Nursing Theory and Practice Pre-Test Questions
Course Introduction
Nursing Theory and Practice explores the foundational concepts, models, and frameworks that guide the nursing profession. This course examines the evolution and significance of key nursing theories, linking them to evidence-based practice, patient care, and ethical decision-making. Students will analyze the application of theoretical knowledge in clinical settings, enhancing critical thinking, communication, and problem-solving skills. Through case studies, discussions, and practical exercises, learners will develop a holistic understanding of how theory informs practice, fosters professional growth, and improves patient outcomes within diverse healthcare environments.
Recommended Textbook
Concepts for Nursing Practice 1st Edition by
Jean Foret Giddens
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53 Chapters
406 Verified Questions
406 Flashcards
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Chapter 1: Development
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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) failure to thrive.
C) fetal alcohol syndrome.
D) hydrocephaly.
Answer: D
Q2) A 17-year-old girl is hospitalized for appendicitis,and her mother asks the nurse why she is so needy and acting like a child.The best response of the nurse is that in the hospital,adolescents
A) have separation anxiety.
B) rebel against rules.
C) regress because of stress.
D) want to know everything.
Answer: C
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Chapter 2: Functional Ability
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Sample Questions
Q1) Use A for instrumental activities of daily living (IADLs)and use B for basic activities of daily living (BADLs).
(Your answer should appear as letters separated by commas and spaces [e.g.,A,A,A,A,A,A].)
A) Uses a cane
B) Bathes daily
C) Takes medications as prescribed
D) Dresses self
E) Balances the checkbook
F) Cleans the house
Answer: B,B,A,B,A,A
Functional impairment,disability,or handicap refers to varying degrees of an individual's inability to perform the tasks required to complete normal life activities without assistance.IADLs are more complex skills that are essential to living in the community.
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4
Chapter 3: Family Dynamics
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Sample Questions
Q1) The most appropriate initial nursing intervention when the nurse notes dysfunctional interactions and lack of family support for a patient would be to
A) enforce hospital visiting policies.
B) monitor the dysfunctional interactions.
C) notify the primary care provider.
D) role model appropriate support.
Answer: D
Q2) The nurse planning to assess the structure of a family would which question?
A) "Who lives with you?"
B) "Who does the grocery shopping?"
C) "Who provides support in your family?"
D) "How old are the members of your family?"
Answer: A
Q3) Factors which would alert the nurse to negative/dysfunctional family dynamics include
A) aging of family members.
B) chronic illness of a family member.
C) disability of a family member.
D) intimate partner violence.
Answer: D
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Chapter 4: Culture
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Sample Questions
Q1) Women who are given the job of caretaker for aging relatives are subject to caregiver strain due to
A) feminine attributes.
B) unequal gender.
C) fixed gender roles.
D) female inequality.
Q2) Understanding cultural differences in health care is important because it will help the nurse to understand the manner in which people decide on obtaining treatments and medical care.In independent cultures an individual will
A) put himself first.
B) consult family members for advice.
C) ask for a second opinion.
D) travel great distances to receive the best care.
Q3) 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
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Chapter 5: Motivation
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Sample Questions
Q1) A patient expresses a strong interest in returning to their work,family,and hobbies after having a stroke.Which theory type would the nurse use to develop a plan of care for the best results of this patient's motivation style?
A) Biological
B) Field
C) Sociologic
D) Cognitive
Q2) The nurse is trying to help an obese diabetic patient who has 30 pounds to lose.The nurse is setting weight loss goals that the patient will attain.Which goals would most likely cause an increase in motivation in this patient?
A) Follow American Diabetic Diet, lose 2 pounds a week, and 20 pounds in 2 months.
B) Follow American Diabetic Diet, lose .5 pounds a week, and 5 pounds in 2 months.
C) Follow American Diabetic Diet, lose 1 pound a week, and 10 pounds in 2 months.
D) Follow American Diabetic Diet, lose 3 pounds a week, and 30 pounds in 2 months.
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Chapter 6: Adherence
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Sample Questions
Q1) After the nurse implements a teaching plan for a newly diagnosed patient with hypertension,the patient can explain the information but fails to take the medications as prescribed.The nurse's next action would be to
A) reeducate the patient, because learning did not occur because the patient's behavior did not change.
B) assess the patient's perception and attitude towards the risks associated with not taking their anti-hypertensives.
C) take full responsibility for helping the patient make dietary changes.
D) ask the provider to prescribe a different medication, because the patient does not want to take this medication.
Q2) A 73-year-old male patient is seen in the home setting for a routine physical.The nurse notes which behavior as the most reassuring sign that the patient has been following the treatment plan for the diagnoses of hypertension,diabetes,and hyperlipidemia?
A) The patient has a list of glucose readings for the past 10 days.
B) The patient has a list of medications along with newly refilled meds.
C) The patient has a list of all foods and beverages for a 3-day period.
D) The patient verbalizes the side effects of all his medications.
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Chapter 7: Fluid and Electrolyte Balance
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Sample Questions
Q1) The nurse is assessing a patient before hanging an IV solution of 0.9% NaCl with KCl in it.Which assessment finding should cause the nurse to hold the IV solution and contact the physician?
A) Weight gain of 2 pounds since last week
B) Dry mucous membranes and skin tenting
C) Urine output 8 mL/hr
D) Blood pressure 98/58
Q2) At change-of-shift report,the nurse learns the medical diagnoses for four patients.Which patient should the nurse assess most carefully for development of hyponatremia?
A) Vomiting all day and not replacing any fluid
B) Tumor that secretes excessive antidiuretic hormone (ADH)
C) Tumor that secretes excessive aldosterone
D) Tumor that destroyed the posterior pituitary gland
Q3) 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
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Chapter 8: Acid-Base Balance
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Sample Questions
Q1) Which statements said by patients indicate that the nurse's teaching regarding prevention of acid-base imbalances is successful? (Select all that apply.)
A) "Baking soda is an effective inexpensive antacid."
B) "I shall take my insulin on time every day."
C) "My aspirin is on a high shelf away from children."
D) "I have reliable transportation to dialysis sessions."
E) "Fasting is a great way to lose weight rapidly."
Q2) The patient has severe hyperthyroidism and will have surgery tomorrow.What assessment is most important for the nurse to assess in order to detect development of the acid-base imbalance for which the patient has highest risk?
A) Urine output and color
B) Level of consciousness
C) Heart rate and blood pressure
D) Lung sounds in lung bases
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Chapter 9: Thermoregulation
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Sample Questions
Q1) During orientation to an emergency department,the nurse educator would be concerned if the new nurse listed which of the following as a risk factor for impaired thermoregulation?
A) Impaired cognition
B) Occupational exposure
C) Physical agility
D) Temperature extremes
Q2) The most appropriate measure for a nurse to use in assessing core body temperature when there are suspected problems with thermoregulation is a(n)
A) oral thermometer.
B) rectal thermometer.
C) temporal thermometer scan.
D) tympanic membrane sensor.
Q3) The nurse admitting a patient to the emergency department on a very hot summer day would suspect hyperthermia when the patient demonstrates
A) decreased respirations.
B) low pulse rate.
C) red, sweaty skin.
D) slow capillary refill.
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Page 11
Chapter 10: Cellular Regulation
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Sample Questions
Q1) In caring for a patient following lobectomy for lung cancer,which of the following should the nurse include in the plan of care?
A) Position the patient on the operative side only.
B) Avoid administering narcotic pain medications.
C) Keep the patient on strict bed rest.
D) Instruct the patient to cough and deep breathe.
Q2) While planning care for a patient experiencing fatigue due to chemotherapy,which of the following is the most appropriate nursing intervention?
A) Prioritization and administration of nursing care throughout the day
B) Completing all nursing care in the morning so the patient can rest the remainder of the day
C) Completing all nursing care in the evening when the patient is more rested
D) Limiting visitors, thus promoting the maximal amount of hours for sleep
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12
Chapter 11: Intracranial Regulation
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Sample Questions
Q1) Components of the GCS the nurse would use to assess a patient after a head injury include
A) blood pressure.
B) cranial nerve function.
C) head circumference.
D) verbal responsiveness.
Q2) After shunt procedure,the nurse would monitor the patient's neurologic status by using the A) electroencephalogram.
B) GCS.
C) National Institutes of Health Stroke Scale.
D) Monro-Kellie doctrine.
Q3) The nurse preparing to care for a patient after a suspected stroke would question an order for a(n)
A) antihypertensive.
B) antipyretic.
C) osmotic diuretic.
D) sedative.
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13
Chapter 12: Glucose Regulation
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Sample Questions
Q1) 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
Q2) Which of the following would be included in the assessment of a patient with diabetes mellitus who is experiencing a hypoglycemic reaction? (Select all that apply.)
A) Tremors
B) Nervousness
C) Extreme thirst
D) Flushed skin
E) Profuse perspiration
F) Constricted pupils
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Chapter 13: Nutrition
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Sample Questions
Q1) During an interview,the nurse is discussing dietary habits with a patient.Which tool would be the best choice to use as a quick screening tool to assess dietary intake?
A) Food diary
B) Calorie count
C) Comprehensive diet history
D) 24-hour recall
Q2) An African American is at an increased risk for which of the following? (Select all that apply.)
A) Vitamin D deficiency
B) Type 1 diabetes
C) Celiac disease
D) Type 2 diabetes
E) Hypertension
F) Metabolic syndrome
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Page 15
Chapter 14: 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.The best response by the nurse is:
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 process of digestion is important for every living organism for the purpose of nourishment.Where does most digestion take place in the body?
A) Large intestine
B) Stomach
C) Small intestine
D) Pancreas
Q3) A primary prevention tool used for colon cancer screening is
A) abdominal x-rays.
B) blood, urea, and nitrogen (BUN) testing.
C) serum electrolytes.
D) occult blood testing.
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Chapter 15: Perfusion
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Sample Questions
Q1) A patient was diagnosed with hypertension.The patient asks the nurse how this disease could have happened to them.The nurse's best response is "Hypertension
A) happens to everyone sooner or later. Don't be concerned about it."
B) can happen from eating a poor diet, so change what you are eating."
C) can happen from arterial changes that impede the blood flow."
D) happens when people do not exercise, so you should walk every day."
Q2) A patient's serum electrolytes are being monitored.The nurse notices that the potassium level
Is low.The nurse knows that the patient should be observed for A) tissue ischemia.
B) brain malformations.
C) intestinal blockage.
D) cardiac dysthymia.
Q3) The patient asks the nurse to explain the sinoatrial node in the heart.The nurse's best response would be,"The sinoatrial node
A) provides the heart with the stimulation to beat in a normal rhythm."
B) protects the heart from atherosclerotic changes."
C) provides the heart with oxygenated blood."
D) protects the heart from infection."
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Page 17
Chapter 16: Gas Exchange
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Sample Questions
Q1) The nurse is assessing a patient for the adequacy of ventilation.What assessment findings would indicate the patient has good ventilation? (Select all that apply.)
A) Respiratory rate is 24 breaths/min.
B) Oxygen saturation level is 98%.
C) The right side of the thorax expands slightly more than the left.
D) Trachea is just to the left of the sternal notch.
E) Nail beds are pink with good capillary refill.
F) There is presence of quiet, effortless breath sounds at lung base bilaterally.
Q2) The nurse would identify which patient as having a problem of impaired gas exchange secondary to a perfusion problem? A patient with
A) peripheral arterial disease of the lower extremities
B) chronic obstructive pulmonary disease (COPD)
C) chronic asthma
D) severe anemia secondary to chemotherapy
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Chapter 17: Clotting
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Sample Questions
Q1) 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
Q2) Which statement by a patient indicates additional teaching is required about the medication warfarin?
A) "I will continue my diabetic diet and restrict sugar."
B) "I will increase the intake of green, leafy vegetables for a more healthful diet."
C) "I will restrict the intake of foods high in vitamin C."
D) "I will increase the amount of protein in my diet to protect my kidneys."
Q3) A patient on a medical surgical unit has a platelet count of 90,000 per mm³.The nurse knows to include which of the following precautions in discharge instructions?
A) Use a standard safety razor for shaving.
B) Use a soft bristle toothbrush.
C) Have aggressive dental care immediately to prevent dental caries.
D) Do not eat fresh fruit.
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Chapter 18: Reproduction
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Sample Questions
Q1) The RN at the Preconception Counseling Clinic takes a male history for infertility evaluation.Which finding has the greatest implication for this patient's care?
A) Practice of nightly masturbation
B) Primary anovulation
C) High testosterone levels
D) Impotence due to alcohol ingestion
Q2) 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 weed 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
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Chapter 19: Sexuality
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Sample Questions
Q1) Symptoms of sexual dysfunction and altered body image often coexist with prolapse of the female reproductive organs.Nursing care requires a great deal of sensitivity,because many women are embarrassed by their condition.Your patient is a 44-year-old married woman who is complaining of painful intercourse and incontinence.Clinical evaluation reveals that the patient has a cystocele.Which treatment option is most appropriate for this patient?
A) Pelvic floor training
B) Vaginal pessaries
C) Surgical correction
D) Lifestyle changes
Q2) A 55-year-old male patient post-myocardial infarction (MI)queries the nurse caring for him whether he will be healthy enough for sexual activity after discharge from the hospital.The patient has been prescribed anti-hypertensives and beta-blockers.While 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
A) excitement, plateau, and orgasmic.
B) plateau, orgasmic, and resolution.
C) excitement, orgasmic, and resolution.
D) arousal, excitement, and plateau.
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Page 21
Chapter 20: Immunity
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Sample Questions
Q1) 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
Q2) The nurse is preparing to administer medications to a patient with rheumatoid arthritis (RA).The nurse explains to the patient that the goal of medication treatments for RA is to
A) eradicate the disease.
B) enhance immune response.
C) control inflammation.
D) manage pain.
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22
Chapter 21: Inflammation
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Q1) A patient comes to the clinic with a complaint of painful,itchy feet.On interview,the patient tells the nurse that he is a college student living in a dormitory apartment that he shares with five other students.The nurse plans to teach the patient to
A) not eat with the other students.
B) avoid sharing razors and other personal items.
C) have his CBC checked monthly.
D) disinfect showers and bathroom floors weekly after use.
Q2) A patient is being treated with an antibiotic.The nurse explains to the patient that this medication is required for the reduction of inflammation at the injury site because this medication
A) will decrease the pain at the site.
B) helps to kill the infection causing the inflammation.
C) inhibits cyclooxygenase.
D) will reduce the patient's fever.
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Chapter 22: Infection
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Q1) The nurse is caring for a patient with a diagnosed case of Clostridium difficile.The nurse expects to implement which of the following interventions? (Select all that apply.)
A) Administration of protease inhibitors
B) Use of personal protective equipment
C) Patient teaching on methods to inhibit transmission
D) Preventing visitors from entering the room
E) Administration of intravenous fluids
F) Strict monitoring of intake and output
Q2) The nurse is working on a plan of care with her patient which includes turning and positioning and adequate nutrition to help the patient maintain intact skin integrity.The nurse helps the patient to realize that this breaks the chain of infection by eliminating a A) host.
B) mode of transmission.
C) portal of entry.
D) reservoir.
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24
Chapter 23: Mobility
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Sample Questions
Q1) What percentage of hip fractures are 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 concept of mobility and proper moving techniques when he or she states,"Patients must
A) have a trapeze over the bed to move properly."
B) move themselves in bed to prevent immobility."
C) always have a two-person assist to move in bed."
D) be moved correctly in bed to prevent shearing."
Q3) A patient who has been in the hospital for several weeks is about to be discharged.The patient is weak from the hospitalization and asks the nurse to explain why this is happening.The nurse's best response is "You are weak because
A) your iron level is low. This is known as anemia."
B) of your immobility in the hospital. This is known as deconditioning."
C) of your poor appetite. This is known as malnutrition."
D) of your medications. This is known as drug induced weakness."
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Page 25
Chapter 24: Tissue Integrity
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Q1) A older patient has developed age spots and is concerned about skin cancer.How would the nurse instruct the patient to check himself or herself?
A) "Limit the time you spend in the sun."
B) "Monitor for signs of infection."
C) "Monitor spots for color change."
D) "Use skin creams to prevent drying."
Q2) To help decrease the threat of a melanoma in a blonde-haired,fair-skinned patient at risk,the nurse would advise the patient to do which of the following?
A) Apply sunscreen 1 hour prior to exposure.
B) Drink plenty of water to prevent hot skin.
C) Use vitamins to help prevent sunburn by replacing lost nutrients.
D) Apply sunscreen 30 minutes prior to exposure.
Q3) The nurse is instructing the nursing assistant to prevent pressure ulcers in a frail older patient; the nursing assistant understands the instruction when she agrees to A) bathe and dry the skin vigorously to stimulate circulation.
B) keep the head of the bed elevated 30 degrees.
C) limit intake of fluid and offer frequent snacks.
D) turn the patient at least every 2 hours.
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26
Chapter 25: Sensory Perception
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Q1) The nurse requests that a mother give permission for a hearing test in a newborn infant.The mother questions the importance of such a test.The nurse correctly responds with which of the following statements?
A) "This will help us to identify your baby's risk for ear infections the first year of life."
B) "Hearing is important so your baby hears and responds to your voice, which makes you feel like a mother."
C) "Socialization skills include the need to hear in order to interpret the emotional aspect of the words that are spoken to your child."
D) "Imitation of sounds is the first step in language development, and it is important to identify alterations early."
Q2) The patient who had a hip replacement yesterday has a visual acuity of 20/200 after correction.To provide recreational activities during the rehabilitation phase,the nurse should
A) place the television to the left or right of patient's visual field.
B) encourage the patient to learn braille.
C) suggest use of talking books.
D) provide headphones for listening to music.
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Chapter 26: Pain
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Q1) An elderly Chinese woman is interested in biologically based therapies to relieve osteoarthritis pain (OA).You are preparing a plan of care for her OA.Options most conducive to her expressed wishes may include
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) Controlling pain is important to promoting wellness.Unrelieved pain has been associated with
A) prolonged stress response and a cascade of harmful effects system-wide.
B) large tidal volumes and decreased lung capacity.
C) decreased tumor growth and longevity.
D) decreased carbohydrate, protein, and fat destruction.
Q3) A 19-year-old male has sustained a transaction of C-7 in an MVA rendering him a quadriplegic.He describes his pain as burning,sharp,and shooting.This is characteristic of A) neuropathic pain.
B) ghost pain.
C) mixed pain syndrome.
D) nociceptive pain.
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Page 28
Chapter 27: Stress
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Q1) A patient tells the nurse "My doctor thinks my problems with stress relate to the negative way I think about things,and he wants me to learn a new way of thinking." Which response would be in keeping with the doctor's recommendations?
A) Teaching the patient to recognize, reconsider, and reframe irrational thoughts
B) Encouraging the patient to imagine being in calming circumstances
C) Teaching the patient to use instruments that give feedback about bodily functions
D) Provide the patient with a blank journal and guidance about journaling
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 28: Coping
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Q1) A patient is the primary caregiver for a disabled family member at home,and has now been unexpectedly hospitalized for surgery.What action can the nurse take to enhance the coping ability of the patient?
A) Ask if there is another family member who can help at home while the patient is in the hospital.
B) Plan to transfer the patient to a rehabilitation unit after surgery to allow uninterrupted time to recover.
C) Coordinate an ambulance transfer of the family member to an alternate family member's home.
D) Ask social services to assess what the patient's needs will be after discharge to home.
Q2) The nurse is reviewing the care plan for a patient experiencing difficulty coping with stress.The nurse recognizes that an example of initiating a cognitive restructuring intervention to enhance coping abilities is which of the following?
A) Identifying the cause of fear
B) Accessing a community support group
C) Identifying relaxation methods
D) Reviewing an educational pamphlet
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Chapter 29: Mood and Affect
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Q1) A patient who is taking prescribed lithium carbonate is exhibiting signs of diarrhea,blurred vision,frequent urination,and an unsteady gait.Which serum lithium level would the nurse expect for this patient?
A) 0 to 0.5 mEq/L
B) 0.6 to 0.9 mEq/L
C) 1.0 to 1.4 mEq/L
D) 1.5 or higher mEq/L
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 30: Anxiety
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Q1) A patient complains of insomnia while 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
Q2) A female patient is anxious after receiving the news that she needs a breast biopsy to rule out breast cancer.The nurse is assisting with a breast biopsy.Which relaxation technique will be best to use at this time?
A) Massage
B) Meditation
C) Guided imagery
D) Relaxation breathing
Q3) The nurse is teaching a hospitalized patient to use mindfulness to reduce anxiety.Which statement by the nurse is appropriate?
A) "How do you feel about what happened to you as a child?
B) "How do you feel about what is going on right now?"
C) "Remember a time when you were calm."
D) "Tap your hands until the feeling goes away."
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Page 32
Chapter 31: Cognition
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Q1) An older adult who is cognitively impaired is admitted to the hospital with pneumonia.Which signs and symptoms would the nurse expect to be exhibited by the patient?
A) Severe headache
B) Flank pain
C) Increased confusion
D) Decreased blood glucose
Q2) A patient who is dehydrated has been experiencing confusion.The daughter is concerned about taking the patient home in a confused state.What statement by the nurse is correct?
A) "Don't worry; the patient should be fine once they are in a familiar environment."
B) "I can make a referral for a home health aide to assist with the patient."
C) "Once the dehydration is corrected, the patient's confusion should improve."
D) "I can show you how to care for the patient once you return home."
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Chapter 32: Psychosis
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Q1) A client with schizophrenia has relapsed and has been identified as being in stage four of relapse.Behavior which is most consistent with this stage of relapse would include
A) expressing feelings of anxiety.
B) expressing feelings of being overwhelmed.
C) bizarre behaviors and speech.
D) presence of hallucinations.
Q2) 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
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Chapter 33: Addiction
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Q1) The nurse assesses the outcomes of a motivational interview on a patient with a dual diagnosis of alcoholism with DTs and determines that the communication was nontherapeutic.What should the nurse's next priority be?
A) Encourage the patient to think of ways to change environmental triggers to abuse substances.
B) Ask the patient what methods they think would work and encourage participating in self-help groups.
C) Notify provider to obtain order for oxazepam (Serax) and vitamin B infusion.
D) Notify provider to obtain order for CT scan and psychologic consult.
Q2) The nurse is caring for a patient who is experiencing alcohol withdrawal.What is the main priority for this patient?
A) Describe how the alcohol is causing the withdrawal effects.
B) Leave the patient by him/herself so as not to cause agitation.
C) Promote a safe, calm, and comfortable environment.
D) Refer the patient to an alcohol-abuse counselor.
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Chapter 34: Interpersonal Violence
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Q1) The nurse is admitting a child with a history of abuse.The nurse understands that the child may exhibit what behaviors that are consequences of being in an abusive environment? (Select all that apply.)
A) Reliving abuse incidents
B) Sleep disturbance
C) Overeating
D) Acting out behaviors
E) Intermittent fever
Q2) 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
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36
Chapter 35: Professionalism
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Q1) Nursing demonstrates dedication to improving public health through A) changing health care standards.
B) legal regulations.
C) scope of practice.
D) technology.
Q2) Components of a professional identity in nursing include which of the following? (Select all that apply.)
A) Accountability
B) Advocacy
C) Autonomy
D) Competence
E) Culture
Q3) Recommendations published in the IOM's report The future of nursing: Leading change,advancing health include that nurses
A) teach, advocate, assess, and nurture.
B) should have a graduate degree to practice.
C) diagnose and recommend treatments.
D) must have continuing education.
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Chapter 36: Clinical Judgment
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Q1) A nurse has committed a serious medication error and has reported their 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 patient has been admitted for a skin graft following third degree burns to the bilateral calves.The plan of care involves 3 days inpatient and 6 months outpatient treatment,to include home care and dressing changes.When should the nurse initiate the educational plan?
A) After the operation and the patient is awake
B) On admission, along with the initial assessment
C) The day before the patient is to be discharged
D) When narcotics are no longer needed routinely
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Chapter 37: Leadership
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Q1) The nurse who is certified as a Critical Care Registered Nurse (CCRN )represents the unit on the organizational performance improvement team.This is an example of _____ leadership.
A) formal
B) unit
C) organizational
D) informal
Q2) The nursing unit director exhibits the definition of leadership in which of the following responses?
A) The nurse manager refers the concern to the director of the department.
B) The nurse manager corrects the concern with the patient directly and does not communicate her actions to the staff.
C) The nurse manager meets with the staff to discuss the concern and identify solutions.
D) The nurse manager tells the staff that they need to correct the situation by tomorrow and leaves the meeting.
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Chapter 38: Ethics
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Q1) A male patient suffered a brain injury from a motor vehicle accident and has no brain activity.The spouse has come up to see the patient every day for the past 2 months.She asks the nurse,"Do you think when he moves his hands he is responding to my voice?" The nurse feels bad because she believes the movements are involuntary,and the prognosis is grim for this patient.She states,"He can hear you,and it appears he did respond to your voice." The nurse is violating which principle of ethics?
A) Autonomy
B) Veracity
C) Utilitarianism
D) Deontology
Q2) The nurse is faced with an ethical issue.When assessing the ethical issue,the nurse must first
A) ask, "What is the issue?"
B) identify all possible alternatives.
C) select the best option from a list of alternatives.
D) justify the choice of action or inaction.
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Chapter 39: Patient Education
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Q1) Interrelated concepts to the professional nursing role a nurse manager would consider when addressing concerns about the quality of patient education include A) adherence.
B) developmental level.
C) motivation.
D) technology.
Q2) When planning to evaluate a patient's satisfaction with a teaching activity,the most appropriate strategy would be to
A) include a survey instrument.
B) observe for level of skill mastery.
C) present information more than one time.
D) provide for a return demonstration.
Q3) When describing patient education approaches,the nurse educator would explain that informal teaching is an approach that A) addresses group needs.
B) follows formalized plans.
C) has standardized content.
D) often occurs one-to-one.
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Chapter 40: Health Promotion
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Q1) 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
Q2) At the well-child clinic,the nurse teaching a mother about health promotion activities describes immunizations as
A) unique for children.
B) primary prevention.
C) secondary prevention.
D) tertiary prevention.
Q3) The plan of care for a patient newly diagnosed with diabetes includes health promotion with the tertiary prevention measure of
A) avoiding carcinogens.
B) foot screening techniques.
C) glaucoma screening.
D) seat belt use.
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Chapter 41: 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) Critical Thinking: A patient states,"I had a bad nightmare.When I woke up,I felt emotionally drained,as though I hadn't rested well." Which response by the nurse would be an example of interpersonal therapeutic communication?
A) "It sounds as though you were uncomfortable with the content of your dream."
B) "I understand what you're saying. Bad dreams leave me feeling tired, too."
C) "So, all in all, you feel as though you had a rather poor night's sleep?"
D) "Can you give me an example of what you mean by a 'bad nightmare'?"
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Chapter 42: Collaboration
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Q1) The nurse and physician are explaining the home care that will be needed by a patient after discharge.The patient's spouse states angrily that it will not be possible to provide the care recommended.What is the best response by the nurse?
A) "Let me review what is needed again."
B) "It is important that you do what the physician has prescribed."
C) "What concerns do you have about the prescribed care?"
D) "I can come back after you talk with your spouse about the care."
Q2) Which activities are appropriate for the nurse to collaborate with a patient? (Select all that apply.)
A) Prescribing a new medication dose
B) Health promotion activities
C) End-of-life comfort decisions
D) Interpreting laboratory results
E) Lifestyle changes to improve health
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44
Chapter 43: Safety
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Q1) Essential elements of a standard order set to verify a medication order include A) volume only.
B) number of tablets.
C) metric dose/strength.
D) hour of administration.
Q2) A staff nurse reports a medication error,failure to administer a medication at the scheduled time.An appropriate response of the charge nurse would be
A) "We'll do a root cause analysis."
B) "That means you'll have to do continuing education."
C) "Why did you let that happen?"
D) "You'll need to tell the patient and family."
Q3) Aspects of safety culture that contribute to a culture of safety in a health care organization include A) communication.
B) fear of punishment.
C) malpractice implications.
D) team nursing.
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Chapter 44: Technology and Informatics
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Q1) The staff nurse who uses informatics in promoting quality patient care is most likely to access data in the domain of
A) certified clinical information systems (CIS).
B) clinical health care informatics.
C) public health/population informatics.
D) translational bioinformatics.
Q2) When discussing the purposes of health care informatics with a nurse during orientation,the nurse educator would be concerned if the nurse orientee said that one purpose would be to
A) develop a cognitive science.
B) improve disease tracking.
C) improve the health provider's work flow.
D) increase administrative efficiencies.
Q3) Exemplars of the health informatics concept include
A) clinical research informatics.
B) hardware and software.
C) privacy and security.
D) standard terminology.
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Chapter 45: Evidence
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Q1) Which statements are true about the Iowa model of EBP? (Select all that apply.)
A) It addresses utilization of research findings at an individual level.
B) It prioritizes pressing items of interest related to quality of care.
C) Individual nurses enact an Iowa decision tree when they examine risk management data.
D) It identifies triggers capable of posing hazard or benefit.
E) It reiterates that innovators embrace change far earlier than laggards.
Q2) 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
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Chapter 46: 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.The best response by the instructor is "Quality of care is evaluated
A) by the patient getting well."
B) on the basis of process and outcomes."
C) by the physician's assessment."
D) by the patient's satisfaction."
Q2) The focus of quality health care should be on which of the following items? (Select all that apply.)
A) Excellent services
B) Comprehensive communication
C) Private hospital rooms
D) Health team collaboration
E) Culturally competent care
Q3) The patient's perception of his or her care is not as important as the outcome of the care.
A)True
B)False
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Chapter 47: Care Coordination
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Q1) Student nurses are being questioned by the nursing instructor about the health care coordination system.The instructor knows the students understand health care delivery when they state,"Health care
A) is available for everyone at every time."
B) needs are best met with a collaborative effort."
C) is adequately meeting the needs of the homeless populations."
D) needs are mostly in third world countries."
Q2) Nurses work to serve the population,and they know that the priority population who needs to be served by care coordination is the
A) most vulnerable and the frail.
B) uninsured and the very young.
C) underinsured and the elderly population.
D) whole population of the community.
Q3) Medical models coordinate medical services and were traditionally designed to be A) patient specific.
B) nursing oriented.
C) diagnosis specific.
D) community oriented.
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Chapter 48: 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) The community health nurse is assessing a family who has a chronically ill child.The child needs special care,and the nurse has to coordinate the care for the home setting.What behavior will the nurse assess for to know that the family can care for the child?
A) The family is willing to learn about the care and share the caregiving needs.
B) The mother is going to care for the child and the family herself.
C) The older siblings are going to care for the child while the parents are at work.
D) An outside agency will be coming to the home three times a week to give care.
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Chapter 49: Palliation
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Q1) Palliative care used in the management of a patient with symptomatic chronic obstructive pulmonary disease (COPD)is an example of which of the following?
A) Palliative care is used when the patient is beginning to die.
B) Palliative care is used to help manage the symptoms that often accompany COPD.
C) Hospice nurses must be involved to provide palliative care in a cancer patient.
D) Patient must be enrolled into the Medicare Hospice Benefit to receive palliative care.
Q2) Palliative care does everything except
A) promote comfort.
B) reduce disease exacerbations.
C) decrease acute care hospital admissions.
D) promote a cure for chronic disease.
Q3) One of the biggest challenges facing current nursing practice is
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 50: Health Care Organizations
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Q1) A hospital is experiencing a drop in patient admissions,resulting in the implementation of a hiring freeze.What is a potential critical consequence of this internal organizational decision?
A) A decrease in the availability of future nurses to hire
B) A savings of salaries and benefits
C) Increased scholarships to nursing students from the local high school
D) Increased cross-training of current staff
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 51: Health Care Economics
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Q1) The economics of health care include
A) Medicare and Medicaid dollars.
B) patients' rights.
C) equal distribution of health care.
D) nurse salaries.
Q2) A student nurse is discussing Medicare coverage with the clinical instructor.The instructor knows the student understands Medicare when the student makes this which statement(s)? (Select all that apply.)
A) Medicare covers all patients while they are in the hospital.
B) Medicare is funded by the federal government.
C) Medicare is for persons 65 years old and older.
D) Medicare is partially funded by private third-party payers.
E) Medicare is for patients who are disabled and/or have end-stage renal disease.
Q3) Which of the following statements is true about health care in the US?
A) The US spends more money on health care than any other nation.
B) The US provides health care to every citizen.
C) The US relies on government funding to treat most citizens.
D) The US spends less money on pediatric care than other nations.
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Chapter 52: Health Policy
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Q1) A nursing student is preparing a care plan for an assigned patient.When accessing the electronic medical record,what is acceptable information to view? (Select all that apply.)
A) Laboratory data of the assigned patient
B) Admission diagnosis for a patient who is a former neighbor
C) The patient's age, date of birth, and gender
D) The history and physical of the assigned patient
E) A classmate's brother's chest x-ray report
Q2) Which of the following components are included in health policy at the state level?
A) Americans with Disabilities Act of 1990
B) Scope of nursing practice
C) Health Insurance Portability and Accountability Act (HIPAA) of 1996
D) Patient Safety and Quality Improvement Act of 2005
Q3) A definition of health policy includes which of the following elements?
A) Funding for public education
B) Appropriation of funds for roadwork
C) Selection of congressional members of committees
D) Public policy made to support health-related goals
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54
Chapter 53: Health Care Law
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Q1) One of the major attributes of health care law is
A) it defines the expected behavior of persons in the business of health care.
B) the law or rule is easy to interpret and comply with.
C) it is established by any health care authority.
D) the creator must be an expert in health care.
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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