Clinical Reasoning in Nursing Practice Questions
Course Introduction
Clinical Reasoning in Nursing is a foundational course that equips students with the critical thinking and decision-making skills necessary for effective nursing practice. Through the exploration of case studies and real-life scenarios, students learn to assess patient information, identify key health problems, prioritize care, and formulate sound clinical judgments. The course emphasizes the application of systematic reasoning processes to ensure safe, evidence-based patient care across diverse clinical settings. By integrating theory with practice, students develop the confidence and competence needed to navigate complex clinical situations, enhancing their ability to achieve positive patient outcomes.
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) 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
Q2) The school nurse talking with a high school class about the difference between growth and development would best describe growth as A) processes by which early cells specialize.
B) psychosocial and cognitive changes.
C) qualitative changes associated with aging.
D) quantitative changes in size or weight.
Answer: D
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Chapter 2: Functional Ability
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) Uses a cane
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: B
Q2) Bathes daily
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: B
Q3) A 65-year-old female patient has been admitted to the medical/surgical unit. The nurse is assessing the patient's risk for falls so that falls prevention can be implemented if necessary. Select all the risk factors that apply from this patient's history and physical. (Select all that apply.)
A) Being a woman
B) Taking more than six medications
C) Having hypertension
D) Having cataracts
E) Muscle strength 3/5 bilaterally
F) Incontinence
Answer: B, D, E, F
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Page 4
Chapter 3: Family Dynamics
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7 Verified Questions
7 Flashcards
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Sample Questions
Q1) The nurse planning to assess the structure of a family should ask which question?
A) "Who lives with you in this home?"
B) "Who does the grocery shopping?"
C) "Who provides support in your family?"
D) "How old are the members of your family?"
Answer: A
Q2) 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
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5
Chapter 4: Culture
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Sample Questions
Q1) A 60-year-old Italian immigrant presents for an annual physical. He is counseled about diagnostic testing including laboratory testing, colonoscopy, influenza vaccination, and pneumococcal vaccination. His reply is "If it ain't broke, don't try to fix it."
When developing a plan of care, the nurse should consider which cultural orientation for this patient?
A) Short term
B) Long term
C) Leisurely term
D) Noncommittal
Q2) The emphasis on understanding cultural influence on health care is important because of
A) disability entitlements.
B) HIPAA requirements.
C) increasing global diversity.
D) litigious society.
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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7 Verified Questions
7 Flashcards
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Sample Questions
Q1) The nurse is assessing a patient's spirituality and observes the patient meditating before any treatments. What is the nurse's best action?
A) Document that the patient is not religious
B) Offer the patient a copy of the bible to read
C) Arrange for quiet time for the patient as needed
D) Limit the time patient can meditate before procedures
Q2) The nurse recognizes that which life events can be spiritually life changing? (Select all that apply.)
A) Births
B) Weddings
C) Medical diagnoses
D) Career day to day job duties
E) Loss of independence
Q3) When developing a plan of care, the nurse should consider which attribute of the Chapter of spirituality?
A) Spirituality is not a well-known universal concept
B) Chronic versus acute illnesses affect spirituality
C) Convincing patients to pray is a priority intervention
D) Referrals may be needed to spiritual counselors
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Page 7
Chapter 6: Adherence
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) The nurse is evaluating the need to refer a patient with osteoarthritis for a home care visit to be sure the patient can function in accomplishing daily activities independently. What is the nurse's first priority?
A) Determine if the patient has had home visits before and if the experience was positive.
B) Check the patient's ability to bathe without any assistance the next day.
C) Have the patient demonstrate the learned skills at the end of the teaching session.
D) Arrange a physical therapy visit before the patient is discharged from the hospital.
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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7 Flashcards
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Sample Questions
Q1) 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?"
Q2) 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."
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9
Chapter 8: Fluid and Electrolyte Balance
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9 Flashcards
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Sample Questions
Q1) 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.
Q2) The nurse is admitting an older adult with decompensated congestive heart failure. The nursing assessment reveals adventitious lung sounds, dyspnea, and orthopnea. The nurse should question which doctor's order?
A) Intravenous (IV) 500 mL of 0.9% NaCl at 125 mL/hr
B) Furosemide (Lasix) 20 mg PO now
C) Oxygen via face mask at 8 L/min
D) KCl 20 mEq PO two times per day
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Chapter 9: Acid-Base Balance
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7 Verified Questions
7 Flashcards
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Sample Questions
Q1) The patient is hyperventilating from anxiety and abdominal pain. Which assessment findings should the nurse attribute to respiratory alkalosis? (Select all that apply.)
A) Skin pale and cold
B) Tingling of fingertips
C) Heart rate of 102
D) Numbness around mouth
E) Cramping in feet
Q2) The patient has severe hyperthyroidism and will have surgery tomorrow. What assessment is most important for the nurse to assess in order to detect development of the acid-base imbalance for which the patient has highest risk?
A) Urine output and color
B) Level of consciousness
C) Heart rate and blood pressure
D) Lung sounds in lung bases
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Chapter 10: Thermoregulation
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8 Verified Questions
8 Flashcards
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Sample Questions
Q1) The nurse planning care for a patient with hypothermia should consider what similar exemplar?
A) Heat exhaustion
B) Heat stroke
C) Infection
D) Prematurity
Q2) 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
Q3) The nursery nurse should identify which newborn at significant risk for hypothermic alteration in thermoregulation?
A) Large for gestational age
B) Low birth weight
C) Born at term
D) Well nourished
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12
Chapter 11: Sleep
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7 Verified Questions
7 Flashcards
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Sample Questions
Q1) 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."
Q2) The nurse is making rounds on the hospital unit and observes a patient sleeping. The patient's pulse and respiratory rates are slower than baseline. The nurse realizes the patient has most likely just entered which stage of non-rapid eye movement sleep?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
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13
Chapter 12: Cellular Regulation
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11 Flashcards
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Sample Questions
Q1) While planning care for a patient experiencing fatigue due to chemotherapy, which of the following is the most appropriate nursing intervention?
A) Prioritization and administration of nursing care throughout the day
B) Completing all nursing care in the morning so the patient can rest the remainder of the day
C) Completing all nursing care in the evening when the patient is more rested
D) Limiting visitors, thus promoting the maximal amount of hours for sleep
Q2) The nurse is caring for a patient who received a bone marrow transplant 10 days ago. The nurse would monitor for which of the following clinical manifestations that could indicate a potentially life-threatening situation?
A) Mucositis
B) Confusion
C) Depression
D) Mild temperature elevation
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14
Chapter 13: Intracranial Regulation
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7 Flashcards
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Sample Questions
Q1) The nurse preparing to care for a patient after a suspected stroke would question which order?
A) Antihypertensive
B) Antipyretic
C) Osmotic diuretic
D) Sedative
Q2) The nurse should teach a patient that which is a primary prevention strategy to reduce the occurrence of head injuries?
A) Blood pressure control
B) Smoking cessation
C) Maintaining a healthy weight
D) Violence prevention
Q3) 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
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15
Chapter 14: Hormonal Regulation
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7 Flashcards
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Sample Questions
Q1) Radioactive iodine is indicated for the treatment of hyperthyroidism. The nurse should include which teaching in this patient's plan of care?
A) Isolation is required for 6-8 weeks
B) An additional dose may be needed
C) Thyroid replacement therapy is prescribed
D) An overnight hospital stay is required
Q2) 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
Q3) 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
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16
Chapter 15: Glucose Regulation
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7 Flashcards
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Sample Questions
Q1) Which of the following would be included in the assessment of a patient with diabetes mellitus who is experiencing a hypoglycemic reaction? (Select all that apply.)
A) Tremors
B) Nervousness
C) Extreme thirst
D) Flushed skin
E) Profuse perspiration
F) Constricted pupils
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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8 Verified Questions
8 Flashcards
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Sample Questions
Q1) The home care nurse is assessing an older patient diagnosed with mild cognitive impairment (MCI) in the home setting. Which information is of concern?
A) The patient's son uses a marked pillbox to set up the patient's medications weekly.
B) The patient has lost 10 pounds (4.5 kg) during the last month.
C) The patient is cared for by a daughter during the day and stays with a son at night.
D) The patient tells the nurse that a close friend recently died.
Q2) An African American is at an increased risk for which of the following? (Select all that apply.)
A) Vitamin D deficiency
B) Type 1 diabetes
C) Celiac disease
D) Type 2 diabetes
E) Hypertension
F) Metabolic syndrome
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Chapter 17: Elimination
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Sample Questions
Q1) When conducting a health history assessment, the nurse would want to know what most important information about the patient's elimination status? (Select all that apply.)
A) Recent changes in elimination patterns
B) Changes in color, consistency, or odor of stool or urine
C) Time of day patient defecates
D) Discomfort or pain with elimination
E) List of medications taken by patient
F) Patient's preferences for toileting
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."
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19
Chapter 18: Perfusion
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Sample Questions
Q1) The patient asks the nurse to explain the function of the sinoatrial node in the heart. What is the nurse's best response?
A) "The sinoatrial node stimulates the heart to beat in a normal rhythm."
B) "The sinoatrial node protects the heart from atherosclerotic changes."
C) "The sinoatrial node provides the heart with oxygenated blood."
D) "The sinoatrial node protects the heart from infection."
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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10 Flashcards
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Sample Questions
Q1) A 3-month-old infant is at increased risk for developing anemia. The nurse would identify which principle contributing to this risk?
A) The infant is becoming more active.
B) There is an increase in intake of breast milk or formula.
C) The infant is unable to maintain an adequate iron intake.
D) A depletion of fetal hemoglobin occurs.
Q2) Which patient finding would the nurse identify as being a risk factor for altered transport of oxygen?
A) Hemoglobin level of 8.0
B) Bronchoconstriction and mucus
C) Peripheral arterial disease
D) Decreased thoracic expansion
Q3) Which clinical management prevention Chapter would the nurse identify as representative of secondary prevention?
A) Decreasing venous stasis and risk for pulmonary emboli
B) Implementation of strict hand washing routines
C) Maintaining current vaccination schedules
D) Prevention of pneumonia in patients with chronic lung disease
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Chapter 20: Clotting
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Sample Questions
Q1) The nurse would expect to administer an anticoagulant to a patient following which surgery?
A) Hip replacement
B) Hysterectomy
C) Abdominal aorta aneurism (AAA) repair
D) Appendectomy
Q2) A patient on a medical surgical unit has a platelet count of 90,000 per mm³. The nurse knows to include which of the following precautions in discharge instructions?
A) Use a standard safety razor for shaving.
B) Use a soft bristle toothbrush.
C) Have aggressive dental care immediately to prevent dental caries.
D) Do not eat fresh fruit.
Q3) Which nursing observation would indicate that the nurse hold the medication warfarin (Coumadin)?
A) An INR (international normalize ratio) of 1.8
B) An INR of 4.8
C) A partial thromboplastin time (APTT) level of 25 seconds
D) An APTT level of 35 seconds
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Chapter 21: Reproduction
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Sample Questions
Q1) A female college student is planning to become sexually active. She is considering birth control options and desires a method in which ovulation will be prevented. To prevent ovulation while reaching 99% effectiveness in preventing pregnancy, which option should be given the strongest consideration?
A) Intrauterine device
B) Coitus interruptus
C) Natural family planning
D) Oral contraceptive pills
Q2) The emergency department nursing assessment of a pregnant female at 35 weeks gestation reveals back pain, blood pressure 150/92, and leaking of clear fluid from the vagina. Which complication of pregnancy does the nurse suspect?
A) Ectopic pregnancy
B) Spontaneous abortion
C) Premature rupture of membranes
D) Supine hypotension
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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) An 18-month-old female patient is diagnosed with her fifth ear infection in the past 10 months. The physician notes that the child's growth rate has decreased from the 60th percentile for height and weight to the 15th percentile over that same time period. The child has been treated for thrush consistently since the third ear infection. The nurse understands that the patient is at risk for which condition?
A) Primary immunodeficiency
B) Secondary immunodeficiency
C) Cancer
D) Autoimmunity
Q2) The nurse is caring for a patient who was started on intravenous antibiotic therapy earlier in the shift. As the second dose is being infused, the patient reports feeling dizzy and having difficulty breathing and talking. The nurse notes that the patient's respirations are 26 breaths/min with a weak pulse of 112 beats/min. The nurse suspects that the patient is experiencing which condition?
A) Suppressed immune response
B) Hyperimmune response
C) Allergic reaction
D) Anaphylactic reaction
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25
Chapter 24: Inflammation
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Sample Questions
Q1) The nurse assesses the patient and notes all of the following. Select all of the findings that indicate the systemic manifestations of inflammation.
A) Oral temperature 38.6° C/101.5° F
B) Thick, green nasal discharge
C) Patient complaint of pain at 6 on a 0 to 10 scale on palpation of frontal and maxillary sinuses
D) WBC 20 cells/McL \(\times\) 10<sup>9</sup>/L
E) Patient reports, "I'm tired all the time. I haven't felt like myself in days."
Q2) 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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Chapter 25: Infection
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Sample Questions
Q1) Individuals of low socioeconomic status are at an increased risk for infection because of which of the following? (Select all that apply.)
A) Uninsured or underinsured status
B) Easy access to health screenings
C) High cost of medications
D) Inadequate nutrition
E) Mostly female gender
Q2) In order to provide the best intervention for a patient, the nurse is often responsible for obtaining a sample of exudate for culture. What information will this provide?
A) Whether a patient has an infection.
B) Where an infection is located.
C) What cells are being utilized by the body to attack an infection.
D) What specific type of pathogen is causing an infection.
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Chapter 26: Mobility
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Sample Questions
Q1) The nurse is talking to the unlicensed assistive personnel about moving a patient in bed. The nurse knows the unlicensed assistive personnel understands the Chapter of mobility and proper moving techniques when making which statement?
A) "Patients must have a trapeze over the bed to move properly."
B) "Patients should move themselves in bed to prevent immobility."
C) "Patients should always have a two-person assist to move in bed."
D) "Patients must be moved correctly in bed to prevent shearing."
Q2) The lack of weight bearing leads to what effects on the skeletal system?
A) Demineralization, calcium loss
B) Thickened bones
C) Increased range of motion
D) Increased calcium deposition in the bones
Q3) A patient who has been in the hospital for several weeks is about to be discharged. The patient is weak from the hospitalization and asks the nurse to explain why this is happening. 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."
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Page 28
Chapter 27: Tissue Integrity
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Sample Questions
Q1) To help decrease the threat of a melanoma in a blonde-haired, fair-skinned patient at risk, the nurse would advise the patient to do which of the following?
A) Apply sunscreen 1 hour prior to exposure.
B) Drink plenty of water to prevent hot skin.
C) Use vitamins to help prevent sunburn by replacing lost nutrients.
D) Apply sunscreen 30 minutes prior to exposure.
Q2) A patient in the outpatient setting was diagnosed with atopic dermatitis. What interventions will the plan of care focus primarily on?
A) Decreasing pain
B) Decreasing pruritus
C) Preventing infection
D) Promoting drying of lesions
Q3) The nurse is instructing the nursing assistant to prevent pressure ulcers in a frail older patient. Which action indicates the nursing assistant has understood the nurse's teaching?
A) Bathing and drying the skin vigorously to stimulate circulation
B) Keeping the head of the bed elevated 30 degrees
C) Limiting intake of fluid and offer frequent snacks
D) Turning the patient at least every 2 hours
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Page 29
Chapter 28: Sensory Perception
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Sample Questions
Q1) During the examination of the ear, a dark yellow substance is noted in the ear canal. The tympanic membrane is not visible. The patient's wife complains that he never hears what she says lately. These findings would suggest that the nurse prepare the patient for which procedure?
A) Tympanoplasty
B) Irrigation of the ear
C) Pure tone test
D) Otoscopic exam by a specialist
Q2) The nurse is providing health teaching to a group of mothers of school-aged children. Which statement by a mother indicates the need for additional instruction?
A) "I will take my child to the audiologist because he doesn't seem to hear me except when I look directly at him."
B) "Both of my children have the same eye medication, which is a real bonus, because I only need to buy one bottle."
C) "Making my child wear ear plugs when she goes to a rock concert may save her hearing!"
D) "I see now why when my child has a cold, he complains about everything tasting blah!"
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30
Chapter 29: Pain
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Sample Questions
Q1) An elderly Chinese woman is interested in biologically based therapies to relieve osteoarthritis (OA) pain. You are preparing a plan of care for her OA. Options most conducive to her expressed wishes may include which actions or activities?
A) Pilates, breathing exercises, and aloe vera
B) Guided imagery, relaxation breathing, and meditation
C) Herbs, vitamins, and tai chi
D) Alternating ice and heat to relieve pain and inflammation
Q2) Controlling pain is important to promoting wellness. Unrelieved pain has been associated with 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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Source URL: https://quizplus.com/quiz/2351
Sample Questions
Q1) The nurse is caring for a patient diagnosed with amyotrophic lateral sclerosis. The nurse should assess for which priority problem?
A) Fatigue
B) Bradypnea
C) Hypertension
D) Fall risk
Q2) A patient presents to the clinic complaining of nausea, vomiting, and fatigue. Lab results reveal elevated BUN and creatinine levels. Which acute condition is this patient at most risk for developing?
A) Influenza
B) Mononucleosis
C) Acute renal failure
D) Pneumonia
Q3) A patient with chronic kidney disease is most likely to complain of which symptom?
A) Fatigue
B) Thirst
C) Constipation
D) Excess bleeding
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Chapter 31: Stress
10 Flashcards
Source URL: https://quizplus.com/quiz/2352
Sample Questions
Q1) A patient tells the nurse "My doctor thinks my problems with stress relate to the negative way I think about things, and he wants me to learn a new way of thinking." Which response would be in keeping with the doctor's recommendations?
A) Teaching the patient to recognize, reconsider, and reframe irrational thoughts
B) Encouraging the patient to imagine being in calming circumstances
C) Teaching the patient to use instruments that give feedback about bodily functions
D) Provide the patient with a blank journal and guidance about journaling
Q2) An older patient presents to the outpatient clinic with a chief complaint of headache and insomnia. In gathering the history, the nurse notes which factors as contributing to this patient's chief complaint?
A) The patient is responsible for caring for two school-age grandchildren.
B) The patient's daughter works to support the family.
C) The patient is being treated for hypertension and is overweight.
D) The patient has recently lost her spouse and needed to move in with her daughter.
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Chapter 32: Coping
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Sample Questions
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 developing a care plan for a patient with ineffective coping skills. Which intervention would be an example of a problem-focused coping strategy?
A) Scheduling a regular exercise program
B) Attending a seminar on treatment options
C) Identifying a confidant to share feelings
D) Attending a support group for families
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Chapter 33: Mood and Affect
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Sample Questions
Q1) As a nurse in the emergency department, you are caring for a patient who is exhibiting signs of depression. What is a priority nursing intervention you should perform for this patient?
A) Assess for depression and ask directly about suicide thoughts.
B) Ask the care provider to prescribe blood lab work to assess for depression.
C) Focus on the presenting problems and refer the patient for a mental health evaluation.
D) Interview the patient's family to identify their concerns about the patient's behaviors.
Q2) An older adult has experienced severe depression for many years and is unable to tolerate most antidepressant medications due to adverse effects of the medications. He is scheduled for electroconvulsive therapy (ECT) as a treatment for his depression. What teaching should the nurse give the patient regarding this treatment?
A) There are no special preparations needed before this treatment.
B) Common side effects include headache and short-term memory loss.
C) One treatment will be needed to cure the depression.
D) This treatment will leave you unconscious for several hours.
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35
Chapter 34: Anxiety
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Sample Questions
Q1) 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.
Q2) The nurse is teaching a hospitalized patient to use mindfulness to reduce anxiety. Which statement by the nurse is appropriate?
A) "How do you feel about what happened to you as a child?"
B) "How do you feel about what is going on right now?"
C) "Remember a time when you were calm."
D) "Tap your hands until the feeling goes away."
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Chapter 35: Cognition
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Sample Questions
Q1) 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
Q2) The nurse is reviewing new medication orders for several patients in a long-term care facility. Which patient does the nurse recognize as being at the highest risk for having cognitive impairment related to prescribed medications?
A) The patient prescribed an antibiotic for a urinary tract infection.
B) The patient prescribed a cholinesterase inhibitor for early Alzheimer's disease.
C) The patient prescribed a beta-blocker for hypertension.
D) The patient prescribed a bisphosphonate for osteoporosis.
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Chapter 36: Psychosis
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Sample Questions
Q1) Clients who are psychotic because of underlying psychiatric illness are treated with antipsychotic medications. Typical antipsychotic medications can improve positive symptoms in clients with schizophrenia. Positive symptoms include which of the following? (Select all that apply.)
A) Hallucinations
B) Disorganized speech and behavior
C) Anhedonia
D) Delusions
E) Agitation
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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Sample Questions
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) The nurse is caring for a patient who is experiencing alcohol withdrawal. What is the highest priority for this patient?
A) Describe how the alcohol is causing the withdrawal effects.
B) Leave the patient by him/herself so as not to cause agitation.
C) Promote a safe, calm, and comfortable environment.
D) Refer the patient to an alcohol-abuse counselor.
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Chapter 38: Interpersonal Violence
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Sample Questions
Q1) 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.
Q2) The nurse is admitting a child with a history of abuse. The nurse understands that the child may exhibit what behaviors that are consequences of being in an abusive environment? (Select all that apply.)
A) Reliving abuse incidents
B) Sleep disturbance
C) Overeating
D) Acting out behaviors
E) Intermittent fever
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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) What nursing recommendations are published in the Institute of Medicine (IOM's) report The future of nursing: Leading change, advancing health?
A) Teach, advocate, assess, and nurture.
B) Should have a graduate degree to practice.
C) Diagnose and recommend treatments.
D) Must have continuing education.
Q3) The qualities of leadership, clinical expertise and judgment, mentorship, and lifelong learning would best describe which type of nurse?
A) Administrator
B) Certified nurse specialist
C) Practitioner
D) Professional
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Chapter 40: Clinical Judgment
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Sample Questions
Q1) A nurse has designed an individualized nursing care plan for a patient, but the patient is not meeting goals. Further assessment reveals that the patient is not following through on many items. Which action by the nurse would be best for determining the cause of the problem?
A) Assess whether the actions were too hard for the patient.
B) Determine whether the patient agrees with the care plan.
C) Question the patient's reasons for not following through.
D) Reevaluate data to ensure the diagnoses are sound.
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
8 Verified Questions
8 Flashcards
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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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Sample Questions
Q1) A nursing student is conducting a survey of fellow nursing students. Which ethical Chapter is the student following when calculating the risk-to-benefit ratio and concluding that no harmful effects were associated with a survey?
A) Beneficence
B) Human dignity
C) Justice
D) Human rights
Q2) A patient suffered a brain injury from a motor vehicle accident and has no brain activity. The patient has a living will which states no heroic measures. The family requests that no additional heroic measures be instituted for their son. The nurse respects this decision in keeping with which principle?
A) Accountability
B) Autonomy
C) Nonmaleficence
D) Veracity
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Chapter 43: Patient Education
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Sample Questions
Q1) Barriers to patient education the nurse considers in implementing a teaching plan include which factor?
A) Family resources
B) High school education
C) Hunger and pain
D) Need perceived by patient
Q2) Interrelated Chapters to the professional nursing role a nurse manager would consider when addressing concerns about the quality of patient education include which factor?
A) Adherence
B) Developmental level
C) Motivation
D) Technology
Q3) 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
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Page 45
Chapter 44: Health Promotion
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Sample Questions
Q1) At the well-child clinic, how does the nurse correctly teach a mother about health promotion activities and describe immunizations?
A) Unique for children
B) Primary prevention
C) Secondary prevention
D) Tertiary prevention
Q2) Which tertiary prevention measure should be included in the health promotion plan of care for a patient newly diagnosed with diabetes?
A) Avoiding carcinogens
B) Foot screening techniques
C) Glaucoma screening
D) Seat belt use
Q3) 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
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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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Sample Questions
Q1) A nurse manager has recently overheard several negative comments made by nurses on the unit about other nurses on the unit. The manager recognizes that the nurses are exhibiting what type of behavior that is detrimental to collaboration?
A) Vertical violence
B) Lateral violence
C) Descending violence
D) Personal violence
Q2) 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."
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Chapter 47: Safety
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Sample Questions
Q1) Prior to drug administration the nurse reviews the seven rights, which include right patient, right medication, right time, right dose, right education, right documentation, and what other right?
A) Room
B) Route
C) Physician
D) Manufacturer
Q2) A staff nurse reports a medication error due to failure to administer a medication at the scheduled time. What is the charge nurse's best response?
A) "We'll conduct a root cause analysis."
B) "That means you'll have to do continuing education."
C) "Why did you let that happen?"
D) "You'll need to tell the patient and family."
Q3) Which is an essential element of a standard order set to verify a medication order?
A) Volume only
B) Number of tablets
C) Metric dose/strength
D) Hour of administration
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Chapter 48: Technology and Informatics
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Sample Questions
Q1) The nurse manager of a medical/surgical unit wants to increase the use of health care technology on the unit and is working with an ANA-certified informatics nurse to reduce which barriers to health information exchange?
A) Basic informatics knowledge and skills
B) Offering the best set of tools
C) Privacy and security policies
D) Unit-specific terminology
Q2) Florence Nightingale, the first nurse informatician, sought hospital data for comparison purposes to compete which goal?
A) Allow faster and accurate diagnosis.
B) Better coordinate care.
C) Improve the efficiency of care.
D) Show people how their money was spent.
Q3) Which are exemplars of the health informatics Chapter?
A) Clinical research informatics
B) Hardware and software
C) Privacy and security
D) Standard terminology
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Chapter 49: Evidence
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Sample Questions
Q1) 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.
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) The nurse administrator is doing a study that entails gathering data about new employees over a 10-year period. Which research method would be the best one to use for this type of study?
A) Quantitative longitude cohort
B) Qualitative longitudinal
C) Qualitative interview
D) Qualitative case study
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Chapter 50: Health Care Quality
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Sample Questions
Q1) Which statement is true regarding the patient's perception of his or her care?
A) Patent perception is just as important as the outcome of care.
B) Patient perception is insignificant compared to the outcome of care.
C) Patient satisfaction has no relation to quality of care.
D) Patient satisfaction is insignificant compared to the outcome of care.
Q2) A student nurse and clinical instructor are discussing quality in health care. The instructor knows the student understands when the student makes which statement?
A) "Quality is apparent in all health care."
B) "Quality is an outcome of health care."
C) "Quality is seen and unseen in health care."
D) "Quality is achieved by collaboration in health care."
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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Sample Questions
Q1) Care coordination models should be adopted in health care facilities. If models are not put into practice, the shortcomings of the health care system may display which of the following items? (Select all that apply.)
A) Decrease in patients
B) Fragmented services
C) Low birth weight newborns
D) Cost inefficiencies
E) Poor health outcomes
F) Increased pharmacy costs
Q2) The nurse is discussing care coordination with a patient. The patient asks the nurse to explain care coordination. What is the nurse's best response?
A) "Care coordination is a cost effective method created by the community."
B) "Care coordination forces the health care facilities in the community to work together."
C) "Care coordination exists for the children and uninsured in the community."
D) "Care coordination allows health care services to work together in the community."
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Chapter 52: Caregiving
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Sample Questions
Q1) A young wife is talking with the nurse about her husband who is returning from the military. The wife confides that her husband is physically okay but is behaving differently. What is the nurse's best response?
A) "He is just trying to adjust to civilian life again; he'll be okay."
B) "You should observe him closely, because he could attack you."
C) "Many times people need care for emotional trauma."
D) "Talk with your physician to get medication, and then put it in his food."
Q2) Many grandparents today are caring for grandchildren in place of a parent. Identify the reasons why this phenomenon is happening. (Select all that apply.)
A) Children prefer living with their grandparents.
B) Parents are incarcerated.
C) Parents are deceased.
D) Grandparents are better caregivers.
E) Parents are mentally ill.
F) Parents are substance abusers.
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54
Chapter 53: Palliation
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Sample Questions
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) Which is one of the biggest challenges facing current nursing practice?
A) The number of aging Americans living with chronic disease.
B) The number of patients entering into hospice programs.
C) The number of cancer patients receiving supportive care.
D) Reduced length of stay in hospice care.
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) Before beginning work on a culturally diverse hospital unit, the nurse should perform which action first?
A) Improve self-awareness of one's own biases
B) Attend an anti-discrimination rally or march
C) Build rapport and trust with the patients
D) Take a foreign language class
Q2) The nurse in the immunization clinic should place emphasis on educating and reaching which groups about the disease preventing effects of immunizations? (Select all that apply.)
A) Caucasian
B) African American
C) Low income
D) Middle income
E) High income
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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Chapter 55: Health Care Organizations
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Q1) A nurse is reported for taking prescribed patient medications for their personal use. Who has direct authority over deciding if the nurse may keep their professional license to continue practicing as a nurse?
A) The hospital where the nurse is currently employed
B) The American Nurses Association
C) The National League for Nursing
D) The State Board of Nursing who issued the license
Q2) A hospital organization is applying for Magnet status to show excellence in nursing practice. What components would indicate that the hospital is meeting Magnet principles? (Select all that apply.)
A) The education budget for nursing has been cut to provide for new laboratory equipment.
B) On average, 40% of new nurses are leaving within 1 year of hire.
C) Nurses are active participants on all major hospital committees.
D) Quality improvement projects are planned and evaluated by nurses.
E) Patient care outcome data are reported in the annual executive board meeting.
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Chapter 56: Health Care Economics
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Sample Questions
Q1) A student asks the instructor about health care economics. The instructor knows the student understands when the student makes which statement?
A) "The elderly population uses most of the health care services."
B) "Everyone should have health insurance to obtain services."
C) "Health care dollars should be partitioned by the government."
D) "Resources will be needed to serve health care issues."
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) 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
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Chapter 57: Health Policy
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Sample Questions
Q1) Nurses can be health advocates in which of the following ways? (Select all that apply.)
A) Supporting their professional nursing organization when discussing upcoming legislation
B) Discussing the upcoming classes with a neighbor
C) Rallying for coverage for childhood immunizations
D) Arranging for a patient to meet with case management for home health care
E) Discussing a patient they are concerned about with a fellow student in the public cafeteria
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.
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Chapter 58: Health Care Law
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Sample Questions
Q1) Which of the following is an example of a nurse violating the Health Insurance Portability and Accountability Act (HIPAA) of 1996?
A) The nurse asks the unit clerk to look up lab values for her relative recently admitted to the hospital.
B) A group of fellow employees are discussing a patient's clinical status in a public place. The nurse manager requests that they step into private room to complete the discussion.
C) After entering the progress notes on a patient's electronic medical record, the nurse logs off the computer to allow her coworker to use the terminal.
D) As a family approaches the nursing desk, the nurse removes the patient census sheet from view on the counter.
Q2) The new nurse correctly defines a law when stating which information?
A) "Law is a fundamental concept for health care professionals."
B) "Law's rule is developed by the employee's organization."
C) "Law's rule is enacted by a government agency that defines what must be done in a given circumstance."
D) "Law is a mandate from the Joint Commission or other accrediting agency."
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