Introduction to Nursing Midterm
Exam
Course Introduction
Introduction to Nursing is a foundational course designed to familiarize students with the essential concepts, roles, and responsibilities within the nursing profession. The course covers the history and evolution of nursing, the development of professional values and ethics, and the significance of patient-centered care. Students will explore the healthcare delivery system, basic communication skills, and interdisciplinary teamwork. Emphasis is placed on the nursing process, cultural competence, safety, and evidence-based practice to prepare students for further studies and the diverse realities of clinical practice.
Recommended Textbook
Nursing Now! Todays Issues Tomorrows Trends 6th Edition by Joseph T. Catalano
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Page 2
Chapter 1: The Development of the Profession
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Q1) Which of the following types of nurses are classified as technical nurses?
A)BSNs and MSNs
B)LPNs and ADNs
C)LVNs and BSNs
D)UAPs and BSNs
Answer: B
Q2) What allows a nurse to exert referent power over a client when providing nursing care?
A)The ability to withhold pain medication if the client does not comply with routines
B)The ability to provide the client with additional food when he or she does comply with the nurse's requests
C)The power given to the nurse by reason of state licensure
D)The establishment of a professional and personal relationship with the client
Answer: D
Q3) The overall goal of nurses who work as case managers is to ________________the use of health-care services in the most efficient and cost-effective manner possible.
Answer: coordinate
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3
Chapter 2: Historical Perspectives
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Q1) Which belief about what nurses needed to do shaped Lillian D. Wald's nursing practice?
A)Spend more time in clinical preparation and less time in the classroom.
B)Fight political corruption to procure the types of legislation needed to improve social conditions.
C)Conduct more research into the conditions of hospital patients.
D)Stand up to medical doctors who were arrogant and obnoxious.
Answer: B
Q2) What was a major goal of Lavinia Dock?
A)Establish a new nursing organization.
B)Publish a nursing journal.
C)Obtain the right to vote for women.
D)Improve the education of nurses.
Answer: C
Q3) The Dark Ages brought the advent of _____________________that were composed exclusively of men who wore suits of armor to protect themselves and their hospitals.
Answer: military nursing orders
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4
Chapter 3: The Evolution of Licensure, Certification, and Nursing Organizations
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Q1) Which group composes the primary membership in the American Nurses Association?
A)Schools of nursing
B)Health-care facilities such as hospitals
C)Individual nurses
D)State nursing organizations
Answer: D
Q2) One of the most important factors in recent changes that have occurred in the health-care system is demands by ______________________for higher quality care.
Answer: health-care consumers
health care consumers
Q3) Identify the primary function of permissive licensure.
A)Protects only the title "registered nurse"
B)Allows anyone to use the title "registered nurse"
C)Used by states to maintain quality and control over nurses
D)Allows institutions to use foreign nurses as RNs
Answer: A
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Chapter 4: Theories and Models of Nursing
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Q1) Identify the major component for the maintenance of health used in the Roy Adaptation Model of nursing.
A)Systems
B)Lack of illness
C)Adaptation
D)Use of medicine
Q2) "Stimuli" in the Roy Adaptation Model is synonymous with which element in systems theory?
A) Output
B) Feedback
C) Input
D) Coping
Q3) In the Roy Adaptation Model of nursing, the second-level assessment modes are most closely related to which part of the system?
A)Input
B)Output
C)Ventral system
D)Feedback loop
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6
Chapter 5: The Process of Educating Nurses
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Q1) Select all the elements from the list below that were found as assumptions in the ANA Position Paper on Nursing Education.
A)Nursing education should meet the increasing need for nurses as quickly as possible.
B)The professional practitioner is responsible for the nature and quality of all nursing care clients receive.
C)Education for those in the health-care professions must increase in depth and breadth as scientific knowledge expands.
D)Community colleges are able to prepare nurses just as well as 4-year colleges.
E)The demand for the services of nurses will continue to increase.
Q2) Select all the elements from the list below that are found in the Pew Health Professions Commission Report on the reform for nursing education.
A)Increasing the use of computer technology and interactive software
B)Preparing all nursing faculty at the doctoral level
C)Promoting interdisciplinary education
D)Developing cultural sensitivity
E)Limiting nursing class size to no more than 50 students
F)Expanding the scientific basis of the programs
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Page 7
Chapter 6: Critical Thinking
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Sample Questions
Q1) What is the first step in the process of critical thinking?
A)Identify the underlying beliefs.
B)Identify the problem.
C)Identify the value systems conflicts.
D)Identify the best solution to the conflict.
Q2) How does a nurse best begin the planning step in the nursing process?
A)Formulate and establish goals or outcomes for the client
B)Collect all the data available about the client's condition
C)Prioritize the steps of the nursing care to be provided
D)Write down the nursing diagnosis
Q3) Which type of information obtained by a nurse during the assessment step in the nursing process is considered subjective in nature?
A)Vital signs
B)Laboratory test values
C)Information from old hospital records
D)Description of symptoms by the client
Q4) Nurses who are not influenced by others with strong opinions are using ________________critical thinking.
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8
Chapter 7: Ethics in Nursing
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Sample Questions
Q1) Over time, popular acceptance of ________________rights can give them force of ________________rights.
Q2) Identify the term used when an ethical situation arises in which there is a choice between two equally unfavorable alternatives.
A)A tort
B)Ethical antagonism
C)Contraindication
D)Ethical dilemma
Q3) What is the best definition of the ethical principle of nonmaleficence?
A)Health-care workers avoiding harm to clients
B)Telling the truth to clients in all matters
C)Being faithful to commitments made to clients
D)The right of self-determination of clients
Q4) What are rules of conduct that protect the social fabric?
A)Morals
B)Values
C)Laws
D)Ethics
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Chapter 8: Bioethical Issues
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Sample Questions
Q1) From the list below, select all of the elements that should be included in a living will.
A)Statement that the document was freely written
B)Section that specifies what general health-care measures are to be excluded from care
C)List of people who should have input into the decisions on funeral arrangements
D)Section specifying the diseases for which the will should apply
E)Notary seal
Q2) The essential ethical principle of ________________is the legal and ethical foundation for the use of advanced directives.
Q3) Identify the two most important ethical issues that surround clients infected with HIV and those who have AIDS.
A)Confidentiality and right to care
B)Self-determination and distributive justice
C)Veracity and informed consent
D)Fidelity and option rights
Q4) As a general ethical principle, ________________and ________________should be excluded from the selection of an organ transplant recipient.
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Chapter 9: Nursing Law and Liability
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Q1) The nurse working in an emergency room is of the opinion that to carry out a certain order written by a physician could possibly constitute unethical or illegal behavior. Which one of the following courses of action would be best for the nurse to take in this situation?
A)Carry out the order and then discuss it with the physician.
B)Carry out the order and then discuss it with the supervisor.
C)Do not carry out the order and report the situation to the physician.
D)Do not carry out the order and report the situation to the supervisor.
Q2) Which statement made by a nursing student about the term "tort" during a class about legal issues in health care indicates that the student requires additional instruction?
A)If the plaintiff wins, he will be awarded money.
B)Intentional torts can sometimes be considered crimes.
C)It is considered to be a violation of a personal right.
D)It is considered to be a legal wrong against the public.
Q3) Identify the situation in which a nurse would likely be charged with negligence.
A)Slapping a client across the face for using foul language
B)Leaving the side rails down on a bed of a confused client
C)Using restraints on a client without a doctor's order
D)Telling the local newspaper of a client's diagnosis
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Chapter 10: How to Take and Pass Tests
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Sample Questions
Q1) The nurse in an outpatient clinic notes that a client with a persistent nagging cough has come in for treatment after hearing about the seven signs of cancer on the television show Oprah. Identify the statement by the nurse that best reinforces this client's understanding of the warning signs of cancer.
A)All the signs have to be present in order to detect cancer.
B)Other signs to look for include indigestion, difficulty swallowing, and changes in the size or shape of a mole.
C)If you develop persistent nausea, skin rash, or acute pain, you are at high risk for having a cancer.
D)The warning signs you hear about are just to scare people who do not schedule regular appointments into visiting the physician.
Q2) Identify the intervention by the nurse that has the highest priority when assisting a client diagnosed with multiple myeloma with ADLs.
A)Keep the client on oxygen by nasal cannula at all times.
B)Use great care in transferring the client from bed to chair to prevent bone injury.
C)Allow the client to rest for 10 minutes before and after each activity.
D)Encourage the client to be as independent as possible.
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Chapter 11: Nclex: What You Need to Know
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Sample Questions
Q1) Select the action by the nurse that best helps promote the adaptation of a client in Addisonian crisis.
A)Assign the client to a private room.
B)Cover the client with one or two extra blankets to keep him warm.
C)Ambulate the client four times per day to maintain exercise tolerance.
D)Encourage the client to take a shower instead of a bed bath.
Q2) Select the nursing action that would best help reduce the cramping experience by a client who was receiving intermittent feedings though a gastric tube (PEG tube).
A)Warm the feeding to near body temperature prior to administration.
B)Elevate the client's head to 35 to 45 degrees<sup> </sup>during feedings.
C)Encourage the client to suck on a hard candy 5 to 10 minutes prior to the feeding.
D)Assess the tube for placement prior to each feeding.
Q3) Identify the action by the nurse that is most important in providing care for a client who has a Fiberglas cast on her right arm.
A)Cover the cast with a pillowcase to keep the arm warm.
B)Keep a cast cutter at the bedside.
C)Assess the fingers of the right hand for movement and sensation every 2 hours.
D)Elevate the cast 45 degrees for the first 48 hours.
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Page 13
Chapter 12: Reality Shock in the Workplace
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Sample Questions
Q1) Which question should the new graduate anticipate being asked during a job interview?
A)What would make you more desirable as an employee than the other applicants for this job?
B)Do you attend church regularly, and what church do you go to?
C)Are you planning to become pregnant in the near future?
D)Are you married to the person you are presently living with?
Q2) Identify the most important aspect of good time management.
A)Doing the job yourself
B)Doing the job well no matter how long it takes
C)Setting priorities
D)Establishing long-term goals
Q3) Which personality characteristics would make a person more susceptible to burnout?
A)Average intelligence, procrastinator, poor health
B)Above average intelligence, idealistic, perfectionist
C)Below average intelligence, procrastinator, excellent health
D)Average motivation level, high income, idealistic
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Chapter 13: Principles of Leadership and Management
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Sample Questions
Q1) What is the first action the nurse manager should take when changing a procedure for the distribution of cardiac telemetry units when there are more clients than units available?
A)Review the current standards of care.
B)Rewrite applicable policies and procedures.
C)Designate the most critical clients as the ones to receive the units first.
D)Poll the physicians who commonly use telemetry for their opinions.
Q2) The nurses on the 7 a.m. to 3 p.m. shift have been complaining to the head nurse that the nurses on the 11 p.m. to 7 a.m. shift have not been doing the ordered client daily weights, and the physicians are very upset when they make their early morning rounds. Identify the initial action the head nurse should take to resolve this conflict.
A) Post a stern memo that reminds the night shift nurses to do the daily weights.
B) Review the daily weight flow sheet.
C) Change the time for daily weights to the late morning.
D) Hold a meeting with the physicians to discuss their attitudes.
Q3) Based on a task-oriented philosophy, ____________________ requires each person to perform a specific job that is narrowly defined according to the needs of the unit.
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Chapter 14: Communicating Successfully
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Sample Questions
Q1) When does the encoding process of communication take place?
A)The receiver thinks about the information, understands it, and forms an idea based on the message.
B)The receiver responds to the message and gives feedback.
C)The sender sends the message.
D)The message is sent in a way that causes confusion in the receiver.
Q2) Which statement by a nurse manager during a staff meeting best demonstrates use of an assertive style of communication?
A)"I am the manager, and we will do it my way."
B)"I'm sorry, but your suggestion was useless to solving the problem."
C)"I really don't care; do it the way you think best."
D)"You have made some good points, but I have another suggestion."
Q3) Select all those items from the list below that constitute barriers to clear communication.
A)Retaliation
B)Desire for power
C)Comfort
D)Increased knowledge
E)Preoccupation
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Page 16
Chapter 15: Incivility: the Antithesis of Caring
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Sample Questions
Q1) The caring-civility link is best exemplified by which of the following?
A)Helping in disasters in foreign countries
B)Conducting scholarly research into overcoming health-care disparities
C)Accepting criticisms from physicians even though unjustified
D)Making nursing assignments based on clients' needs and nurses' skills
Q2) What is an example of horizontal violence?
A)A student talking back to an instructor in the classroom
B)Posting false and derogatory information on YouTube about a fellow student
C)Faculty assigning additional homework when students fall asleep during class
D)Keying the cars of faculty who are unreasonable and unfair
Q3) What has been identified as a key element to effective education of nursing students?
A)A feeling of personal safety in the classroom setting
B)Low stress levels produced by decreased work assignments
C)Permitting students to use cell phones during classes
D)High-quality interpersonal relationships between students and teachers
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Chapter 16: Delegation in Nursing
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Q1) Select the personal characteristic of an RN that would tend to render his or her delegation ineffective.
A)Many years of experience in delegation
B)Demands perfection of employees
C)Feels self-confident in his or her ability as a leader
D)Trusts in the abilities of others
Q2) A LPN who has been assigned four clients asks the charge nurse which client should be assessed first after report. Which client should the charge nurse suggest be assessed first?
A)A 56-year-old man with type I diabetes with 4 p.m.blood sugar of 92
B)A 77-year-old man with congestive heart failure (CHF) who has a potassium level of 3.1
C)A 24-year-old woman with pyelonephritis and a fever of 101.1°F
D)A 38-year-old man with 22% deep partial-thickness burns of the legs and abdomen.
Q3) Select the most appropriate client for the RN to assign to the CNA.
A)A client with difficulty swallowing food and fluids
B)A client with constipation who needs tap-water enemas
C)A client with a colostomy who requires irrigations
D)A client with a PEG tube who is receiving continuous tube feedings
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Chapter 17: Governance and Collective Bargaining
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Sample Questions
Q1) What is the most important feature of the shared governance model?
A)Nursing administration retains most of the power over nurses to better regulate practice.
B)Power and authority are transferred to the nursing staff rather than being located primarily in nursing administration.
C)Clients are billed for nursing care as a separate item similar to the way they are billed for physician services.
D)The nursing staff hierarchy structure is similar to the medical staff structure.
Q2) In attempting to decide whether to go on strike, nurses are often concerned about the well-being of the clients in the hospital. What legal requirement helps alleviate this concern?
A)Hospitals are permitted to hire unlicensed personnel to substitute for the striking RNs.
B)Enough RNs are required to stay and work on the floors to maintain safe levels of care.
C)A 10-day notice must be given to the hospital before a strike takes place.
D)LPNs are permitted to function as RNs in strike situations.
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19
Chapter 18: Health-Care Delivery Systems
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Sample Questions
Q1) Which methods are used by health maintenance organizations (HMOs) to reduce the cost of health-care delivery?
A)Increasing the number of diagnostic studies to detect diseases early
B)Encouraging clients to remain in the hospital longer so that they can recover completely and not be readmitted
C)Referring more clients to specialists so that complex health-care problems can be treated better
D)Providing more health-promotion and illness-prevention services
Q2) What is a major problem identified with self-insured health-care plans?
A)Increased cost to the members
B)Shielding from many state tax regulations
C)Exclusion of potential employees based on their health history
D)Elimination of outside regulators to supervise private insurance plans
Q3) Cross-trained personnel are an integral part of which of the following care delivery models?
A)Team nursing
B)Modular nursing
C)Primary care nursing
D)Functional nursing
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Page 20
Chapter 19: Nursing Informatics
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Sample Questions
Q1) Identify the element that is not commonly found in information science.
A)Data or tasks that are processed
B)Configuration and architecture of the computer system
C)How problems are solved
D)Where products are produced
Q2) Which system, when developed, is expected to contain client outcomes, indicators, and measurement activities at five to six levels of abstraction?
A)Nursing Intervention Classification (NIC)
B)Nursing Outcome Classification (NOC)
C)Home Healthcare Classification (HHC)
D)Omaha Problem Classification Scheme (OPCS)
Q3) Identify the element that has been found most effective in the reduction of technology-related errors in client care.
A)Extended periods of training
B)Computer-based reminder systems
C)Systems involving 8 to 10 steps
D)Hiring only the most intelligent nurses
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21
Chapter 20: The Politically Active Nurse
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Sample Questions
Q1) What role do executive orders play in the political process?
A)Actively involve the legislature in key political decisions.
B)Shorten the time it takes to implement a political decision.
C)Help nurses by targeting endorsements.
D)Formulate policy with minimal involvement from the legislature.
Q2) Although most voters tend toward the middle of the political spectrum, ________________attempt to force their parties to the extreme ends of the spectrum.Multiple Response
Identify one or more choices that best complete the statement or answer the question.
Q3) A board of supervisors is usually found in which type of government structure?
A)State
B)County
C)Federal
D)City
Q4) Which statement best indicates the use of political capital?
A)"I will issue an executive order on that topic."
B)"Without your vote, the bill will never pass."
C)"If you vote for my bill, I will vote for your bill."
D)"Large groups of citizens support this issue."
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Chapter 21: Spirituality and Health Care
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Q1) Identify a statement made by a client that has a nocebo effect.
A)"My father died at age 55, so I will also."
B)"The food on this tray is nutrition to help me heal."
C)"I'll take my medication because it will help my lungs."
D)"I should be able to walk by the end of the week."
Q2) Identify the term used when a person lives with consciousness of a reality beyond what is knowable through the five senses and is aware of a transcendent reality.
A)Religion
B)Spirituality
C)Truth
D)Meditation
Q3) What is the least effective measure for nurses to use to maintain an internal state of balance and prevent burnout?
A)Use multitasking at work
B)Take time to feed their spirits
C)Use periodic retreats
D)Play basketball
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Chapter 22: Cultural Diversity
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Q1) Identify the outcome that is usually excluded from the purposes of cultural beliefs and practices.
A)Explanation of unusual or unpredictable events
B)Protection of the group members from harm
C)Expression of religious beliefs
D)Revelation of beliefs to strangers
Q2) What would identify a person who is demonstrating heritage consistency?
A)Accepting all the elements of the dominant culture and attempting to fit in as much as possible
B)Rejecting the dominant culture and clinging to the traditional ways of behavior
C)Going along with the dominant culture during the workday but reverting to his or her own cultural practices when at home
D)Refusing to learn the language of the dominant culture
Q3) Which statement accurately describes minority nurses in the United States?
A)They mirror the ethnic composition of the country as a whole.
B)They compose about 10% of all nurses.
C)They are increasing in numbers proportionate to the general population.
D)They are expected to outnumber nonminority nurses by the year 2080.
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Chapter 23: Developments in Current Nursing Practice
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Q1) Why do forensic nurses practicing in an institutional setting commonly face basic value conflicts?
A)Health care is the primary goal.
B)Inmates do not regard the nurse as an authority figure.
C)Resources for health-care services are severely limited.
D)The principles of security are often at odds with the principles of treatment.
Q2) In a disaster situation, a nurse often functions as a ____________________, assessing several victims and prioritizing care for the best use of resources.Multiple Response
Identify one or more choices that best complete the statement or answer the question.
Q3) Identify an important aspect of the role of forensic psychiatric nurses.
A)Conduct deep analyses of perpetrators to determine what caused the crime.
B)Provide intervention to prevent crimes before they occur.
C)Identify changes in behaviors linking criminals to criminal offenses.
D)Promote functional disabilities.
Q4) Nurse case managers act as ________________for clients and their families by coordinating care and linking the client with the physician, other members of the health-care team, resources, and the payer.
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Page 25
Chapter 24: Client Education: a Moral Imperative
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Q1) Which statement by the nurse would best indicate the nurse's use of the shared power concept in client teaching?
A)If you do the procedure just as I showed you, you will not have any infections.
B)The physician wants you to take this medication at the same time every day.
C)Once you get home, you can do whatever you want.
D)Tell me what your greatest concern is about being discharged.
Q2) A client tells the nurse that she has been using a health information website to find information about her illness. Which statement by the client does the nurse need to correct?
A)Some of the websites do not have very accurate information.
B)All of my personal information will be kept secure.
C)I should speak to my physician before using any alternative therapies.
D)Other clients seem to be having the same symptoms I have.
Q3) Select the factor that is most likely to increase a client's motivation to learn.
A)A severe illness with the potential to be fatal
B)The presence of the client's significant other during teaching session
C)A college education
D)A high socioeconomic level
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Chapter 25: Nursing Research and Evidence-Based Practice
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Q1) What is the purpose of qualitative inquiry research?
A)Gaining an understanding of how individuals find meaning in their world
B)Measuring the variables identified as dependent
C)Testing an identified hypothesis and proving a theory
D)Generalizing relationships between concepts
Q2) In nursing research, what is the critical link necessary to connect the researcher's framework with the appropriate type of data collection?
A)The research design
B)The research question
C)The nursing diagnosis statement
D)The propositional statement
Q3) It is important for nurses to develop the skill of ________________so that they will have the ability to understand the research process and then be able to sift through and carefully assesses all available and credible research findings.
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Chapter 26: Alternative and Complementary Healing Practices
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Q1) Select from the list below all methods that would make a health care be considered alternative.
A)Self-care
B)Wellness
C)Illness recovery
D)Self-healing
E)Health promotion
F)Illness prevention
Q2) With the goal of restoring the natural movement of vital forces, life essences, or other such vitalities, ________________bring balance back to factors disturbed by diseases or trauma.
Q3) Why is the term healing preferred to medicine when referring to alternative and complementary modalities?
A)Medicine implies that only physicians can carry out the treatment.
B)The treatments are based on holistic philosophies that go beyond treatment or cure of the physiologic dimensions of care.
C)Clients might associate alternative treatments with hospital care.
D)Nurses have had a strong influence in naming this modality.
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