Foundations of Nursing Practice Final
Test Solutions
Course Introduction
Foundations of Nursing Practice introduces students to the essential principles and skills that form the basis of professional nursing. The course emphasizes patient-centered care, safety, communication, ethical and legal considerations, and the development of critical thinking in clinical decision-making. Through a combination of classroom instruction, laboratory simulations, and clinical experiences, students learn basic nursing procedures, infection control, and understand the role of the nurse within healthcare teams. The course also explores the history, philosophy, and scope of the nursing profession, preparing students for more advanced clinical practice.
Recommended Textbook
Concepts for Nursing Practice 2nd Edition by Giddens
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58 Chapters
459 Verified Questions
459 Flashcards
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Page 2
Chapter 1: Development
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8 Verified Questions
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Sample Questions
Q1) The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, the expected stage of development for a preschooler is
A) concrete operational.
B) formal operational.
C) preoperational.
D) sensorimotor.
Answer: C
Q2) To plan early intervention and care for a child with a developmental delay, the nurse would consider knowledge of the Chapters most significantly impacted by development, including A) culture.
B) environment.
C) functional status.
D) nutrition.
Answer: C
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Page 3
Chapter 2: Functional Ability
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) The nurse is assessing a patient with a mobility dysfunction and wants to gain insight into the patient's functional ability. What question would be the most appropriate?
A) "Are you able to shop for yourself?"
B) "Do you use a cane, walker, or wheelchair to ambulate?"
C) "Do you know what today's date is?"
D) "Were you sad or depressed more than once in the last 3 days?"
Answer: B
Q2) The nurse is assessing a patient's functional abilities and asks the patient, "How would you rate your ability to prepare a balanced meal?" "How would you rate your ability to balance a checkbook?" "How would you rate your ability to keep track of your appointments?" Which tool would be indicated for the best results of this patient's perception of their abilities?
A) Functional Activities Questionnaire (FAQ)
B) Mini Mental Status Exam (MMSE)
C) 24hFAQ
D) Performance-based functional measurement
Answer: A
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Chapter 3: Family Dynamics
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Sample Questions
Q1) The most appropriate initial nursing intervention when the nurse notes dysfunctional interactions and lack of family support for a patient would be to
A) enforce hospital visiting policies.
B) monitor the dysfunctional interactions.
C) notify the primary care provider.
D) role model appropriate support.
Answer: D
Q2) When reviewing the purposes of a family assessment, the nurse educator would identify a need for further teaching if the student responded that family assessment is used to gain an understanding of which aspect of the family?
A) Development
B) Function
C) Political views
D) Structure
Answer: C
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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) What interrelated constructs facilitate a nurse to become culturally competent?
A) Cultural diversity, self-awareness, cultural skill, and cultural knowledge
B) Cultural desire, self-awareness, cultural knowledge, and cultural identity
C) Cultural desire, self-awareness, cultural knowledge, and cultural diversity
D) Cultural desire, self-awareness, cultural knowledge, and cultural skill
Q3) The emphasis on understanding cultural influence on health care is important because of
A) disability entitlements.
B) HIPAA requirements.
C) increasing global diversity.
D) litigious society.
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Chapter 5: Spirituality
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Sample Questions
Q1) When completing the FICA tool for spiritual assessment, which questions should the nurse ask the patient? (Select all that apply.)
A) What things do you believe in that give meaning to life?
B) Are you connected with a faith center in your community?
C) How has your illness affected your personal beliefs?
D) When was the last time you have been to church?
E) What can I do for you?
Q2) A patient uses rosary beads and attends mass once a week. This expression of spirituality is best described with which term?
A) Religiosity
B) Faith
C) Belief
D) Authenticity
Q3) 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
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Page 7
Chapter 6: Adherence
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Sample Questions
Q1) A diabetic patient presents to the diabetes clinic with A<sub>1</sub>c levels of 7.5%. The nurse has met this patient for the first time. When applying principles of Theory of Planned Behavior (TPB), which teaching strategy by the nurse is most likely to be effective?
A) Provide information on the importance of blood glucose control in maintenance of long-term health and evaluate how the patient has been following the prescribed regime.
B) Establish a rapport with the patient by complimenting them on what they did correctly, and ask what strategies they have tried thus far.
C) Refer the patient to a certified diabetic educator, because the educator is an expert on management of diabetes complications.
D) Have the patient explain what medications they are on and what diet they should be following.
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Chapter 7: Self-Management
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Sample Questions
Q1) The nurse is developing a plan of care for a newly diagnosed hypertensive patient who is being discharged on medications and given the Dietary Approaches to Stop Hypertension (DASH) diet to follow. What statement by the patient signals to the nurse that the patient is motivated to learn?
A) "I am sure the medications will help to bring down my blood pressure."
B) "I can't wait to try the new recipes, and I'm hopeful I will lose weight."
C) "Do I really need to follow the diet and take medications?"
D) "I have my parents to blame for this. They both have high blood pressure."
Q2) The nurse is assessing a patient's readiness to be discharged and ability to manage care at home. What is the most appropriate question for the nurse to ask to determine the patient's learning needs before planning teaching activities?
A) "What are your hobbies and occupation?"
B) "What do you need to know before you go home from the hospital?"
C) "Do you have any cultural or religious beliefs that you would like incorporated into your plan of care?"
D) "What were your grades and learning style when you were in school?"
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9
Chapter 8: Fluid and Electrolyte Balance
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Sample Questions
Q1) The patient with which diagnosis should have the highest priority for teaching regarding foods that are high in magnesium?
A) Severe hemorrhage
B) Diabetes insipidus
C) Oliguric renal disease
D) Adrenal insufficiency
Q2) At change-of-shift report, the nurse learns the medical diagnoses for four patients. Which patient should the nurse assess most carefully for development of hyponatremia?
A) Vomiting all day and not replacing any fluid
B) Tumor that secretes excessive antidiuretic hormone (ADH)
C) Tumor that secretes excessive aldosterone
D) Tumor that destroyed the posterior pituitary gland
Q3) The patient is receiving tube feedings due to a jaw surgery. What change in assessment findings should prompt the nurse to request an order for serum sodium concentration?
A) Development of ankle or sacral edema
B) Increased skin tenting and dry mouth
C) Postural hypotension and tachycardia
D) Decreased level of consciousness
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Page 10
Chapter 9: Acid-Base Balance
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Sample Questions
Q1) The nurse has telephone messages from four patients who requested information and assistance. Which one should the nurse refer to a social worker or community agency first?
A) "Is there a place that I can dispose of my unused morphine pills?"
B) "I want to lose at least 20 pounds without getting sick this time."
C) "I think I have asthma because I cough when dogs are near."
D) "I ran out of money and am cutting my insulin dose in half."
Q2) The nurse is making a home visit to a child who has a chronic disease. Which finding has the greatest implication for acid-base aspects of this patient's care?
A) Urine output is very small today.
B) Whites of the eyes appear more yellow.
C) Skin around the mouth is very chapped.
D) Skin is sweaty under three blankets.
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Chapter 10: Thermoregulation
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Sample Questions
Q1) During orientation to an emergency department, the nurse educator would be concerned if the new nurse listed which of the following as a risk factor for impaired thermoregulation?
A) Impaired cognition
B) Occupational exposure
C) Physical agility
D) Temperature extremes
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 nurse planning care for a patient with hypothermia should consider what similar exemplar?
A) Heat exhaustion
B) Heat stroke
C) Infection
D) Prematurity
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Page 12
Chapter 11: Sleep
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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 caring for a child with tonsillar enlargement. What is the nurse's priority concern?
A) Low oxygen saturation
B) Daytime fatigue
C) Increased temperature
D) Antibiotic administration
Q3) The nurse must awaken a patient from Stage 4 non-rapid eye movement sleep in order to prepare the patient for a procedure. The patient is disoriented. What is the nurse's best action?
A) Notify the healthcare provider
B) Re-assess the patient's orientation
C) Administer an anti-anxiety medication
D) Cancel the patient's procedure
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Chapter 12: Cellular Regulation
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Sample Questions
Q1) While collecting a health history on a patient admitted for colon cancer, which of the following questions would be a priority to ask this patient?
A) "Have you noticed any blood in your stool?"
B) "Have you been experiencing nausea?"
C) "Do you have back pain?"
D) "Have you noticed any swelling in your abdomen?"
Q2) The nurse would incorporate which of the following into the plan of care as a primary prevention strategy for reduction of the risk for cancer?
A) Yearly mammography for women aged 40 years and older
B) Using skin protection during sun exposure while at the beach
C) Colonoscopy at age 50 and every 10 years as follow-up
D) Yearly prostate specific antigen (PSA) and digital rectal exam for men aged 50 and over
Q3) What is the priority nursing diagnosis for a patient experiencing chemotherapy-induced anemia?
A) Risk for injury related to poor blood clotting
B) Fatigue related to decreased cellular oxygenation
C) Disturbed body image related to skin color changes
D) Imbalanced nutrition, less than body requirements related to anorexia
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Page 14
Chapter 13: Intracranial Regulation
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Sample Questions
Q1) The nurse preparing to care for a patient after a suspected stroke would question which order?
A) Antihypertensive
B) Antipyretic
C) Osmotic diuretic
D) Sedative
Q2) When caring for a patient after a head injury, the nurse would be most concerned with assessment findings which included respiratory changes along with what other findings?
A) Hypertension and bradycardia
B) Hypertension and tachycardia
C) Hypotension and bradycardia
D) Hypotension and tachycardia
Q3) After shunt procedure, the nurse would monitor the patient's neurologic status by using which test?
A) Electroencephalogram
B) Glasgow Coma Scale
C) National Institutes of Health Stroke Scale
D) Monro-Kellie doctrine
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Page 15
Chapter 14: Hormonal Regulation
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Sample Questions
Q1) Following a parathyroidectomy, which electrolyte should the nurse most closely monitor?
A) Potassium
B) Sodium
C) Magnesium
D) Calcium
Q2) Which important teaching point should the nurse include in the plan of care for a patient diagnosed with Cushing's disease?
A) Daily weight using same scale
B) Wash hands frequently
C) Use exfoliating soaps when bathing
D) Avoid yearly influenza vaccine
Q3) The nurse is caring for a patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What is the nurse's best action?
A) Encourage increased fluid and water intake
B) Teach about risk for malignancies
C) Monitor for changes in level of consciousness
D) Assess labwork for potassium level changes
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Chapter 15: Glucose Regulation
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Sample Questions
Q1) A diabetic patient is brought into the emergency department unresponsive. The arterial pH is 7.28. Besides the blood pH, which clinical manifestation is seen in uncontrolled diabetes mellitus and ketoacidosis?
A) Decreased hunger sensation
B) Report of no urine output
C) Increased respiratory rate
D) Decreased thirst
Q2) The nurse associates which assessment finding in the diabetic patient with decreasing renal function?
A) Ketone bodies in the urine during acidosis
B) Glucose in the urine during hyperglycemia
C) Protein in the urine during a random urinalysis
D) White blood cells in the urine during a random urinalysis
Q3) 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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Chapter 16: Nutrition
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Sample Questions
Q1) The nurse is completing a nutritional assessment on a patient with hypertension. What foods would be recommended for this patient?
A) Regular diet
B) Low sodium diet
C) Pureed diet
D) Low sugar diet
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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Page 18
Chapter 17: Elimination
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Sample Questions
Q1) What is a primary prevention tool used for colon cancer screening?
A) Abdominal x-rays
B) Blood, urea, and nitrogen (BUN) testing
C) Serum electrolytes
D) Occult blood testing
Q2) The nurse is listening for bowel sounds in a postoperative patient. The bowel sounds are slow, as they are heard only every 3 to 4 minutes. The patient asks the nurse why this is happening. What is the nurse's best response?
A) "Anesthesia during surgery and pain medication after surgery may slow peristalsis in the bowel."
B) "Some people have a slower bowel than others, and this is nothing to be concerned about."
C) "The foods you eat contribute to peristalsis, so you should eat more fiber in your diet."
D) "Bowel peristalsis is slow because you are not walking. Get more exercise during the day."
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Chapter 18: Perfusion
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Sample Questions
Q1) A patient's serum electrolytes are being monitored. The nurse notices that the potassium level is low. What should the nurse monitor for in this patient?
A) Tissue ischemia
B) Brain malformations
C) Intestinal blockage
D) Cardiac dysrhythmia
Q2) The nurse is explaining to a student nurse about impaired central perfusion. The nurse knows the student understands this problem when the student makes which statement?
A) "Central perfusion is monitored only by the physician."
B) "Central perfusion involves the entire body."
C) "Central perfusion is decreased with hypertension."
D) "Central perfusion is toxic to the cardiac system."
Q3) 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."
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Page 20
Chapter 19: Gas Exchange
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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) The nurse is reviewing the patient's arterial blood gas results. The PaO<sub>2</sub> is 96 mm Hg, pH is 7.20, PaCO<sub>2</sub> is 55 mm Hg, and HCO<sub>3</sub> is 25 mEq/L. What might the nurse expect to observe on assessment of this patient?
A) Disorientation and tremors
B) Tachycardia and decreased blood pressure
C) Increased anxiety and irritability
D) Hyperventilation and lethargy
Q3) 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
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Chapter 20: Clotting
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Sample Questions
Q1) A patient states that his legs have pain with walking that decreases with rest. The nurse observes absence of hair on the patient's lower leg and the patient has a thready, posterior tibial pulse. How would the nurse position the patient's legs?
A) Elevated
B) Crossed at the knee
C) Slightly bent with a pillow under the knees
D) Dependent position
Q2) Which statement by a patient indicates additional teaching is required about the medication warfarin?
A) "I will continue my diabetic diet and restrict sugar."
B) "I will increase the intake of green, leafy vegetables for a more healthful diet."
C) "I will restrict the intake of foods high in vitamin C."
D) "I will increase the amount of protein in my diet to protect my kidneys."
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22
Chapter 21: Reproduction
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Sample Questions
Q1) A female 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 nurse at the family planning clinic conducts a male history for infertility evaluation. Which finding has the greatest implication for this patient's care?
A) Practice of nightly masturbation
B) Primary anovulation
C) High testosterone levels
D) Impotence due to alcohol ingestion
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Chapter 22: Sexuality
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Sample Questions
Q1) 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
Q2) The nurse is caring for a 44-year-old married woman who is complaining of painful intercourse and incontinence due to prolapse of reproductive organs. Clinical evaluation reveals that the patient has a cystocele. Which treatment option is most appropriate for this patient?
A) Pelvic floor training
B) Vaginal pessaries
C) Surgical correction
D) Lifestyle changes
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24
Chapter 23: Immunity
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Sample Questions
Q1) The nurse is preparing to administer medications to a patient with rheumatoid arthritis (RA). The nurse should explain which goal of treatment to the patient?
A) Eradicate the disease
B) Enhance immune response
C) Control inflammation
D) Manage pain
Q2) The nurse is caring for a postoperative patient who had an open appendectomy. The nurse understands that this patient should have some erythema and edema at the incision site 12 to 24 hours post operation dependent on which condition?
A) His immune system is functioning properly.
B) He is properly vaccinated.
C) He has an infection.
D) The suppressor T-cells in his body are activated.
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Chapter 24: Inflammation
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Q1) The nurse reviews the patient's complete blood count (CBC) results and notes that the neutrophil levels are elevated, but monocytes are still within normal limits. This indicates what type of inflammatory response?
A) Chronic
B) Resolved
C) Early stage acute
D) Late stage acute
Q2) A patient comes to the clinic with a complaint of painful, itchy feet. On interview, the patient tells the nurse that he is a college student living in a dormitory apartment that he shares with five other students. What teaching should the nurse provide for this patient?
A) "Don't eat with the other students."
B) "Avoid sharing razors and other personal items."
C) "Have a complete blood count (CBC) checked monthly."
D) "Disinfect showers and bathroom floors weekly after use."
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Chapter 25: Infection
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Q1) A nurse is teaching a group of business people about disease transmission. He knows that he needs to reeducate when one of the participants states which of the following?
A) "When traveling outside of the country, I need to be sure that I receive appropriate vaccinations."
B) "Food and water supplies in foreign countries can contain microorganisms to which my body is not accustomed and has no resistance."
C) "If I don't feel sick, then I don't have to worry about transmitted diseases."
D) "I need to be sure to have good hygiene practices when traveling in crowded planes and trains."
Q2) The nurse is working on a plan of care with her patient which includes turning and positioning and adequate nutrition to help the patient maintain intact skin integrity. The nurse helps the patient to realize that this breaks the chain of infection by eliminating which element?
A) Host
B) Mode of transmission
C) Portal of entry
D) Reservoir
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Chapter 26: Mobility
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Q1) 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
Q2) An older patient is talking with the nurse about hip fractures. The patient would like to know the best approach to strengthen the bones. What is the nurse's best response?
A) "Walk at least 5 miles every day for exercise."
B) "Wear proper fitting shoes to prevent tripping."
C) "Talk with your physician about a calcium supplement."
D) "Stand up slowly so you don't feel faint."
Q3) Mobility for the patient changes throughout the life span. What is the term that best describes this process?
A) Aging and illness
B) Illness and disease
C) Health and wellness
D) Growth and development
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Chapter 27: Tissue Integrity
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Sample Questions
Q1) A patient asks the nurse what the purpose of the Wood's light is. Which response by the nurse is accurate?
A) "We will put an anesthetic on your skin to prevent pain."
B) "The lamp can help detect skin cancers."
C) "Some patients feel a pressure-like sensation."
D) "It is used to identify the presence of infectious organisms and proteins associated with specific skin conditions."
Q2) A nurse is educating a 21-year-old lifeguard about the risk of skin cancer and the need to wear sunscreen. Which statement by the patient indicates that the need for further teaching?
A) "I wear a hat and sit under the umbrella when not in the water."
B) "I don't bother with sunscreen on overcast days."
C) "I use a sunscreen with the highest SPF number."
D) "I wear a UV shirt and limit exposure to the sun by covering up."
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Chapter 28: Sensory Perception
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Sample Questions
Q1) The nurse is examining the eyes of a newborn infant. If the nurse notes the absence of the red reflex, what is the next best action?
A) Notify the physician.
B) Document the finding in the records.
C) Recheck the reflex after several hours.
D) Monitor the eye movements and pupil reactions closely.
Q2) An 80-year-old patient is being discharged after he was diagnosed with diabetes mellitus and retinopathy. His daughter has been part of the discharge instruction process. Understanding of the instructions is evident when the daughter says which of the following?
A) "I will make sure that Dad always wears warm socks."
B) "Dad needs to wear his glasses so he can delay the onset of macular degeneration."
C) "I will ask the home health aide to carefully inspect Dad's feet every day when she helps him bathe."
D) "We will give him only warm foods, so that he doesn't burn his mouth."
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Chapter 29: Pain
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Sample Questions
Q1) A 70-year-old retired nurse is interested in nondrug, mind-body therapies, self-management, and alternative strategies to deal with joint discomfort from rheumatoid arthritis. What options should you consider in her plan of care considering her expressed wishes?
A) Stationary exercise bicycle, free weights, and spinning class
B) Mind-body therapies such as music therapy, distraction techniques, meditation, prayer, hypnosis, guided imagery, relaxation techniques, and pet therapy
C) Chamomile tea and IcyHot gel
D) Acupuncture and attending church services
Q2) An 80-year-old male patient is in the intensive care unit has suffered a fractured femur. You are making rounds and notice he is somnolent, with no response to verbal or physical stimulation. He has been on round the clock opioid doses q 4 hours. What is the nurse's first action?
A) Call the rapid response team to care for the patient immediately.
B) Discontinue the opioids on the medication administration record.
C) Assess the patient's blood pressure and pain level.
D) Start a second intravenous line with a large bore catheter.
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Page 31
Chapter 30: Fatigue
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Sample Questions
Q1) Which are treatment related causes of fatigue? (Select all that apply.)
A) Blood transfusion
B) Chemotherapy
C) Radiation therapy
D) Surgery
E) Side effects of medications
Q2) The nurse is assessing a patient for risk factors of chronic fatigue syndrome. Which factors should the nurse identify as placing the patient at risk for chronic fatigue syndrome? (Select all that apply.)
A) Feeling tired upon awakening
B) Chronic migraines
C) Tenderness under the jaw
D) 5 episodes tonsillitis/past year
E) Swollen, painful knees
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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Page 32
Chapter 31: Stress
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Sample Questions
Q1) A diabetic patient who is hospitalized tells the nurse, "I don't understand why I can keep my blood sugar under control at home with diet alone, but when I get sick, my blood sugar goes up." Which response by the nurse is appropriate?
A) "It is probably just coincidental that your blood sugar is high when you are ill."
B) "Stressors such as illness cause the release of hormones that increase blood sugar."
C) "Increased blood sugar occurs because the kidneys are not able to metabolize glucose as well during stressful times."
D) "Your diet is different here in the hospital than at home, and that is the most likely cause of the increased glucose level."
Q2) Which action should the nurse take to monitor the effects of an acute stressor on a hospitalized patient? (Select all that apply.)
A) Assess for bradycardia.
B) Ask about epigastric pain.
C) Observe for increased appetite.
D) Check for elevated blood glucose levels.
E) Monitor for a decrease in respiratory rate.
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33
Chapter 32: Coping
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Sample Questions
Q1) The nurse is developing a care plan for a patient with ineffective coping skills. Which intervention would be an example of a problem-focused coping strategy?
A) Scheduling a regular exercise program
B) Attending a seminar on treatment options
C) Identifying a confidant to share feelings
D) Attending a support group for families
Q2) The nurse is assessing the coping patterns of a newly admitted patient. What will the nurse include in this assessment? (Select all that apply.)
A) Current stressors as perceived by the patient
B) Use of drugs or alcohol
C) Recent weight changes
D) Age and height
E) Temperature
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34
Chapter 33: Mood and Affect
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Q1) A patient has been prescribed a selective serotonin reuptake inhibitor (SSRI) antidepressant. After taking the new medication, the patient states, "This medication isn't working. I don't feel any different." What is the best response by the nurse?
A) "I will call your care provider. Perhaps you need a different medication."
B) "Don't worry. You can try taking it at a different time of day to help it work better."
C) "It usually takes a few weeks for you to notice improvement from this medication."
D) "Your life is much better now. You will feel better soon."
Q2) A patient has been resistant to treatment with antidepressant therapy. The care provider prescribes a monoamine oxidase inhibitor (MAOI) medication. What teaching is critical for the nurse to give the patient?
A) Serum blood levels must be regularly monitored to assess for toxicity.
B) To prevent side effects, the medication should be administered as an intramuscular injection.
C) Eating foods such as blue cheese or red wine will cause side effects.
D) This medication class may only be used safely for a few days at a time.
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Chapter 34: Anxiety
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Q1) The nurse wishes to use guided imagery to help an anxious patient relax. Which comment would be appropriate to include in the guided imagery script? (Select all that apply.)
A) "Imagine others treating you the way they should, the way you want to be treated "
B) "With each breath, you are feeling calmer, more relaxed, almost as if you are floating "
C) "You are alone on a beach; the sun is warm; and you hear only the sound of the surf "
D) "You have taken control; nothing can hurt you now; everything is going your way "
E) "You have grown calm; your mind is still; there is nothing to disturb your well-being "
F) "You will feel better as work calms down, as your boss becomes more understanding "
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36
Chapter 35: Cognition
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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) An older adult who is cognitively impaired is admitted to the hospital with pneumonia. Which sign or symptom would the nurse expect to be exhibited by the patient?
A) Severe headache
B) Flank pain
C) Increased confusion
D) Decreased blood glucose
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Chapter 36: Psychosis
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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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Q1) A 45-year-old man is brought to the emergency department presenting with a respiratory rate of 6 breaths/min, and cardiac dysrhythmias. What is the most appropriate question the nurse should ask the patient's friend?
A) "Does he take amphetamines or uppers?"
B) "Has he ever used LSD?"
C) "Have you two been out of the country in the last 2 days?"
D) "Is he using any opioids such as heroin?"
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.
Q3) To prevent Wernicke's encephalopathy from heavy alcohol use, the nurse anticipates an order for which medications?
A) Benzodiazepine
B) Thiamine and B complex
C) Vitamins C and D<sub>3</sub>
D) Klonopin
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Page 39
Chapter 38: Interpersonal Violence
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Q1) The nurse is seeing a patient who has been in the clinic eight times in the past 6 months for injuries from an abusive partner. The patient states, "I don't see any way to get away from my partner, and I can't keep going on like this." What assessment question is most important for the nurse to ask?
A) "Do you have any family in the area that can help?"
B) "Have you thought about hurting yourself or someone else?"
C) "Have you thought about moving to a different city?"
D) "Have you discussed this with anyone else?"
Q2) Critical Thinking: A crisis intervention nurse is training emergency department staff on treatment needs of persons in abusive relationships. What is a common difficulty staff encounter when caring for this population?
A) There is not a good legal pathway to help persons in abusive relationships.
B) The abused person may return to the abusive home setting.
C) Hospital policies do not identify the legal care needed for abused persons.
D) Because length of care is short in the emergency department, there is little staff can do for patients who have been abused.
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Chapter 39: Professional Identity
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Sample Questions
Q1) Components of a professional identity in nursing include which attributes? (Select all that apply.)
A) Accountability
B) Advocacy
C) Autonomy
D) Competence
E) Culture
Q2) The scope of professional nursing practice is determined by the rules promulgated by which organization?
A) American Nurses' Association (ANA)
B) Institute of Medicine (IOM)
C) State Board of Nursing
D) State Nursing Association
Q3) A new registered nurse asks the registered nurse (RN) preceptor what could be done to become more professional. What is the preceptor's best response?
A) "Attend nursing educational meetings."
B) "Listen to other nurses."
C) "Read the agency newsletter."
D) "Pass the licensing exam."
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Chapter 40: Clinical Judgment
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Q1) A new graduate nurse is working with an experienced nurse to chart assessment findings. The new nurse notes that the physical therapist wrote on the chart that the patient is lazy and did not want to participate in assigned therapies this AM. The experienced nurse asks the new nurse what may be going on here. What is the best explanation for this statement?
A) Data on the chart can sometimes be documented in a biased manner.
B) Data on the chart changes as the patient's condition changes.
C) Data on the chart is usually accurate and can be verified from the patient.
D) Reading the chart is not a wise use of time as this can be time consuming and tedious.
Q2) A nurse has designed an individualized nursing care plan for a patient, but the patient is not meeting goals. Further assessment reveals that the patient is not following through on many items. Which action by the nurse would be best for determining the cause of the problem?
A) Assess whether the actions were too hard for the patient.
B) Determine whether the patient agrees with the care plan.
C) Question the patient's reasons for not following through.
D) Reevaluate data to ensure the diagnoses are sound.
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Chapter 41: Leadership
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Q1) The nurse who is certified as a Critical Care Registered Nurse (CCRN) represents the unit on the organizational performance improvement team. This is an example of which type of leadership?
A) Formal
B) Unit
C) Organizational
D) Informal
Q2) According to situational and contingency theory, which statement is true?
A) The theory challenges the concept that one leadership style is always best.
B) The theory supports employee feelings, morale, and feedback during the change process.
C) Motivation through inspiration and recognition is the focus for transforming employee behavior.
D) A leader is someone who possesses great intelligence and decision-making authority.
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Chapter 42: Ethics
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Q1) A drug-addicted nurse switches a patient's morphine injection with normal saline so that the nurse can use the morphine. The nurse is violating which principles of ethics? (Select all that apply.)
A) Autonomy
B) Utilitarianism
C) Beneficence
D) Dilemmas
E) Veracity
Q2) A male patient suffered a brain injury from a motor vehicle accident and has no brain activity. The spouse has come up to see the patient every day for the past 2 months. She asks the nurse, "Do you think when he moves his hands he is responding to my voice?" The nurse feels bad because she believes the movements are involuntary, and the prognosis is grim for this patient. She states, "He can hear you, and it appears he did respond to your voice." The nurse is violating which principle of ethics?
A) Autonomy
B) Veracity
C) Utilitarianism
D) Deontology
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44
Chapter 43: Patient Education
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Q1) 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
Q2) Strategies to include in a teaching plan for an adult who has repeatedly not followed the written discharge instructions would include which information source?
A) Individualized handout
B) Instructional videos
C) Internet resources
D) Self-help books
Q3) When planning to evaluate a patient's satisfaction with a teaching activity, what is the most appropriate strategy?
A) Include a survey instrument.
B) Observe for level of skill mastery.
C) Present information more than one time.
D) Provide for a return demonstration.
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Page 45
Chapter 44: Health Promotion
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Sample Questions
Q1) Which tertiary prevention measure should be included in the health promotion plan of care for a patient newly diagnosed with diabetes?
A) Avoiding carcinogens
B) Foot screening techniques
C) Glaucoma screening
D) Seat belt use
Q2) When teaching a patient with a family history of hypertension about health promotion, the nurse describes blood pressure screening as which type of prevention?
A) Illness
B) Primary
C) Secondary
D) Tertiary
Q3) The primary health care nurse would recommend screening based on known risk factors, because of which action?
A) Eliminate the possibility of developing a condition.
B) Identify appropriate treatment guidelines.
C) Initiate treatment of a condition or disease.
D) Make a substantial difference in morbidity and mortality.
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Chapter 45: Communication
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Sample Questions
Q1) A patient is admitted to the intensive care unit for congestive heart failure. Using the situation-background-assessment-recommendation (SBAR) format, put the following statements in the order in which the nurse should report changes to the health care team.
A) Our patient was admitted 2 days ago with heart failure and has been receiving furosemide (Lasix) for diuresis, but his urine output has been low.
B) I think that our patient needs to be evaluated immediately and may need intubation and mechanical ventilation.
C) This is the nurse on the surgical unit. I am calling about our patient in room 3. After assessing him, I am very concerned about his shortness of breath.
D) Today, our patient has crackles audible throughout the posterior chest and his O<sub>2</sub> saturation is 89%. His condition is very unstable.
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Chapter 46: Collaboration
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Q1) The nurse is caring for a patient with a progressive, degenerative muscle illness. The patient states that she would like to remain in her home with her daughter as long as possible. What action should the nurse take?
A) Teach the patient muscle strengthening and stretching exercises.
B) Tell the patient to make plans to move to an assisted-living facility.
C) Discuss resources to help the patient and make appropriate referrals.
D) Ask the patient to come in for daily physical therapy.
Q2) Which patient scenario describes the best example of professional collaboration?
A) The nurse, physician, and physical therapist have all visited separately with the patient.
B) The nurse, physical therapist, and physician have all developed separate care plans for the patient.
C) The nurse mentions to the physical therapist that the patient may benefit from a muscle strengthening evaluation.
D) The nurse and physician discuss the patient's muscle weakness and initiate a referral for physical therapy.
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Chapter 47: Safety
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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) To promote a safety culture, the nurse manager preparing the staff schedule considers the anticipated census in planning the number and experience of staff on any given shift. Which is the human factor primarily addressed with this consideration?
A) Available supplies
B) Interdisciplinary communication
C) Interruptions in work
D) Workload fluctuations
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Chapter 48: Technology and Informatics
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Q1) To design and implement a decubitus ulcer risk management protocol in the electronic health record, the informatics nurse would first perform which action?
A) Build the screens in the electronic health record.
B) Determine evidence supporting decubitus ulcer risk management.
C) Develop the training program for staff.
D) Select the appropriate standardized language.
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) The staff nurse who uses informatics in promoting quality patient care is most likely to access data in which domain?
A) Certified clinical information systems (CIS)
B) Clinical health care informatics
C) Public health/population informatics
D) Translational bioinformatics
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Chapter 49: Evidence
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Q1) The nurse in the psychiatric unit is involved in a research study for a depression medication. In the study, patients are randomly assigned to one depression medication and the other group is receiving no medication to treat the depression. What method of research are the patients involved with?
A) Descriptive
B) Correlational
C) Quasi-experimental
D) Experimental
Q2) 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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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) The focus of quality health care should be on which of the following items? (Select all that apply.)
A) Excellent services
B) Comprehensive communication
C) Private hospital rooms
D) Health team collaboration
E) Culturally competent care
Q3) A student nurse and clinical instructor are discussing quality in health care. The instructor knows the student understands when the student makes which statement?
A) "Quality is apparent in all health care."
B) "Quality is an outcome of health care."
C) "Quality is seen and unseen in health care."
D) "Quality is achieved by collaboration in health care."
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Chapter 51: Care Coordination
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Q1) Medical models coordinate medical services and were traditionally designed fulfill which function?
A) Be patient specific.
B) Be nursing oriented.
C) Be diagnosis specific.
D) Be community oriented.
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."
Q3) For children and teens, which model includes school-based services?
A) Social
B) Integrated
C) Medically-Oriented
D) Nurse-Oriented
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Chapter 52: Caregiving
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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) The community health nurse is assessing a family who has a chronically ill child. The child needs special care, and the nurse has to coordinate the care for the home setting. What behavior will the nurse assess for to know that the family can care for the child?
A) The family is willing to learn about the care and share the caregiving needs.
B) The mother is going to care for the child and the family herself.
C) The older siblings are going to care for the child while the parents are at work.
D) An outside agency will be coming to the home three times a week to give care.
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Chapter 53: Palliation
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Q1) The student demonstrates a lack of understanding of palliative care when making which statement?
A) "Palliative care is designed to promote comfort."
B) "Palliative care is designed to reduce disease exacerbations."
C) "Palliative care is designed to decrease acute care hospital admissions."
D) "Palliative care is designed to promote a cure for chronic disease."
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) What is the most prominent goal of palliative care?
A) Integrate into chronic disease management sooner rather than later.
B) Enroll the patient into the Medicare Hospice Benefit.
C) Ensure that the patient has a 6-month prognosis.
D) Reserve this type of care until the patient is actively dying.
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Chapter 54: Health Disparities
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Q1) Which is the best strategy the nurse manager should include when working to reduce health care disparities on a medical-surgical unit?
A) Less diverse workforce
B) Increase interpreter availability
C) Authoritarian leadership
D) Annual staff training
Q2) The nurse is caring for a Chinese patient diagnosed with cancer who is suffering from pain, yet refuses analgesia administration. What type of health disparities is this patient exhibiting?
A) Avoidable and acceptable
B) Avoidable and unacceptable
C) Unavoidable and acceptable
D) Unavoidable and unacceptable
Q3) 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
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Page 56
Chapter 55: Health Care Organizations
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Q1) A hospital organization is working to improve a feeling of being valued and respected among all staff members. Which action by administration would reinforce the feeling of being valued?
A) Create professional pathways that require advanced education for any advancement of staff.
B) Seek staff input when planning a remodeling project of patient rooms.
C) Form committees that consist of upper management to plan organizational goals.
D) Consistently schedule required staff meetings at the same time each month.
Q2) A hospital organization is applying for Magnet status to show excellence in nursing practice. What components would indicate that the hospital is meeting Magnet principles? (Select all that apply.)
A) The education budget for nursing has been cut to provide for new laboratory equipment.
B) On average, 40% of new nurses are leaving within 1 year of hire.
C) Nurses are active participants on all major hospital committees.
D) Quality improvement projects are planned and evaluated by nurses.
E) Patient care outcome data are reported in the annual executive board meeting.
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Chapter 56: Health Care Economics
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Q1) 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.
Q2) An accountable care organization (ACO) seeks to deliver which of the following aspects of health care? (Select all that apply.)
A) Lessen Medicare payments
B) Integrate care
C) Enhance evidence-based practices
D) Manage acute conditions
E) Support hospice charges
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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Q1) A definition of health policy includes which of the following elements?
A) Funding for public education
B) Appropriation of funds for roadwork
C) Selection of congressional members of committees
D) Public policy made to support health-related goals
Q2) Which of the following components are included in health policy at the state level?
A) Americans with Disabilities Act of 1990
B) Scope of nursing practice
C) Health Insurance Portability and Accountability Act (HIPAA) of 1996
D) Patient Safety and Quality Improvement Act of 2005
Q3) A nursing student is preparing a care plan for an assigned patient. When accessing the electronic medical record, what is acceptable information to view? (Select all that apply.)
A) Laboratory data of the assigned patient
B) Admission diagnosis for a patient who is a former neighbor
C) The patient's age, date of birth, and gender
D) The history and physical of the assigned patient
E) A classmate's brother's chest x-ray report
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Chapter 58: Health Care Law
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Q1) In which of the following answers is the hospital in compliance with the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA)?
A) The emergency department staff asks a patient to stay in the waiting room until the patients with insurance are treated.
B) The emergency registration personnel explain to a patient that they must have proper identification to receive treatment.
C) A patient with chest pain is triaged directly to a room for evaluation and registration information is obtained after the patient is stabilized.
D) The emergency department physician discharges and instructs a patient who is actively suicidal to go the neighbor facility that has psychiatric services.
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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