Professional Nursing Concepts
Pre-Test Questions
Course Introduction
This course explores the foundational concepts essential to the practice of professional nursing, emphasizing the development of a professional identity, ethical and legal principles, and evidence-based practice. Students will examine the history and evolution of nursing, the scope of practice, and the roles and responsibilities of nurses within diverse healthcare settings. Communication, cultural competence, interprofessional collaboration, leadership, and quality improvement are key themes. Through case studies and reflective activities, learners will integrate theory with practice, preparing them to deliver holistic and patient-centered care while adapting to the changing landscape of healthcare.
Recommended Textbook Concepts for Nursing Practice 2nd Edition by Giddens
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58 Chapters
459 Verified Questions
459 Flashcards
Source URL: https://quizplus.com/study-set/174
Page 2
Chapter 1: Development
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8 Verified Questions
8 Flashcards
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Sample Questions
Q1) The nurse manager of a pediatric clinic could confirm that the new nurse recognized the purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it is used to assess for needs related to
A) anticipatory guidance.
B) low-risk adolescents.
C) physical development.
D) sexual development.
Answer: A
Q2) A 17-year-old girl is hospitalized for appendicitis, and her mother asks the nurse why she is so needy and acting like a child. The best response of the nurse is that in the hospital, adolescents
A) have separation anxiety.
B) rebel against rules.
C) regress because of stress.
D) want to know everything.
Answer: C
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Chapter 2: Functional Ability
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) The nurse is assessing a patient with a mobility dysfunction and wants to gain insight into the patient's functional ability. What question would be the most appropriate?
A) "Are you able to shop for yourself?"
B) "Do you use a cane, walker, or wheelchair to ambulate?"
C) "Do you know what today's date is?"
D) "Were you sad or depressed more than once in the last 3 days?"
Answer: B
Q2) Uses a cane
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: B
Q3) Bathes daily
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: B
Q4) Balances the checkbook
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: A
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Chapter 3: Family Dynamics
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Sample Questions
Q1) The nurse caring for a patient would identify a need for additional interventions related to family dynamics when
A) extended family offers to help.
B) family members express concern.
C) the ill member demands attention.
D) memories are shared.
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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Page 5
Chapter 4: Culture
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Sample Questions
Q1) Understanding cultural differences in health care is important because it will help the nurse to understand the manner in which people decide on obtaining treatments and medical care. In independent cultures an individual will
A) put himself first.
B) consult family members for advice.
C) ask for a second opinion.
D) travel great distances to receive the best care.
Q2) Women who are given the job of caretaker for aging relatives are subject to caregiver strain due to
A) feminine attributes.
B) unequal gender.
C) fixed gender roles.
D) female inequality.
Q3) What interrelated constructs facilitate a nurse to become culturally competent?
A) Cultural diversity, self-awareness, cultural skill, and cultural knowledge
B) Cultural desire, self-awareness, cultural knowledge, and cultural identity
C) Cultural desire, self-awareness, cultural knowledge, and cultural diversity
D) Cultural desire, self-awareness, cultural knowledge, and cultural skill
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Chapter 5: Spirituality
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Sample Questions
Q1) 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
Q2) A patient uses rosary beads and attends mass once a week. This expression of spirituality is best described with which term?
A) Religiosity
B) Faith
C) Belief
D) Authenticity
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Chapter 6: Adherence
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Sample Questions
Q1) A 73-year-old male patient is seen in the home setting for a routine physical. The nurse notes which behavior as the most reassuring sign that the patient has been following the treatment plan for the diagnoses of hypertension, diabetes, and hyperlipidemia?
A) The patient has a list of glucose readings for the past 10 days.
B) The patient has a list of medications along with newly refilled meds.
C) The patient has a list of all foods and beverages for a 3-day period.
D) The patient verbalizes the side effects of all his medications.
Q2) A patient has been newly diagnosed with hypertension. The nurse assesses the need to develop a collaborative plan of care that includes a goal of adhering to the prescribed regimen. When the nurse is planning teaching for the patient, which is the most important initial learning goal?
A) The patient will select the type of learning materials they prefer.
B) The patient will verbalize an understanding of the importance of following the regimen.
C) The patient will demonstrate coping skills needed to manage hypertension.
D) The patient will verbalize the side effects of treatment.
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Page 8
Chapter 7: Self-Management
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Sample Questions
Q1) The nurse is developing a plan of care for a newly diagnosed hypertensive patient who is being discharged on medications and given the Dietary Approaches to Stop Hypertension (DASH) diet to follow. What statement by the patient signals to the nurse that the patient is motivated to learn?
A) "I am sure the medications will help to bring down my blood pressure."
B) "I can't wait to try the new recipes, and I'm hopeful I will lose weight."
C) "Do I really need to follow the diet and take medications?"
D) "I have my parents to blame for this. They both have high blood pressure."
Q2) The nurse is assessing a patient's readiness to be discharged and ability to manage care at home. What is the most appropriate question for the nurse to ask to determine the patient's learning needs before planning teaching activities?
A) "What are your hobbies and occupation?"
B) "What do you need to know before you go home from the hospital?"
C) "Do you have any cultural or religious beliefs that you would like incorporated into your plan of care?"
D) "What were your grades and learning style when you were in school?"
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9
Chapter 8: Fluid and Electrolyte Balance
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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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7 Verified Questions
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Sample Questions
Q1) The nurse is making a home visit to a child who has a chronic disease. Which finding has the greatest implication for acid-base aspects of this patient's care?
A) Urine output is very small today.
B) Whites of the eyes appear more yellow.
C) Skin around the mouth is very chapped.
D) Skin is sweaty under three blankets.
Q2) The patient had diarrhea for 5 days and developed an acid-base imbalance. Which statement would indicate that the nurse's teaching about the acid-base imbalance has been effective?
A) "To prevent another problem, I should eat less sodium during diarrhea."
B) "My blood became too acid because I lost some base in the diarrhea fluid."
C) "Diarrhea removes fluid from the body, so I should drink more ice water."
D) "I should try to slow my breathing so my acids and bases will be balanced."
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Chapter 10: Thermoregulation
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8 Flashcards
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Sample Questions
Q1) What is the most appropriate measure for a nurse to use in assessing core body temperature when there are suspected problems with thermoregulation?
A) Oral thermometer
B) Rectal thermometer
C) Temporal thermometer scan
D) Tympanic membrane sensor
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 nurse planning care for a patient with hypothermia should consider what similar exemplar?
A) Heat exhaustion
B) Heat stroke
C) Infection
D) Prematurity
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Page 12
Chapter 11: Sleep
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7 Flashcards
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Sample Questions
Q1) The nurse must awaken a patient from Stage 4 non-rapid eye movement sleep in order to prepare the patient for a procedure. The patient is disoriented. What is the nurse's best action?
A) Notify the healthcare provider
B) Re-assess the patient's orientation
C) Administer an anti-anxiety medication
D) Cancel the patient's procedure
Q2) A mother tells the nurse she is concerned because her 8 month old infant sleeps all day and night and is only awake about 2-3 hours per day. What is the nurse's best response?
A) "This sleep pattern is very normal for an infant at this age."
B) "Adding an additional feeding will keep the child awake more."
C) "I recommend that you notify the child's pediatrician."
D) "Be sure you are laying the child on his back to sleep at night."
Q3) 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 Flashcards
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Sample Questions
Q1) While the nurse is obtaining the health history of a 75-year-old female patient, which of the following has the greatest implication for the development of cancer?
A) Being a woman
B) Family history of hypertension
C) Cigarette smoking as a teenager
D) Advancing age
Q2) A patient with prostate cancer is taking estrogen daily to control tumor growth. He reports that his left calf is swollen and painful. Which of the following would be the nurse's best action?
A) Instruct the client to keep the leg elevated.
B) Measure the calf circumference and compare the measurement with the right calf circumference measurement.
C) Apply ice to the calf after a 10-minute massage of the area.
D) Document assessment findings as an expected response with estrogen therapy.
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14
Chapter 13: Intracranial Regulation
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Sample Questions
Q1) 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
Q2) 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
Q3) Components of the Glasgow Coma Scale (GCS) the nurse would use to assess a patient after a head injury include which assessment?
A) Blood pressure
B) Cranial nerve function
C) Head circumference
D) Verbal responsiveness
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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) Which important teaching point should the nurse include in the plan of care for a patient diagnosed with Cushing's disease?
A) Daily weight using same scale
B) Wash hands frequently
C) Use exfoliating soaps when bathing
D) Avoid yearly influenza vaccine
Q3) Following a parathyroidectomy, which electrolyte should the nurse most closely monitor?
A) Potassium
B) Sodium
C) Magnesium
D) Calcium
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Chapter 15: Glucose Regulation
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Sample Questions
Q1) 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."
Q2) The nurse recognizes which patient as having the greatest risk for undiagnosed diabetes mellitus?
A) Young white man
B) Middle-aged African-American man
C) Young African-American woman
D) Middle-aged Native American woman
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17
Chapter 16: Nutrition
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Sample Questions
Q1) An African American is at an increased risk for which of the following? (Select all that apply.)
A) Vitamin D deficiency
B) Type 1 diabetes
C) Celiac disease
D) Type 2 diabetes
E) Hypertension
F) Metabolic syndrome
Q2) During a physical examination, the nurse notes that the patient's skin is dry and flaking. 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) 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
Q2) 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."
Q3) The process of digestion is important for every living organism for the purpose of nourishment. Where does most digestion take place in the body?
A) Large intestine
B) Stomach
C) Small intestine
D) Pancreas
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19
Chapter 18: Perfusion
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Sample Questions
Q1) A patient's serum electrolytes are being monitored. The nurse notices that the potassium level is low. What should the nurse monitor for in this patient?
A) Tissue ischemia
B) Brain malformations
C) Intestinal blockage
D) Cardiac dysrhythmia
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
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Sample Questions
Q1) The nurse would identify which patient condition as a problem of impaired gas exchange secondary to a perfusion problem?
A) Peripheral arterial disease of the lower extremities
B) Chronic obstructive pulmonary disease (COPD)
C) Chronic asthma
D) Severe anemia secondary to chemotherapy
Q2) The nurse would identify which body systems as directly involved in the process of normal gas exchange? (Select all that apply.)
A) Neurologic system
B) Endocrine system
C) Pulmonary system
D) Immune system
E) Cardiovascular system
F) Hepatic system
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21
Chapter 20: Clotting
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Sample Questions
Q1) A patient states that his legs have pain with walking that decreases with rest. The nurse observes absence of hair on the patient's lower leg and the patient has a thready, posterior tibial pulse. How would the nurse position the patient's legs?
A) Elevated
B) Crossed at the knee
C) Slightly bent with a pillow under the knees
D) Dependent position
Q2) Which statement by a patient indicates additional teaching is required about the medication warfarin?
A) "I will continue my diabetic diet and restrict sugar."
B) "I will increase the intake of green, leafy vegetables for a more healthful diet."
C) "I will restrict the intake of foods high in vitamin C."
D) "I will increase the amount of protein in my diet to protect my kidneys."
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22
Chapter 21: Reproduction
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Sample Questions
Q1) A female patient comes to the clinic after missing one menstrual period. She lives in a house beneath electrical power lines which is located near an oil field. She drinks two caffeinated beverages a day, is a daily beer drinker, and has not stopped eating sweets. She takes a multivitamin and exercises daily. She denies drug use. Which finding in the history has the greatest implication for this patient's plan of care?
A) Electrical power lines are a potential hazard to the woman and her fetus.
B) Living near an oil field may mean the water supply is polluted.
C) Alcohol exposure should be avoided during pregnancy due to teratogenicity.
D) Eating sweets may cause gestational diabetes or miscarriage.
Q2) The nurse at the family planning clinic conducts a male history for infertility evaluation. Which finding has the greatest implication for this patient's care?
A) Practice of nightly masturbation
B) Primary anovulation
C) High testosterone levels
D) Impotence due to alcohol ingestion
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Chapter 22: Sexuality
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Sample Questions
Q1) A 37-year-old heterosexual African-American man has come for his annual health screening. Which test must the nurse ensure is ordered for this patient?
A) Human papilloma virus (HPV)
B) Prostate-specific antigen (PSA)
C) HIV
D) Venereal disease research laboratory (VDRL)
Q2) The school nurse is developing a curriculum for a junior human sexuality class. In order to provide the most up-to-date information, the nurse should be aware that which is the single most effective primary prevention strategy for preventing sexually transmitted infections (STIs)?
A) A vaccine to prevent HPV infection
B) HIV screening
C) Abstinence
D) The male condom
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Chapter 23: Immunity
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Sample Questions
Q1) While caring for a patient preparing for a kidney transplant, the nurse knows that the patient understands teaching on immunosuppression when she makes which statement?
A) "My body will treat the new kidney like my original kidney."
B) "I will have to make sure that I avoid being around people."
C) "The medications that I take will help prevent my body from attacking my new kidney."
D) "My body will only have a problem with my new kidney if the donor is not directly related to me."
Q2) The nurse is caring for a postoperative patient who had an open appendectomy. The nurse understands that this patient should have some erythema and edema at the incision site 12 to 24 hours post operation dependent on which condition?
A) His immune system is functioning properly.
B) He is properly vaccinated.
C) He has an infection.
D) The suppressor T-cells in his body are activated.
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Chapter 24: Inflammation
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Q1) A nurse is instructing her patient with ulcerative colitis regarding the need to avoid enteric coated medications. The nurse knows that the patient understands the reason for this teaching when he states which of the following?
A) "The coating on these medications is irritating to my intestines."
B) "I need a more immediate response from my medications than can be obtained from enteric coated medications."
C) "Enteric coated medications are absorbed lower in the digestive tract and can be irritating to my intestines or inadequately absorbed by my inflamed tissue."
D) "I don't need to use these medications because they cause diarrhea, and I have had enough trouble with diarrhea and rectal bleeding over the past weeks."
Q2) A patient is being treated with an antibiotic for an infected orthopedic injury. What explanation should the nurse give to the patient about this medication?
A) "Antibiotics will decrease the pain at the site."
B) "An antibiotic helps to kill the infection causing the inflammation."
C) "An antibiotic inhibits cyclooxygenase, an enzyme in the body."
D) "Antibiotics will reduce the patient's fever."
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26
Chapter 25: Infection
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Q1) 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
Q2) While reviewing the complete blood count (CBC) of a patient on her unit, the nurse notes elevated basophil and eosinophil readings. The nurse realizes that this is most indicative of which type of infection?
A) Bacterial
B) Fungal
C) Parasitic
D) Viral
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Chapter 26: Mobility
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Sample Questions
Q1) A patient who has been in the hospital for several weeks is about to be discharged. The patient is weak from the hospitalization and asks the nurse to explain why this is happening. What is the nurse's best response?
A) "Your iron level is low. This is known as anemia."
B) "Your immobility in the hospital is known as deconditioning."
C) "Your poor appetite is known as malnutrition."
D) "Your medications have caused drug induced weakness."
Q2) 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
Q3) What percentage of hip fractures is the result of falls?
A) 50%
B) 80%
C) 90%
D) 100%
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Chapter 27: Tissue Integrity
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Sample Questions
Q1) A nurse is conducting community education classes on skin cancer. One participant says to the nurse: "I read that most melanomas occur on the face and arms in fair-skinned women. Is this true?" The nurse's most helpful response would be which of the following?
A) "That is not correct. Melanoma is more commonly found on the torso or the lower legs of women."
B) "That is correct, because the face and arms are exposed more often to the sun."
C) "That is not correct. Melanoma occurs on the top of the head in men but is rare in women."
D) "That is incorrect. Melanoma is most commonly seen in dark-skinned individuals."
Q2) An older patient has developed age spots and is concerned about skin cancer. How would the nurse instruct the patient to perform skin checks to assess for signs of skin cancer?
A) "Limit the time you spend in the sun."
B) "Monitor for signs of infection."
C) "Monitor spots for color change."
D) "Use skin creams to prevent drying."
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Chapter 28: Sensory Perception
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Sample Questions
Q1) A 75-year-old woman walks into the emergency department with complaints of "not feeling well." Her blood pressure is 145/95, pulse 85 beats/min, respirations 24 breaths/min, and blood sugar 300. Upon inspection, the nurse notices that the woman has an open wound on the bottom of her foot, but the patient states she is not aware of this. How should the nurse interpret these findings?
A) Normal in the older adult
B) A need for the patient to be evaluated for cognitive impairment
C) A side effect of anti-hypertensive medication
D) Pathologic impairment of sensory responses
Q2) An 80-year-old patient is being discharged after he was diagnosed with diabetes mellitus and retinopathy. His daughter has been part of the discharge instruction process. Understanding of the instructions is evident when the daughter says which of the following?
A) "I will make sure that Dad always wears warm socks."
B) "Dad needs to wear his glasses so he can delay the onset of macular degeneration."
C) "I will ask the home health aide to carefully inspect Dad's feet every day when she helps him bathe."
D) "We will give him only warm foods, so that he doesn't burn his mouth."
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Page 30
Chapter 29: Pain
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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) Controlling pain is important to promoting wellness. Unrelieved pain has been associated with complication?
A) Prolonged stress response and a cascade of harmful effects system-wide
B) Large tidal volumes and decreased lung capacity
C) Decreased tumor growth and longevity
D) Decreased carbohydrate, protein, and fat destruction
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Chapter 30: Fatigue
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Q1) The nurse is assessing a patient for risk factors of chronic fatigue syndrome. Which factors should the nurse identify as placing the patient at risk for chronic fatigue syndrome? (Select all that apply.)
A) Feeling tired upon awakening
B) Chronic migraines
C) Tenderness under the jaw
D) 5 episodes tonsillitis/past year
E) Swollen, painful knees
Q2) Based on the significant effects of chronic idiopathic fatigue, what is the nurse's priority assessment?
A) Cholesterol level and lipid profile
B) Creatinine and BUN levels
C) Memory loss testing
D) Mental health evaluation
Q3) Which are treatment related causes of fatigue? (Select all that apply.)
A) Blood transfusion
B) Chemotherapy
C) Radiation therapy
D) Surgery
E) Side effects of medications
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Chapter 31: Stress
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Sample Questions
Q1) The nurse is working with a patient who recently lost her spouse after a lengthy illness. The patient shares that she would like to sell her home and move to another state now that her spouse has passed away. Which of the following interventions would be considered a priority for this patient? (Select all that apply.)
A) Notify the provider to evaluate for antidepressant therapy.
B) Suggest that the patient consider a support group for widows.
C) Suggest that the patient learn stress reduction breathing exercises.
D) Suggest that the patient take prescribed antianxiety medications.
E) Assist the patient in identifying support systems.
F) Notify the provider to evaluate the need for antianxiety medications.
Q2) A patient has not been sleeping well because he is worried about losing his job and not being able to support his family. The nurse takes the patient's vital signs and notes a pulse rate of 112 beats/min, respirations are 26 breaths/min, and his blood pressure is 166/88 instead his usual 110-120/76-84 range. Which nursing intervention or recommendation should be used first?
A) Go to sleep 30 to 60 minutes earlier each night to increase rest.
B) Relax by spending more time playing with his pet dog.
C) Slow and deepen breathing via use of a positive, repeated word.
D) Consider that a new job might be better than his present one.
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Page 33
Chapter 32: Coping
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Q1) The nurse has been asked to administer a coping measurement instrument to a patient. What education would the nurse present to the patient related to this tool?
A) "This tool will let us compare your stress to other patients in the hospital."
B) "This tool is short because it only measures the negative stressors you are experiencing."
C) "You will need to ask your parents about stressors you had as a child to complete this tool."
D) "This tool will help assess recent positive and negative events you are experiencing."
Q2) The nurse is reviewing the care plan for a patient experiencing difficulty coping with stress. The nurse recognizes that an example of initiating a cognitive restructuring intervention to enhance coping abilities is known as which of the following?
A) Identifying the cause of fear
B) Accessing a community support group
C) Identifying relaxation methods
D) Reviewing an educational pamphlet
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Chapter 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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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) A patient is newly diagnosed with anxiety and placed on a selective serotonin reuptake inhibitors (SSRIs). The nurse is developing the plan of care for this patient. How long will it take for this medication to become effective?
A) The medication will become effective immediately.
B) The medication may take up to 12 weeks to become effective.
C) The medication may take up to 6 weeks to become effective.
D) The medication may take up to 4 weeks to become effective.
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Chapter 35: Cognition
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Q1) The nurse is teaching primary prevention of cognitive impairment at a community health fair. Which topics would be included in the presentation? (Select all that apply.)
A) Do not use substances such as cannabis and alcohol.
B) Wear helmets when riding bicycles and motorcycles.
C) Complete a Mini Mental Status Exam (MMSE) yearly.
D) Correct acid-base imbalances related to underlying disease processes.
E) Wear a seat belt whenever riding in a motorized vehicle.
F) Complete a Confusion Assessment Method (CAM) scale yearly.
Q2) An 82-year-old patient who is in the hospital awakens from sleep and is disoriented to where she is at the present time. The nurse reorients the patient to her surroundings and helps the patient return to sleep. What data does the nurse consider as a probable cause of the patient's confusion?
A) Pain medication received earlier in the night
B) The death of the patient's spouse 2 years ago
C) The patient's history of diabetes
D) The age of the patient
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Chapter 36: Psychosis
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Q1) 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
Q2) Which side effect is highest priority for the nurse to assess for when diphenhydramine is administered to a patient also taking antipsychotic medication?
A) Increased pychosis
B) Cognitive impairment
C) Respiratory depression
D) Impaired memory
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Chapter 37: Addiction
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Q1) The nurse recognizes a potential health threat to an alcoholic patient who is using the drug disulfiram when the nurse reads in the health record that the patient is also taking which of the following? (Select all that apply.)
A) Blood thinners
B) Diphenhydramine
C) Alcohol
D) Penicillin
E) Mouthwash
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) Critical Thinking: A crisis intervention nurse is training emergency department staff on treatment needs of persons in abusive relationships. What is a common difficulty staff encounter when caring for this population?
A) There is not a good legal pathway to help persons in abusive relationships.
B) The abused person may return to the abusive home setting.
C) Hospital policies do not identify the legal care needed for abused persons.
D) Because length of care is short in the emergency department, there is little staff can do for patients who have been abused.
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Chapter 39: Professional Identity
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Q1) The American Nurses' Association (ANA) outlines expectations of the nursing profession in which type of documentation?
A) Gallup poll
B) Goldman report
C) Social Policy Statement
D) Social identity theory
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 home care nurse receives a physician order for a medication that the patient does not want to take because the patient has a history of side effects from this medication. The nurse carefully listens to the patient, considers it in light of the patient's condition, questions its appropriateness, and examines alternative treatments. What is the nurse's best action?
A) Call the physician, explain rationale, and suggest a different medication.
B) Consult an experienced nurse on whether there are other similar treatments.
C) Hold the drug until the physician returns to the unit and can be questioned.
D) Question other staff as to the physician's acceptance of nursing input.
Q2) A patient has been admitted for a skin graft following third degree burns to the bilateral calves. The plan of care involves 3 days inpatient and 6 months outpatient treatment, to include home care and dressing changes. When should the nurse initiate the educational plan?
A) After the operation and the patient is awake
B) On admission, along with the initial assessment
C) The day before the patient is to be discharged
D) When narcotics are no longer needed routinely
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Chapter 41: Leadership
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Sample Questions
Q1) To be an effective nursing leader today requires effective collaboration, which is modeled by which answer below?
A) The nursing manager of the observation unit was certain the psychology department would assist the unit with a motivational plan, so she did not request their assistance.
B) The nursing manager of the observation unit worked with the psychology department and physical therapy to develop a motivational plan for patients on the unit.
C) The nursing director of behavioral health services followed the administrative directive to reduce services and refused to provide services for patients on other units.
D) Frustrated by the trend of patients unwilling to work with therapy, the unit manager recommended that these patients be placed on another unit.
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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) An unconscious patient is treated in the emergency department for head trauma. The patient is unconscious and on life support for 2 weeks prior to making a full recovery.
The initial actions of the medical team are based on which ethical principle?
A) Utilitarianism
B) Deontology
C) Autonomy
D) Veracity
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44
Chapter 43: Patient Education
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Q1) 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
Q2) 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
Q3) When describing patient education approaches, the nurse educator would explain that informal teaching is an approach that involves which quality?
A) Addresses group needs
B) Follows formalized plans
C) Has standardized content
D) Often occurs one-to-one
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45
Chapter 44: Health Promotion
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Sample Questions
Q1) 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
Q2) When there is evidence that supports a screening for an individual patient but not for the general population, the nurse would expect the United States Preventive Services Task Force Grading to be what?
A) No recommendation for or against
B) Recommends
C) Recommends against
D) Strongly recommends
Q3) The primary health care nurse would recommend screening based on known risk factors, because of which action?
A) Eliminate the possibility of developing a condition.
B) Identify appropriate treatment guidelines.
C) Initiate treatment of a condition or disease.
D) Make a substantial difference in morbidity and mortality.
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Page 46
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) The nurse and physician are explaining that home care that will be needed by a patient after discharge. The patient's spouse states angrily that it will not be possible to provide the care recommended. What is the best response by the nurse?
A) "Let me review what is needed again."
B) "It is important that you do what the physician has prescribed."
C) "What concerns do you have about the prescribed care?"
D) "I can come back after you talk with your spouse about the care."
Q2) The management of a community hospital is trying to encourage a more collaborative environment among staff members. Which Chapter is most important for management to develop first?
A) Post educational posters about how well collaboration is being performed
B) Highlight that no single profession can meet the needs of all patients
C) Provide meetings for each department on how their role affects patients
D) Begin implementing evaluations of collaborative skills on annual performance reviews
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Chapter 47: Safety
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Q1) Aspects of safety culture that contribute to a culture of safety in a health care organization include which component?
A) Communication
B) Fear of punishment
C) Malpractice implications
D) Team nursing
Q2) 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
Q3) The strategy to avoid medication errors endorsed by the Institute for Safe Medication Practices (ISMP) to differentiate products with look-alike names is referred to as which term?
A) Automatic alerts
B) Bar coding
C) Computer order entry
D) Tallman lettering
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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) Which are exemplars of the health informatics Chapter?
A) Clinical research informatics
B) Hardware and software
C) Privacy and security
D) Standard terminology
Q3) 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.
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Page 50
Chapter 49: Evidence
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Q1) Which statements are true about the Iowa model of EBP? (Select all that apply.)
A) It addresses utilization of research findings at an individual level.
B) It prioritizes pressing items of interest related to quality of care.
C) Individual nurses enact an Iowa decision tree when they examine risk management data.
D) It identifies triggers capable of posing hazard or benefit.
E) It reiterates that innovators embrace change far earlier than laggards.
Q2) 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.
Q3) How does the Iowa model transcend mere nursing care? (Select all that apply.)
A) It includes formalized internal feedback loops.
B) Its triggers can have their origins practically anywhere.
C) It generates change in practice solely through research.
D) It implies a layer of policy development.
E) It addresses multiple disciplines' impacts on quality.
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Chapter 50: Health Care Quality
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Q1) A student nurse is talking with his instructor. The student asks how quality of care is evaluated. What is the best response by the instructor?
A) "Quality of care is evaluated by the patient getting well."
B) "Quality of care is evaluated on the basis of process and outcomes."
C) "Quality of care is evaluated by the physician's assessment."
D) "Quality of care is evaluated by the patient's satisfaction."
Q2) 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.
Q3) What are the major attributes of health care quality? (Select all that apply.)
A) Conforms to standards
B) Sound decision making
C) High acuity patients
D) Low health care costs
E) Identifies adverse events
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Chapter 51: Care Coordination
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Q1) For children and teens, which model includes school-based services?
A) Social
B) Integrated
C) Medically-Oriented
D) Nurse-Oriented
Q2) Nurses work to serve the population, and they know that which priority population needs to be served by care coordination?
A) Most vulnerable and the frail
B) Uninsured and the very young
C) Underinsured and the elderly population
D) Whole population of the community
Q3) 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) Caregivers are often categorized by their relationship to the person being cared for. Which of the following are the roles? (Select all that apply.)
A) Grandparent
B) Spouse
C) Parent
D) Adult children
E) Neighbor/friend
F) Young children
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Chapter 53: Palliation
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Q1) When considering the trajectory of a specific disease, what is the most important Chapter?
A) Hospital admissions
B) Physical functioning
C) Quality of life
D) Symptom management
Q2) 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.
Q3) 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
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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 is caring for diverse population groups at a health clinic. Which of the following patients demonstrates a potential health disparity group?
A) A 26-year-old woman who is receiving follow-up after a car accident.
B) A 30-year-old immigrant who does not speak English.
C) A 28-year-old man who needs a tetanus booster.
D) A 12-month-old with an appointment for immunizations.
Q3) A new nurse requires further teaching when failing to identify which practice as a health disparity?
A) Annual mammogram
B) Early prenatal care
C) Blood pressure screening
D) Frequent fast food meals
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Page 56
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 nurse is interviewing at an agency owned by a national religious organization that serves homeless and uninsured patients. A large poster display shows a proposed addition that would add 16 beds to the facility that will be funded from profits of the previous 3 years of operation. The nurse recognizes that the agency is most likely what type of agency?
A) For-profit
B) Not-for-profit
C) Publicly-owned
D) Investor-owned
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Chapter 56: Health Care Economics
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Q1) What do the economics of health care include?
A) Medicare and Medicaid dollars
B) Patients' rights
C) Equal distribution of health care
D) Nurse salaries
Q2) Which of the following statements is true about health care in the US?
A) The US spends more money on health care than any other nation.
B) The US provides health care to every citizen.
C) The US relies on government funding to treat most citizens.
D) The US spends less money on pediatric care than other nations.
Q3) Two nurses are discussing health care in the past and the present. The two nurses know which to be true about health care in the present?
A) Health care in the present is mostly provided by nurses.
B) Health care in the present is controlled by third party payers.
C) Health care in the present is controlled by physicians.
D) Health care in the present is dictated by the patient.
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Chapter 57: Health Policy
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Q1) 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
Q2) Which of the following is the intent of HIPAA?
A) Release of patient information for purposes of insurance reimbursement.
B) Prevent health care providers from billing for procedures done for the insured person.
C) Protect patients from reviewing their own medical records.
D) Limit the ability of health care providers to sell patient information to outside sources.
Q3) Which of the following components are included in health policy at the state level?
A) Americans with Disabilities Act of 1990
B) Scope of nursing practice
C) Health Insurance Portability and Accountability Act (HIPAA) of 1996
D) Patient Safety and Quality Improvement Act of 2005
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Chapter 58: Health Care Law
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Q1) The admission personnel working to comply with the Patient Self Determination Act of 1991 would do which of the following?
A) Request identification from the patient to complete the registration process.
B) Ask the patient if they would like a private or semi-private room.
C) Inquire about the patient's reason for their visit.
D) Ask the patient or representative if the patient has an advanced directive and inform them of their right to participate in their medical decisions.
Q2) Which is an example of the regulatory power to make law?
A) Joint Commission establishing a medication reconciliation standard.
B) Centers for Disease Control and Prevention (CDC) developing recommendations for childhood immunizations.
C) Institute of Medicine (IOM) defining the approximate number of medication errors that result in significant patient harm or death.
D) Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals.
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