Chapter 01: Nursing Today

1. Which nurse most likely kept records on sanitation techniques and the effects on health?
2. The nurse prescribes strategies and alternatives to attain expected outcome. Which standard of nursing practice is the nurse following?
3. An experienced medical-surgical nurse chooses to work in obstetrics. Which level of proficiency is the nurse upon initial transition to the obstetrical floor?
4. A nurse assesses a patient’s fluid status and decides that the patient needs to drink more fluids. The nurse then encourages the patient to drink more fluids. Which concept is the nurse demonstrating?
5. A nurse prepares the budget and policies for an intensive care unit. Which role is the nurse implementing?
6. The nurse has been working in the clinical setting for several years as an advanced practice nurse. However, the nurse has a strong desire to pursue research and theory development. To fulfill this desire, which program should the nurse attend?
7. A nurse attends a workshop on current nursing issues provided by the American Nurses Association. Which type of education did the nurse receive?
8. A nurse identifies gaps between local and best practices. Which Quality and Safety Education for Nurses (QSEN) competency is the nurse demonstrating?
9. A nurse has compassion fatigue. What is the nurse experiencing?
10. A patient is scheduled for surgery. When getting ready to obtain the informed consent, the patient tells the nurse, “I have no idea what is going to happen. I couldn’t ask any questions.” The nurse does not allow the patient to sign the permit and notifies the health care provider of the situation. Which role is the nurse displaying?
11. The patient requires routine gynecological services after giving birth to her son, and while seeing the nurse-midwife, the patient asks for a referral to a pediatrician for the newborn. Which action should the nurse-midwife take initially?
12. The nurse has a goal of becoming a certified registered nurse anesthetist (CRNA). Which activity is appropriate for a CRNA?
13. A nurse teaches a group of nursing students about nurse practice acts. Which information is most important to include in the teaching session about nurse practice acts?
14. A bill has been submitted to the State House of Representatives that is designed to reduce the cost of health care by increasing the patient-to-nurse ratio from a maximum of 2:1 in intensive care units to 3:1. What should the nurse realize?
15. A nurse is using a guide that provides principles of right and wrong to provide care to patients. Which guide is the nurse using?
16. A graduate of a baccalaureate degree program is ready to start working as an RN in the emergency department. Which action must the nurse take first?
17. While providing care to a patient, the nurse is responsible, both professionally and legally. Which concept does this describe?
18. A nurse is teaching the staff about Benner’s levels of proficiency. In which order should the nurse place the levels from beginning level to ending level?

1. A nurse is preparing a teaching session about contemporary influences on nursing. Which examples should the nurse include? (Select all that apply.)
2. After licensure, the nurse wants to stay current in knowledge and skills. Which programs are the most common ways nurses can do this? (Select all that apply.)
3. A nurse wants to become an advanced practice registered nurse. Which options should the nurse consider? (Select all that apply.)
4. The nurse manager from the oncology unit has had two callouts; the orthopedic unit has had multiple discharges and probably will have to cancel one or two of its nurses. The orthopedic unit has agreed to “float” two of its nurses to the oncology unit if oncology can “float” a nursing assistant to the orthopedic unit to help with obtaining vital signs. Which concepts does this situation entail? (Select all that apply.)

Chapter 06: Health and Wellness

1. A nurse is teaching about the goals of Healthy People 2020. Which information should the nurse include in the teaching session?
2. A nurse is following the goals of Healthy People 2020 to provide care. Which action should the nurse take?
3. A nurse is using the World Health Organization definition of health to provide care. Which area will the nurse focus on while providing care?
4. The nurse is preparing a smoking cessation class for family members of patients with lung cancer. The nurse believes that the class will convert many smokers to nonsmokers once they realize the benefits of not smoking. Which health care model is the nurse following?
5. A nurse is using Maslow’s hierarchy to prioritize care for an anxious patient that is not eating and will not see family members. Which area should the nurse address first?
6. The patient is reporting moderate incisional pain that was not relieved by the last dose of pain medication. The patient is not due for another dose of medication for another 2 1/2 hours. The nurse repositions the patient, asks what type of music the patient likes, and sets the television to the channel playing that type of music. Which health care model is the nurse using?
7. A nurse is assessing internal variables that are affecting the patient’s health status. Which area should the nurse assess?
8. The nurse is admitting a patient with uncontrolled diabetes mellitus. It is the fourth time the patient is being admitted in the last 6 months for high blood sugars. During the admission process, the nurse asks the patient about employment status and displays a nonjudgmental attitude. What is the rationale for the nurse’s actions?
9. The nurse is working on a committee to evaluate the need for increasing the levels of fluoride in the drinking water of the community. Which concept is the nurse fostering?
10. The nurse is working in a clinic that is designed to provide health education and immunizations. Which type of preventive care is the nurse providing?
11. The patient is admitted to the emergency department of the local hospital from home with reports of chest discomfort and shortness of breath. The patient is placed on oxygen, has labs and blood gases drawn, and is given an electrocardiogram and breathing treatments. Which level of preventive care is this patient receiving?
12. A patient is admitted to a rehabilitation facility following a stroke. The patient has right-sided paralysis and is unable to speak. The patient will be receiving physical therapy and speech therapy. Which level of preventive care is the patient receiving?
13. Upon completing a history, the nurse finds that a patient has risk factors for lung disease. How should the nurse interpret this finding?
14. The nurse is caring for a patient who has been trying to quit smoking. The patient has been smoke free for 2 weeks but had two cigarettes last night and at least two this morning. What should the nurse anticipate?
15. The nurse is working in a drug rehabilitation clinic and is in the process of admitting a patient for “detox.” What should the nurse do next?
16. A female patient has been overweight for most of her life. She has tried dieting in the past and has lost weight, only to regain it when she stopped dieting. The patient is visiting the weight loss clinic/health club because she has decided to do it. She states that she will join right after the holidays, in 3 months. Which stage is the patient displaying?
17. Upon completion of the assessment, the nurse finds that the patient has quit drinking and has been alcohol free for the past 2 years. Which stage best describes the nurse’s assessment finding?
18. The patient had a colostomy placed 1 week ago. When approached by the nurse, the patient and spouse refuse to talk about it and refuse to be taught about how to care for it. How will the nurse evaluate this couple’s stage of adjustment?
19. A patient has had emphysema (lung disease) for many years. When approached by the nurse, the patient states “I would be better off dead.” The patient supports the family, and now because of oxygen dependency the patient must quit work. The patient’s spouse will have to go to work. Which action should the nurse take?
20. A nurse is teaching about the transtheoretical model of change. In which order will the nurse place the progression of the stages from beginning to end?

1. Which areas should the nurse assess to determine the effects of external variables on a patient’s illness? (Select all that apply.)
2. A nurse meets the following goals: helps a patient maintain health and helps a patient with an illness. Which factors assist the nurse in achieving these goals? (Select all that apply.)

Chapter 16: Nursing Assessment

1. The nurse is using critical thinking skills during the first phase of the nursing process. Which action indicates the nurse is in the first phase?
2. A nurse is using the problem-oriented approach to data collection. Which action will the nurse take first?
3. After reviewing the database, the nurse discovers that the patient’s vital signs have not been recorded by the nursing assistive personnel (NAP). Which clinical decision should the nurse make?
4. The nurse is gathering data on a patient. Which data will the nurse report as objective data?
5. A patient expresses fear of going home and being alone. Vital signs are stable and the incision is nearly completely healed. What can the nurse infer from the subjective data?
6. Which method of data collection will the nurse use to establish a patient’s database?
7. A nurse is gathering information about a patient’s habits and lifestyle patterns. Which method of data collection will the nurse use that will best obtain this information?
8. While interviewing an older female patient of Asian descent, the nurse notices that the patient looks at the ground when answering questions. What should the nurse do?
9. A nurse has already set the agenda during a patient-centered interview. What will the nurse do next?
10. The nurse is attempting to prompt the patient to elaborate on the reports of daytime fatigue. Which question should the nurse ask?
11. A nurse is conducting a nursing health history. Which component will the nurse address?
12. While the patient’s lower extremity, which is in a cast, is assessed, the patient tells the nurse about an inability to rest at night. The nurse disregards this information, thinking that no correlation has been noted between having a leg cast and developing restless sleep. Which action would have been best for the nurse to take?
13. The nurse begins a shift assessment by examining a surgical dressing that is saturated with serosanguineous drainage on a patient who had open abdominal surgery yesterday (or 1 day ago)……… type of assessment approach is the nurse using?
14. Which statement by a nurse indicates a good understanding about the differences between data validation and data interpretation?
15. Which scenario best illustrates the nurse using data validation when making a nursing clinical decision for a patient?
16. While completing an admission database, the nurse is interviewing a patient who states “I am allergic to latex.” Which action will the nurse take first?
17. A patient verbalizes a low pain level of 2 out of 10 but exhibits extreme facial grimacing while moving around in bed. What is the nurse’s initial action in response to these observations?
18. The nurse is interviewing a patient with a hearing deficit. Which area should the nurse use to conduct this interview?
19. A new nurse is completing an assessment on an 80-year-old patient who is alert and oriented. The patient’s daughter is present in the room. Which action by the nurse will require follow-up by the charge nurse?.

Chapter 22: Ethics and Values

1. Four patients in labor all request epidural analgesia to manage their pain at the same time. Which ethical principle is most compromised when only one nurse anesthetist is on call?
2. The patient reports to the nurse of being afraid to speak up regarding a desire to end care for fear of upsetting spouse and children. Which principle in the nursing code of ethics ensures that the nurse will promote the patient’s cause?
3. The patient’s son requests to view documentation in the medical record. What is the nurse’s best response to this request?
4. When professionals work together to solve ethical dilemmas, nurses must examine their own values. What is thebestrationale for this step?
5. A nurse is experiencing an ethical dilemma with a patient. Which information indicates the nurse has a correct understanding of the primary cause of ethical dilemmas?
6. The nurse questions a health care provider’s decision to not tell the patient about a cancer diagnosis. Which ethical principle is the nurse trying to uphold for the patient?
7. The nurse finds it difficult to care for a patient whose advance directive states that no extraordinary resuscitation measures should be taken. Which step may help the nurse to find resolution in this assignment?
8. The nurse values autonomy above all other principles. Which patient assignment will the nurse find most difficult to accept?
9. A nurse must make an ethical decision concerning vulnerable patient populations. Which philosophy of health care ethics would be particularly useful for this nurse?
10. A nurse agrees with regulations for mandatory immunizations of children. The nurse believes that immunizations prevent diseases as well as prevent spread of the disease to others. Which ethical framework is the nurse using?
11. The nurse has become aware of missing narcotics in the patient care area. Which ethical principle obligates the nurse to report the missing medications?
12. A young woman who is pregnant with a fetus exposed to multiple teratogens consents to have her fetus undergo serial PUBS (percutaneous umbilical blood sampling) to examine how exposure affects the fetus over time. Although these tests will not improve the fetus’s outcomes and will expose it to some risks, the information gathered may help infants in the future. Which ethical principle is at greatest risk?
13. A nurse is discussing quality of life issues with another colleague. Which topic will the nurse acknowledge for increased attention paid to quality of life concerns?
14. Which action by the nurse indicates a safe and efficient use of social networks?
15. The nurse is caring for a dying patient. Which intervention is considered futile?
16. During a severe respiratory epidemic, the local health care organizations decide to give health care workers priority access to ventilators over other members of the community who also need that resource. Which philosophy would give the strongest support for this decision?
17. A nurse is teaching a patient and family about quality of life. Which information should the nurse include in the teaching session about quality of life?
18. The nurse is caring for a patient supported with a ventilator who has been unresponsive since arrival via ambulance 8 days ago. The patient has not been identified, and no family members have been found. The nurse is concerned about the plan of care regarding maintenance or withdrawal of life support measures. Place the steps the nurse will use to resolve this ethical dilemma in the correct order.

1. A nurse is working at a health fair screening people for liver cancer. Which population group should the nurse monitor most closely for liver cancer?
2. A nurse is caring for an immigrant with low income. Which information should the nurse consider when planning care for this patient?
3. A nurse is assessing the health care disparities among population groups. Which area is the nurse monitoring?
4. A nurse is providing care to a patient from a different culture. Which action by the nurse indicates cultural competence?
5. The nurse learns about cultural issues involved in the patient’s health care belief system and enables patients and families to achieve meaningful and supportive care. Which concept is the nurse demonstrating?
6. A nurse is beginning to use patient-centered care and cultural competence to improve nursing care. Which step should the nurse take first?
7. A nurse is performing a cultural assessment using the ETHNIC mnemonic for communication. Which area will the nurse assess for the “H”?
8. The nurse is caring for a patient of Hispanic descent who speaks no English. The nurse is working with an interpreter. Which action should the nurse take?
9. Which action indicates the nurse is meeting a primary goal of cultural competent care for patients?
10. The nurse is caring for a Chinese patient using the Teach-Back technique. Which action by the nurse indicates successful implementation of this technique?
11. A nurse is using core measures to reduce health disparities. Which group should the nurse focus on to cause themost improvement in core measures?
12. A nurse is designing a form for lesbian, gay, bisexual, and transgender (LGBT) patients. Which design should the nurse use?
13. A nurse is assessing population groups for the risk of suicide requiring medical attention. Which group should the nurse monitor most closely?
14. A nurse is assessing a patient’s ethnohistory. Which question should the nurse ask?
15. A nurse is teaching patients about health care information. Which patient will the nurse assess closely for health literacy?
16. A nurse works at a hospital that uses equity-focused quality improvement. Which strategy is the hospital using?
17. A nurse is providing care to a culturally diverse population. Which action indicates the nurse is successful in the role of providing culturally congruent care?
18. A nurse is assessing the patient’s meaning of illness. Which area of focus by the nurse is priority?

1. A nurse is assessing the family unit to determine the family’s ability to adapt to the change of a member having surgery. Which area is the nurse monitoring?
2. A nurse reviews the current trends affecting the family. Which trend will the nurse find?
3. A spouse brings the children in to visit their mother in the hospital. The nurse asks how the family is doing. The husband states, “None of her jobs are getting done, and I don’t do those jobs, so the house and the kids are falling apart.” How will the nurse interpret this finding?
4. A nurse cares for the family’s as well as the patient’s needs using available resources. Which approach is the nurse using?
5. A nurse is caring for a patient who needs constant care in the home setting and for whom most of the care is provided by the patient’s family. Which action should the nurse take to help relieve stress?
6. A nurse is working with a patient. When the nurse asks about family members, the patient states that it includes my spouse, children, and aunt and uncle. How will the nurse describe this type of family?
7. A nurse is assessing a child that lives in a car with family members who presents to the emergency department. Which area should the nurse assess closely?
8. The nurse is interviewing a patient who is being admitted to the hospital. The patient’s family went home before the nurse’s interview. The nurse asks the patient, “Who decides when to come to the hospital?” What is the rationale for the nurse’s action?
9. A nurse is caring for a patient from a motor vehicle accident. Which action by the unlicensed assistive personnel will cause the nurse to intervene?
10. A nurse is using the family as context approach to provide care to a patient. What should the nurse do next?
11. The nurse is caring for a patient in hospice. …….. notes that the patient is getting adequate care, but the spouse is not sleeping well. ————– also assesses the need for better family nutrition and meals assistance. The nurse discusses these needs with the patient and family and develops a plan of care with them using community resources. Which approach is the nurse using?
12. The nurse is caring for an older adult patient who has no apparent family. When questioned about family and the definition of family, the patient states, “I have no family. They’re all gone.” When asked, “Who prepares your meals?” the patient states, “I do, or I go out.” Which approach should the nurse use for this patient?
13. The nurse is caring for an older adult patient at home who requires teaching for dressing changes. The spouse and adult child are also involved in changing the dressing. Which statement by the nurse will most likely elicit a positive response from the patient and family?
14. The nurse is providing discharge teaching for an older-adult patient who will need tube feedings at home. The spouse is the only source of care and states “I will not be able to perform the feedings due to arthritis.” Which action should the nurse take?