Nursing Concepts
Midterm Exam
Course Introduction
Nursing Concepts introduces students to the foundational principles and theories essential to the practice of nursing. This course explores core themes such as patient-centered care, professionalism, clinical reasoning, communication, and safety within healthcare environments. Students will learn about the nursing process, ethical and legal considerations in nursing, and the role of evidence-based practice in delivering quality care. Emphasis is placed on developing critical thinking and decision-making skills necessary for effective patient assessment, intervention, and evaluation. The course prepares students to integrate these fundamental concepts into diverse clinical settings and work collaboratively with interdisciplinary healthcare teams.
Recommended Textbook Concepts for Nursing Practice 2nd Edition by Giddens
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58 Chapters
459 Verified Questions
459 Flashcards
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Chapter 1: Development
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8 Verified Questions
8 Flashcards
Source URL: https://quizplus.com/quiz/2322
Sample Questions
Q1) To plan early intervention and care for an infant with Down syndrome, the nurse considers knowledge of other physical development exemplars such as A) cerebral palsy.
B) autism.
C) attention deficit hyperactivity disorder (ADHD).
D) failure to thrive.
Answer: D
Q2) A mother complains to the nurse at the pediatric clinic that her 4-year-old child always talks to her toys and makes up stories. The mother wants her child to have a psychological evaluation. The nurse's best initial response is to
A) refer the child to a psychologist immediately.
B) explain that playing make believe is normal at this age.
C) complete a developmental screening using a validated tool.
D) separate the child from the mother to get more information.
Answer: B
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Chapter 2: Functional Ability
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) The nurse is developing an interdisciplinary plan of care using the Roper-Logan-Tierney Model of Nursing for a patient who is currently unconscious. Which interventions would be most critical to developing a plan of care for this patient?
A) Eating and drinking, personal cleansing and dressing, working and playing
B) Toileting, transferring, dressing, and bathing activities
C) Sleeping, expressing sexuality, socializing with peers
D) Maintaining a safe environment, breathing, maintaining temperature
Answer: D
Q2) The nurse is assessing a patient's functional ability. Which patient best demonstrates the definition of functional ability?
A) Considers self as a healthy individual; uses cane for stability
B) College educated; travels frequently; can balance a checkbook
C) Works out daily, reads well, cooks, and cleans house on the weekends
D) Healthy individual, volunteers at church, works part time, takes care of family and house
Answer: D
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Chapter 3: Family Dynamics
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7 Verified Questions
7 Flashcards
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Sample Questions
Q1) When reviewing the purposes of a family assessment, the nurse educator would identify a need for further teaching if the student responded that family assessment is used to gain an understanding of which aspect of the family?
A) Development
B) Function
C) Political views
D) Structure
Answer: C
Q2) Two women have an established long-term relationship and are attending parenting classes in anticipation of finalizing adoption of a baby. The nurse identifies them as which type of family?
A) Cohabiting
B) Nuclear
C) Same-sex
D) Single parent
Answer: C
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Chapter 4: Culture
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7 Verified Questions
7 Flashcards
Source URL: https://quizplus.com/quiz/2325
Sample Questions
Q1) A 60-year-old Italian immigrant presents for an annual physical. He is counseled about diagnostic testing including laboratory testing, colonoscopy, influenza vaccination, and pneumococcal vaccination. His reply is "If it ain't broke, don't try to fix it." When developing a plan of care, the nurse should consider which cultural orientation for this patient?
A) Short term
B) Long term
C) Leisurely term
D) Noncommittal
Q2) What interrelated constructs facilitate a nurse to become culturally competent?
A) Cultural diversity, self-awareness, cultural skill, and cultural knowledge
B) Cultural desire, self-awareness, cultural knowledge, and cultural identity
C) Cultural desire, self-awareness, cultural knowledge, and cultural diversity
D) Cultural desire, self-awareness, cultural knowledge, and cultural skill
Q3) The emphasis on understanding cultural influence on health care is important because of
A) disability entitlements.
B) HIPAA requirements.
C) increasing global diversity.
D) litigious society.
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Chapter 5: Spirituality
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7 Verified Questions
7 Flashcards
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Sample Questions
Q1) The nurse recognizes that which life events can be spiritually life changing? (Select all that apply.)
A) Births
B) Weddings
C) Medical diagnoses
D) Career day to day job duties
E) Loss of independence
Q2) Which are true statements about the definition of spirituality in nursing? (Select all that apply.)
A) Patient's quality of life, health, and sense of wholeness are affected by spirituality
B) An exact definition was developed and adopted in the late 1980s
C) Encompasses principle, an experience, attitudes, and belief regarding God
D) Head knowledge affects spirituality more than heart knowledge
E) Mind, body, spirit, love, and caring are interconnected
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Chapter 6: Adherence
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10 Flashcards
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Sample Questions
Q1) A diabetic patient presents to the diabetes clinic with A<sub>1</sub>c levels of 7.5%. The nurse has met this patient for the first time. When applying principles of Theory of Planned Behavior (TPB), which teaching strategy by the nurse is most likely to be effective?
A) Provide information on the importance of blood glucose control in maintenance of long-term health and evaluate how the patient has been following the prescribed regime.
B) Establish a rapport with the patient by complimenting them on what they did correctly, and ask what strategies they have tried thus far.
C) Refer the patient to a certified diabetic educator, because the educator is an expert on management of diabetes complications.
D) Have the patient explain what medications they are on and what diet they should be following.
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Chapter 7: Self-Management
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Sample Questions
Q1) When developing a plan of care to promote self-management, which patient is least likely to be affected by depression?
A) 55-year-old employed female
B) 35-year-old Hispanic male
C) 40 year old with 5th grade education
D) 42 year old with private insurance
Q2) The nurse is developing a teaching plan for a patient diagnosed with congestive heart failure. Which are the most appropriate teaching points to include that will assist in self-management of the disease? (Select all that apply.)
A) Side effects of medications
B) Activity restrictions
C) Daily weights
D) Increased sodium intake
E) Blood pressure monitoring
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Chapter 8: Fluid and Electrolyte Balance
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9 Verified Questions
9 Flashcards
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Sample Questions
Q1) The patient is receiving tube feedings due to a jaw surgery. What change in assessment findings should prompt the nurse to request an order for serum sodium concentration?
A) Development of ankle or sacral edema
B) Increased skin tenting and dry mouth
C) Postural hypotension and tachycardia
D) Decreased level of consciousness
Q2) The patient's laboratory report today indicates severe hypokalemia, and the nurse has notified the physician. Nursing assessment indicates that heart rhythm is regular. What is the most important nursing intervention for this patient now?
A) Raise bed side rails due to potential decreased level of consciousness and confusion.
B) Examine sacral area and patient's heels for skin breakdown due to potential edema.
C) Establish seizure precautions due to potential muscle twitching, cramps, and seizures.
D) Institute fall precautions due to potential postural hypotension and weak leg muscles.
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Chapter 9: Acid-Base Balance
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Sample Questions
Q1) The nurse has telephone messages from four patients who requested information and assistance. Which one should the nurse refer to a social worker or community agency first?
A) "Is there a place that I can dispose of my unused morphine pills?"
B) "I want to lose at least 20 pounds without getting sick this time."
C) "I think I have asthma because I cough when dogs are near."
D) "I ran out of money and am cutting my insulin dose in half."
Q2) The patient has type B chronic obstructive pulmonary disease (COPD) exacerbated by an acute upper respiratory infection. Which blood gas values should the nurse expect to see?
A) pH high, PaCO<sub>2</sub> high, HCO<sub>3</sub>- high
B) pH low, PaCO<sub>2</sub> low, HCO<sub>3</sub>- low
C) pH low, PaCO<sub>2</sub> high, HCO<sub>3</sub>- high
D) pH low, PaCO<sub>2</sub> high, HCO<sub>3</sub>- normal
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11
Chapter 10: Thermoregulation
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8 Verified Questions
8 Flashcards
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Sample Questions
Q1) What is the priority nursing action for a patient suspected to be hypothermic?
A) Assess vital signs.
B) Hydrate with intravenous (IV) fluids.
C) Provide a warm blanket.
D) Remove wet clothes.
Q2) 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
Q3) The nursery nurse should identify which newborn at significant risk for hypothermic alteration in thermoregulation?
A) Large for gestational age
B) Low birth weight
C) Born at term
D) Well nourished
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Chapter 11: Sleep
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7 Flashcards
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Sample Questions
Q1) A patient complains of not being able to fall asleep at night and asks the nurse if there is a safe, non-prescription medication he can try. After consulting the healthcare provider, the nurse should recommend which naturally occurring hormone?
A) Melatonin
B) Cortisol
C) Leutinizing hormone
D) Estrogen
Q2) The nurse is caring for a child with tonsillar enlargement. What is the nurse's priority concern?
A) Low oxygen saturation
B) Daytime fatigue
C) Increased temperature
D) Antibiotic administration
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Chapter 12: Cellular Regulation
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) A female patient complains of a "scab that just won't heal" under her left breast. During your conversation, she also mentions chronic fatigue, loss of appetite, and slight cough, attributed to allergies. What is the nurse's best action?
A) Continue to conduct a symptom analysis to better understand the patient's symptoms and concerns.
B) End the appointment and tell the patient to use skin protection during sun exposure.
C) Suggest further testing with a cancer specialist and provide the appropriate literature.
D) Tell her to put a bandage on the scab and set a follow-up appointment in one week.
Q2) The nurse is caring for a patient who received a bone marrow transplant 10 days ago. The nurse would monitor for which of the following clinical manifestations that could indicate a potentially life-threatening situation?
A) Mucositis
B) Confusion
C) Depression
D) Mild temperature elevation
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Chapter 13: Intracranial Regulation
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Sample Questions
Q1) The nurse preparing to care for a patient after a suspected stroke would question which order?
A) Antihypertensive
B) Antipyretic
C) Osmotic diuretic
D) Sedative
Q2) Which assessment finding would be the earliest and most sensitive indicator that there is an alteration in intracranial regulation?
A) Change in level of consciousness
B) Inability to focus visually
C) Loss of primitive reflexes
D) Unequal pupil size
Q3) When caring for a patient after a head injury, the nurse would be most concerned with assessment findings which included respiratory changes along with what other findings?
A) Hypertension and bradycardia
B) Hypertension and tachycardia
C) Hypotension and bradycardia
D) Hypotension and tachycardia
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Page 15
Chapter 14: Hormonal Regulation
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Sample Questions
Q1) The nurse is caring for a patient who has undergone a thyroidectomy. Which patient complaint is highest priority requiring further evaluation?
A) Pain at surgical site
B) Thirst
C) Hoarseness
D) Nausea
Q2) The nurse is caring for a patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What is the nurse's best action?
A) Encourage increased fluid and water intake
B) Teach about risk for malignancies
C) Monitor for changes in level of consciousness
D) Assess labwork for potassium level changes
Q3) Radioactive iodine is indicated for the treatment of hyperthyroidism. The nurse should include which teaching in this patient's plan of care?
A) Isolation is required for 6-8 weeks
B) An additional dose may be needed
C) Thyroid replacement therapy is prescribed
D) An overnight hospital stay is required
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16
Chapter 15: Glucose Regulation
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Sample Questions
Q1) The nurse associates which assessment finding in the diabetic patient with decreasing renal function?
A) Ketone bodies in the urine during acidosis
B) Glucose in the urine during hyperglycemia
C) Protein in the urine during a random urinalysis
D) White blood cells in the urine during a random urinalysis
Q2) What is the nurse's best response about developing diabetes to the patient whose father has type 1 diabetes mellitus?
A) "You have a greater susceptibility for development of the disease because of your family history."
B) "Your risk is the same as the general population, because there is no genetic risk for development of type 1 diabetes."
C) "Type 1 diabetes is inherited in an autosomal dominant pattern. Therefore the risk for becoming diabetic is 50%."
D) "Because you are a woman and your father is the parent with diabetes, your risk is not increased for eventual development of the disease. However, your brothers will become diabetic."
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Chapter 16: Nutrition
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8 Flashcards
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Sample Questions
Q1) During a nutritional assessment, the nurse calculates that a female patient's BMI is 27. The nurse would advise the patient to follow which of these recommendations?
A) This measurement indicates that the patient is overweight and should follow a plan of diet and exercise to lose weight.
B) This measurement indicates that the patient is underweight and will need to take measures to gain weight.
C) This measurement indicates that the patient is morbidly obese and may be a candidate for bariatric surgery.
D) This measurement indicates that the patient is of normal weight and should continue with current lifestyle.
Q2) During a physical examination, the nurse notes that the patient's skin is dry and flaking. What additional data would the nurse expect to find to confirm the suspicion of a nutritional deficiency?
A) Hair loss and hair that is easily removed from the scalp
B) Inflammation of the tongue and fissured tongue
C) Inflammation of peripheral nerves and numbness and tingling in extremities
D) Fissures and inflammation of the mouth
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Chapter 17: Elimination
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Sample Questions
Q1) A patient who was diagnosed with senile dementia has become incontinent of urine. The patient's daughter asks the nurse why this is happening. What is the nurse's best response?
A) "The patient is angry about the dementia diagnosis."
B) "The patient is losing sphincter control due to the dementia."
C) "The patient forgets where the bathroom is located due to the dementia."
D) "The patient wants to leave the hospital."
Q2) What is a primary prevention tool used for colon cancer screening?
A) Abdominal x-rays
B) Blood, urea, and nitrogen (BUN) testing
C) Serum electrolytes
D) Occult blood testing
Q3) The nurse is caring for a patient who has suffered a spinal cord injury and is concerned about the patient's elimination status. What is the nurse's best action?
A) Speak with the patient's family about food choices.
B) Establish a bowel and bladder program for the patient.
C) Speak with the patient about past elimination habits.
D) Establish a bedtime ritual for the patient.
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Page 19
Chapter 18: Perfusion
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Sample Questions
Q1) A patient diagnosed with hypertension asks the nurse how this disease could have happened to them. What is the nurse's best response?
A) "Hypertension happens to everyone sooner or later. Don't be concerned about it."
B) "Hypertension can happen from eating a poor diet, so change what you are eating."
C) "Hypertension can happen from arterial changes that block the blood flow."
D) "Hypertension happens when people do not exercise, so you should walk every day."
Q2) A nurse is explaining to a student nurse about perfusion. The nurse knows the student understands the Chapter of perfusion when the student makes which statement?
A) "Perfusion is a normal function of the body, and I don't have to be concerned about it."
B) "Perfusion is monitored by the physician."
C) "Perfusion is monitored by vital signs and capillary refill."
D) "Perfusion varies as a person ages, so I would expect changes in the body."
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Chapter 19: Gas Exchange
10 Verified Questions
10 Flashcards
Source URL: https://quizplus.com/quiz/2340
Sample Questions
Q1) The nurse is assessing a patient's differential white blood cell count. What implications would this test have on evaluating the adequacy of a patient's gas exchange?
A) An elevation of the total white cell count indicates generalized inflammation.
B) Eosinophil count will assist to identify the presence of a respiratory infection.
C) White cell count will differentiate types of respiratory bacteria.
D) Level of neutrophils provides guidelines to monitor a chronic infection.
Q2) A 3-month-old infant is at increased risk for developing anemia. The nurse would identify which principle contributing to this risk?
A) The infant is becoming more active.
B) There is an increase in intake of breast milk or formula.
C) The infant is unable to maintain an adequate iron intake.
D) A depletion of fetal hemoglobin occurs.
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Chapter 20: Clotting
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Sample Questions
Q1) The nurse is making a home visit to a patient who was discharged from the hospital on Lovenox and warfarin following replacement of the patient's pacemaker. Which observation indicates excessive bleeding? (Select all that apply.)
A) New ecchymosis on the abdomen
B) A nosebleed that does not stop with pressure
C) Pain of the lower extremity with flexion
D) Extreme fatigue
E) Pallor
F) Sudden onset of severe headache
Q2) The nurse would expect to administer an anticoagulant to a patient following which surgery?
A) Hip replacement
B) Hysterectomy
C) Abdominal aorta aneurism (AAA) repair
D) Appendectomy
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22
Chapter 21: Reproduction
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Sample Questions
Q1) A female infertility patient is found to be hypoestrogenic at the preChapterual clinic visit. She asks the nurse why she has never been able to get pregnant. Which response is best?
A) Circulating estrogen contributes to secondary sex characteristics.
B) Estrogen deficiency prevents the ovum from reaching the uterus and may be a factor in infertility.
C) Hyperestrogen may be preventing the zona pellucida from forming an ovum protective layer.
D) The corona radiata is preventing fertilization of the ovum.
Q2) A female college student is planning to become sexually active. She is considering birth control options and desires a method in which ovulation will be prevented. To prevent ovulation while reaching 99% effectiveness in preventing pregnancy, which option should be given the strongest consideration?
A) Intrauterine device
B) Coitus interruptus
C) Natural family planning
D) Oral contraceptive pills
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23
Chapter 22: Sexuality
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Sample Questions
Q1) When assessing high-risk behaviors, which question specifically identifies a blood-related risk for a sexually transmitted infection?
A) "Have you ever received donor semen, eggs, or transplanted tissue?"
B) "Have you ever exchanged sex for drugs, money, or shelter?"
C) "How do you protect yourself from HIV and sexually transmitted infections?"
D) "Have you ever injected drugs using shared equipment?"
Q2) A 55-year-old male patient post-myocardial infarction (MI) asks the nurse whether he will be healthy enough for sexual activity after discharge from the hospital. The patient has been prescribed anti-hypertensives and beta-blockers. During health teaching, the nurse understands that the three phases of the four-stage model of the human sexual response cycle that are of concern for this patient include which phases?
A) Excitement, plateau, and orgasmic
B) Plateau, orgasmic, and resolution
C) Excitement, orgasmic, and resolution
D) Arousal, excitement, and plateau
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24
Chapter 23: Immunity
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Sample Questions
Q1) An 18-month-old female patient is diagnosed with her fifth ear infection in the past 10 months. The physician notes that the child's growth rate has decreased from the 60th percentile for height and weight to the 15th percentile over that same time period. The child has been treated for thrush consistently since the third ear infection. The nurse understands that the patient is at risk for which condition?
A) Primary immunodeficiency
B) Secondary immunodeficiency
C) Cancer
D) Autoimmunity
Q2) The nurse is caring for a patient who is being discharged home after a splenectomy. What information on immune function needs to be included in this patient's discharge planning?
A) The mechanisms of the inflammatory response
B) Basic infection control techniques
C) The importance of wearing a face mask in public
D) Limiting contact with the general population
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Chapter 24: Inflammation
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Sample Questions
Q1) The nurse assesses the patient and notes all of the following. Select all of the findings that indicate the systemic manifestations of inflammation.
A) Oral temperature 38.6° C/101.5° F
B) Thick, green nasal discharge
C) Patient complaint of pain at 6 on a 0 to 10 scale on palpation of frontal and maxillary sinuses
D) WBC 20 cells/McL \(\times\) 10<sup>9</sup>/L
E) Patient reports, "I'm tired all the time. I haven't felt like myself in days."
Q2) The nurse reviews the patient's complete blood count (CBC) results and notes that the neutrophil levels are elevated, but monocytes are still within normal limits. This indicates what type of inflammatory response?
A) Chronic
B) Resolved
C) Early stage acute
D) Late stage acute
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Chapter 25: Infection
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Sample Questions
Q1) Which set of assessment data is consistent for a patient with severe infection that could lead to system failure?
A) Blood pressure (BP) 92/52, pulse (P) 56 beats/min, respiratory rate (RR) 10 breaths/min, urine output 1200 mL in past 24 hours
B) BP 90/48, P 112 beats/min, RR 26 breaths/min, urine output 240 mL in past 24 hours
C) BP 112/64, P 98 beats/min, RR 18 breaths/min, urine output 2400 mL in past 24 hours
D) BP 152/90, P 52 beats/min, RR 12 breaths/min, urine output 4800 mL in past 24 hours
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 which element?
A) Host
B) Mode of transmission
C) Portal of entry
D) Reservoir
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Chapter 26: Mobility
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Sample Questions
Q1) Mobility for the patient changes throughout the life span. What is the term that best describes this process?
A) Aging and illness
B) Illness and disease
C) Health and wellness
D) Growth and development
Q2) The nurse is talking to the unlicensed assistive personnel about moving a patient in bed. The nurse knows the unlicensed assistive personnel understands the Chapter of mobility and proper moving techniques when making which statement?
A) "Patients must have a trapeze over the bed to move properly."
B) "Patients should move themselves in bed to prevent immobility."
C) "Patients should always have a two-person assist to move in bed."
D) "Patients must be moved correctly in bed to prevent shearing."
Q3) The lack of weight bearing leads to what effects on the skeletal system?
A) Demineralization, calcium loss
B) Thickened bones
C) Increased range of motion
D) Increased calcium deposition in the bones
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Chapter 27: Tissue Integrity
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Sample Questions
Q1) The nurse is instructing the nursing assistant to prevent pressure ulcers in a frail older patient. Which action indicates the nursing assistant has understood the nurse's teaching?
A) Bathing and drying the skin vigorously to stimulate circulation
B) Keeping the head of the bed elevated 30 degrees
C) Limiting intake of fluid and offer frequent snacks
D) Turning the patient at least every 2 hours
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) A patient is to receive phototherapy for the treatment of psoriasis. What is the nursing priority for this patient?
A) Obtaining a complete blood count (CBC)
B) Protection from excessive heat
C) Protection from excessive ultraviolet (UV) exposure
D) Instructing the patient to take their multivitamin prior to treatment
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Page 29
Chapter 28: Sensory Perception
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Sample Questions
Q1) The nurse is examining the eyes of a newborn infant. If the nurse notes the absence of the red reflex, what is the next best action?
A) Notify the physician.
B) Document the finding in the records.
C) Recheck the reflex after several hours.
D) Monitor the eye movements and pupil reactions closely.
Q2) A 75-year-old woman walks into the emergency department with complaints of "not feeling well." Her blood pressure is 145/95, pulse 85 beats/min, respirations 24 breaths/min, and blood sugar 300. Upon inspection, the nurse notices that the woman has an open wound on the bottom of her foot, but the patient states she is not aware of this. How should the nurse interpret these findings?
A) Normal in the older adult
B) A need for the patient to be evaluated for cognitive impairment
C) A side effect of anti-hypertensive medication
D) Pathologic impairment of sensory responses
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Chapter 29: Pain
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Sample Questions
Q1) A 70-year-old retired nurse is interested in nondrug, mind-body therapies, self-management, and alternative strategies to deal with joint discomfort from rheumatoid arthritis. What options should you consider in her plan of care considering her expressed wishes?
A) Stationary exercise bicycle, free weights, and spinning class
B) Mind-body therapies such as music therapy, distraction techniques, meditation, prayer, hypnosis, guided imagery, relaxation techniques, and pet therapy
C) Chamomile tea and IcyHot gel
D) Acupuncture and attending church services
Q2) A 62-year-old male has fallen while trimming tree branches sustaining tissue injury. He describes his condition as an aching, throbbing back. This is characteristic of what type of pain?
A) Neuropathic pain
B) Nociceptive pain
C) Chronic pain
D) Mixed pain syndrome
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Chapter 30: Fatigue
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Sample Questions
Q1) The nurse palpates swollen nodes in a patient's neck who presented to the clinic with complaints of fatigue lasting at least 2 weeks. What is the nurse's best action?
A) Advise patient this finding is normal.
B) Review patient's thyroid labwork.
C) Perform deep tendon reflexes.
D) Notify the healthcare provider.
Q2) A patient with chronic kidney disease is most likely to complain of which symptom?
A) Fatigue
B) Thirst
C) Constipation
D) Excess bleeding
Q3) The nurse recognizes that which patients are at highest risk for physiologic fatigue? (Select all that apply.)
A) Parents of a newborn
B) Adolesent with anorexia
C) 25-year-old pregnant female
D)Grandmother who takes 1/2 mile walks
E) Businessman who consumes six cups coffee/day
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Chapter 31: Stress
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Sample Questions
Q1) Which action should the nurse take to monitor the effects of an acute stressor on a hospitalized patient? (Select all that apply.)
A) Assess for bradycardia.
B) Ask about epigastric pain.
C) Observe for increased appetite.
D) Check for elevated blood glucose levels.
E) Monitor for a decrease in respiratory rate.
Q2) The nurse is planning to teach a patient how to use relaxation techniques to prevent elevation of blood pressure and heart rate. The nurse is teaching the patient to control which physiological function?
A) Switch from the sympathetic mode of the autonomic nervous system to the parasympathetic mode.
B) Alter the internal state by modifying electronic signals related to physiologic processes.
C) Replace stress-producing thoughts and activities with daily stress-reducing thoughts and activities.
D) Reduce catecholamine production and promote the production of additional beta-endorphins.
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Chapter 32: Coping
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Sample Questions
Q1) The nurse is developing a care plan for a patient with ineffective coping skills. Which intervention would be an example of a problem-focused coping strategy?
A) Scheduling a regular exercise program
B) Attending a seminar on treatment options
C) Identifying a confidant to share feelings
D) Attending a support group for families
Q2) 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.
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Chapter 33: Mood and Affect
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Q1) A patient newly diagnosed with depression states, "I have had other people in my family say that they have depression. Is this an inherited problem?" What is the nurse's best response?
A) "There are a lot of mood disorders that are caused by many different causes. Inheriting these disorders is not likely."
B) "Current research is focusing on fluid and electrolyte disorders as a cause for mood disorders."
C) "All of your family members raised in the same area have probably learned to respond to problems in the same way."
D) "Members of the same family may have the same biological predisposition to experiencing mood disorders."
Q2) 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
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Page 35
Chapter 34: Anxiety
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Sample Questions
Q1) A patient complains of insomnia during his stay in the hospital. Which nursing diagnosis would be a top priority for this patient?
A) Anxiety related to hospitalization
B) Ineffective Coping related to hospitalization
C) Denial related to hospitalization
D) High Risk for Insomnia related to hospitalization
Q2) The nurse is assessing the social support of a patient who is recently divorced and has moved from their hometown to the city due to change in jobs. Which response related to social support would be most therapeutic?
A) Encourage the patient to begin dating again, perhaps with members of her church.
B) Discuss how divorce support groups could increase coping and social support.
C) Note that being so particular about potential friends reduces social contact.
D) Discuss using the Internet as a way to find supportive others with similar values.
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Chapter 35: Cognition
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Q1) A nurse working in a pediatric clinic recognizes that which child is most at risk for cognitive impairment?
A) An infant who is being fed reconstituted powdered formula
B) A toddler living in an older home that is being remodeled
C) A preschooler who attends a play group 3 days a week
D) A school-age child who rides a school bus 5 days a week
Q2) The nurse is reviewing new medication orders for several patients in a long-term care facility. Which patient does the nurse recognize as being at the highest risk for having cognitive impairment related to prescribed medications?
A) The patient prescribed an antibiotic for a urinary tract infection.
B) The patient prescribed a cholinesterase inhibitor for early Alzheimer's disease.
C) The patient prescribed a beta-blocker for hypertension.
D) The patient prescribed a bisphosphonate for osteoporosis.
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Chapter 36: Psychosis
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Q1) The nurse is planning discharge teaching for a patient taking clozapine. Which information is essential to include in the teaching plan?
A) Caution about sunlight exposure
B) Reminder to call the clinic if fever, sore throat, or malaise develops
C) Instructions regarding dietary restrictions
D) A chart to record patient weight
Q2) A client with schizophrenia has relapsed and has been identified as being in stage four of relapse. The nurse expects to observe which behavior that most consistent with this stage of relapse?
A) Expressing feelings of anxiety
B) Expressing feelings of being overwhelmed
C) Bizarre behaviors and speech
D) Presence of hallucinations
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Chapter 37: Addiction
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Q1) Strategies that a nurse could use in a motivational interview to increase the chances of change include which of the following? (Select all that apply.)
A) Educating the patient on the physical damage the substance is causing
B) Encouraging the patient to think of ways to change environmental triggers to abuse substances
C) Asking the patient how they think substance abuse affects their family life
D) Explaining to the patient that substance abuse affects everyone in the family and give examples
E) Asking the patient what methods they think would work and encouraging participating in self-help groups
Q2) A patient who was admitted 24 hours ago has become increasingly irritable and now says there are bugs on his bed. Which condition should the nurse suspect?
A) Alcohol-induced psychosis
B) Delirium tremens (DTs)
C) Neurologic injury related to a fall
D) Posttraumatic stress reaction
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Chapter 38: Interpersonal Violence
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Q1) A nurse is caring for a patient in the emergency department who has been a victim of intimate partner violence. What is most important for the nurse to include in the plan of care?
A) Medication to calm the perpetrator of the violence
B) A list of community resources
C) A referral for self-defense training
D) A referral to the victim's religious advisor
Q2) The nurse working at a women's health clinic is seeing a teenage female patient who has come in for a refill on her birth control medication and with a complaint of abdominal pain. When the nurse enters the room, the patient is sitting in the chair with her head down, rocking back and forth, does not make eye contact, and answers questions with no expression on her face. What assessment question would be important for the nurse to ask the patient?
A) "What brings you to the clinic today?"
B) "What can we do to help you today?"
C) "Do you feel safe in your current relationship?"
D) "Have you changed your diet lately?"
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Page 40
Chapter 39: Professional Identity
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Q1) A new registered nurse asks the registered nurse (RN) preceptor what could be done to become more professional. What is the preceptor's best response?
A) "Attend nursing educational meetings."
B) "Listen to other nurses."
C) "Read the agency newsletter."
D) "Pass the licensing exam."
Q2) The scope of professional nursing practice is determined by the rules promulgated by which organization?
A) American Nurses' Association (ANA)
B) Institute of Medicine (IOM)
C) State Board of Nursing
D) State Nursing Association
Q3) Nursing demonstrates dedication to improving public health through which avenue?
A) Changing health care standards
B) Legal regulations
C) Scope of practice
D) Technology
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Chapter 40: Clinical Judgment
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Q1) A student nurse is studying clinical judgment theories and is working with Tanner's Model of Clinical Judgment. How can the student nurse best generalize this model?
A) A reflective process where the nurse notices, interprets, responds, and reflects in action
B) One conceptual mechanism for critiquing ideas and establishing goal-oriented care
C) Researching best practice literature to create care pathways for certain populations
D) Assessing, diagnosing, implementing, and evaluating the nursing care plans
Q2) A nurse has designed an individualized nursing care plan for a patient, but the patient is not meeting goals. Further assessment reveals that the patient is not following through on many items. Which action by the nurse would be best for determining the cause of the problem?
A) Assess whether the actions were too hard for the patient.
B) Determine whether the patient agrees with the care plan.
C) Question the patient's reasons for not following through.
D) Reevaluate data to ensure the diagnoses are sound.
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Chapter 41: Leadership
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Q1) The hospital must reduce the number of readmissions from 11% to 8% in the next year. Which of the following best represents the transformational leadership style in accomplishing this goal?
A) The director communicates the goal of reducing readmissions to the hospital operations team and tells them to submit their action plan by the end of the week.
B) The organization charters three work teams to identify solutions for the top three causes for readmissions. These teams are given full authority to implement their solution.
C) The director of quality develops a vision statement and action plan to achieve the goal. The director works directly with the involved departments to implement the action plan.
D) The CEO communicates the goal to the organizational directors and managers and states that they are entrusted to solve the problem.
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Chapter 42: Ethics
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Q1) A nursing student is conducting a survey of fellow nursing students. Which ethical Chapter is the student following when calculating the risk-to-benefit ratio and concluding that no harmful effects were associated with a survey?
A) Beneficence
B) Human dignity
C) Justice
D) Human rights
Q2) A nurse on the unit makes an error in the calculation of the dose of medication for a critically ill patient. The patient suffered no ill consequences from the administration. The nurse decides not to report the error or file an incident report. The nurse is violating which principle of ethics?
A) Fidelity
B) Individuality
C) Justice
D) Values clarification
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Chapter 43: Patient Education
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Sample Questions
Q1) Barriers to patient education the nurse considers in implementing a teaching plan include which factor?
A) Family resources
B) High school education
C) Hunger and pain
D) Need perceived by patient
Q2) What is the most appropriate resource to include when planning to provide patient education related to a goal in the psychomotor domain?
A) Diagnosis-related support groups
B) Internet resources
C) Manikin practice sessions
D) Self-directed learning modules
Q3) Strategies to include in a teaching plan for an adult who has repeatedly not followed the written discharge instructions would include which information source?
A) Individualized handout
B) Instructional videos
C) Internet resources
D) Self-help books
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Chapter 44: Health Promotion
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Q1) Interrelated Chapters to professional nursing a nurse manager would consider when addressing concerns about the quality of health promotion include which Chapters? (Select all that apply.)
A) Culture
B) Development
C) Evidence
D) Nutrition
E) Health policy
Q2) Which tertiary prevention measure should be included in the health promotion plan of care for a patient newly diagnosed with diabetes?
A) Avoiding carcinogens
B) Foot screening techniques
C) Glaucoma screening
D) Seat belt use
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Chapter 45: Communication
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Sample Questions
Q1) The nurse is working with a patient diagnosed with posttraumatic stress disorder related to childhood sexual abuse. The patient is crying and states, "I should be over this by now; this happened years ago." Which response(s) by the nurse will facilitate communication? (Select all that apply.)
A) "Why do you think you are so upset?"
B) "I can see that this situation really bothers you."
C) "The abuse you endured is very painful for you."
D) "Crying is a way of expressing the hurt you're experiencing."
E) "Let's talk about something else, since this subject is upsetting you."
Q2) 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 46: Collaboration
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Q1) Which patient scenario describes the best example of professional collaboration?
A) The nurse, physician, and physical therapist have all visited separately with the patient.
B) The nurse, physical therapist, and physician have all developed separate care plans for the patient.
C) The nurse mentions to the physical therapist that the patient may benefit from a muscle strengthening evaluation.
D) The nurse and physician discuss the patient's muscle weakness and initiate a referral for physical therapy.
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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Chapter 47: Safety
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Q1) To promote a safety culture, the nurse manager preparing the staff schedule considers the anticipated census in planning the number and experience of staff on any given shift. Which is the human factor primarily addressed with this consideration?
A) Available supplies
B) Interdisciplinary communication
C) Interruptions in work
D) Workload fluctuations
Q2) A staff nurse reports a medication error due to failure to administer a medication at the scheduled time. What is the charge nurse's best response?
A) "We'll conduct 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) Which is an essential element of a standard order set to verify a medication order?
A) Volume only
B) Number of tablets
C) Metric dose/strength
D) Hour of administration
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Chapter 48: Technology and Informatics
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Q1) The application of information processing that deals with the storage, retrieval sharing, and use of health care data, information, and knowledge for communication and decision making is the definition of which area?
A) Computer science
B) Health informatics
C) Health information technology
D) Nursing informatics
Q2) When discussing the purposes of health care informatics with a nurse during orientation, the nurse educator would be concerned if the nurse orientee stated that which is one purpose of informatics?
A) Develop a cognitive science.
B) Improve disease tracking.
C) Improve the health provider's work flow.
D) Increase administrative efficiencies.
Q3) Which are exemplars of the health informatics Chapter?
A) Clinical research informatics
B) Hardware and software
C) Privacy and security
D) Standard terminology
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Page 50
Chapter 49: Evidence
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Q1) The nurse in the psychiatric unit is involved in a research study for a depression medication. In the study, patients are randomly assigned to one depression medication and the other group is receiving no medication to treat the depression. What method of research are the patients involved with?
A) Descriptive
B) Correlational
C) Quasi-experimental
D) Experimental
Q2) One of the first nurse researchers to document evidence-based practice for nursing was Florence Nightingale. What did Nightingale incorporate into her practice that made her practice different from her colleagues?
A) Nightingale gathered scientific data.
B) Nightingale calculated statistics to report her findings.
C) Nightingale communicated her findings to powerful others.
D) Nightingale based her nursing practice on her findings.
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Chapter 50: Health Care Quality
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Q1) Which statement is true regarding the patient's perception of his or her care?
A) Patent perception is just as important as the outcome of care.
B) Patient perception is insignificant compared to the outcome of care.
C) Patient satisfaction has no relation to quality of care.
D) Patient satisfaction is insignificant compared to the outcome of care.
Q2) What are two major foci of The Joint Commission (TJC) in the delivery of health care?
A) Cost containment; safety
B) Safety; quality
C) Quality; assessment
D) Assessment; evaluation
Q3) A student nurse and clinical instructor are discussing quality in health care. The instructor knows the student understands when the student makes which statement?
A) "Quality is apparent in all health care."
B) "Quality is an outcome of health care."
C) "Quality is seen and unseen in health care."
D) "Quality is achieved by collaboration in health care."
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Chapter 51: Care Coordination
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Q1) For children and teens, which model includes school-based services?
A) Social
B) Integrated
C) Medically-Oriented
D) Nurse-Oriented
Q2) 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 making which statement?
A) "Health care is available for everyone at every time."
B) "Health care needs are best met with a collaborative effort."
C) "Health care is adequately meeting the needs of the homeless populations."
D) "Health care needs are mostly in third world countries."
Q3) A nursing instructor is talking about care coordination with nursing students. The instructor stresses which of the following to the students concerning care coordination?
A) "A patient must ask for what they need in order to coordinate care."
B) "The nurse does most of the work in care coordination."
C) "Medical diagnoses are an integral part of care coordination."
D) "Collaboration is a significant part of care coordination."
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Chapter 52: Caregiving
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Q1) The nurse is counseling a woman who is caring for her 83-year-old father. The father has had mental changes and is becoming more confused. The father lives with the daughter in her home. The nurse knows the daughter understands the father's care needs when she states which of the following?
A) "Dad will only need my help for a short time, and then he will get better."
B) "I can leave dad alone during the day; I'll just deadbolt the door."
C) "I can send dad to the adult daycare; that way I can work and care for him at night."
D) "Dad misses mom since she passed; he will be okay in a few weeks."
Q2) Many middle-aged adults are called the "sandwich" generation because they are caring for their children and their aging parents. What is the priority reason for aging parents needing care?
A) Mental clarity
B) Immobility
C) Blindness
D) Multiple chronic illnesses
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Chapter 53: 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) The interprofessional core team includes members from which disciplines?
A) Nursing, medicine, volunteers, and nutrition
B) Medicine, nursing, social work, and clergy
C) Medicine, nursing, physical therapists, and volunteers
D) Nursing, home health aides, volunteers, and clergy
Q3) What is the most prominent goal of palliative care?
A) Integrate into chronic disease management sooner rather than later.
B) Enroll the patient into the Medicare Hospice Benefit.
C) Ensure that the patient has a 6-month prognosis.
D) Reserve this type of care until the patient is actively dying.
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55
Chapter 54: Health Disparities
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Q1) The nurse is caring for a Chinese patient diagnosed with cancer who is suffering from pain, yet refuses analgesia administration. What type of health disparities is this patient exhibiting?
A) Avoidable and acceptable
B) Avoidable and unacceptable
C) Unavoidable and acceptable
D) Unavoidable and unacceptable
Q2) The nurse who has been hired to work on an oncology unit identifies which group of women as being at highest risk of developing breast cancer?
A) African
B) Caucasian
C) Asian
D) Hispanic
Q3) Which type of health disparities are most frequently encountered by nurses in clinical and community settings?
A) Avoidable and acceptable
B) Avoidable and unacceptable
C) Unavoidable and acceptable
D) Unavoidable and unacceptable
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Chapter 55: Health Care Organizations
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Q1) A hospital organization is working to improve a feeling of being valued and respected among all staff members. Which action by administration would reinforce the feeling of being valued?
A) Create professional pathways that require advanced education for any advancement of staff.
B) Seek staff input when planning a remodeling project of patient rooms.
C) Form committees that consist of upper management to plan organizational goals.
D) Consistently schedule required staff meetings at the same time each month.
Q2) A hospital organization is applying for Magnet status to show excellence in nursing practice. What components would indicate that the hospital is meeting Magnet principles? (Select all that apply.)
A) The education budget for nursing has been cut to provide for new laboratory equipment.
B) On average, 40% of new nurses are leaving within 1 year of hire.
C) Nurses are active participants on all major hospital committees.
D) Quality improvement projects are planned and evaluated by nurses.
E) Patient care outcome data are reported in the annual executive board meeting.
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Chapter 56: Health Care Economics
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Q1) An accountable care organization (ACO) seeks to deliver which of the following aspects of health care? (Select all that apply.)
A) Lessen Medicare payments
B) Integrate care
C) Enhance evidence-based practices
D) Manage acute conditions
E) Support hospice charges
Q2) The US health care system is different from that of other countries in which way?
A) The US charges money from the private sector only.
B) US health care is funded from private organizations.
C) The US health care system is not entirely government funded.
D) The US health care treats the older person first.
Q3) A student asks the instructor about health care economics. The instructor knows the student understands when the student makes which statement?
A) "The elderly population uses most of the health care services."
B) "Everyone should have health insurance to obtain services."
C) "Health care dollars should be partitioned by the government."
D) "Resources will be needed to serve health care issues."
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Chapter 57: Health Policy
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Q1) Which of the following is the intent of HIPAA?
A) Release of patient information for purposes of insurance reimbursement.
B) Prevent health care providers from billing for procedures done for the insured person.
C) Protect patients from reviewing their own medical records.
D) Limit the ability of health care providers to sell patient information to outside sources.
Q2) 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
Q3) Which level of government is responsible for the regulation of a nurse's license?
A) Federal government
B) State government
C) Local government
D) International coalition
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Chapter 58: Health Care Law
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Sample Questions
Q1) The new nurse correctly defines a law when stating which information?
A) "Law is a fundamental concept for health care professionals."
B) "Law's rule is developed by the employee's organization."
C) "Law's rule is enacted by a government agency that defines what must be done in a given circumstance."
D) "Law is a mandate from the Joint Commission or other accrediting agency."
Q2) In which of the following answers is the hospital in compliance with the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA)?
A) The emergency department staff asks a patient to stay in the waiting room until the patients with insurance are treated.
B) The emergency registration personnel explain to a patient that they must have proper identification to receive treatment.
C) A patient with chest pain is triaged directly to a room for evaluation and registration information is obtained after the patient is stabilized.
D) The emergency department physician discharges and instructs a patient who is actively suicidal to go the neighbor facility that has psychiatric services.
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Page 60