Professional Practice in Nursing
Final Exam
Course Introduction
Professional Practice in Nursing explores the foundational principles, standards, and ethical frameworks that guide nursing professionals in diverse healthcare environments. The course emphasizes the development of critical thinking, communication, and leadership skills essential for effective patient care and interdisciplinary collaboration. Topics include professional conduct, legal and ethical responsibilities, evidence-based practice, cultural competence, and lifelong learning. Through case studies and reflective activities, students gain insight into the complexities of the nursing role and strategies for navigating real-world challenges while upholding the highest standards of the profession.
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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Page 2
Chapter 1: Nursing, Theory, and Professional Practice
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25 Verified Questions
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Sample Questions
Q1) The nurse administers a medication to the patient and then realizes that the medication had been discontinued. The error is immediately reported to the physician. The nurse is complying with the standards of professional performance known as:
A) Ethics.
B) Socialization.
C) Altruism.
D) Autonomy.
Answer: A
Q2) The nursing student is writing a paper about the direct patient care role of advanced practice nurses. Which of the following advanced practice roles would the student include in the report?
A) Nurse Administrator
B) Clinical Nurse Leader
C) Clinical Nurse Specialist
D) Nurse Educator
Answer: C
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Chapter 2: Values, Beliefs, and Caring
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Sample Questions
Q1) A nurse working in a dermatology clinic observes that a patient of Mexican-American descent typically arrives 10 to 15 minutes late to every appointment. Based on an understanding of first-order beliefs, the nurse determines that: (Select all that apply.)
A) first-order beliefs serve as the basis of a person's belief system.
B) first-order beliefs begin to develop in early adolescence.
C) first-order beliefs are completely formed in childhood.
D) people seldom question their first-order beliefs.
E) challenging a patient's first-order beliefs may cause cognitive upset.
Answer: A, D, E
Q2) 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
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Page 4
Chapter 3: Communication
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Sample Questions
Q1) 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
Q2) 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
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Chapter 4: Critical Thinking in Nursing
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Sample Questions
Q1) 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
Q2) The nurse is planning care for a group of patients. Which of the following activities may be delegated to unlicensed assistive personnel?
A) Analysis of the patient's physical condition
B) Morning vital signs, height, and weight.
C) Evaluation of whether colostomy drainage is normal
D) Determining patient readiness for postsurgical learning
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6
Chapter 5: Introduction to the Nursing Process
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Sample Questions
Q1) The term nursing process was first used in 1955. In 1973, the American Nurses Association identified five specific steps of the process. The essential step that was added in 1991 is:
A) assessment.
B) diagnosis.
C) outcome identification.
D) evaluation.
Q2) Which of the following statements would be considered objective data? (Select all that apply.)
A) "I'm short of breath."
B) "Blood pressure 90/68, apical pulse 102, skin pale and moist."
C) "Lung sounds clear bilaterally, diminished in right lower lobe."
D) "I feel weak all over when I exert myself."
E) "My pain level is down to 2. It was 8."
Q3) The nursing process is the foundation of professional nursing practice. As such, the nursing process can be defined as:
A) The framework that nurses used to provide care.
B) A complex process during which nurses think about their thinking.
C) The process that allows nurses to collect essential data.
D) Thinking like a nurse in developing plans of care.
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Chapter 6: Assessment
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Sample Questions
Q1) After the patient's data are collected, validated, and interpreted, the nurse organizes the information in a framework (format) that facilitates access by all members of the health care team. The framework that provides the most holistic view of the patient's condition is:
A) the head-to-toe pattern
B) Marjory Gordon's Functional Health Patterns.
C) the cephalic-caudal pattern.
D) the body systems model.
Q2) During the health history interview, the patient tells the nurse, "Just walking to the mailbox and back makes my calves ache. Is this normal?" Which of the following frameworks would the nurse most likely choose to document this data?
A) Head-to-toe model
B) Gordon's Functional Health Patterns
C) Body systems model
D) Cephalic-caudal model
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8
Chapter 7: Nursing Diagnosis
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Sample Questions
Q1) The nurse is reviewing assessment findings on a patient admitted with an extremely slow heart rate. The patient complains of dizziness, shortness of breath, chest pain, and fainting spells. Vital signs are blood pressure of 98/60 mm Hg and pulse of 52 beats/minute. Oxygen saturation is 88%. Which action should the nurse perform next?
A) Exclude all subjective data in favor of objective data.
B) Focus on data gathered during the physical assessment.
C) Evaluate the data looking for patterns and related data.
D) Dismiss family members input as "hearsay."
Q2) The nurse is developing a plan of care for a patient with gastritis and an inflammation of the intestines. The patient is complaining of severe abdominal discomfort and nausea. The patient also reports having restless leg syndrome and an inability to urinate. As a problem statement of the nursing diagnosis, the nurse should write:
A) Gastritis related to inflammation.
B) Alterations in comfort and ability to void.
C) Abdominal pain and nausea related to inflammation.
D) Alteration in comfort related to restless leg syndrome and inflammation.
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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) Measurable goals are: (Select all that apply.)
A) specific
B) concrete
C) vague
D) easy to judge
E) non-specific
Q3) The nurse is formulating the patient's care plan. In determining when to evaluate the patient's progress, the nurse is aware that evaluations:
A) must be done at the end of every shift.
B) should be done at least every 24 hours.
C) depend on intervention and patient condition.
D) are always done at time of discharge.
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Chapter 9: Implementation and Evaluation
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Sample Questions
Q1) The nurse has many roles. One is to support and work on behalf of patients for whom he/she has concern. This role is known as:
A) advocate.
B) primary care provider.
C) collaborator.
D) delegator.
Q2) The registered nurse is providing an independent nursing intervention when:
A) administering oral medications.
B) administering oxygen.
C) providing emotional support.
D) administering intravenous medication.
Q3) The patient has an order for morphine sulfate 2 mg intravenously prn (as needed) every 2 hours. When the nurse administers this medication, she is providing:
A) an independent nursing intervention.
B) a dependent nursing intervention.
C) a referral
D) an indirect care procedure.
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11
Chapter 10: Documentation, Electronic Health Records, and Reporting
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Sample Questions
Q1) Nurses must be aware of the danger of using abbreviations that may be misunderstood and compromise patient safety. The Joint Commission has compiled a list of do-not-use abbreviations, acronyms, and symbols to avoid the possibility of errors that may be life threatening. Of the following, which are acceptable? (Select all that apply.)
A) Daily
B) QD
C) qod
D)0.X mg
E) X mg
Q2) Which of the following is true regarding nursing documentation?
A) Standards for documentation are established by a national commission.
B) Medical records should be accessible to everyone.
C) Documentation should not include the patient's diagnosis.
D) High-quality nursing documentation reflects the nursing process.
Q3) The use of electronic health records:
A) improves patient health status.
B) requires a keyboard to enter data.
C) has not been shown to reduce medication errors.
D) requires increased storage space.
Page 12
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Chapter 11: Ethical and Legal Considerations
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Sample Questions
Q1) Which statements are correct regarding informed consent and someone who requires an interpreter? (Select all that apply.)
A) A professional interpreter is needed.
B) A family member may interpret when convenient.
C) Detailed medical information remains a priority.
D) Professional interpreters are not effective in providing medical information.
E) If necessary, family members can make decisions regarding informed consent.
Q2) The Code of Ethics for Nurses is:
A) like the Constitution and not revisable.
B) a succinct statement of ethical obligations.
C) required by entry level nurses only.
D) a negotiable document dependent on individual conscience.
Q3) Which of the following nurses has committed a serious documentation error?
A) Susan documents all medications for her patients prior to administration.
B) Jim documents medication administration as the medications are given.
C) Jane documents assessments as they are completed.
D) Jon documents meal intake as he picks up meal trays.
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13
Chapter 12: Leadership and Management
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Sample Questions
Q1) The nurse manager of the emergency room believes that efficiency is the expected standard for her department. She also believes that efficiency lies in following established rules, policies, and guidelines. The only way to change procedures is to changes rules, policies, and guidelines. In order to run the emergency room with this philosophy, the nurse manager must take on the role of:
A) laissez-faire leader.
B) democratic leader.
C) bureaucratic leader.
D) autocratic leader.
Q2) The terms leadership and management are often used interchangeably. Although these concepts are related, they are different in definition and in practice. Leadership behaviors and management skills complement each other. However,
A) managers focus on relationships.
B) a manager may not possess leadership traits.
C) leadership focuses on coordinating and directing others.
D) a manager is a visionary who sets the direction for a group.
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14
Chapter 13: Evidence-Based Practice and Nursing Research
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Sample Questions
Q1) The nurse has identified a research problem. What is the next step for this student?
A) Conduct a literature review.
B) Address ethical procedures.
C) Collect data.
D) Analyze data.
Q2) The nurse is preparing to conduct a research study and is interested in exploring the lived experiences of nurses responsible for approaching patients and family members about the donation of organs. This type of research would be considered:
A) grounded theory.
B) ethnography.
C) historical.
D) phenomenologic.
Q3) An institutional review board (IRB) is a review committee established to:
A) approve research involving animal subjects.
B) approve research that is not government funded.
C) function differently than scholarly journals do.
D) protect the rights of human research subjects.
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Chapter 14: Health Literacy and Patient Education
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Sample Questions
Q1) The nurse is to teach an 84-year-old Spanish-speaking patient newly diagnosed with diabetes how to self-administer insulin. The patient has hearing and visual impairments. In order to be effective as a teacher, the nurse should: (Select all that apply.)
A) assess reading level and learning style.
B) determine readiness to learn.
C) use family members as interpreters.
D) provide written instruction in English.
E) place the patient in group classes.
Q2) On completion of assessment, a nursing diagnosis relevant to the educational needs of the patient or caregiver can be determined. Diagnoses specifically related to patient education include: (Select all that apply.)
A) deficient knowledge.
B) readiness for enhanced knowledge.
C) noncompliance.
D) pain.
E) alteration in elimination.
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Page 16
Chapter 15: Nursing Informatics
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22 Verified Questions
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Sample Questions
Q1) While adopting new technology to enhance patient care and safety, nurses can continue to provide:
A) compassionate care.
B) consumer empowerment.
C) self-management of wellness.
D) education about health care.
Q2) The director of nursing on a medical-surgical floor has met education and experience requirements in nursing informatics. The nurse might expect administration to request that he/she pursue:
A) technical competencies.
B) utility competencies.
C) certification from ANCC.
D) leadership competencies.
Q3) The hospital has recently implemented computer charting. The computerization of nursing practice:
A) enhances and increases the time spent on documentation.
B) makes patient data immediately available to the health care team.
C) makes retrieval of data more difficult but safer.
D) is enhanced by limiting the use of point-of-care technology.
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Page 17
Chapter 16: Health and Wellness
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Sample Questions
Q1) 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.
Q2) When caring for patients with chronic illness, the nurse needs to:
A) help the patient face the reality that he will not get better.
B) emphasize to the patient that the illness is not his fault.
C) emphasize improving quality of life through preventive behaviors.
D) acknowledge the limitations placed on the patient by his suffering.
Q3) The World Health Organization defines health as
A) the absence of disease.
B) the lack of infirmity.
C) complete well-being.
D) being independent of fiscal responsibility.
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Page 18
Chapter 17: Human Development: Conception through Adolescence
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Q1) A nurse is assessing a 12-month-old at a well-baby visit. For what developmental milestones does the nurse assess this child? (Select all that apply.)
A) Sitting up by himself or herself
B) Transferring objects from one hand to the other
C) Able to roll around on the floor
D) Using fingers as a pincer to grasp objects
E) Trying to imitate words he hears others say
Q2) The nurse is collecting a history from the parents of a 4-year-old female at a well-child visit. The parents express concern that they often find their daughter performing what appears to be masturbation. The nurse offers reassurance by explaining which stage of development according to Freud?
A) Oral
B) Phallic
C) Anal
D) Latency
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Chapter 18: Human Development Young Adult to Older Adult
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Q1) The nurse working in long-term care knows that there are multiple theories regarding aging. The one the nurse most identifies with proposes that the body's cells are leading to damaged organs and organ systems. This description is congruent with which theory?
A) Cross-linking theory of aging
B) Wear-and-tear theory
C) Gould's theory on adult development
D) Senescence theory of aging
Q2) The nurse working in a family practice clinic has very limited time to assess patients for health concerns. When working with middle-aged patients, which problems does the nurse assess for as the priorities? (Select all that apply.)
A) Heart disease
B) Cancer
C) Sexually transmitted diseases
D) Stroke
E) Functional abilities
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Chapter 19: Vital Signs
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Q1) A nurse is caring for a patient who has a high temperature. The nurse plans to help the patient regain a normal temperature through conduction. What technique does the nurse use?
A) Placing a cooling fan in the patient's room
B) Putting ice packs in the patient's axillae
C) Spraying the patient with a fine mist of water
D) Turning the temperature down in the room
Q2) A nursing student is caring for a patient with metabolic acidosis. The student asks the registered nurse why the patient's respiratory rate is so high. What response by the nurse is best?
A) "The patient's metabolic rate is increased from being ill."
B) "The lungs are trying to rid the body of extra carbon dioxide."
C) "The patient is trying to reduce his temperature through panting."
D) "Patients who are acutely ill often have abnormal vital signs."
Q3) A nurse notes a patient has abnormal vital signs. What action by the nurse is best?
A) Document the findings.
B) Notify the provider.
C) Compare with prior readings.
D) Retake the vital signs.
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Page 21
Chapter 20: Health History and Physical Assessment
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Q1) The nurse examining a patient's skin correlates which conditions with which underlying pathology? (Select all that apply.)
A) Albinism: Full-thickness burns
B) Peripheral cyanosis: poor circulation
C) Purpura: clotting disorders
D) Jaundice: liver disease
E) Vitiligo: skin infestation
Q2) A nurse is educating women on breast cancer risk reduction. What topics does the nurse include in the presentation? (Select all that apply.)
A) Exercise
B) Limiting alcohol
C) Low-fat diet
D) Breast self exams
E) Milk intake
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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Page 22
Chapter 21: Ethnicity and Cultural Assessment
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Q1) 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
Q2) A nurse is caring for a refugee patient who wants the community shaman to perform a healing ritual at the bedside. What action by the nurse is best?
A) Work with the patient to allow the shaman to perform the ritual.
B) Investigate whether the ritual will harm the patient.
C) Check to see if the ritual breaks laws or policies.
D) Offer to call the hospital chaplain instead.
Q3) A nurse has been told he has many obvious stereotypes about a specific cultural group. What action by the nurse is best?
A) Ask to not care for members of this cultural group.
B) Ask to take care of as many members of this group as possible.
C) Begin to educate himself on aspects of this cultural group.
D) Vow to not allow his stereotypes to show when providing care.
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Page 23
Chapter 22: Spiritual Health
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Q1) The student nurse asks why spirituality is important in health care. What response by the registered nurse is best?
A) "All people have a spiritual aspect to their beings."
B) "Spirituality affects behavior, which also affects health."
C) "Knowledge of it is needed to understand a patient holistically."
D) "People who are less spiritual have worse outcomes."
Q2) A patient is considering a life-saving procedure that is not accepted by his faith community. What nursing diagnosis is a priority as the nurse plans care?
A) Spiritual distress
B) Impaired religiosity
C) Moral distress
D) Decisional conflict
Q3) The student using the FICA Spiritual Health Assessment will consider which factors? (Select all that apply.)
A) Faith and belief
B) Focused practices
C) Importance of faith
D) Faith community involvement
E) Address spirituality in care
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Page 24
Chapter 23: Public Health, Community Base, and Home Health Care
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Q1) 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
Q2) A nurse wants to create a community action plan for health problems related to air pollution from a nearby factory. Which stakeholders does the nurse consult as the priority? (Select all that apply.)
A) Factory owners
B) Stock shareholders
C) Community residents
D) Local health care providers
E) Factory employees
Q3) The student learns that which is the best definition of a public health nurse?
A) Works with the public
B) Works in public areas
C) Works with the greater community
D) Works with public funding
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Chapter 24: Human Sexuality
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Q1) A patient has been diagnosed with a sexually transmitted disease (STD) and the patient's partner is angry, saying, "She must have cheated on me." What response by the nurse is most appropriate?
A) "This infection may have been present for a long time."
B) "You need to be tested for this disease too."
C) "Yes, you're right; if you don't have the STD, she cheated."
D) "Now, now, getting angry will not help anything."
Q2) A nurse understands that which characteristics of family dynamics impact a patient's sexuality? (Select all that apply.)
A) Religion
B) Age
C) Ethnicity
D) Culture
E) Geographic location
Q3) The nurse learns that spermatozoa are produced in which sexual organ?
A) Scrotum
B) Testes
C) Glans
D) Prostate
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Page 26
Chapter 25: Safety
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Q1) The nurse knows that which of the following is not used to assess fall risk?
A) Glasgow Falls Scale
B) Johns Hopkins Hospital Fall Assessment Tool
C) Morse Fall Scale
D) Hendrich II Fall Risk Model
Q2) The patient has a nursing diagnosis of risk for falls. Which goal is most important?
A) Patient will ambulate twice a day.
B) Patient will have no symptoms of infection.
C) Patient will perform activities of daily living.
D) Patient will have no injuries during hospital stay.
Q3) Which collaborative team member would be most effective in assisting the nurse to identify medication alternatives that are less likely to cause drowsiness and dizziness to reduce the risk of falls in the elderly patient?
A) Nursing house manager
B) Charge nurse
C) Physical therapist
D) Pharmacist
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Chapter 26: Asepsis and Infection Control
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Q1) The nurse has placed her sterile gloved hands below her waist. Her hands are now considered:
A) sterile.
B) aseptic.
C) non-sterile.
D) free of disease-causing organisms.
Q2) The second line of defense that leads to local capillary dilation and leukocyte infiltration is known as:
A) normal flora.
B) inflammatory response.
C) immune response.
D) humoral immunity.
Q3) The nurse understands that which set of vitals most likely indicates infection?
A) 98.6, 75, 18, 120/80
B) 99, 80, 19, 110/70
C) 100.5, 96, 22, 150/100
D) 98.9, 65, 18, 98/62
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Chapter 27: Hygiene and Personal Care
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Q1) The nurse and UAP are making an occupied bed together. Which action by the nurse is incorrect?
A) The nurse asks and assists the patient to turn toward the UAP and loosens the fitted sheet and rolls it in toward the patient.
B) The nurse rolls dirty linens to the side then places the linens on the floor while finishing.
C) The nurse tucks the clean bottom sheet under the cleaner underside of the dirty linens.
D) The nurse wears gloves to remove dirty linens.
Q2) Which member of the collaborative team is most appropriate to cut the toenails of a diabetic patient?
A) Nurse
B) Physical therapist
C) Occupational therapist
D) Podiatrist
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Chapter 28: Activity, Immobility, and Safe Movement
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Q1) The nurse is educating the family of a patient on falls risk precautions. Which of the following statements by the family indicates a need for further education?
A) "I should keep the wheelchair locked unless using it to move Mom."
B) "I should always leave the bathroom light on."
C) "I should use nonskid socks, not shoes."
D) "I should keep her cell phone close to her bed."
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 implementing generalized falls precautions for his patients who are at risk for falls. Which intervention indicates a lack of understanding of these precautions?
A) The bed is placed in the low position.
B) The patient is wearing socks.
C) The patient's cell phone is by the bedside.
D) The patient's call light is within reach.
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30
Chapter 29: Skin Integrity and Wound Care
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Sample Questions
Q1) The nurse knows the following types of wounds heal by tertiary intention:
A) An acute wound in which the patient has sutures placed when it happened
B) A pressure ulcer that was treated with dressing changes and healed
C) An acute wound in which surgical glue was used to close the wound
D) A wound that was left open initially and closed later with sutures
Q2) The nurse knows a stage III pressure ulcer is:
A) a pressure ulcer that involves exposure of bone and connective tissue.
B) a pressure ulcer that does not extend through the fascia.
C) a pressure ulcer that does not include tunneling.
D) a partial-thick wound that involves the epidermis.
Q3) The nurse is delegating care of a patient with a chronic nonsterile wound to a UAP.
The delegation is inappropriate if:
A) the nurse asks the UAP to assess the wound.
B) the nurse asks the UAP to report increased wound drainage.
C) the nurse asks the UAP to observe changes in dietary intake.
D) the nurse asks the UAP to change the dressing.
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Chapter 30: Nutrition
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Sample Questions
Q1) The nurse knows that initial verification of a nasogastric placement is important. Which method is considered the only reliable method to determine enteral tube placement?
A) Auscultation of air bolus
B) Measurement of pH of the aspirate
C) Radiographic image
D) Aspirate contents to visually inspect appearance
Q2) The nurse is educating a patient about including more omega-3 fatty acids in her diet. Which of the following food sources should be included? (Select all that apply.)
A) Salmon
B) Flaxseed
C) Mackerel
D) Steak
Q3) The nurse knows an appropriate outcome statement for the nursing diagnosis Impaired swallowing is:
A) the patient will consume 50% of his meal.
B) the patient will gain 2 lb a week.
C) the patient will show any signs of aspiration during meals.
D) the patient will demonstrate using an assistive device to feed himself.
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Page 32
Chapter 31: Cognitive and Sensory Alterations
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Sample Questions
Q1) A nurse is caring for a patient with a stroke that has impacted her ability to see. Which area of the brain was likely impacted by the stroke that is responsible for visual function?
A) Parietal lobes
B) Frontal lobes
C) Occipital lobes
D) Temporal lobes
Q2) The nurse is preparing discharge instructions for a patient who has equilibrium alterations. Which instructions should be included? (Select all that apply.)
A) Use grab bars in the tub and/or shower at home.
B) Keep rooms well lit and focus ahead when walking.
C) Change positions quickly to avoid dizziness.
D) Use a cane or walker for stability.
E) Ride in the back seat of the car and look ahead.
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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Sample Questions
Q1) The nurse knows that certain personality factors have been shown to buffer the impact of stress. These factors are: (Select all that apply.)
A) resilience.
B) sense of coherence.
C) gender.
D) hardiness.
E) coping style.
Q2) The nurse is assessing the patient's use of coping skills in response to stressful situations. Which of the following questions is the most useful?
A) "Have you been evaluated for stress?"
B) "Do you have someone you can go to for help when you are stressed?"
C) "How have you managed stressful situations in the past?"
D) "Does stress cause you to experience muscle tension or headaches?"
Q3) The nurse knows that one theory explaining the variation in response to stress among individuals is called:
A) stress appraisal.
B) sense of coherence.
C) allostasis.
D) homeostasis.
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Chapter 33: Sleep
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Sample Questions
Q1) 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.
Q2) The nurse is admitting a patient to the general medical-surgical unit. What should the nurse assess as part of a routine sleep assessment? (Select all that apply.)
A) Usual sleeping and waking times
B) Bedtime routines
C) Sleeping environment preferences
D) Medications used for sleep
E) Any current life events
F) None of the above
Q3) The nurse knows an appropriate goal for the nursing diagnosis Sleep deprivation is:
A) the patient will remain asleep for 6 to 7 hours consistently for 1 week.
B) the patient will fall asleep within 15 minutes of going to bed.
C) the patient will report an ability to concentrate on tasks.
D) the patient will repeat medication instructions on discharge.
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35
Chapter 34: Diagnostic Testing
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Q1) The nurse is caring for a patient who is sedated following a colonoscopy. Which is the priority action of the nurse?
A) Provide a quiet, dark environment so that the patient can rest comfortably.
B) Monitor the patient's pulse oximetry and respirations closely.
C) Inform the patient that the procedure has been completed.
D) Assess the patient's bowel sounds and passage of flatus.
Q2) The nurse is caring for a patient who has been having abdominal pain. The doctor suspects that the patient may have an abdominal aortic aneurysm. Which tests would confirm the doctor's suspicion? (Select all that apply.)
A) Magnetic resonance imaging (MRI) scan
B) Needle aspiration with biopsy
C) Fiberoptic endoscopy
D) Computed tomography (CT) scan
E) Flexible sigmoidoscopy
F) Thoracentesis
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Chapter 35: Medication Administration
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Q1) The nurse is caring for a patient who is NPO with a new PEG (percutaneous endoscopic gastrostomy) tube. Which of the patient's medications can the nurse administer through the tube? (Select all that apply.)
A) Edluar (zolpidem tartrate) sublingual tablet 5 mg nightly at bedtime
B) Ondansetron (Zofran) oral disintegrating tablet 8 mg q 8 hours PRN nausea
C) Ceclor (cefaclor for oral suspension) 250 mg q 6 hours
D) Oxymorphone hydrochloride extended release (Opana ER) 40 mg q 12 hours
E) Phenytoin (Dilantin) chewable tablet 100 mg q 12 hours
F) Potassium chloride oral solution 20 mEq daily
Q2) The nurse suspects that the patient is experiencing a drug toxicity rather than a side effect. Which question will the nurse ask to help confirm this suspicion?
A) "When did you take your last dose of the medication?"
B) "Have you been taking extra doses of the medication?"
C) "Are you taking any other medications?"
D) "Have you ever taken this medication in the past? "
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Chapter 36: Pain Management
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Q1) The nurse is caring for a patient who has severe burning pain in his right arm caused by a compressed nerve in his neck. Which medications can be used along with a narcotic pain reliever to relieve the patient's pain until surgery can be performed to release the nerve? (Select all that apply.)
A) Diphenhydramine (Benadryl) 50 mg PO daily
B) Amitriptyline (Elavil) 50 mg PO BID
C) Ondansetron (Zofran) 8 mg PO q 4 hours PRN
D) Gabapentin (Neurontin) 400 mg PO BID
E) Senna (Senokot) 8.6 mg PO daily
F) Naloxone (Narcan) 0.4 mg IV now, may repeat in 1 hour PRN
Q2) What is the priority nursing assessment for a patient who his receiving postoperative epidural analgesia with hydromorphone (Dilaudid)?
A) Respiratory rate, depth, and pattern
B) Skin underneath the epidural dressing
C) Bladder scanning to check for urinary retention
D) Itching on the trunk and/or extremities
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38
Chapter 37: Perioperative Nursing Care
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Sample Questions
Q1) Which of the following patients would benefit from preoperative teaching about splinting of incisions to minimize discomfort? (Select all that apply.)
A) Patient having coronary bypass graft surgery
B) Patient having open breast biopsy
C) Patient having total hip replacement surgery
D) Patient having lumbar spine decompression surgery
E) Patient having surgery to repair retinal detachment
F) Patient having total abdominal hysterectomy
Q2) The nurse will be caring for a patient who has just arrived on the medical-surgical unit following surgical repair of his fractured right ankle. Which is the priority action of the nurse when the patient arrives on the unit?
A) Instruct the patient how to call for assistance using the call light.
B) Assess the color and warmth of the toes on the patient's right foot.
C) Determine when the patient's next pain medication is due.
D) Check pulse oximetry and obtain a full set of vital signs.
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Chapter 38: Oxygenation and Tissue Perfusion
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Q1) 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
Q2) The nurse is caring for a patient with a chest tube who was transported to radiology for testing. When the patient returns to the nursing unit, the transporter shows the nurse the patient's chest tube collection device, which was badly damaged after being caught in the elevator door. What is the priority action of the nurse?
A) Clamp the chest tube until the collection device is replaced.
B) Cover the insertion site with a new occlusive dressing.
C) Ensure that there is gentle bubbling in the water seal chamber.
D) Check the patient's lung sounds and pulse oximetry.
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Chapter 39: Fluid, Electrolytes, and Acid-Base Balance
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Q1) The nurse is caring for a patient with congestive heart failure who requires intermittent IV bolus doses of furosemide (Lasix) for a few days to correct fluid volume overload. No continuous IV fluids are ordered. Which type of IV will the nurse insert in order to administer the patient's medication?
A) Peripherally inserted central catheter
B) Midline inside-the-needle catheter
C) Central venous catheter
D) Over-the-needle catheter
Q2) The nurse is caring for a patient who is admitted with a serum sodium level of 120 mEq/L. Which is the most important intervention for the nurse to perform?
A) Perform regular neurologic checks and institute seizure precautions.
B) Encourage the patient to eat foods that are high in sodium.
C) Administer hypotonic IV solutions as ordered by the physician.
D) Assess for signs and symptoms of digoxin (Lanoxin) toxicity.
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Chapter 40: Bowel Elimination
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Q1) The nurse is caring for a postoperative patient who underwent bowel resection surgery that morning. The nurse assesses the patient's abdomen and notes that there are hypoactive bowel sounds. The patient is resting quietly without nausea or vomiting. What is the appropriate action of the nurse?
A) Keep the patient NPO and document the findings in the chart.
B) Administer a laxative suppository to stimulate peristalsis.
C) Insert a Salem sump nasogastric tube to low continuous suction.
D) Notify the surgeon and prepare the patient to return to surgery.
Q2) The nurse is caring for a postoperative patient who had a colostomy placed 2 days ago. The appliance needs to be changed for the first time. Which ostomy care actions may the nurse delegate to the nursing assistant? (Select all that apply.)
A) Gently cleaning the stoma with warm water and a washcloth.
B) Assessing the stoma and incision for signs of infection or ischemia.
C) Obtaining needed supplies from the clean utility room.
D) Teaching the patient how to care for the ostomy after discharge.
E) Determining which type of ostomy appliance to use.
F) Application of skin protectant to the area surrounding the stoma.
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Chapter 41: Urinary Elimination
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Q1) The nurse is caring for a patient who recently underwent ileal conduit surgery. Which nursing diagnosis is the highest priority for this patient?
A) Ineffective sexuality pattern related to changed body structure
B) Social isolation related to potential for accidental leakage of urine
C) Knowledge deficit related to care and maintenance of ostomy appliance
D) Disturbed body image related to presence of stoma and appliance
Q2) The nurse is caring for a patient who will undergo ultrasound testing of the bladder and kidneys the next morning. Which instruction will the nurse provide to the patient about the test?
A) "A small IV will be inserted into your arm to inject the contrast dye."
B) "You will need to drink lots of water but not use the toilet."
C) "You should not have anything to eat or drink after midnight."
D) "You will receive a cleansing enema before you have the test."
Q3) 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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Page 43
Chapter 42: Death and Loss
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Q1) The nurse is caring for a patient who died a few minutes ago. The patient's family is at the bedside and very demonstrative in their grief, weeping loudly and holding on to the patient's body. What is the most appropriate action of the nurse?
A) Inform the family that the patient's body must be taken to the morgue shortly.
B) Ask the family members to step outside while postmortem care is provided.
C) Obtain required signatures for the body to be taken to the funeral home.
D) Provide privacy and allow the patient's family to grieve over the body.
Q2) The nurse is caring for a terminally ill patient whose family is insistent that additional chemotherapy be administered even though the patient will most likely die within the next few days. What is the best response of the nurse?
A) "The insurance company will not pay for chemotherapy at this stage."
B) "The focus right now needs to be on keeping your loved one comfortable."
C) "I will call the physician and let him know that you would like to restart chemotherapy."
D) "The patient needs to get stronger first before chemotherapy can be administered."
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