Introduction to Nursing Study Guide Questions
Course Introduction
Introduction to Nursing provides students with a comprehensive overview of the nursing profession, including its history, foundational concepts, professional roles, and ethical considerations. This course explores the core values and principles that guide nursing practice, introduces the nursing process, and emphasizes the importance of patient-centered care, cultural competence, and effective communication. Students will also gain insight into various healthcare settings, interdisciplinary collaboration, evidence-based practice, and current trends and challenges in nursing. The course serves as a foundation for further study in nursing and prepares students to develop the knowledge, skills, and attitudes necessary for a successful nursing career.
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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Chapter 1: Development
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Sample Questions
Q1) 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
Q2) To plan early intervention and care for an infant with Down syndrome, the nurse considers knowledge of other physical development exemplars such as A) cerebral palsy.
B) autism.
C) attention deficit hyperactivity disorder (ADHD).
D) failure to thrive.
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) The home care nurse is trying to determine the necessary services for a 65-year-old patient who was admitted to the home care service after left knee replacement. Which tool is the best for the nurse to utilize?
A) Minimum Data Set (MDS)
B) Functional Status Scale (FSS)
C) 24-Hour Functional Ability Questionnaire (24hFAQ)
D) The Edmonton Functional Assessment Tool
Answer: C
Q2) Dresses self
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: B
Q3) Uses a cane
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: B
Q4) Cleans the house
A)for instrumental activities of daily living (IADLs)
B)for basic activities of daily living (BADLs)
Answer: A
Page 4
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Chapter 3: Family Dynamics
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Sample Questions
Q1) Two women have an established long-term relationship and are attending parenting classes in anticipation of finalizing adoption of a baby. The nurse identifies them as which type of family?
A) Cohabiting
B) Nuclear
C) Same-sex
D) Single parent
Answer: C
Q2) 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
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5
Chapter 4: Culture
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Sample Questions
Q1) Women who are given the job of caretaker for aging relatives are subject to caregiver strain due to
A) feminine attributes.
B) unequal gender.
C) fixed gender roles.
D) female inequality.
Q2) Understanding cultural differences in health care is important because it will help the nurse to understand the manner in which people decide on obtaining treatments and medical care. In independent cultures an individual will
A) put himself first.
B) consult family members for advice.
C) ask for a second opinion.
D) travel great distances to receive the best care.
Q3) What interrelated constructs facilitate a nurse to become culturally competent?
A) Cultural diversity, self-awareness, cultural skill, and cultural knowledge
B) Cultural desire, self-awareness, cultural knowledge, and cultural identity
C) Cultural desire, self-awareness, cultural knowledge, and cultural diversity
D) Cultural desire, self-awareness, cultural knowledge, and cultural skill
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Chapter 5: Spirituality
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Sample Questions
Q1) 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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Sample Questions
Q1) The nurse is assessing a newly diagnosed diabetic, and the patient's readiness to learn about glucose monitoring. Before planning teaching activities, which approach would be most effective?
A) Assist the patient with long-term goals and plan teaching according to these goals.
B) Provide the patient with all the latest research from the Internet on glucose monitoring.
C) Refer the patient to the diabetic specialist who can assist the patient with the glucometer.
D) Assist the patient in developing realistic short-term goals.
Q2) When assessing a 22-year-old male patient, the nurse learns that he smokes a pack of cigarettes daily. The patient tells the nurse, "I enjoy smoking and have no plans to quit." Which nursing diagnosis is most appropriate?
A) Health Seeking Behaviors related to cigarette use
B) Ineffective Health Maintenance related to tobacco use
C) Readiness for Enhanced Self-Health Management related to smoking
D) Deficient Knowledge related to long-term effects of cigarette smoking
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Chapter 7: Self-Management
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Sample Questions
Q1) The nurse planning care for a patient realizes that which acute medical event requires self-management?
A) Prenatal care
B) Depression
C) Diabetes
D) Femur fracture
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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Sample Questions
Q1) The home health nurse is caring for a patient with a diagnosis of acute immunodeficiency syndrome (AIDS) who has chronic diarrhea. Which assessments should the nurse use to detect the fluid and electrolyte imbalances for which the patient has high risk? (Select all that apply.)
A) Bilateral ankle edema
B) Weaker leg muscles than usual
C) Postural blood pressure and heart rate
D) Positive Trousseau's sign
E) Flat neck veins when upright
F) Decreased patellar reflexes
Q2) The nurse is assessing a patient before hanging an IV solution of 0.9% NaCl with KCl in it. Which assessment finding should cause the nurse to hold the IV solution and contact the physician?
A) Weight gain of 2 pounds since last week
B) Dry mucous membranes and skin tenting
C) Urine output 8 mL/hr
D) Blood pressure 98/58
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10
Chapter 9: Acid-Base Balance
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Sample Questions
Q1) The patient had diarrhea for 5 days and developed an acid-base imbalance. Which statement would indicate that the nurse's teaching about the acid-base imbalance has been effective?
A) "To prevent another problem, I should eat less sodium during diarrhea."
B) "My blood became too acid because I lost some base in the diarrhea fluid."
C) "Diarrhea removes fluid from the body, so I should drink more ice water."
D) "I should try to slow my breathing so my acids and bases will be balanced."
Q2) The patient has type B chronic obstructive pulmonary disease (COPD) exacerbated by an acute upper respiratory infection. Which blood gas values should the nurse expect to see?
A) pH high, PaCO<sub>2</sub> high, HCO<sub>3</sub>- high
B) pH low, PaCO<sub>2</sub> low, HCO<sub>3</sub>- low
C) pH low, PaCO<sub>2</sub> high, HCO<sub>3</sub>- high
D) pH low, PaCO<sub>2</sub> high, HCO<sub>3</sub>- normal
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11
Chapter 10: Thermoregulation
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Sample Questions
Q1) What is the most appropriate measure for a nurse to use in assessing core body temperature when there are suspected problems with thermoregulation?
A) Oral thermometer
B) Rectal thermometer
C) Temporal thermometer scan
D) Tympanic membrane sensor
Q2) 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
Q3) Which strategies should the nurse include in a community program for senior citizens related to dealing with cold winter temperatures?
A) Avoiding hot beverages
B) Shopping at an indoor mall
C) Using a fan at low speed
D) Walking slowly in the park
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12
Chapter 11: Sleep
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Sample Questions
Q1) 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
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
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Chapter 12: Cellular Regulation
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11 Flashcards
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Sample Questions
Q1) A cancer patient's susceptibility to the syndrome of inappropriate antidiuretic hormone (SIADH) can be suspected with which of the following laboratory results?
A) Serum potassium of 5.2 mmol/L
B) Serum sodium of 120 mmol/L
C) Hematocrit of 40%
D) Blood urea nitrogen (BUN) of 10 mg/dL
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
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) Which assessment finding would be the earliest and most sensitive indicator that there is an alteration in intracranial regulation?
A) Change in level of consciousness
B) Inability to focus visually
C) Loss of primitive reflexes
D) Unequal pupil size
Q2) The nurse is caring for a patient with increased intracranial pressure. Which action is considered unsafe?
A) Aligning the neck with the body
B) Clustering many nursing activities
C) Elevating the head of the bed 30 degrees
D) Providing stool softeners or laxatives as ordered
Q3) Components of the Glasgow Coma Scale (GCS) the nurse would use to assess a patient after a head injury include which assessment?
A) Blood pressure
B) Cranial nerve function
C) Head circumference
D) Verbal responsiveness
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15
Chapter 14: Hormonal Regulation
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Sample Questions
Q1) A patient presents to the emergency room complaining of vomiting with severe back and leg pain. The patient's home medications include daily oral corticosteroids. Vital signs reveal a low blood pressure and there are peaked T waves on the electrocardiogram. What is the nurse's priority intervention?
A) Start an intravenous line
B) Collect urine specimen
C) Administer antiemetic
D) Administer narcotic analgesia
Q2) 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) When a diabetic patient asks about maintaining adequate blood glucose levels, which of the following statements by the nurse relates most directly to the necessity of maintaining blood glucose levels no lower than about 74 mg/dL?
A) "Glucose is the only type of fuel used by body cells to produce the energy needed for physiologic activity."
B) "The central nervous system cannot store glucose and needs a continuous supply of glucose for fuel."
C) "Without a minimum level of glucose circulating in the blood, erythrocytes cannot produce ATP."
D) "The presence of glucose in the blood counteracts the formation of lactic acid and prevents acidosis."
Q2) 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
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Chapter 16: Nutrition
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Sample Questions
Q1) During an interview, the nurse is discussing dietary habits with a patient. Which tool would be the best choice to use as a quick screening tool to assess dietary intake?
A) Food diary
B) Calorie count
C) Comprehensive diet history
D) 24-hour recall
Q2) The nurse is assisting a 79-year-old patient with information about diet and weight loss. The patient has a body mass index (BMI) of 31. How should the nurse instruct this patient?
A) "Your weight is within normal limits. Continue maintaining with current lifestyle choices."
B) "You are a little overweight. Cut down on calories and increase your activity, and you should be fine."
C) "You are morbidly obese, and we would like to schedule you an appointment to speak with a bariatric specialist about surgery."
D) "You are considered obese and will need to consult with your doctor about a plan that includes exercises, not diet, to decrease weight."
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Chapter 17: Elimination
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Sample Questions
Q1) 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."
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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Page 19
Chapter 18: Perfusion
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Sample Questions
Q1) 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."
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."
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Chapter 19: Gas Exchange
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Sample Questions
Q1) The nurse is assessing a patient's differential white blood cell count. What implications would this test have on evaluating the adequacy of a patient's gas exchange?
A) An elevation of the total white cell count indicates generalized inflammation.
B) Eosinophil count will assist to identify the presence of a respiratory infection.
C) White cell count will differentiate types of respiratory bacteria.
D) Level of neutrophils provides guidelines to monitor a chronic infection.
Q2) 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) The nurse is making a home visit to a patient who was discharged from the hospital on Lovenox and warfarin following replacement of the patient's pacemaker. Which observation indicates excessive bleeding? (Select all that apply.)
A) New ecchymosis on the abdomen
B) A nosebleed that does not stop with pressure
C) Pain of the lower extremity with flexion
D) Extreme fatigue
E) Pallor
F) Sudden onset of severe headache
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22
Chapter 21: Reproduction
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Sample Questions
Q1) 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
Q2) 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
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Chapter 22: Sexuality
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Sample Questions
Q1) 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
Q2) 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)
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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) On admission to the clinic, the nurse notes a moderate amount of serous exudate leaking from the patient's wound. The nurse realizes what information about this fluid?
A) Contains the materials used by the body in the initial inflammatory response.
B) Indicates that the patient has an infection at the site of the wound.
C) Is destroying healthy tissue.
D) Results from ineffective cleansing of the wound area.
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26
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) 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
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Chapter 26: Mobility
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Q1) The nurse and a student nurse are discussing the effects of bed immobility on patients. The nurse knows that the student nurse understands the Chapter of mobility when making which statement?
A) "Patients with impaired bed mobility have an increased risk for pressure ulcers."
B) "Patients with impaired bed mobility like to have extra visitors."
C) "Patients with impaired bed mobility need to have a mechanical soft diet."
D) "Patients with impaired bed mobility are prone to constipation."
Q2) 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."
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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 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."
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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) An 80-year-old patient is being discharged after he was diagnosed with diabetes mellitus and retinopathy. His daughter has been part of the discharge instruction process. Understanding of the instructions is evident when the daughter says which of the following?
A) "I will make sure that Dad always wears warm socks."
B) "Dad needs to wear his glasses so he can delay the onset of macular degeneration."
C) "I will ask the home health aide to carefully inspect Dad's feet every day when she helps him bathe."
D) "We will give him only warm foods, so that he doesn't burn his mouth."
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Page 30
Chapter 29: Pain
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Sample Questions
Q1) 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.
Q2) A 30-year-old male is admitted to the hospital with acute pancreatitis. He is in acute pain described as a 10/10, which is localized to the abdomen, periumbilical area, and some radiation to his back. The abdomen is grossly distended so it is difficult to assess. He is restless and agitated, with elevated pulse and blood pressure. An appropriate pain management plan of care may include which medication(s)?
A) IV Dilaudid q 4 hours prn, hydrocodone 5/500 PO q 6 hours prn, and acetaminophen
B) Norco 5/500 q 4 hours PO and Benadryl 25 mg PO q 6 hours
C) Phenergan 25 mg IM q 6 hours
D) Tylenol 325 mg q 6 hours
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Chapter 30: Fatigue
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Q1) The nurse is assessing a patient for risk factors of chronic fatigue syndrome. Which factors should the nurse identify as placing the patient at risk for chronic fatigue syndrome? (Select all that apply.)
A) Feeling tired upon awakening
B) Chronic migraines
C) Tenderness under the jaw
D) 5 episodes tonsillitis/past year
E) Swollen, painful knees
Q2) 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
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32
Chapter 31: Stress
10 Flashcards
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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) A patient who was recently diagnosed with diabetes is having trouble concentrating. This patient is usually very organized and laid back. Which action should the nurse take?
A) Ask the health care provider for a psychiatric referral.
B) Administer the PRN sedative medication every 4 hours.
C) Suggest the use of a home caregiver to the patient's family.
D) Plan to reinforce and repeat teaching about diabetes management.
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Chapter 32: Coping
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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 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."
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Chapter 33: Mood and Affect
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Q1) 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.
Q2) A patient with a diagnosis of depression and suicidal ideation was started on an antidepressant 1 month ago. When the patient comes to the community health clinic for a follow-up appointment he is cheerful and talkative. What priority assessment must the nurse consider for this patient?
A) The medication dose needs to be decreased.
B) Treatment is successful, and medication can be stopped.
C) The patient is ready to return to work.
D) Specific assessment for suicide plan must be evaluated.
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Chapter 34: Anxiety
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Q1) The nurse is assessing the social support of a patient who is recently divorced and has moved from their hometown to the city due to change in jobs. Which response related to social support would be most therapeutic?
A) Encourage the patient to begin dating again, perhaps with members of her church.
B) Discuss how divorce support groups could increase coping and social support.
C) Note that being so particular about potential friends reduces social contact.
D) Discuss using the Internet as a way to find supportive others with similar values.
Q2) A female patient is anxious after receiving the news that she needs a breast biopsy to rule out breast cancer. The nurse is assisting with a breast biopsy. Which relaxation technique will be best to use at this time?
A) Massage
B) Meditation
C) Guided imagery
D) Relaxation breathing
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Chapter 35: Cognition
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Q1) The nurse is teaching primary prevention of cognitive impairment at a community health fair. Which topics would be included in the presentation? (Select all that apply.)
A) Do not use substances such as cannabis and alcohol.
B) Wear helmets when riding bicycles and motorcycles.
C) Complete a Mini Mental Status Exam (MMSE) yearly.
D) Correct acid-base imbalances related to underlying disease processes.
E) Wear a seat belt whenever riding in a motorized vehicle.
F) Complete a Confusion Assessment Method (CAM) scale yearly.
Q2) The nurse is sitting with the family of a patient who has just received the diagnosis of dementia. The family asks for information on what treatment will be needed to cure the condition. What is the nurse's best response?
A) "Hormone therapy will reverse the condition."
B) "Vitamin C and zinc will reverse the condition."
C) "There is no treatment that reverses dementia."
D) "Dementia can be reversed with diet, exercise, and medications."
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Chapter 36: Psychosis
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Q1) A 23-year-old male veteran of the war in Iraq is admitted with a diagnosis of posttraumatic stress disorder (PTSD) following his arrest for destroying his girlfriend's apartment. This is not his first angry outburst resulting in destruction of property. Which interventions by the nurse will be most helpful to this patient? (Select all that apply.)
A) Allow opportunities for him to express his anger.
B) Provide patient and family teaching regarding PTSD.
C) Tell the patient that hurting himself will solve nothing.
D) Report him to the authorities.
E) Exhibit a nonjudgmental attitude.
F) Reassure him that everything will be all right.
Q2) The nurse is planning discharge teaching for a patient taking clozapine. Which information is essential to include in the teaching plan?
A) Caution about sunlight exposure
B) Reminder to call the clinic if fever, sore throat, or malaise develops
C) Instructions regarding dietary restrictions
D) A chart to record patient weight
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Chapter 37: Addiction
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Q1) 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.
Q2) The nurse is assessing a patient using the CAGE Questionnaire. The patient answers yes to all of the questions. The nurse suspects alcoholism and feels the patient is in denial when the patient makes which statement?
A) "I go to meetings once a day and still drink."
B) "My family and friends have been avoiding me lately."
C) "I don't have a problem with alcohol. I can quit anytime I want to."
D) "I know it will be hard to quit, but I am willing to try."
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 counseling women at a crisis shelter about risk factors for increased intimate partner violence. What event is most likely to trigger an increase in abusive behaviors?
A) Moving to a new community
B) Starting a new job
C) Becoming pregnant
D) The death of a grandfather
Q2) Critical Thinking: A crisis intervention nurse is training emergency department staff on treatment needs of persons in abusive relationships. What is a common difficulty staff encounter when caring for this population?
A) There is not a good legal pathway to help persons in abusive relationships.
B) The abused person may return to the abusive home setting.
C) Hospital policies do not identify the legal care needed for abused persons.
D) Because length of care is short in the emergency department, there is little staff can do for patients who have been abused.
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Chapter 39: Professional Identity
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Q1) 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."
Q2) Nursing demonstrates dedication to improving public health through which avenue?
A) Changing health care standards
B) Legal regulations
C) Scope of practice
D) Technology
Q3) 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
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Chapter 40: Clinical Judgment
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Q1) The nurse is implementing a plan of care for a patient newly diagnosed with type 2 diabetes mellitus. The plan includes educating the patient about diet choices. The patient states that they enjoy exercising and understand the need to diet; however, they can't see living without chocolate on a daily basis. Using the principles of responding in the Model of Clinical Judgment, how would the nurse proceed with the teaching?
A) The nurse explains to the patient that chocolate has a high glycemic index. The nurse then focuses on foods that have low glycemic indexes and provides a list for the patient to choose from.
B) The nurse explains that the patient may eat whatever they would like as long as the patient's glucose reading and A1c remain stable.
C) The nurse derives a new nursing diagnosis of Knowledge Deficit and readjusts the plan of care to include additional sessions with the registered dietician.
D) The nurse examines the patient's daily glucose log and incorporates the snack into the time of day that has the lowest readings. The nurse then follows up and evaluates the response in 1 week.
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Chapter 41: Leadership
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Q1) The nursing unit director exhibits the definition of leadership in which of the following responses?
A) The nurse manager refers the concern to the director of the department.
B) The nurse manager corrects the concern with the patient directly and does not communicate her actions to the staff.
C) The nurse manager meets with the staff to discuss the concern and identify solutions.
D) The nurse manager tells the staff that they need to correct the situation by tomorrow and leaves the meeting.
Q2) What are the main features of complex adaptive systems that are relevant to nursing leadership? (Select all that apply.)
A) Focused on creating organizational change and looking at the whole versus individual parts.
B) Defined by efforts of leadership to mandate organizational change.
C) Autocratic in nature with a top-down structure for change.
D) Dependent on employees knowing what change is necessary and acting independently.
E) Non-linear and dynamic in nature, versus a static process.
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Chapter 42: Ethics
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Q1) 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
Q2) 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
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44
Chapter 43: Patient Education
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Q1) 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.
Q2) The nurse educator would identify a need for further teaching when the student lists which example as a type of learning?
A) Affective
B) Cognitive
C) Psychomotor
D) Self-directed
Q3) When describing patient education approaches, the nurse educator would explain that informal teaching is an approach that involves which quality?
A) Addresses group needs
B) Follows formalized plans
C) Has standardized content
D) Often occurs one-to-one
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45
Chapter 44: Health Promotion
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Q1) Interrelated Chapters to professional nursing a nurse manager would consider when addressing concerns about the quality of health promotion include which Chapters? (Select all that apply.)
A) Culture
B) Development
C) Evidence
D) Nutrition
E) Health policy
Q2) When there is evidence that supports a screening for an individual patient but not for the general population, the nurse would expect the United States Preventive Services Task Force Grading to be what?
A) No recommendation for or against
B) Recommends
C) Recommends against
D) Strongly recommends
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Chapter 45: Communication
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Sample Questions
Q1) The nurse and the patient are conversing face to face. What communication technique is being demonstrated?
A) Linguistic
B) Paralinguistic
C) Explicit
D) Metacommunication
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'?"
Q3) The nurse is seeking clarification of a statement that was made by a patient. What is the best way for the nurse to seek clarification?
A) "What are the common elements here?"
B) "Tell me again about your experiences."
C) "Am I correct in understanding that "
D) "Tell me everything from the beginning."
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Page 47
Chapter 46: Collaboration
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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 management of a community hospital is trying to encourage a more collaborative environment among staff members. Which Chapter is most important for management to develop first?
A) Post educational posters about how well collaboration is being performed
B) Highlight that no single profession can meet the needs of all patients
C) Provide meetings for each department on how their role affects patients
D) Begin implementing evaluations of collaborative skills on annual performance reviews
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48
Chapter 47: Safety
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Q1) 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
Q2) 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
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Chapter 48: Technology and Informatics
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Q1) 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.
Q2) 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
Q3) When discussing the purposes of health care informatics with a nurse during orientation, the nurse educator would be concerned if the nurse orientee stated that which is one purpose of informatics?
A) Develop a cognitive science.
B) Improve disease tracking.
C) Improve the health provider's work flow.
D) Increase administrative efficiencies.
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Chapter 49: Evidence
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Q1) 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.
Q2) 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.
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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Q1) 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
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) Two nurses are discussing health care quality. They agree which event contributes to increased health care quality?
A) Magnet status hospitals
B) Fewer adverse events
C) Collaboration of multiple health care agencies
D) Increased patient education
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Page 52
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 mother is talking with the community-based nurse concerning her adult son. The son is mentally challenged and not able to live on his own. The mother is concerned about her son's welfare when she is no longer able to care for him. What is the best response by the nurse?
A) "Let's look into the community resources that are available to assist you."
B) "You have raised your son well, and he will be okay on his own."
C) "Contact your distant relatives to see if anyone would take your son."
D) "There are places for mentally challenged adults; let's place him there."
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) 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
Q3) 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
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Chapter 54: Health Disparities
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Q1) 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
Q2) 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
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Chapter 55: Health Care Organizations
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Q1) 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.
Q2) A nurse manager finds an unsigned note reporting that patient care standards are not consistently being followed. Within the organizational structure, what is the best action for the manager?
A) Schedule a staff meeting to ask staff who left the note.
B) Send an email reminder that all staff need to review the policy and procedure book.
C) Wait for a staff member to come forward who is willing to be identified.
D) Form a small group to explore why staff are not comfortable reporting errors.
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Chapter 56: Health Care Economics
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Q1) Two nurses are discussing health care in the past and the present. The two nurses know which to be true about health care in the present?
A) Health care in the present is mostly provided by nurses.
B) Health care in the present is controlled by third party payers.
C) Health care in the present is controlled by physicians.
D) Health care in the present is dictated by the patient.
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) 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."
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Chapter 57: Health Policy
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Q1) 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
Q2) Which level of government is responsible for the regulation of a nurse's license?
A) Federal government
B) State government
C) Local government
D) International coalition
Q3) 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
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59
Chapter 58: Health Care Law
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Q1) Which is an example of the regulatory power to make law?
A) Joint Commission establishing a medication reconciliation standard.
B) Centers for Disease Control and Prevention (CDC) developing recommendations for childhood immunizations.
C) Institute of Medicine (IOM) defining the approximate number of medication errors that result in significant patient harm or death.
D) Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals.
Q2) The admission personnel working to comply with the Patient Self Determination Act of 1991 would do which of the following?
A) Request identification from the patient to complete the registration process.
B) Ask the patient if they would like a private or semi-private room.
C) Inquire about the patient's reason for their visit.
D) Ask the patient or representative if the patient has an advanced directive and inform them of their right to participate in their medical decisions.
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