdrawn.
D) Suction is applied continuously as the catheter is withdrawn.
E) The patient's oxygen is reapplied between suction attempts.
F) Water-soluble lubricant is applied to the suction catheter before insertion.
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Chapter 39: Fluid, Electrolytes, and Acid-Base Balance
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Q1) The nurse is caring for a patient with a history of hyperparathyroidism who presents with a serum calcium level of 14.5 mg/dL.What is the highest priority nursing diagnosis for this patient?
A) Risk for injury related to weakened bones that may easily fracture
B) Deficient knowledge related to need for supplemental calcium in diet
C) Risk for constipation caused by decreased gastrointestinal motility
D) Activity intolerance related to muscle cramping and spasms
Q2) The nurse is caring for a patient with congestive heart failure who requires intermittent IV bolus doses of furosemide (Lasix)for a few days to correct fluid volume overload.No continuous IV fluids are ordered.Which type of IV will the nurse insert in order to administer the patient's medication?
A) Peripherally inserted central catheter
B) Midline inside-the-needle catheter
C) Central venous catheter
D) Over-the-needle catheter
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Chapter 40: Bowel Elimination
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Q1) The nurse is caring for a patient with a history of dementia who is incontinent of stool because she cannot communicate the need to defecate.What is the priority action of the nurse?
A) Administer a daily laxative and take the patient to the toilet afterward.
B) Digitally remove stool from the patient's rectum every other day.
C) Insert a rectal tube to facilitate drainage of soft or liquid stool.
D) Begin a prompted toileting program to facilitate bowel continence.
Q2) The nurse is caring for a postoperative patient who underwent bowel resection surgery that morning.The nurse assesses the patient's abdomen and notes that there are hypoactive bowel sounds.The patient is resting quietly without nausea or vomiting.What is the appropriate action of the nurse?
A) Keep the patient NPO and document the findings in the chart.
B) Administer a laxative suppository to stimulate peristalsis.
C) Insert a Salem sump nasogastric tube to low continuous suction.
D) Notify the surgeon and prepare the patient to return to surgery.
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Chapter 41: Urinary Elimination
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Q1) The nurse is caring for a patient who had prostate surgery the previous day.The patient has had significantly decreased urine output over the last shift despite ample oral and IV fluid intake.The patient's urine from the indwelling catheter is cherry red with occasional small clots.What is the appropriate action of the nurse?
A) Remove the urinary catheter and replace it with a new one
B) Gently irrigate the catheter using warmed sterile normal saline
C) Send a sample of the patient's urine to the laboratory for analysis
D) Call the physician and obtain an order for kidney and bladder ultrasound
Q2) The nurse is caring for a male patient who will be performing intermittent self-catheterization at home.Which actions by the patient indicate the need for additional teaching about this procedure? (Select all that apply. )
A) Patency of the balloon is tested prior to insertion of the catheter.
B) The catheter is inserted another 2 inches after urine is seen in the tubing.
C) The catheter is carefully secured to the leg to prevent accidental removal.
D) The foreskin is returned to its natural position after the catheter is removed.
E) Catheterization is performed regularly before the bladder becomes distended.
F) Water-soluble lubricant is generously applied along the length of the catheter.
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Chapter 42: Death and Loss
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Q1) The nurse is caring for a patient who has just died in a motor vehicle accident.What is the priority action of the nurse before the patient's family arrives to see the patient's body?
A) Gently wash the body and provide perineal care.
B) Remove the patient's dentures and jewelry.
C) Ensure that the death certificate has been signed.
D) Determine which funeral home will pick up the body.
Q2) The nurse is caring for a male Islamic patient who has just died.Which action is the priority for the nurse to take when postmortem care is provided?
A) Arranging for embalming to preserve the body until burial
B) Arranging for male staff to gently wash the patient's body
C) Arranging for transportation of the body to the crematorium
D) Preparing the room so that the family can say the rosary at the bedside
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