You are the charge nurse responsible for the eveningshift. During rounds, you hear the patient care techni-cian yelling loudly to a patient regarding his transferfrom the bed to chair. When entering the room, whichof the following is your best response?

a.“You need to speak to the patient quietly. You aredisturbing the patient.”

b.“Let me help you with your transfer technique.”

c.“When you are finished, be sure to apologize foryour rough demeanor.”

d.“When your patient is safe and comfortable, meetme at the desk.”

The public health nurse is leaving the home of a youngmother who has a special needs baby. The neighborstates, “How is she doing, since the baby’s father is nohelp?” What is the nurse’s best response to the neighbor?

a.“New mothers need support.”

b.“The lack of a father is difficult.”

c.“How are you today?”

d.“It is a very sad situation.”

A 3-year-old child is being admitted to the medical divi-sion for vomiting, diarrhea, and dehydration. During theadmission interview, the nurse should implement whichof the following communication techniques to elicit themost information from the parents?

a.The use of statements that indicate the patient willbe all right

b.The use of questions that contain the word how

c.The use of a leading question and those involving yes or no

d.The use of questions that direct comments to clarify

The nurse enters the patient’s room and examines thepatient’s IV fluids and cardiac monitor. The patientstates, “Well, I haven’t seen you before. Who are you?”Which of the following is the nurse’s best response?

a.“I’m just the IV therapist checking your IV.”

b.“I’ve been transferred to this division and will becaring for you.”

c.“I’m sorry, my name is John Smith. I’m responsiblefor your IV.”

d.“My name is John Smith. I’ll be caring for you until11 p.m.”

The nurse enters the room of a patient with cancer. Heis crying and states, “I feel so alone.” Of the followingstatements, which is the most therapeutic?

a.The nurse stands at the patient’s bedside and states,“I understand how you feel. My mother said thesame thing when she was ill.”

b.The nurse places a hand on the patient’s arm andstates, “You feel so alone.”

c.The nurse stands in the patient’s room and asks,“Why do you feel so alone? Your wife has been here every day.”

d.The nurse holds the patient’s hand and asks, “Whatmakes you feel so alone?

During discharge teaching, the nurse should:

a.Determine the progress made in established goals

b.Clarify when the patient should take medications

c.Report the progress made in teaching to the staff

d.Include all family members in the teaching session

the nursing student is nervous and concerned about thework she is about to do at the clinical facility. To allayanxiety and be successful in her provision of care, it isimportant for her to:

a.Determine the established goals of the institution

b.Be sure her verbal and nonverbal communication iscongruent

c.Engage in self-talk to plan her day and decrease herfear

d.Speak with her fellow colleagues about how theyfeel

A nurse on the rehabilitation division states to her headnurse, “I need the day off and you didn’t give it to me!”The head nurse replies, “Well, I wasn’t aware youneeded the day off, and it isn’t possible since staffing is so inadequate.” In the act of sending the message,which statement would be considered more effective?

a.“Mr. Tyler, I placed a request to have August 8th off,but I’m working and I have a doctor’s appointment.”

b.“Mr. Tyler, I would like to discuss my schedule withyou. I requested the 8th of August off for a doctor’sappointment. Could I make an appointment?”

c.“Mr. Tyler, I will need to call in on the 8th of Augustbecause I have a doctor’s appointment.”

d.“Mr. Tyler, since you didn’t give me the 8th of Augustoff, will I need to find someone to work for me?”

During a nursing staff meeting, the nurses determinethat they will make sure all vital signs are reported andcharted within 15 minutes following assessment. Thisis an example of:

a.Group Decision Making

b.Group Leadership

c.Group Identity

d.Group Patterns of Interaction

A patient walking to the bathroom with a stooped gaitis noted with facial grimacing. It is important that thenurse assess the patient for which of the following?

a.Pain

b.Anxiety

c.Depression

d.Fluid Volume Deficit

A nursing student is preparing to administer morningcare to the patient. What is the most important questionthat the nursing student should ask the patient?

a.“Would you prefer a bath or a shower?”

b.“May I help you with a bed bath now or later thismorning?”

c.“I will be giving you your bath. Do you use soap orshower gel?”

d.“I prefer a shower in the evening. When would youlike your bath?

A nurse is providing instruction to the patient regardingthe procedure to change his colostomy bag. During theteaching session, he asks, “What type of foods should Iavoid to prevent gas?” The question the patient hasasked allows for which of the following?

a.A closed-ended answer

b.Information clarification

c.The nurse to give advice

d.A yes or no answer

When interacting with a patient, the nurse answers, “I am sure everything will be fine. You have nothing to worry about.” This is an example of which of thefollowing inappropriate communication techniques?

a.Cliché

b.Giving advice

c.Being judgmental

d.Changing the subject

A 76-year-old patient states, “I have been experiencingcomplications of diabetes.” The nurse needs to directthe patient to gain more information. What is the mostappropriate comment or question to elicit additionalinformation?

a.“Do you take two injections of insulin to decreasethe complications?”

b.“Most physicians recommend diet and exercise toregulate blood sugar.”

c.“Most complications of diabetes are related to neu-ropathy.”

d.“What specific complications have you experienced?”

During an interaction with a critically ill patient’s fam-ily, the nurse uses the communication technique ofsilence. This technique assists the family to:

a.Communicate with the patient

b.Plan for discharge

c.Organize their thoughts

d.Decrease anxiety

A nurse assesses an oral temperature for a patient as38.5C (101.3F). What term would the nurse use toreport this temperature?

a.Fever

b.Hypothermia

c.Hypertension

d.Afebrile

A nurse is assessing vital signs on several hospitalizedchildren. The nurse would plan to use the oral route toassess temperature for which patient?

a.6-month-old infant

b.Patient receiving oxygen therapy by mask

c.15-year-old healthy adolescent

d.Unconscious patient

When assessing a temperature rectally, the nurse woulduse extreme care when inserting the thermometer toprevent which of the following?

a.An increase in heart rate

b.A decrease in heart rate

c.A decrease in blood pressure

d.An increase in respirations

While taking an adult patient’s pulse, a nurse finds therate to be 140 beats/min. What should the nurse do next?

a.Check the pulse again in 2 hours.

b.Check the blood pressure.

c.Record the information.

d.Report the rate.

A patient complains of severe abdominal pain. Whenassessing the vital signs, the nurse would not besurprised to find what assessment?

a.An increase in the pulse rate

b.A decrease in body temperature

c.A decrease in blood pressure

d.An increase in respiratory depth

The nurse is taking an apical pulse. What equipmentwill he take into the patient’s room?

a.Sphygmomanometer

b.Electronic thermometer

c.Stethoscope

d.Doppler apparatus

Two nurses are taking an apical-radial pulse and note a difference in pulse rate of 8 beats per minute. Thenurse would document this difference as which of thefollowing?

a.Pulse deficit

b.Pulse amplitude

c.Ventricular rhythm

d.Heart arrhythmia

Before assessing respirations, the nurse reviews normalrates for adults. Which rate would the nurse identify asnormal?

a.1 to 6 breaths/min

b.12 to 20 breaths/min

c.60 to 80 breaths/min

d.100 to 120 breaths/min

A patient is having dyspnea. What would the nurse dofirst?

a.Remove pillows from under the head

b.Elevate the head of the bed

c.Elevate the foot of the bed

d.Take the blood pressure

A student nurse is learning to assess blood pressure.What does the blood pressure measure?

a.Flow of blood through the circulation

b.Force of blood against arterial walls

c.Force of blood against venous walls

d.Flow of blood through the heart

A nurse knows that the blood pressure is often higherin older adults based on the understanding that whichof the following occurs with aging?

a.Loss of muscle mass

b.Changes in exercise level

c.Decreased peripheral resistance

d.Decreased elasticity in arterial walls

A patient has a blood pressure reading of 130/90 mm Hgwhen visiting a clinic. What would the nurserecommend to the patient?

a.Follow-up measurements of blood pressure

b.Immediate treatment by a physician

c.Nothing, because the nurse considers this reading isdue to anxiety

d.A change in dietary intake

A nurse is documenting a blood pressure of 120/80 mm Hg. The nurse interprets the 120 to represent which of the following?

a.Pulse rate

b.Diastolic pressure

c.Systolic pressure

d.Pulse deficit

It is important to have the appropriate cuff size whentaking the blood pressure. What error may result from a cuff that is too large or too small?

a.An incorrect reading

b.Injury to the patient

c.Prolonged pressure on the arm

d.Loss of Korotkoff sounds

A patient has intravenous fluids infusing in the rightarm. When taking a blood pressure on this patient,what would the nurse do in this situation?

a.Take the blood pressure in the right arm

b.Take the blood pressure in the left arm

c.Use the smallest possible cuff

d.Report inability to take the blood pressure

1.When assessing a patient’s eyes, which instrumentwould the nurse use to visualize the retina?

a.Otoscope

b.Ophthalmoscope

c. Stethoscope

d. Tuning fork

Which of the following would be most important for anurse to do to ensure the accuracy of inspection duringassessment?

a. Compare bilateral body parts

b. Have 20/20 vision

c. Focus on selected body systems

d. Use touch judiciously

When palpating body structures, the nurse uses whichsense?

a. Intuition

b. Vision

c. Hearing

d. Touch

Percussion over the stomach reveals a loud, drum-likesound. The nurse would document this nding aswhich of the following?

a. Dullness

b. Flatness

c.Tympany

d. Resonance

While conducting a physical assessment, the nurseuses the bell of the stethoscope to hear which type ofsounds?

a. Tympanic sounds

b. Bowel sounds

c. Lung sounds

d. Heart sounds

Which technique would a nurse use to assess skinturgor?

a. Indent area with fingertips

b. Use a special type of lighting

c. Touch the area to detect moisture

d. Lightly pinch a fold of skin

A patient’s visual acuity is assessed as 20/40 in botheyes using the Snellen chart. The nurse interprets thisnding as which of the following?

a. The patient can see twice as well as normal

b. The patient has double vision

c. The patient has less than normal vision

d. The patient has normal vision

When using an otoscope to assess the tympanic mem-brane of an adult, the nurse straightens the ear canal by gently pulling the pinna in which direction?

a. Up and back

b. Down and forward

c. Away from the examiner

d. In any direction

Which phrase best describes the science of nursing?

a.The skilled application of knowledge

b.The knowledge base for care

c.Hands-on care, such as giving a bath

d.Respect for each individual patient

b.The science of nursing is the knowledge base for carethat is provided. In contrast, the skilled application of thatknowledge is the art of nursing.

Which nurse in history is credited with establishingnursing education?

a.Clara Barton

b.Lillian Wald

c.Lavinia Dock

d.Florence Nightingale

What historic event in the 20th century led to anincreased emphasis on nursing and broadened the role of nurses?a.Religious reform

b.Crimean War

c.World War II

d.Vietnam War

Which of the following phrases describes one of thepurposes of the ANA’s Nursing’s Social PolicyStatement?

a.To describe the nurse as a dependent caregiver

b.To provide standards for nursing educationalprograms

c.To regulate nursing research

d.To describe nursing’s values and social responsibility

5.A school nurse is teaching a class of junior-highstudents about the effects of smoking. This educationalprogram will meet which of the aims of nursing?

a.Promoting health

b.Preventing illness

c.Restoring

d.Facilitating coping with disability or death

Which of the following nursing degrees prepares anurse for advanced practice as a clinical specialist ornurse practitioner?a.LPN

b.ADN

c.BSN

d.Master’s

Which nursing organization was the first internationalorganization of professional women?

a.ICN

b.ANA

c.NLN

d.NSNA

What is the purpose of the ANA’s Scope and Standardsof Practice?

a.To describe the ethical responsibility of nurses

b.To define the activities that are special and unique tonursing

c.To establish nursing as an independent and free-standing profession

d.To regulate the practice of nursing

What type of authority regulates the practice of nursing?a.International standards and codes

b.Federal guidelines and regulations

c.State nurse practice acts

d.Institutional policies

Who are the largest group of healthcare providers inthe United States?

a.Registered nurses

b.Physicians

c.Physical therapists

d.Social workers

Which of the following phrases best defines culture?

a.A dominant group within a society

b.A shared system of beliefs, values, and behaviors

c.One’s values are replaced by the values of the domi-nant culture

d.Categories are based on specific physical character-istics

Minority groups living within a dominant culture maylose the cultural characteristics that made them differ-ent. What is this process called?

a.Cultural diversity

b.Cultural imposition

c.Cultural assimilation

d.Ethnocentrism

Which of the following terms is defined as the sense ofidentification with a collective cultural group?

a.Ethnicity

b.Race

c.Cultural acquisition

d.Culture shock

A nurse states, “That woman is 78 years old—too oldto learn how to change a dressing.” What is the nursedemonstrating?

a.Cultural imposition

b.Clustering

c.Cultural competency

d.Stereotyping

A young Hispanic mother comes to the local clinicbecause her baby is sick. She speaks only Spanishand the nurse speaks only English. What should thenurse do?

a.Use short words and talk more loudly

b.Ask an interpreter for help

c.Explain why care can’t be provided

d.Provide instructions in writing

A nurse is interviewing a newly admitted patient. Whichquestion would be considered culturally sensitive?

a.“Do you think you will be able to eat the food wehave here?”

b.“Do you understand that we can’t prepare specialmeals?”

c.“What types of food do you eat for meals?”

d.“Why can’t you just eat our food while you arehere?”

7.What group is the largest subculture of the healthcaresystem?

a.Nurses

b.Physicians

c.Social workers

d.Physical therapists

A nurse states, “I know I am cleaner than most of mypatients.” What does this statement indicate?

a.Cultural assimilation

b.Racism

c.Ethnocentrism

d.Stereotyping

A nurse wants to acquire knowledge of a specificculture. What could be done first?

a.Talk to coworkers

b.Review literature

c.Talk to family members of the patient

d.Ask others with more experience for help

Although all of the following are important to culturallycompetent nursing care, which one is most basic?

a.Learning another language

b.Having significant information

c.Treating each person as an individual

d.Recognizing the importance of family

Of the following statements, which is most true ofhealth and illness?

a.Health and illness are the same for all people.

b.Health and illness are individually defined by eachperson.

c.People with acute illnesses are actually healthy.

d.People with chronic illnesses have poor healthbeliefs

A nurse has volunteered to give influenza injectionsat a local clinic. What level of care is he demonstrating?

a.Tertiary

b.Secondary

c.Primary

d.Promotive

A nurse’s neighbor tells her, “I have a hightemperature, feel awful, and I am not going to work.”What stage of illness behavior is the neighborexhibiting?

a.Experiencing symptoms

b.Assuming the sick role

c.Assuming a dependent role

d.Achieving recovery and rehabilitation

A nurse is caring for a patient with heart failure, achronic illness. Which of the following characteristicsis not a part of chronic illness?

a.Permanent change in body structure or function

b.Self-treatment that relieves symptoms

c.Long period of treatment and care

d.Often has remissions and exacerbations

The agent–host–environment model of health andillness is based on what concept?

a.Risk factors

b.Infectious diseases

c.Behaviors to promote health

d.Stages of illness

When providing health promotion classes, a nurse usesconcepts from models of health. What do both thehealth–illness continuum and the high-level wellnessmodels demonstrate?

a.Illness as a fixed point in time

b.The importance of family

c.Wellness as a passive state

d.Health as a constantly changing state

Following the birth of his first child and after readingabout the long-term effects of nicotine, John decides tostop smoking. This behavior change is most likelybased on John’s perceptions of all but one of thefollowing. Which one is nottrue?

a.His susceptibility to lung cancer

b.How serious lung cancer would be

c.What benefits his stopping smoking will have

d.Personal choice and economic factors

Of the following clinic patients, which one is mostlikely to have annual breast examinations andmammograms based on the physical humandimension?

a.Jane, because her best friend had a benign breastlump removed

b.Sarah, who lives in a low-income neighborhood

c.Tricia, who has a family history of breast cancer

d.Nancy, because her family encourages regularphysical examinations

A nurse is asked to teach a group of young adults ahealthy lifestyle. One young man says, “I stopped eat-ing fast foods to lose weight.” What model of health orillness explains this behavior?

a.Health–illness continuum

b.Agent–host–environment model

c.Health promotion model

d.Health belief model

A nurse follows the guidelines for a healthy lifestyle.How can this promote health in others?

a.By being a role model for healthy behaviors

b.By not requiring sick days from work

c.By never exposing others to any type of illness

d.By spending less money on food

A nurse is providing care based on Maslow’s hierarchyof basic human needs. For which of the following nurs-ing activities is this approach useful?

a.Making accurate nursing diagnoses

b.Establishing priorities of care

c.Communicating concerns more concisely

d.Integrating science into nursing care

Which of the following levels of basic human needs ismost basic?

a.Physiologic

b.Safety and security

c.Love and belonging

d.Self-actualization

Of all the physiologic needs, which one is the mostessential?

a.Food

b.Water

c.Elimination

d.Oxygen

Practicing careful hand hygiene and using sterile tech-niques are ways in which nurses meet which basichuman need?a.Physiologic

b.Safety and security

c.Self-esteem

d.Love and belonging

Of the following statements, which one is true of self-actualization?

a.Humans are born with fully developed self-actualization.

b.Self-actualization needs are met by havingconfidence and independence.

c.The self-actualization process continues throughoutlife.

d.Loneliness and isolation occur when self-actualizationneeds are unmet.

What is the best broad definition of a family?

a.A father, a mother, and children

b.A group whose members are biologically related

c.A unit that includes aunts, uncles, and cousins

d.A group of people who live together

Where do individuals learn their health beliefs andvalues?

a.In the family

b.In school

c.From school nurses

d.From peers

John and Mary, each parents of one child, are bothdivorced. When they marry, the family structure that is formed will be described as which of thefollowing?

a.Nuclear family

b.Extended family

c.Blended family

d.Cohabiting family

Which of the following is one of the developmentaltasks of the older adult family?

a.Maintain a supportive home base

b.Prepare for retirement

c.Cope with loss of energy and privacy

d.Adjust to loss of spouse

Which of the following is one element of a healthycommunity?

a.Meets all the needs of its inhabitants

b.Offers access to healthcare services

c.Has mixed residential and industrial areas

d.Is little concerned with air and water quality

When you ask an older student why it is necessary tochange the patient’s bed every day, he says, “I guess wehave always done it that way.” This answer is an exam-ple of which of the following?

a.Unsubstantiated knowledge

b.Scientific knowledge

c.Authoritative knowledge

d.Traditional knowledge

One method of developing a theory is by first examin-ing a general idea and then considering specific actionsor ideas. What is this method called?

a.Inductive reasoning

b.Deductive reasoning

c.Conceptual modeling

d.Concept development

When describing the term conceptto a group of students, which word would the instructor mostlikely use?

a.Fact

b.Science

c.Idea

d.Truth

Which type of theory focuses on clinical nursingpractice?

a.Prescriptive theory

b.Descriptive theory

c.Developmental theory

d.Systems theory

After reviewing information about the four conceptscommon to nursing theories, the students demonstrateunderstanding of the information when they identifywhich concept as most important?

a.Person

b.Environment

c.Health

d.Nursing

When conducting research, information is collected.This would be identified as which of the following?

a.Subject

b.Analysis

c.Data

d.Abstract

Which type of quantitative research is conducted todirectly influence or improve clinical practice?

a.Basic research

b.Applied research

c.Experimental research

d.Descriptive research

A nurse researcher is studying the effects of exerciseand sleep on blood pressure. The researcher identifiesblood pressure as which type of variable?

a.Exploratory

b.Correlational

c.Dependent

d.Independent

Of the following types of qualitative research, whichmethod developed in anthropology?

a.Historical

b.Ethnography

c.Grounded theory

d.Phenomenology

A nurse is formulating a clinical question in PICOformat. Which of the following is represented by the letter P?

a.Comparison to another similar treatment

b.Clearly defined, focused literature review

c.Specific identification of the desired outcome

d.Explicit descriptions of population of interest

Five-year-old Bobby has dietary modifications relatedto his diabetes. His parents want him to value goodnutritional habits and they decide to deprive him of afavorite TV program when he becomes angry after theydeny him foods not on his diet. This is an example ofwhat mode of value transmission?

a.Modeling

b.Moralizing

c.Laissez-faire

d.Rewarding and punishing

e.Responsible choice

Which of the following is the best professional responseto a patient who tells you that she believes that “whitenurses are smarter than nurses of color” and then asks ifyou agree?

a.“You are right!” (The patient/customer is alwaysright!)

b.“What I think doesn’t matter. What’s important iswhatever you believe.” (Value neutrality)

c.“I don’t believe being smart is related to race orethnicity.” (Commitment to human dignity)

The American Association of Colleges of Nursing iden-tified five values that epitomize the caring professionalnurse. Which of these is best described as acting inaccordance with an appropriate code of ethics andaccepted standards of practice?

a.Altruism

b.Autonomy

c.Human dignity

d.Integrity

e.Social justice

A professional nurse with a commitment to socialjustice is most apt to:

a.Provide honest information to patients and the public

b.Promote universal access to healthcare

c.Plan care in partnership with patients

d.Document care accurately and honestly

When an older nurse complains that nurses just aren’t eth-ical anymore, which reply reflects the best understandingof moral development?

a.“The ability to behave ethically must be carefullycultivated; maybe we don’t value this sufficiently topay it the attention it deserves.”

b.“I don’t agree that nurses were more ethical in thepast. It’s a new age and the ethics are new!”

c.“Ethics is genetically determined . . . it’s like havingblue or brown eyes. Maybe we’re evolving out ofthe ethical sense you and your generation had.”

d.“No kidding! Who could be ethical in a practice setting like this!”

A home health nurse who performs a careful safetyassessment of the home of a frail elderly patient to pre-vent harm to the patient is acting in accord with whichof the principles of bioethics?

a.Autonomy

b.Beneficence

c.Justiced.Fidelity

e.Nonmaleficence

A professional nurse committed to the principle of

autonomy would be careful to:

a.Provide the information and support a patientneeded to make decisions to advance her owninterests

b.Treat each patient fairly, trying to give everyone hisor her due

c.Keep any promises made to a patient or another pro-fessional caregiver

d.Avoid causing harm to a patient

A friend asks you about the new Bill of Rights fornurses. What can you tell her that accurately reflectsthe concerns of the drafters of these rights?

a.The Bill of Rights was drafted by nurses who care more about themselves than they do aboutpatients.

b.The Bill of Rights was drafted by union nurses whoare always looking for a reason to strike.

c.The Bill of Rights was drafted to empower nursesand to improve conditions in the workplace.

Janie wants to call an ethics consult to clarify treatmentgoals for a patient no longer able to speak for himself.She believes his dying is being prolonged painfully. She is troubled when the patient’s doctor tells her that she’llbe fired if she raises questions about his care or calls theconsult. This is a good example of:

a.Ethical uncertainty

b.Ethical distress

c.Ethical dilemma

Nurse advocates often are conflicted about respecting apatient’s right to be self-determining, while at the sametime wanting to do everything in their power to promotethe patient’s best interests. Which is the best generalguideline for situations like these?

a.Patient rules! “It’s my life!”

b.Nurse rules! “It may be your life, but in this instanceyou don’t know enough to make the right choice!”

c.When in conflict, weigh the benefits and risks offollowing each option and then choose wisely.

When a state attorney decides to charge a nurse withmanslaughter for allegedly administering a lethal med-ication order, this is an example of what type of law?

a.Public law

b.Private law

c.Civil law

d.Criminal law

If you wanted to find a list of the violations that canresult in disciplinary actions against a nurse, youshould read which of the following?

a.Nurse Practice Act

b.Code of Ethics for Nurses

c.Nurses’Bill of Rights

d.American Journal of Nursing

“Jean,” a veteran nurse, pleaded guilty to amisdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into acoma during routine outpatient eye surgery at an eyesurgery center. Jean admitted she failed to monitorthe woman’s vital signs during the procedure. Thesurgeon who performed the procedure called thenurse’s action pure negligence, saying the patientcould have been saved. The patient was a vibrantgrandmother of 10 who had walked three quarters ofa mile the morning of her surgery and had sung in her church choir the day before. As part of her pleaarrangement, the nurse agreed to serve 6 months ofprobation—the first 2 months on house arrest—andsurrender her nursing license.

Those bringing the charges against Jean are called:

a.Appellates

b.Defendants

c.Plaintiffs

d.Attorneys

“Jean,” a veteran nurse, pleaded guilty to amisdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into acoma during routine outpatient eye surgery at an eyesurgery center. Jean admitted she failed to monitorthe woman’s vital signs during the procedure. Thesurgeon who performed the procedure called thenurse’s action pure negligence, saying the patientcould have been saved. The patient was a vibrantgrandmother of 10 who had walked three quarters ofa mile the morning of her surgery and had sung in her church choir the day before. As part of her pleaarrangement, the nurse agreed to serve 6 months ofprobation—the first 2 months on house arrest—andsurrender her nursing license.

Jean’s attorney was careful to explain in her defensethat Jean had specialty knowledge, experience, andclinical judgment and had met certain criteriaestablished by a nongovernmental association, as aresult of which she was granted recognition in a speci-fied practice area. What is this sort of credential called?

a.Accreditation

b.Licensure

c.Certification

d.Board approval

“Jean,” a veteran nurse, pleaded guilty to amisdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into acoma during routine outpatient eye surgery at an eyesurgery center. Jean admitted she failed to monitorthe woman’s vital signs during the procedure. Thesurgeon who performed the procedure called thenurse’s action pure negligence, saying the patientcould have been saved. The patient was a vibrantgrandmother of 10 who had walked three quarters ofa mile the morning of her surgery and had sung in her church choir the day before. As part of her pleaarrangement, the nurse agreed to serve 6 months ofprobation—the first 2 months on house arrest—andsurrender her nursing license.

If review of this patient’s record revealed that she hadnever consented to the eye surgery, of which intentionaltort might the surgeon have been guilty?

a.Assault

b.Battery

c.Invasion of privacy

d.False imprisonment

“Jean,” a veteran nurse, pleaded guilty to amisdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into acoma during routine outpatient eye surgery at an eyesurgery center. Jean admitted she failed to monitorthe woman’s vital signs during the procedure. Thesurgeon who performed the procedure called thenurse’s action pure negligence, saying the patientcould have been saved. The patient was a vibrantgrandmother of 10 who had walked three quarters ofa mile the morning of her surgery and had sung in her church choir the day before. As part of her pleaarrangement, the nurse agreed to serve 6 months ofprobation—the first 2 months on house arrest—andsurrender her nursing license.

What must be established to prove that malpractice ornegligence has occurred in this case?

a.The surgeon who performed the procedure calledthe nurse’s action pure negligence, saying thepatient could have been saved.

she was a vibrant grandmother of 10 who hadwalked three quarters of a mile the morning of hersurgery and had sung in her church choir the daybefore.

c.The nurse intended to harm the patient and was will-fully negligent.

d.The nurse had a duty to monitor the patient’s vitalsigns, failed to do so, the patient died, and it wasJean’s failure to do her duty that caused the patient’sdeath.

“Jean,” a veteran nurse, pleaded guilty to amisdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into acoma during routine outpatient eye surgery at an eyesurgery center. Jean admitted she failed to monitorthe woman’s vital signs during the procedure. Thesurgeon who performed the procedure called thenurse’s action pure negligence, saying the patientcould have been saved. The patient was a vibrantgrandmother of 10 who had walked three quarters ofa mile the morning of her surgery and had sung in her church choir the day before. As part of her pleaarrangement, the nurse agreed to serve 6 months ofprobation—the first 2 months on house arrest—andsurrender her nursing license

When the attorney representing the patient’s familycalls Jean and asks to talk with her about the case sothat he can better understand her actions, how shouldJean respond?

a.“I’m sorry, but I can’t talk with you. You’ll have tocontact my attorney.”

b.Answer the attorney’s questions honestly and makesure that he understands her side of the story.

c.Appeal to the attorney’s sense of compassion and tryto enlist his sympathy by telling him how busy itwas that morning.

d.“Why are you doing this to me? This could ruinme!”

If you harm a patient by administering a medication(wrong drug, wrong dose, etc.) ordered by a physician,which of the following is true?

a.You are not responsible, since you were merely fol-lowing the doctor’s orders.

b.Only you are responsible, since you actually admin-istered the medication.

c.Only the physician is responsible, since he or sheactually ordered the drug.

d.Both you and the physician are responsible for your respective actions.

A friend tells you not to even think about carrying yourown insurance because “you’ll be a magnet forattorneys trying to make a buck.” When you seek theadvice of the American Nurses Association, you arelikely to read which of the following reasons for purchasing a personal professional liability insurancepolicy?

(1)Protection of the nurse’s best interests

(2)Limitations of employer’s coverage

(3)Care or advice given outside of work

(4)Protection of the institution’s best interests

a.(1)

b.(1) and (2)

c.(1), (2), (3)

d.All of the above

A fellow student asks you about your legal liabilitywhen you do your clinical practice. Which of thefollowing are true?

(1)Student nurses are responsible for their own acts ofnegligence if these result in patient injury.

(2)Students nurses are held to the same standard ofcare that would be used to evaluate the actions of aregistered nurse.

(3)A hospital may also be held liable for thenegligence of a student nurse enrolled in ahospital-controlled program because the student isconsidered an employee of the hospital.

(4)Nursing instructors may share a student’s responsi-bility for damages in the event of patient injury ifthe instructor failed to provide reasonable and pru-dent clinical supervision.

a.(1) and (3)

b.(2) and (4)

c.(1), (2), (3)

d.All of the above

A group of students are reviewing information abouthospitals in preparation for a quiz the next day. Whichof the following, if identified by the students as associ-ated with a hospital, demonstrates the need foradditional study?

a.Provision of acute care

b.Inpatient services

c.Outpatient services

d.Parish nursing activities

Which type of healthcare facility employs the largestpercentage of RNs?

a.Ambulatory care

b.Long-term care

c.Hospitals

d.Physician offices

When reviewing information about the growth of health-care services, which area would the nurse expect to findas the most rapidly growing area?

a.Hospitals

b.Home care

c.Nursing homes

d.Parish nursing

Which healthcare provider is a major source of healthassessment and health education for children?

a.Hospital emergency department

b.Community center

c.Nurse practitioner

d.School nurse

A caregiver asks a nurse to explain respite care. Howwould the nurse respond?

a.“A service that allows time away for caregivers”

b.“A special service for the terminally ill and theirfamily”

c.“Direct care provided to individuals in nursing homes”

d.“Living units for people without regular shelter”

After teaching a class about the various healthcareagencies and services, the instructor determines that theteaching was successful when the class identifies whichof the following as a government agency?

a.Alcoholics Anonymous

b.Public Health Service

c.Rural health center

d.Ambulatory care center

Which purpose best describes managed care as a frame-work for healthcare?

a.A design to control the cost of care while maintain-ing the quality of care

b.Care coordination to maximize positive outcomes tocontain costs

c.The delivery of services from initial contact throughongoing care

d.Based on a philosophy of ensuring death in comfortand dignity

Your newly employed friend is a part of the company’sHMO. You interpret that to mean the friend

a.Can have healthcare services from a provider of hischoice

b.Will be unable to have emergency care

c.Receives all healthcare from providers within theorganization

d.Must pay an additional monthly premium

Private insurance most often is called a third-partypayer, indicating which of the following?

a.You pay no monthly premium, paying for all health-care costs yourself.

b.You belong to a preferred provider organization.

c.You are at risk if your healthcare provider is not apart of the plan.

d.You pay a monthly premium, and the insurancecompany pays the bills.

A nurse is developing a presentation for a localcommunity group about the knowledgeable healthcareconsumer. Which technology would the nurse includeas having the greatest effect on this area?

a.Television

b.Computers

c.Cell phones

d.Global positioning system (GPS) devices

A group of students are reviewing information abouthospitals in preparation for a quiz the next day. Whichof the following, if identified by the students as associ-ated with a hospital, demonstrates the need foradditional study?
a.Provision of acute care

b.Inpatient services

c.Outpatient services

d.Parish nursing activities

Which type of healthcare facility employs the largest percentage of RNs?

a.Ambulatory care

b.Long-term care

c.Hospitals

d.Physician offices

When reviewing information about the growth of health-care services, which area would the nurse expect to findas the most rapidly growing area?

a.Hospitals

b.Home care

c.Nursing homes

d.Parish nursing

Which healthcare provider is a major source of healthassessment and health education for children?

a.Hospital emergency department

b.Community center

c.Nurse practitioner

d.School nurse

A caregiver asks a nurse to explain respite care. Howwould the nurse respond?

a.“A service that allows time away for caregivers”

b.“A special service for the terminally ill and theirfamily”

c.“Direct care provided to individuals in nursing homes”

d.“Living units for people without regular shelter”

After teaching a class about the various healthcareagencies and services, the instructor determines that theteaching was successful when the class identifies whichof the following as a government agency?

a.Alcoholics Anonymous

b.Public Health Service

c.Rural health center

d.Ambulatory care cente

Which purpose best describes managed care as a frame-work for healthcare?

a.A design to control the cost of care while maintain-ing the quality of care

b.Care coordination to maximize positive outcomes tocontain costs

c.The delivery of services from initial contact throughongoing care

d.Based on a philosophy of ensuring death in comfortand dignity

Your newly employed friend is a part of the company’sHMO. You interpret that to mean the friend

a.Can have healthcare services from a provider of hischoice

b.Will be unable to have emergency care

c.Receives all healthcare from providers within theorganization

d.Must pay an additional monthly premium

Private insurance most often is called a third-partypayer, indicating which of the following?

a.care costs yourself.

b.You belong to a preferred provider organization.

c.You are at risk if your healthcare provider is not apart of the plan.

d.You pay a monthly premium, and the insurancecompany pays the bills.

A nurse is developing a presentation for a localcommunity group about the knowledgeable healthcareconsumer. Which technology would the nurse includeas having the greatest effect on this area?

a.Television

b.Computers

c.Cell phones

d.Global positioning system (GPS) devices

A nurse is the discharge planner at a large metropolitanhospital. What would the nurse do to ensure continuityof care as patients move from acute care to home care?

a.Perform an admission health assessment

b.Participate in the transfer of patients to the ICU

c.Make referrals to appropriate agencies

d.Maintain records of patient satisfaction withservices

Which of the following phrases best describes the phi-losophy of community-based care?

a.It considers the healthcare needs of the communityas a whole.

b.It centers on individuals and families with acute andchronic illness needs.

c.It has a population-based focus, with an emphasison illness prevention.

d.It provides direction for the roles of the nurse in theacute care setting.

When admitting a patient to the hospital, the nurse may delegate some activities to other members of thehealthcare team. Which activity would be appropriateto delegate?

a.Collecting information for a health history

b.Performing a physical assessment

c.Contacting the physician for medical orders

d.Preparing the bed and collecting needed supplies

Based on the Health Insurance Portability and Account-ability Act (HIPAA), a patient admitted to a healthcarefacility must be provided with a written explanation of:

a.The names and addresses of responsible providers

b.A Patient’s Bill of Rights

c.How health information will be used and disclosed

d.How often family members or friends may visit orcall

A patient is being transferred from the ICU to a regularhospital room. What must the ICU nurse be prepared todo as part of this transfer?

a.Provide a verbal report to the nurse on the new unit

b.Provide a detailed written report to the unit secretary

c.Delegate the responsibility for providing information

d.Make a copy of the patient’s medical record

At what point during a hospital stay should dischargeplanning be initiated?

a.After surgery and successful recovery

b.After the patient is less anxious

c.Immediately before discharge

d.On admission to the acute care setting

Which of the following statements or questions wouldbe appropriate in establishing a discharge plan for apatient who has had major abdominal surgery?

a.“I’ll bet you will be so glad to be home in your ownbed.”

b.“What are your expectations for recovery from yoursurgery?”

c.“Be sure and take your pain medications and changeyour dressing.”

d.“You will just be fine! Please stop worrying.”

A patient who decides to leave the hospital againstmedical advice (AMA) must sign a form. What is thepurpose of this form?

a.To indicate the patient’s wishes

b.To use in the event of readmission

c.To release the physician and hospital from legalresponsibility for the patient’s health status

d.To ethically illustrate that the patient has control ofhis or her own care and treatment

What is the primary purpose of the identificationbracelet worn by hospitalized patients?

a.Safety

b.Communication

c.Advocacy

d.Legality

The Patient Care Partnership form, given to patients onadmission to the hospital, includes several specificrights during hospitalization. Which of the following isincluded in this form?

a.The right to wear one’s own bed clothing

b.The right to use a personal cell phone

c.The right to have help when leaving the hospital

d.The right to take medications brought from home

1.Which one of the following statements is a requirementfor Medicare home healthcare reimbursement?

a.The patient must be essentially homebound.

b.The patient must require intravenous therapy.

c.The caregiver must be able to provide all physicalcare.

d.The caregiver must live with the patient.

n general, how does home care nursing compare withhospital-based nursing?

a.Nursing care provided in the home is no differentfrom hospital-based nursing care.

b.Home care patients do not have the same basic needsas those in the hospital.

c.In the home, care must be adapted to the patient’sschedules and customs.

d.The family or caregiver’s role is less important inhome care nursing.

3.Although the home care nurse follows an established planof care, he or she is more independent in what role?

a.Deciding which physician orders can be followed

b.Assuming responsibility for decision making

c.Shifting accountability for care to family caregivers

d.Delegating advanced clinical skills to unlicensed per-sonnel

Although all of the following skills are important, whatwould be the mostimportant to effective coordination ofcare and services?

a.Physical assessment

b.Knowledge of the law

c.How to use equipment

d.Effective communication

Which of the following activities would the nurse do inthe pre-entry phase of the home visit?

a.Call the physician for a referral order

b.Conduct a health history and physical assessment

c.Collect information and schedule a visit

d.Establish mutually acceptable goals for care

Before washing her hands, what might a home healthnurse ask or say to the patient?

a.“I need to wash my hands. May I use your bathroom?”

b.“I’m going to wash my hands in your bathroom.”

c.“I will wash my hands after I leave so I don’t botheryou.”

d.“How often do you wash your hands?”

What one activity is most important in preventing infec-tion when providing home care?

a.Wearing gloves whenever touching the patient

b.Following proper procedures for sterile dressingchanges

c.Asking the caregiver to step out of the room duringvisits

d.Performing hand hygiene before and after care

How often must a home care nurse document progressnotes?

a.Once a week

b.At the initial visit

c.At each visit

d.At the final visit

Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.

1.The nursing activity represented as (1) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.

The nursing activity represented as (2) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.

The nursing activity represented as (2) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.

.The nursing activity represented as (3) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

The nursing activity represented as (4) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.

The nursing activity represented as (5) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Which of the following statements about the nursingprocess is most accurate?

a.The nursing process is a four-step procedure foridentifying and resolving patient problems.

b.Beginning in Florence Nightingale’s days, nursingstudents learned and practiced the nursing process.

c.Use of the nursing process is optional for nurses, sincethere are many ways to accomplish the work of nursing.

d.The state board examinations for professional nurs-ing practice now use the nursing process rather thanmedical specialties as an organizing concept.

The nursing process ensures that nurses are patient cen-tered rather than task centered. Rather than simplyapproaching a patient to take vital signs, the nursethinks “How is Mrs. Barclay today? Are our nursingactions helping her to achieve her goals? How can webetter help her?” This demonstrates which characteris-tic of the nursing process?

a.Systematic

b.Interpersonal

c.Dynamic

d.Universally applicable in nursing situations

An experienced nurse tells you not to bother studyingtoo hard, since most clinical reasoning becomes “sec-ond nature” and “intuitive” once you start practicing.What thinking below should underlie your response?

a.When intuition is used alone, there are increasedrisks and fewer benefits. Intuition often moves prob-lem solving forward quickly, but it might result in alot of trial-and-error approaches.

b.For nursing to remain a science, nurses must continueto be vigilant about stamping out intuitive reasoning.c.The emphasis on logical, scientifi

c, evidence-basedreasoning has held nursing back for years. It’s timeto champion intuitive, creative thinking!

d.It’s simply a matter of preference. Some of us arelogical, scientific thinkers, and some are intuitive,creative thinkers.

This text is based upon a notion of blended skills. Sim-ply described, what does this mean?

a.Nursing works best when nurses competently usethe intellectual and technical skills that achievepatient outcomes. Nursing has been held back byoutdated notions of care and compassion (interper-sonal skills), which can be done by anyone.

b.Nursing works best when each nurse competentlyuses the intellectual, interpersonal, technical, andethical/legal skills demanded by each situation.

c.All of the blended skills are important, but not everynurse has to be skilled in each area. We benefitpatients by knowing what we do best. I might beutterly deficient in interpersonal skills but excellentin intellectual skills.

d.Every nursing situation demands the same blend ofbasic nursing skills, intellectual, technical, interper-sonal, and ethical/legal.

The best description of critical thinking indicators(CTIs) is which of the following?

a.Evidence-based descriptions of behaviors thatdemonstrate the knowledge that promotes criticalthinking in clinical practice

b.Evidence-based descriptions of behaviors thatdemonstrate the knowledge and skills that promotecritical thinking in clinical practice

c.Evidence-based descriptions of behaviors thatdemonstrate the knowledge, characteristics, and skills that promote critical thinking in clinicalpractice

d.Evidence-based descriptions of behaviors thatdemonstrate the knowledge, characteristics,standards, and skills that promote critical thinking inclinical practice

Although the nursing process is presented as an orderlyprogression of steps, in reality there is great interactionand overlapping among the five steps. Which of the fol-lowing describes this characteristic of the nursingprocess?

a.Systematic

b.Dynamic

c.Interpersonal

d.Outcome oriented

While administering a medication to relieve a patient’spain, you wonder if there are some nonpharmacologicinterventions that would enhance relief by complement-ing the pain medication. When you discuss this questionwith your instructor, which of the following responsesare you most likely to hear?

a.“You should wait until after you evaluate the effectof the medication you just administered before plan-ning a different intervention.”

b.“One step at a time. Don’t start planning a newintervention until you evaluate the old.”

c.“Let’s talk about this . . . we often get new informa-tion that we can incorporate successfully into theplan of care. Sometimes the steps of the processinteract or overlap.”

d.“Think about this patient. Nonpharmacologic inter-ventions wouldn’t be effective with her.”

When a patient you are admitting to the unit asks youwhy you are doing a history and exam since the doctorjust did one, which of the following statements is yourbest reply?

a.“In addition to providing us with valuable informa-tion about your health status, the nursing assessmentwill allow us to plan and deliver individualized,holistic nursing care that draws on your strengths.”

b.“It’s hospital policy. I know it must be tiresome, butI will try to make this quick!”

c.“I’m a student nurse and need to develop the skill ofassessing your health status and need for nursingcare. This information will help me develop a planof care individualized to your unique needs.”

d.“We want to make sure that your responses are con-sistent and that all our data are accurate.”

When you receive the shift report, you learn that your patient has no special skin care needs. You aresurprised during the bath to observe reddened areasover bony prominences. What action is appropriate?

a.Correct the initial assessment form.

b.Redo the initial assessment and document currentfindings.

c.Conduct and document an emergency assessment.

d.Perform and document a focused assessment on skinintegrity.

Fearful of attempting your first nursing history, you ask your instructor how anyone ever learns every-thing you have to ask to get good baseline data. Youare most likely to hear which reply from theinstructor?

a.“There’s a lot to learn at first, but once it becomespart of you, you just keep asking the same questionsover and over in each situation until you can do it inyour sleep!”

b.“You make the basic questions a part of you andthen learn to modify them for each unique situation,asking yourself how much you need to know to plangood care.”

c.“No one ever really learns how to do this wellbecause each history is different! I often feel likeI’m starting afresh with each new patient.”

d.“Don’t worry about learning all of the questions toask. Every agency has its own assessment form youmust use.”

A patient complains about feeling nauseated afterlunch. This is an example of what type of data?

a.Subjective

b.Objective

c.Signs and symptoms

d.Overt

When you enter the patient’s room to begin your nurs-ing history, the patient’s wife is there. What shouldyou do?

a.Introduce yourself to both and thank the wife forbeing present.

b.Introduce yourself to both and ask the wife if shewants to remain.ourself to both and ask the wife to

c. Introduce yourself to both and ask the wife to leave.

d. Introduce yourself and ask the patient if he wouldd Intrlike the wife to stay.

The patient is Vietnamese and does not speak English.Her son is with her and does speak English. Howshould you respond?

a. Ask the son if he is willing to translate and be sureto thank him if he says yes.

b. Determine if the son can translate medical informa-tion and if so, begin.

c. After determining that the son can translate, evalu-ate if he can do so objectively and if the patientwants him to serve in this capacity.

d. Explain to the patient and her son that you willobtain the services of a hospital-approvedtranslator.

You are surprised to detect an elevated temperature(102F) in a patient scheduled for surgery. The patienthas been afebrile and shows no other signs of beingfebrile. What is the first thing you do?

a. Inform the charge nurse

b. Inform the surgeon

c. Validate your  finding

d. Document your finding

You tell your instructor that your patient is ne and has“no complaints.” You are likely to hear:

a. “You made an inference that she is ne because shehas no complaints. How did you validate this?”

b. “She probably just doesn’t trust you enough to sharewhat she is feeling. I’d work on developing a trust-ing relationship.”

c. “Sometimes everyone gets lucky. Why don’t you tryto help another patient?”

d. “Maybe you should reassess the patient. He has tohave a problem—why else would he be here?

Identify all of the following that are purposes of diagnosing. The purpose of diagnosing is to identify:(1)how an individual, group, or community respondsto actual or potential health and life processes(2)factors that contribute to or cause health problems(etiologies)(3)strengths the patient can draw on to prevent orresolve problems(4)nursing interventions to resolve health problems

a.(1) and (2)

b.(3) and (4)

c.(1), (2), and (3)

d.All of the above

The terms diagnoseand diagnosishave legal implica-tions. They imply that there is a specific problem thatrequires management by a qualified expert. Which ofthe following statements is false?

a.If you make a diagnosis, it means that you acceptaccountability for accurately naming and managingthe problem.

b.If you treat a problem or allow a problem to persistwithout ensuring that the correct diagnosis hasbeen made, you may cause harm and be accused of negligence.

c.You are accountable for detecting, identifying, orrecognizing signs and symptoms that may indicateproblems beyond your expertise.

d.When nurses diagnose a medical problem, they arejust as accountable as physicians for detecting,identifying, and managing the signs and symptomsof disease.

Which was the first state to identify diagnosing as partof the legal domain of professional nursing?

a.New Jersey

b.New York

c.North Carolina

d.North Dakota

b.New York was the first state to identify diagnosing aspart of the legal domain of professional nursing.

Which group is responsible for the promotion andorganization of activities to continue the development,classification, and scientific testing of nursingdiagnoses?

a.American Nurses Association

b.National Nursing Diagnosis Association

c.North American Nursing Diagnosis Association

d.Clearinghouse for Nursing Diagnoses

Altered Health Maintenance is an example of which ofthe following types of problems?

a.Collaborative problem

b.Interdisciplinary problem

c.Medical problem

d.Nursing problem

To determine the significance of a blood pressure read-ing of 148/100, it is first necessary for the nurse to dowhich of the following?

a.Compare this reading to standards.

b.Check the taxonomy of nursing diagnoses for a pertinent label.

c.Check a medical text for the signs and symptoms ofhigh blood pressure.

d.Consult with colleagues.

a.A standard, or a norm, is a generally accepted rule,measure, pattern, or model to which can be compareddata in the same class or category. For example, whendetermining the signicance of a patient’s blood pres-sure reading, appropriate standards include normativevalues for the patient’s age group, race, and illness cat-egory. Deviation from an appropriate norm may be thebasis for writing a diagnosis.

When the initial nursing assessment revealed that thepatient had not had a bowel movement for 2 days, the student wrote the diagnostic label “constipation.”Which of the following comments is she most likely to hear from her instructor?

a.“Hold on a minute . . . Nursing diagnoses shouldalways be derived from clusters of significant datarather than from a single cue.”

b.“Job well done . . . You’ve identified this problemearly and we can manage it before it becomes moreacute.”

c.“Is this an actual or a possible diagnosis?”

d.“This is a medical, not a nursing problem.”

A clinical judgment that an individual, family, or com-munity is more vulnerable to develop the problem thanothers in the same or similar situation is what type ofnursing diagnosis?

a.Actual

b.Risk

c.Possible

d.Wellness

e.Syndrome

Which of the following nursing diagnoses are correctlywritten as two-part nursing diagnoses?(1) Ineffective Coping related to inability to maintainmarriage(2) Defensive Coping related to loss of job andeconomic security(3) Altered Thought Processes related to panic state(4) Decisional Conict related to placement of parentin nursing home

a. (1) and (2)

b. (3) and (4)

c. (1), (2), and (3)

d. All of the above

Which of the following nursing diagnoses are correctlywritten as three-part nursing diagnoses?(1) Disabled Family Coping related to lack of knowl-edge about home care of child on ventilator(2) Imbalanced Nutrition: Less Than Body Requirementsrelated to inadequate caloric intake while striving toexcel in gymnastics as evidenced by 20-pound weightloss since beginning the gymnastic program, andgreatly less than ideal body weight when comparedto standard height weight charts(3) Need to learn how to care for child on ventilatorat home related to unexpected discharge of daugh-ter after 3-month hospital stay as evidenced byrepeated comments “I cannot do this,” “I knowI’ll harm her because I’m not a nurse,” and “Ican’t do medical things.”(4) Spiritual Distress related to inability to accept diag-nosis of terminal illness as evidenced by multiplecomments such as “How could God do this tome?,” “I don’t deserve this,” “I don’t understand.I’ve tried to live my life well,” “How could Godmake me suffer this way?”(5) Caregiver Role Strain related to failure of homehealth aides to appropriately diagnose needs offamily caregivers and initiate a plan to facilitatecoping as evidenced by caregiver’s loss of weightand clinical depression.

a. (1) and (3)

b. (2) and (4)

c. (1), (2), and (3)

d. All of the above

During the outcome identification and planning step ofthe nursing process, the nurse works in partnershipwith the patient and family to do which of the follow-ing? Select all that apply.

a.Formulate and validate prioritized nursing diagnoses

b.Identify expected patient outcomes

c.Select evidence-based nursing interventions

d.Communicate the plan of nursing care

Mr. Price tells the nurse he fears becoming “hookedon drugs” and consequently waits until his painbecomes unbearable before requesting his PRN analgesic. The nurse plans to be more attentive to Mr. Price and to assess his needs for pain managementmore closely. Which of the following consequences ofinformal planning ought to be the major concern forthis nurse?a.The lack of a coordinated plan known by everyonewill

result in uneven pain management.

b.Faulty prioritization of patient needs

c.Inability to evaluate the patient’s responses to nursing care

d.Lack of a record for reimbursement purposes

When helping Mr. Price turn in bed, the nurse noticesthat his heels are reddened and plans to place him onprecautions for skin breakdown. This is an example ofwhat type of planning?

a.Initial planning

b.Standardized planning

c.Ongoing planning

d.Discharge planning

For the following patient problems:(1)Disturbed Body Image(2)Ineffective Airway Clearance(3)Spiritual Distress(4)Impaired Social Interaction.Which answer choice below lists the problems in orderof highest priority to lowest priority based on Maslow’shierarchy of human needs?

a.2, 4, 1, 3

b.3, 1, 4, 2

c.1, 4, 3, 2

d.3, 2, 4, 1

From which of the following are nursing outcomesderived?

a.The problem statement of the nursing diagnosis

b.The etiology of the problem of the nursing diagnosis

c.The defining characteristics of the problem

d.The evaluative statement

a.Outcomes are derived from the problem statement ofthe nursing diagnosis. For each nursing diagnosis in theplan of care, at least one outcome should be writtenthat, if achieved, demonstrates a direct resolution of the problem statement.

Which of the following is an example of an affectiveoutcome?

a.Within 1 day after teaching, the patient will listthree benefits of continuing to apply moistcompresses to leg ulcer after discharge.

b.By 6/12/12, the patient will correctly demonstrateapplication of wet-to-dry dressing on leg ulcer.

c.By 6/19/12, the patient’s ulcer will begin to showsigns of healing (e.g., size shrinks from 3"to 2.5").

d.By 6/12/12, the patient will verbalize valuing healthsufficiently to practice new health behaviors to pre-vent recurrence of leg ulcer.

d.Affective outcomes describe changes in patientvalues, beliefs, and attitudes. Cognitive outcomes (a) describe increases in patient knowledge or intellec-tual behaviors; psychomotor outcomes (b) describe thepatient’s achievement of new skills. cis an outcomedescribing a physical change in the patient.

Which of the following is an optional element in ameasurable outcome?

a.Subject

b.Verb

c.Performance criteria

d.Conditionse.Target time

Which of the following outcomes are correctly written?Select all that apply.

a.Offer Mr. Myer 60 mL fluid every 2 hours whileawake.

b.During the next 24-hour period, the patient’s fluidintake will total at least 2,000 mL.

c.Teach Mrs. Gaston proper newborn care by 1/15/11.

d.By discharge, Mrs. Gaston will know how to batheher newborn.

e.At the next visit, 12/23/11, the patient will correctlydemonstrate relaxation exercises.

Which of the following guidelines for outcome writingare correct? Select all that apply.a.At least one of the outcomes shows

a direct resolutionof the problem statement in the nursing diagnosis.

b.The patient (and family) values the outcomes.

c.The outcomes are supportive of the total treatmentplan.

d.Each outcome is brief and specific (clearly describesone observable, measurable patient behavior/manifestation), is phrased positively, and specifiesa time line.

Which of the following are examples of well-statednursing interventions? Select all that apply.

a.Offer patient 60 mL water or juice (prefers orangeor cranberry juice) every 2 hours while awake for atotal minimum PO intake of 500 mL.

b.Teach patient the necessity of carefully monitoringfluid intake and output; remind patient each shift tomark off fluid intake on record at bedside.

c.Walk with patient to bathroom for toileting every 2 hours (on even hours) while patient is awake.

d.Manage patient’s pain.

A school nurse notices that Jill is losing weight andwants to perform a focused assessment on Jill’snutritional status, fearing that she might have an eatingdisorder. How should the nurse proceed?

a.Perform the focused assessment. This is an independ-ent nurse-initiated intervention.

b.Request an order from Jill’s physician since this is aphysician-initiated intervention.

c.Request an order from Jill’s physician since this is acollaborative intervention.

d.Request an order from the nutritionist since this is acollaborative intervention.

Which of the following would you expect to find in theNursing Interventions Classification Taxonomy?

a.Case studies illustrating a complete set of activitiesthat a nurse performs to carry out nursing interventions

b.Nursing interventions, each with a label, a definition,and a set of activities that a nurse performs to carry itout, with a short list of background readings

c.A complete list of nursing diagnoses, outcomes, andrelated nursing activities for each nursing intervention

d.A complete list of reimbursable charges for eachnursing intervention

You are a brand new RN. When you orient to a newnursing unit that is currently understaffed, you are toldthat the UAPs have been trained to obtain the initialnursing assessment. What is the best response?

a.Allow the UAPs to do the admission assessment andreport the findings to you.

b.Do your own admission assessments but don’t inter-fere with the practice if other professional RNs seemcomfortable with the practice.

c.Tell the charge nurse that you are choosing not to del-egate the admission assessment at this time until youcan get further clarification from admission.

d.Contact your labor representative and complain.

Jeanne is a college student who wants to lose 20 pounds.She meets with the student health nurse and develops aplan to increase her activity level and decrease theconsumption of the wrong types of foods and excesscalories. The nurse plans to evaluate her weight lossmonthly. When Jeanne arrives for her first “weigh-in,”the nurse discovers that instead of the projected weightloss of 5 pounds, Jeanne has only lost 1 pound. Which isthe best nursing response?

a.Congratulate Jeanne and continue the plan of care.

b.Terminate the plan of care since it is not working.

c.Try giving Jeanne more time to reach the targetedoutcome.

d.Modify the plan of care after discussing possible rea-sons for Jeanne’s partial success

The following are all classic elements of evaluation.Which item below places them in their correctsequence?

(1)Interpreting and summarizing findings

(2)Collecting data to determine whether evaluative criteria and standards are met

(3)Documenting your judgment

(4)Terminating, continuing, or modifying the plan

(5)Identifying evaluative criteria and standards (whatyou are looking for when you evaluate, e.g., expectedpatient outcomes)

a.(1), (2), (3), (4), (5)

b.(3), (2), (1), (4), (5)

c.(5), (2), (1), (3), (4)

d.(2), (3), (1), (4), (5)

When a new nurse is oriented to the subacute unit, she istold that each nurse is expected to observe her patients atleast every hour, and more if their condition warrantsextra monitoring. This expectation is best termed:

a.Standard

b.Criteria

c.Custom

d.Order

Remember Jeanne, the college student who wants to lose20 pounds? When the nurse weighs her during the fifthstep of the nursing process, what is she doing?

a.Collecting assessment data to identify healthproblems

b.Collecting assessment data to identify patientstrengths

c.Collecting evaluative data to justify terminating theplan of care

d.Collecting evaluative data to measure outcomeachievement

One of the outcomes Jeanne and the nurse planned isthat Jeanne “appreciates or values a healthy body suffi-ciently to try to new behaviors.” Which of the followingbest describes this type of outcome?

a.Cognitive

b.Psychomotor

c.Affective

d.Physical changes

Another of the outcomes Jeanne and the nurse planned isthat Jeanne “can explain the relationship between weightloss, increased exercise, and decreased calorie intake.”Which of the following best describes this type ofoutcome?

a.Cognitive

b.Psychomotor

c.Affective

d.Physical changes

Which of the following is the correct example of anevaluative statement?

a.“Outcome not met.”

b.“1/21/09—Patient reports no change in tobacco use.”

c.“Outcome not met. Patient reports no change intobacco use.”

d.“1/21/09—Outcome not met. Patient reports nochange in tobacco use.”

A quality-assurance program reveals a higher incidenceof falls and other safety violations on a particular unit. Anurse manager states, “We’d better find the folks respon-sible for these errors and see if we can’t replace them.”This is an example of which of the following?

a.Quality by inspection

b.Quality by punishment

c.Quality by surveillance

d.Quality by opportunity

One nursing unit with an excellent safety record meetsto review the findings of the audit and the nurse managerstates, “We’re doing well, but we can do better! Who’sgot an idea to foster increased patient well-being andsatisfaction?” This is an example of leadership that values which of the following?

a.Quality assurance

b.Quality improvement

c.Process evaluation

d.Outcome evaluation

Which of the following documentation guidelines arecorrect? Select all that apply.

a.Enter information in a complete, accurate, concise,factual, and organized manner.

b.Use words such as “good,” “average,” “normal,” or“sufficient” to communicate judgments about data.

c.Wait until the end of the shift to document nursinginterventions to ensure comprehensive charting.

d.Date and time each entry.

Which of the following documentation guidelines arecorrect? Select all that apply.

a.Erase or use correcting fluid to completely deletemistaken entries.

b.Document nursing interventions as closely as possi-ble to the time of their execution.

c.Note problems as they occur in an orderly, sequentialmanner.

d.Carefully document all the factors that compromisepatient safety and contribute to patient harm.

According to the Health Insurance Portability andAccountability Act of 1996, patients have a right towhich of the following? Select all that apply.

a.To see and copy their health record

b.To update their health record

c.To get a list of the disclosures a healthcare institutionhas made independent of disclosures made for thepurposes of treatment, payment, and healthcare operations

d.To request a restriction on certain uses or disclosures

e.To choose how to receive health information

According to the Health Insurance Portability andAccountability Act of 1996, if a health institution wants to release a patient’s health information forpurposes other than treatment, payment, and routinehealthcare operations, the patient must be asked tosign an authorization. There are exceptions to thisrequirement. In which case below is an authorizationneeded?

a.The patient is a public figure and the local newsmedia are preparing a news report.

b.Data are needed for the tracking and notification ofdisease outbreaks.

c.Child abuse and neglect are suspected.

d.Protected health information is needed to facilitateorgan donations.

A friend of yours calls you and asks if you are stillworking at Memorial Hospital. You reply “yes.” Hetells you that his girlfriend’s father was just admittedas a patient, and he wants you to find out how he is.“Sue (his girlfriend) seems unusually worried abouther dad, but she won’t talk to me and I want to be ableto help her.” What is the best response you can maketo your friend?

a.“Listen, you shouldn’t be asking me to do this. Icould be fined big bucks or even lose my job for disclosing this information.”

b.“Sorry, but I’m not able to give information aboutpatients to the public—even when my best friend or a family member asks.”

c.“Because of the Health Insurance Portability andAccountability Act, you shouldn’t be asking for thisinformation unless the patient has authorized you toreceive it! This could get you in trouble!”

d.“Why do you think Sue isn’t talking about herworries?”

Your patient has an order for an analgesic medication to be given as needed. The correct abbreviation for “as needed” is:

a.TURP

b.PMH

c.PRN

d.TPR

If you were looking for trends in a patient’s vital signs,what form should you consult first?

a.Admission sheet

b.Admission nursing assessment

c.Activity flow sheet

d.Graphic sheet

This method of documentation uses the categories data,action, and response (DAR) to facilitate charting.

a.Narrative notes

b.Focus charting

c.Charting by exception

d.Case management model

A resident called to see a patient in the middle of thenight is leaving the unit and remembers that he forgot to write a new order for a pain medication you had requested for another patient. Tired and already beingpaged to another unit, he verbally tells you the order andasks you to document it on the physician’s order sheet.Your best response is:

a.“Thank you!”

b.Get a second nurse to listen to the order, and afterwriting the order on the physician order sheet, haveboth nurses sign.

c.“I am sorry but verbal orders can only be given in anemergency situation that prevents us from writingthem out. I’ll bring the chart and we can do thisquickly.”

d.Try calling another resident for the order or wait untilthe next shift.