Patient-Centered Care
Exam Answer Key
Course Introduction
Patient-Centered Care is a course that emphasizes the importance of placing patients and their families at the core of the healthcare experience. It explores the foundational principles of respectful, individualized, and holistic care, focusing on effective communication, shared decision-making, and the incorporation of patient preferences and values into clinical practice. Students will develop skills to collaborate with patients as active partners in their own health, enhance cultural competence, and apply ethical frameworks to ensure dignity and empathy in all healthcare settings. The course also addresses strategies to improve health outcomes, patient satisfaction, and overall quality of care through evidence-based practices.
Recommended Textbook
Fundamentals of Nursing Active Learning for Collaborative Practice 1st Edition by Yoost
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42 Chapters
1050 Verified Questions
1050 Flashcards
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Chapter 1: Nursing, Theory, and Professional Practice
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25 Verified Questions
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Sample Questions
Q1) The nurse is caring for a patient who refuses two units of packed red blood cells. The nurse notifies the health care provider of the patient's decision. The nurse is acting in the role of the:
A) Manager.
B) Change agent.
C) Advocate.
D) Educator.
Answer: C
Q2) The nurse is determining the patient care assignments for a nursing unit. Which of the following responsibilities may be delegated to the licensed practical nurse?
A) Initiating the nursing care plans
B) Formulating nursing diagnoses
C) Assessing a newly admitted patient
D) Administering oral medications
Answer: D
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Chapter 2: Values, Beliefs, and Caring
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Sample Questions
Q1) Which action observed by a nurse manager may be indicative of codependency behavior?
A) A staff nurse orders extra desserts for a patient diagnosed with morbid obesity.
B) A medication nurse administers scheduled pain medication to patients as ordered.
C) A respiratory therapist teaches a patient's wife how to adjust an oxygen mask.
D) A nursing assistant encourages a patient to assist with the morning bath.
Answer: A
Q2) The nurse is caring for a patient who is under arrest for murder. She is attempting to perform her duties while, at the same time, feeling a sense of repugnance toward the patient. The nurse is undergoing:
A) value clarification
B) value conflict
C) first-order beliefs
D) higher-order beliefs
Answer: B
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4
Chapter 3: Communication
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Sample Questions
Q1) The nursing student is writing a report on the use of nonverbal techniques to encourage therapeutic communication. Which examples should be included in the report? (Select all that apply.)
A) Providing a backrub
B) Remaining silent
C) Avoiding distracting body movements
D) Facing the patient
E) Nodding
Answer: A, B, C, D
Q2) A mother of a young child kicks a trashcan in anger and says to the nurse, "You just don't understand! Why can't the doctor find out what is wrong with my child?" This behavior is most likely an example of:
A) suppression
B) sublimation
C) displacement
D) rationalization
Answer: C
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Chapter 4: Critical Thinking in Nursing
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Sample Questions
Q1) The nurse completes the health interview and physical exam on a patient admitted with an infection of the gallbladder. The nurse reviews the medical record and compares the abnormal lab results to the normal standards. Which critical thinking skill is the nurse using in this part of the nursing process?
A) Interpretation
B) Analysis
C) Evaluation
D) Inference
Q2) A patient is admitted to a skilled nursing facility with a closed head injury. The nurse believes that the patient has been pocketing food in his cheeks during the noon meal although she has not found any food pocketed. The nurse refers the patient to the speech therapist for a swallowing evaluation. The nurse is using which critical thinking component in making this decision?
A) Inference
B) Deductive reasoning
C) Intuition
D) Inductive reasoning
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Chapter 5: Introduction to the Nursing Process
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Sample Questions
Q1) The nurse is assisting a patient to bed when the patient says, "My chest hurts and my left arm feels numb. What's wrong with me?" What is the type and source of data obtained from the patient's complaint?
A) Objective data from a primary source
B) Objective data from a secondary source
C) Subjective data from a primary source
D) Subjective data from a secondary source
Q2) The nursing process is cyclic rather than linear. Because of the cyclic nature, as an individual patient's condition changes:
A) The nurse's thought processes do not have to vary.
B) Plans of care are easier to use and do not need modification.
C) The accuracy and effectiveness of thought processes must be considered.
D) Reflective thought is not necessary since issues tend to be repetitive.
Q3) The nurse is gathering data on a patient with acute bacterial pneumonia. This is an example of which step of the nursing process?
A) Assessment
B) Planning
C) Implementation
D) Evaluation
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Page 7
Chapter 6: Assessment
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Sample Questions
Q1) The nurse is monitoring the blood sugar results of a patient receiving an intravenous nutritional supplement. The patient tells the nurse, "I have never had sugar problems before. My doctor says it is because I am getting this sugar water." These types of data are considered:
A) primary, objective data.
B) primary, subjective data.
C) secondary, objective data.
D) secondary, subjective data.
Q2) The nurse is performing a physical exam on a patient diagnosed with liver failure resulting from chronic alcoholism. The nurse notes that the abdomen is swollen and decides to assess for abdominal skin tenderness and temperature. Which of the following techniques would the nurse use to collect this data?
A) Inspection
B) Percussion
C) Palpation
D) Auscultation
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Chapter 7: Nursing Diagnosis
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Sample Questions
Q1) The nurse is caring for a complex patient needing physical and emotional support. As the primary care giver, the nurse:
A) is ultimately responsible for assessment of patient needs and progress.
B) delegates to people who know what they are doing and operate independently.
C) provides total care to the patient after getting direction from other disciplines.
D) understands that the patient is ultimately responsible for failure or success.
Q2) The nurse in an outpatient clinic obtains a blood pressure of 190/88 mm Hg on a patient diagnosed with high blood pressure. The patient tells the nurse, "My blood pressure medicine is really expensive. Do you think I really need it?" The nurse assumes the patient is not taking the medication based on the blood pressure result and the patient's statement and chooses noncompliance as a diagnostic label. The action by the nurse is an example of:
A) clustering unrelated data in the diagnostic statement.
B) selecting erroneous data for use in the diagnostic statement.
C) using medical diagnoses in the diagnostic statement.
D) identifying multiple problems within one diagnostic statement.
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Chapter 8: Planning
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Sample Questions
Q1) Which of the following is a correctly written example of a short-term goal?
A) By attending the gym, the patient will lose 50 lb in 1 year.
B) In 6 months, patient will be able to ambulate 1 mile without shortness of breath.
C) Patient will be able to change his colostomy bag within 6 weeks of surgery.
D) With diet and exercise, the patient will lose 1 lb this week.
Q2) The nurse is accurate when stating that adequate discharge planning:
A) "May decrease the incidence of patients required to return to the hospital."
B) "Increases complications and readmissions in most cases."
C) "Adapts to the situation as the patient's conditions changes."
D) "Should begin as soon as the patient is discharged home."
Q3) The nurse has a thorough understanding of the planning phase of the nursing process when stating:
A) "Patients should be included in the planning process."
B) "Patient families should not interfere in the planning process."
C) "The planning process should focus on short-term goals only."
D) "Planning is the first phase of the nursing process."
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Chapter 9: Implementation and Evaluation
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Sample Questions
Q1) The final phase of the nursing process is evaluation, which focuses on:
A) recording the care that was implemented.
B) medical and nursing goals for the welfare of the patient.
C) long-term goals only.
D) the patient responses to interventions and outcomes.
Q2) After the nurse completes a patient's initial assessment and develops a plan of care:
A) continual reassessment of the patient is required.
B) no changes to the care interventions should be allowed.
C) reassessment should be done randomly.
D) the nursing process becomes static to maintain the course of the cure.
Q3) During the evaluation phase of the nursing process, the nurse realizes that the patient's short-term goals have not been met. The nurse should:
A) revise or adapt the plan of care.
B) assume that the patient did not want to achieve his goals.
C) understand that a plan of care is almost never changed.
D) reassess plans of care only after major patient-nurse interactions.
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Chapter 10: Documentation, Electronic Health Records, and Reporting
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Sample Questions
Q1) The nurse is charting using electronic documentation. With electronic documentation:
A) errors can be corrected and totally removed from the record in the screen view.
B) log-on access to the electronic record identifies the person charting.
C) each entry requires the nurse to sign her/his name and credentials.
D) documenting significant changes in the electronic record ends the nurse's responsibility.
Q2) The nurse is admitting a patient who has had several previous admissions. In order to obtain a knowledge base about the patient's medical history, the nurse may use the:
A) electronic medical record (EMR).
B) the computerized provider order entry (CPOE).
C) electronic health record (EHR).
D) American Recovery and Reinvestment Act.
Q3) PIE, APIE, SOAP, and SOAPIE are:
A) chronologic.
B) examples of problem-oriented charting.
C) narrative charting.
D) forms of "charting by exception."
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Chapter 11: Ethical and Legal Considerations
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Sample Questions
Q1) In the nursing profession, ethical issues:
A) are rare occurrences, but take a great deal of time to resolve.
B) have required The Joint Commission to mandate ethics committees.
C) most frequently lead to legal intervention in patient care matters.
D) lead to ethics committees made up entirely by nurses.
Q2) The nurse is providing end-of-life care. It is essential for the nurse to:
A) tell the patient what he might like to hear to relieve anxiety.
B) begin making health care decisions for the patient.
C) provide the patient with the nurse's personal opinions.
D) offer unconditional support for the patient and family.
Q3) The nurse is providing care for a patient who has had a stroke recently and has multiple self-care deficits. The nurse is coordinating care with in-home agencies and arranging for the delivery of needed equipment. What ethical concept is being applied?
A) Advocacy
B) Confidentiality
C) Autonomy
D) Accountability
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Chapter 12: Leadership and Management
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Sample Questions
Q1) According to Fayol, controlling is a function of management. Controlling compares to what phase of the nursing process?
A) Evaluation
B) Diagnosis
C) Assessment
D) Implementation
Q2) Hiscock and Shuldham state that, in order to deliver quality care, it is important for nurse leaders to be focused on the:
A) patient.
B) self.
C) staff.
D) physician.
Q3) Which of the following has been done improperly?
A) The UAP re-delegates vital signs to the student nurse.
B) The RN delegates assistance with bathing to the student nurse.
C) The RN delegates monitoring of intake and output to the UAP.
D) The RN delegates assistance with mobility to the UAP.
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Chapter 13: Evidence-Based Practice and Nursing Research
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Sample Questions
Q1) A Magnet hospital is characterized by: (Select all that apply.)
A) excellent medical outcomes.
B) a high level of nursing job satisfaction.
C) a low number of grievances.
D) nursing care leading excellent patient outcomes.
E) a high nurse turnover rate.
Q2) The American Nurses Association (ANA) standards of professional performance require nurses to use research findings in practice. This means that nurses:
A) need to regulate their practice according to the latest journal articles.
B) nurses need to use the best available evidence to guide practice decisions.
C) nurses only need to participate in research while in advanced practice.
D) may use evidence-based practice to develop procedures but not policies.
Q3) The nurse is conducting a qualitative research study. Qualitative research:
A) is based on a constructivist philosophy.
B) assumes that reality is the same for everyone.
C) is deductive in nature and approach.
D) proceeds from specific facts to generalizations.
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Chapter 14: Health Literacy and Patient Education
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Sample Questions
Q1) To teach effectively, nurses must recognize that:
A) age and socioeconomic status play a large role in understanding.
B) 90% of Americans possess rudimentary literary skills.
C) the ability to comprehend is a very new concept in health care.
D) most health care teaching is effective and understood.
Q2) Which of the following patients would most likely need to have adjustments made to the education plan for discharge because of role function?
A) A 67-year-old married female who lives with her retired husband
B) A 32-year-old single mother of a toddler following hysterectomy.
C) A 13-year-old who lives at home with his parents after appendectomy
D) A 50-year-old married mother with 2 child in college and teenager at home
Q3) In determining patient goals, the nurse should:
A) allow patients to identify what is most important to them.
B) take the lead and determine what is best for the patient.
C) should focus on health promotion and staying healthy.
D) explain the importance of avoiding complications.
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Chapter 15: Nursing Informatics
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Sample Questions
Q1) When using electronic medical records (EMR), the nurse knows that the EMR:
A) holds the documentation of a single episode of care.
B) is a longitudinal record of care for each patient.
C) is widely used for individual health care encounters.
D) includes progress notes for all disciplines.
Q2) Information technology (IT) can be used to increase patient safety. The nurse uses IT in this way by:
A) creating redundancy in orders making them safer.
B) removing the need for verification by the nurse.
C) analyzing errors to develop prevention strategies.
D) eliminating the need for bar codes in medication administration.
Q3) The Technology Informatics Guiding Education Reform (TIGER) initiative identified a set of skills needed by all nurses practicing in the 21st century. The TIGER Vision Pillars include: (Select all that apply.)
A) management and leadership.
B) certification by HIMSS.
C) communication and Collaboration.
D) informatics design.
E) IT policy and culture.
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Page 17
Chapter 16: Health and Wellness
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Sample Questions
Q1) A patient is diagnosed with pneumonia after an abrupt onset of fever, cough, and malaise. The patient is started on antibiotic therapy and is expected to improve in 2 to 3 weeks. The nurse correctly identifies this illness as:
A) acute.
B) chronic.
C) remission.
D) exacerbation.
Q2) An overweight, sedentary middle-aged smoker with a family history of cardiac disease has noticed a steady rise in resting blood pressure over a 3- to 4-year period. The patient is concerned about his slightly elevated blood pressure and begins walking 20 to 30 minutes in the evenings with his wife and reduces his pack-a-day cigarette habit to ten cigarettes a day. This person has taken the first steps in:
A) risk factor reduction.
B) self-actualization.
C) self-transcendence.
D) health promotion.
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Chapter 17: Human Development: Conception through Adolescence
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Q1) A home health care nurse is making a well-baby visit to the home of a new mother who has an infant. What assessment finding leads the nurse to provide further anticipatory guidance and teaching to the mother?
A) Mother states she does not breastfeed but uses a recommended formula.
B) Crib has colorful blankets and pillows for the baby to cuddle.
C) A mobile is hanging well above the crib playing soft music.
D) Several rattles and plush toys are available in different textures.
Q2) A father expresses frustration that his school-aged child is suddenly "sick all the time." What action by the nurse is best?
A) Encourage the father to give the child a multivitamin each day.
B) Explain that illness is frequent in this age group because of exposure to others.
C) Encourage the father to discuss testing the child's immunity with the provider.
D) Make sure the parents are washing their hands frequently in the home.
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Chapter 18: Human Development Young Adult to Older Adult
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Q1) The nurse knows that which attributes are characteristics of the young adult age group? (Select all that apply.)
A) The number of high school graduates going to college is decreasing.
B) More than 88% of people aged 25 to 34 have completed high school.
C) More males aged 20 to 24 were married than females in the same age group.
D) A significant percentage of those aged 25 to 34 has advanced degrees.
E) Adult roles for the young adult are more diverse than for other age groups.
Q2) A young nursing student is assessing an older patient. The nurse questions whether or not to take a sexual history. What response by the faculty is best?
A) Since procreation is not an issue, you do not need to discuss this.
B) Only discuss this topic if you are comfortable in doing so.
C) Ask the patient if he or she wants to talk about sexuality.
D) Sexuality is a basic human need and needs to be assessed.
Q3) A nurse notes an older adult puts excessive amounts of salt on her food. What intervention by the nurse is best?
A) Teach the adult how salt intake relates to hypertension.
B) Ask the older adult why she puts so much salt on food.
C) Encourage the older adult to use less salt on her food.
D) Explore other herbs and flavor enhancers with the adult.
Page 20
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Chapter 19: Vital Signs
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Q1) The nurse assessing respirations understands that problems in what organs can directly affect the process of respiration? (Select all that apply.)
A) Brain
B) Lungs
C) Heart
D) Liver
E) Skeletal muscle
Q2) A nurse works on a postoperative care unit and sees many patients who have orthopedic surgery. One patient complains of significantly more pain than the other postoperative patients usually do. What action by the nurse is best?
A) Explain to the patient that so much pain is not reasonable.
B) Ask the patient to rate and describe the pain.
C) Give the patient pain medications as prescribed.
D) Call the provider and request an extra dose of pain medication.
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21
Chapter 20: Health History and Physical Assessment
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Q1) A nurse is conducting a physical assessment in a clinic with a partly undressed patient. What action by the nurse is most appropriate?
A) Offer the patient a small pillow for under his/her head.
B) Provide a method for ensuring the patient stays warm.
C) Raise the head of the bed to about 30 degrees.
D) Ensure there is enough lighting for an adequate examination.
Q2) A nurse has assessed a patient's capillary refill, which was 5 seconds. What action by the nurse is most appropriate?
A) Document the findings and continue the examination.
B) Ask the patient about the use of artificial nails.
C) Ask the patient about his/her occupation.
D) Assess the patient for signs of hypoxia.
Q3) The nurse is assessing a patient's cranial nerve III. What technique is best?
A) Have patient identify a common scent with closed eyes.
B) Shine a light into the patient's eyes to assess pupil response.
C) Have the patient read a newspaper or use the Snellen chart.
D) Assess if patient can hear both spoken and whispered words.
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Chapter 21: Ethnicity and Cultural Assessment
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Q1) A charge nurse works on an inpatient unit in a diverse city. Knowing some generalizations about different ethnic groups, which action is best?
A) Assign a female nurse to a female Muslim patient.
B) Allow the family to stay when the Russian patient is told he has cancer.
C) Start a meeting with a Hispanic family promptly on time.
D) Have the Amish patient watch patient education podcasts.
Q2) The nurse understands that which are important in the process of developing a cultural identity? (Select all that apply.)
A) School
B) Church/religious institution
C) Family
D) History
E) Community
Q3) A nurse is working with a patient who has limited English proficiency. What action by the nurse is best?
A) Use a qualified interpreter.
B) Ask family members to translate.
C) Use drawings and pictures.
D) Speak in simple sentences.
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Chapter 22: Spiritual Health
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Q1) A nurse works in a pediatric oncology unit and is feeling depressed and discouraged. What initial action by the nurse is best?
A) Apply for a job transfer to another unit.
B) Consult with the hospital chaplain.
C) Make an appointment with Employee Assistance.
D) Ask other nurses how they deal with the stress.
Q2) The nurse who is aware of spirituality practices of major religions knows that which religions view health and illness as a process of balance or imbalance? (Select all that apply.)
A) Catholicism
B) Native American
C) Hinduism
D) Greek Orthodox
E) Buddhism
Q3) When does the nurse assess patients' spirituality? (Select all that apply.)
A) Upon admission
B) New diagnosis
C) Life-changing diagnosis
D) When the chaplain makes rounds
E) When facing treatment decisions
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Chapter 23: Public Health, Community Base, and Home Health Care
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Q1) A nurse is orienting to a new job in a home health care agency and is told that most of her patients need tertiary prevention. What activity does the nurse plan to include in the daily routine?
A) Household safety checks
B) Well-baby checkups
C) Antibiotic administration
D) Monthly blood pressure assessments
Q2) A community was devastated by a tornado several months ago. What nursing diagnosis would be most appropriate for the nurse to consider?
A) Social isolation
B) Deficient community resources
C) Ineffective community coping
D) Deficient community health
Q3) The nurse has implemented a community-wide immunization program for seasonal influenza. Once the program has ended, what action by the nurse is best?
A) Begin planning for next year's program.
B) Send mail surveys to participants.
C) Determine financial gains or losses.
D) Evaluate the program and outcomes.
25
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Chapter 24: Human Sexuality
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Q1) A patient states, "I just don't conform to my gender role." What does the nurse understand about this statement?
A) The patient is a homosexual.
B) The patient's behaviors are abnormal.
C) The patient's actions differ from what is expected.
D) The patient is having a gender crisis.
Q2) A parent confides to the nurse that the parent's 3-year-old son seems to be touching his genitals frequently. What response by the nurse is best?
A) "This is normal behavior at his age."
B) "Why do you think he is doing that?"
C) "Does he complain of burning with urination?"
D) "I'd ignore that behavior; it's attention-seeking."
Q3) A nurse in the emergency department wants to screen a patient for domestic violence, but the woman's partner won't leave. What action by the nurse is best?
A) Ask the questions anyway.
B) Tell the partner to leave.
C) Go with the patient to the bathroom.
D) Skip the abuse assessment.
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26
Chapter 25: Safety
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Q1) The nurse recognizes that a patient is using a portable generator in the house as a power source. What source of poisoning does the nurse appropriately identify?
A) Lead
B) Carbon monoxide
C) Antifreeze
D) Pesticide
Q2) The nurse is caring for a confused, combative patient. Which action would be considered last by the nurse to control behavior of the client?
A) Orient the patient frequently.
B) Apply restraints.
C) Move the patient to a room close to the nurse's station.
D) Encourage the family to spend time with the patient.
Q3) The nurse is ambulating her patient back from the bath when the patient begins to have a seizure. Which of the following actions should the nurse do first?
A) Lower the patient to the floor if standing.
B) Move sharp or hard objects away from the patient.
C) Turn the patient to his/her side to prevent aspiration.
D) Attempt to place a tongue blade to prevent choking.
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Chapter 26: Asepsis and Infection Control
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Q1) The nurse knows that which of the following skills does not require the use of sterile technique?
A) NG tube insertion
B) Foley catheterization
C) Tracheostomy care
D) PICC line insertion
Q2) The patient is on protective precautions. Which is true regarding these precautions? (Select all that apply.)
A) A positive-pressure room with a HEPA filtration system is required.
B) Special respirator masks should be available and one size fits all.
C) No live plants are allowed in the room.
D) The patient may eat any foods desired.
Q3) The antigen-antibody reaction is an example of what type of immunity?
A) Humoral
B) Cellular
C) Innate
D) Passive
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Chapter 27: Hygiene and Personal Care
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Q1) The nurse notes that a trauma patient has multiple tangles in the hair. Which of the following actions taken by the nurse is appropriate? (Select all that apply.)
A) Work the tangles to the ends of the hair, then trim with scissors.
B) Apply warm water and conditioner.
C) Apply detangler as available.
D) Use a comb or fingers to work through tangles.
Q2) The UAP asks why the arms are washed from distal to proximal. Which response by the nurse is appropriate?
A) To promote circulation
B) To maintain asepsis
C) To maintain comfort
D) To maintain tradition
Q3) The nurse knows that routine hygienic care does not include:
A) massage with lotion.
B) oral care with a toothbrush.
C) shaving with a disposable razor.
D) ear hygiene with cotton-tipped applicators.
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Chapter 28: Activity, Immobility, and Safe Movement
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Sample Questions
Q1) The nurse is correctly assisting the patient in using a cane when the patient demonstrates the following: (Select all that apply.)
A) The top of the cane is level with the patient's bent elbow.
B) The patient holds the cane on his/her weaker side.
C) The patient moves the cane forward first.
D) The patient's arm is comfortably bent when walking.
Q2) The nurse correctly teaches the patient to rise from a chair using crutches when the following interventions are used:
A) Patient starts from the back of the chair.
B) The weak leg is closest to the chair.
C) The hand on the strong side holds the handbar of the crutch.
D) The strong leg is closest to the chair.
Q3) The nurse is educating the patient about the effects of immobility on the body. The following statements by the patient indicate a need for further education: (Select all that apply.)
A) "I can become very weak."
B) "I will gain weight."
C) "I will lose muscle tone."
D) "I can get bed sores."
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Page 30
Chapter 29: Skin Integrity and Wound Care
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Sample Questions
Q1) The nurse knows that mechanical debridement involves all of the following except:
A) wet to dry dressings.
B) whirlpool baths.
C) damp to dry dressing.
D) enzymatic dressing.
Q2) The nurse knows the layer that delivers the blood supply to the dermis, provides insulation, and has a cushioning effect is:
A) stratum germinativum.
B) epidermis.
C) subcutaneous layer.
D) stratum corneum.
Q3) The nurse is using the Braden scale to assess the patient's risk for a pressure ulcer. Which risk categories are associated with the Braden scale? (Select all that apply.)
A) Activity
B) Friction and shear
C) Moisture
D) Sensory perception
E) Cognition
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Chapter 30: Nutrition
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Sample Questions
Q1) The nurse is educating her patient about who has just been placed on a renal diet. Which statement by the patient indicates a need for further education?
A) "I need to eat a low-sodium diet."
B) "I can have limited amounts of meat."
C) "I can drink unlimited cola if it is diet."
D) "I should avoid or limit bananas."
Q2) The nurse is concerned about aspiration precautions when feeding her patient who has recently suffered a stroke. Which of the following procedures that the nurse performs would demonstrate a need for further education?
A) The nurse uses thickened liquids.
B) The nurse puts the bed at 30 degrees.
C) The nurse encourages slow eating.
D) The nurse has the patient alternate between food and sips of fluid.
Q3) The nurse knows that patients should consume the following amounts of fiber every day:
A) 25-35 g
B) 20-35 g
C) 25-40 g
D) 20-40 g
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Page 32
Chapter 31: Cognitive and Sensory Alterations
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Q1) The nurse is caring for a patient who is hospitalized with cognitive impairment. The following interventions will assist the patient in orientation: (Select all that apply.)
A) Keep a photo of the family in the room.
B) Use a clock on the wall.
C) Make sure the room is kept bright and well lit.
D) Avoid moving the patient from room to room.
E) Have the nurse introduce himself or herself to the patient.
Q2) The nurse is providing discharge instructions to an older adult who is being discharged with orthostatic hypotension. Which of the following responses by the patient indicates a need for further education?
A) "I should take my blood pressure once a day at home."
B) "I should get up quickly to avoid my blood pressure dropping."
C) "I should drink plenty of water during the day."
D) "I should get up slowly and carefully."
Q3) An appropriate goal for a patient with a diagnosis of social isolation is:
A) the patient will participate in cognitive exercises.
B) the patient will interact with other residents during activities.
C) the patient will communicate basic needs through use of photos.
D) the patient will remain within the unit while in long-term care.
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Page 33
Chapter 32: Stress and Coping
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Q1) The nurse knows an appropriate goal for Stress overload is:
A) The patient will attend a weekly support group.
B) The patient will discuss possible coping strategies during weekly office visits.
C) The patient will discuss strategies for coping with relationship violence within 24 hours.
D) The patient's family will use respite care once a week for the next month.
Q2) The nurse is educating the patient on the use of relaxing therapy. Which statement by the patient indicates a need for further education?
A) "I should relax my muscles from head to toe."
B) "I visual the relaxed muscle."
C) "I should do this three times a week."
D) "I focus on muscles that are tense."
Q3) The nurse is caring for a patient with a new diagnosis of diabetes type 2. Which of the following statements indicates a negative coping response?
A) "I will look up information on the Internet about diabetes."
B) "I will join a support group."
C) "I will only focus on learning to manage my medication first."
D) "I will make changes slowly so I can adapt to each change."
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Chapter 33: Sleep
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Sample Questions
Q1) The nurse is educating a patient about taking measures to help avoid disruption to the circadian rhythm. The following statement by the patient indicates a need for further education:
A) "I know the circadian rhythm influences biological functions."
B) "I know the circadian rhythm exists only in humans."
C) "I know the sleep-wake circadian rhythm is impacted by the light-dark cycle."
D) "The most familiar circadian rhythm is the day-night 24-hour cycle."
Q2) The nurse knows an appropriate goal for the nursing diagnosis Insomnia is:
A) The patient will report an ability to concentrate on tasks.
B) The patient will repeat medication instructions on discharge.
C) The patient will be able to sleep for at least 2 hours at a time.
D) The patient will be able to fall asleep within 15 minutes.
Q3) Which of the following is inappropriate to delegate to the unlicensed assistive personnel (UAP)?
A) Providing oral care
B) Evaluating sleep patterns
C) Providing bedtime routines
D) Documenting sleep hours
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35
Chapter 34: Diagnostic Testing
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Sample Questions
Q1) The nurse is caring for a patient who will be receiving iodine-based contrast medium for a CT scan. Which allergy should be reported to the technician and radiologist before the test is performed?
A) Gluten and lactose
B) Strawberries
C) Peanuts and cashews
D) Shrimp and scallops
Q2) The nurse is caring for a patient who will be undergoing flexible sigmoidoscopy testing to screen for colon cancer. What goal will the nurse include in the patient's plan of care?
A) Patient will verbalize understanding of pre-procedure preparation to be completed at home the day before the test.
B) Patient will feel comfortable about the upcoming test and have trust in the health care providers.
C) Patient will learn common side effects of the medications used to prepare the GI tract for endoscopy testing.
D) Patient will realize how important regular sigmoidoscopy testing is in the prevention of colon cancer.
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Chapter 35: Medication Administration
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Q1) The nurse is noting an order for a medication to be given TID. Which times will the nurse plan to administer the medication to the patient?
A) 9 A.M., 1 P.M., 5 P.M. and 10 P.M.
B) 9 A.M. and 9 P.M.
C) 9 A.M., 1 P.M. and 5 P.M.
D) Nightly before the patient goes to sleep
Q2) The nurse begins a shift on a busy medical-surgical unit. The nurse will be caring for multiple patients. Which patient will the nurse assess first?
A) A patient who would like some acetaminophen (Tylenol) for a mild headache
B) A patient who has a question about her daily medications
C) A patient who needs discharge teaching about an antibiotic
D) A patient who just received nitroglycerin for chest pain
Q3) Which medication has the highest potential for abuse?
A) Methylphenidate (Ritalin) - schedule II
B) Alprazolam (Xanax) - schedule IV
C) Acetaminophen & codeine (Tylenol #3) - schedule III
D) Diphenoxylate & atropine (Lomotil) - schedule V
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Chapter 36: Pain Management
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Q1) The nurse is caring for a diabetic patient who has painful neuropathy in her feet. The patient asks why the nurse is administering gabapentin (Neurontin) when she does not have a history of seizure disorder. What is the nurse's best response?
A) "Neurontin will help you sleep at night so you can deal with the pain more effectively."
B) "Long-term diabetes can put patients at risk for certain type of seizures."
C) "Neurontin can help relieve your anxiety from being admitted to the hospital."
D) "Neurontin works on the nervous system to help relieve the burning pain in your feet."
Q2) The nurse is caring for a patient who has severe abdominal pain caused by acute cholecystitis. What type of pain is this patient experiencing?
A) Visceral pain
B) Somatic pain
C) Radiating pain
D) Referred pain
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Chapter 37: Perioperative Nursing Care
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Q1) The nurse is walking a postoperative patient in the hallway when she notices a large red stain of fresh blood on the patient's gown over the abdominal incision. The patient states, "I felt something just ripped open." What is the priority action of the nurse?
A) Lift up the patient's gown and assess the incision.
B) Assist the patient to the floor and call for assistance.
C) Return the patient to bed and irrigate the wound with sterile saline.
D) Check the patient's vital signs and pulse oximetry.
Q2) The nurse is caring for a postoperative patient who is recovering from abdominal surgery. The nurse notes that the patient's breath sounds are clear but diminished, shallow, and slightly labored. The patient's pulse oximetry is 96% on room air. What is the priority action of the nurse?
A) Administer a dose of the prescribed pain medication.
B) Administer 2 L of oxygen via nasal cannula.
C) Obtain an order from the physician for a chest x-ray.
D) Ensure that the patient is using the spirometer 10 times every hour.
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Chapter 38: Oxygenation and Tissue Perfusion
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Q1) The nurse is caring for a patient who developed a pulmonary embolism after surgery. Which goal statement is the highest priority for the nurse to include in the patient's care plan for the diagnosis Impaired gas exchange r/t impaired pulmonary blood flow from embolus?
A) The patient will maintain pulse oximetry values of at least 95% on room air.
B) The patient will verbalize understanding of ordered anticoagulants.
C) The patient will report chest pain of no greater than 3 on a 1-10 scale.
D) The patient will ambulate 50 feet in hallway without shortness of breath.
Q2) The nurse is caring for a patient who will be returning to the nursing unit following a cardiac catheterization via the right femoral artery. Which assessment is the highest priority for the nurse to perform when the patient arrives on the unit?
A) Checking the patient's right pedal pulse and warmth of the right leg
B) Checking pulse oximetry and listening to the patient's lung sounds
C) Checking bilateral radial pulses to check for a pulse deficit
D) Estimating the patient's jugular venous pressure
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Chapter 39: Fluid, Electrolytes, and Acid-Base Balance
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Q1) The nurse is caring for a patient who has a serum magnesium level of 0.8 mEq/L. Which is the highest priority goal to include in the patient's plan of care?
A) The patient will maintain urine output of at least 30 mL/hr.
B) The patient will verbalize the importance of sufficient dietary intake of magnesium.
C) The patient's oral mucous membranes will remain free of ulceration and pain.
D) The patient will remain alert and oriented x3 with no confusion or seizure activity.
Q2) The nurse is caring for a patient with a history of hyperparathyroidism who presents with a serum calcium level of 14.5 mg/dL. What is the highest priority nursing diagnosis for this patient?
A) Risk for injury related to weakened bones that may easily fracture
B) Deficient knowledge related to need for supplemental calcium in diet
C) Risk for constipation caused by decreased gastrointestinal motility
D) Activity intolerance related to muscle cramping and spasms
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Chapter 40: Bowel Elimination
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Q1) The nurse is caring for a patient who has had a severe stroke and requires assistance to use the toilet. Which goal is the highest priority for this patient?
A) The patient will remain continent with no perineal skin breakdown.
B) The patient will state satisfaction with use of gait belt for toilet transfers.
C) The patient will regain ability to pull up clothing after using the toilet.
D) Privacy will be provided once the patient is properly positioned on the toilet.
Q2) The nurse is caring for a patient who is to have testing for fecal occult blood. What step will the nurse perform during this testing?
A) Keep the patient on a clear liquid diet for 72 hours.
B) Send the samples to the laboratory while they are still warm.
C) Inform the patient that several stool samples will be needed.
D) Use a sterile container when collecting the stool samples.
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Chapter 41: Urinary Elimination
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Q1) The nurse is caring for a patient with a history of type I diabetes. Which assessment finding indicates to the nurse that the patient may not be compliant with his diabetic treatment regimen?
A) The patient is always thirsty and frequently voids very large amounts of urine.
B) The patient's urine is very concentrated with a dark amber color.
C) The patient complains of throbbing flank pain and burning with urination.
D) The patient has urinary hesitancy and difficulty initiating a stream of urine.
Q2) The nurse is caring for a patient who has urinary frequency. Which nursing diagnosis is the highest priority for this patient?
A) Risk for compromised human dignity r/t occasional incontinence
B) Risk-prone health behavior r/t living alone at home with nocturia
C) Risk for contamination r/t urine contact with perineal area skin
D) Risk for falls r/t hurried trips to the bathroom during the day and night
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Chapter 42: Death and Loss
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Q1) The hospice nurse is caring for a several adult children shortly after the death of their mother. They have various reactions as they deal with their loss. Which reactions are considered to be in the cognitive domain?
A) They let the house get filthy because they can't be bothered to clean it.
B) They are tossing and turning all night and are unable to get a good night's sleep.
C) They are easily distracted and often lose train of thought during conversation.
D) They have lost their appetites and have no desire to eat anything.
Q2) The nurse is caring for an emergency room patient who died as a result of a mishap with a loaded gun. The patient's body will be transported to the coroner's office for an autopsy. Which items will the nursing staff remove from the body before it leaves the hospital?
A) Endotracheal tube
B) Foley catheter and IV line
C) Dentures
D) Necklace and watch
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