Test 7

Palliative care can be used to promote which of the following items? (Select all that apply.) A. Physical functioning B. Reduction in disease exacerbations C. Improved quality of life D. Discussion on advance directives E. Surgical treatment plans versus medical

A. Physical functioning B. Reduction in disease exacerbations C. Improved quality of life D. Discussion on advance directives

A nurse manager is presenting an organizational overview to new nurses during orientation. Which of the following features, common to all organizations, would be included in this overview? A. Policies and procedures for the organization B. Salaries and benefits for employees C. Floor plan of each unit D. Professional development activities

A. Policies and procedures for the organization

Several high school students are attending a job fair hosted by a local hospital. One student asks, "Who determines what type of care a nurse can give to patients?" Which of the following is the nurse's best response? A. Practice is determined by state regulatory boards. B. Practice is determined by institutional policies and procedures. C. Practice is determined by federal health organizations. D. Practice is determined by the Institute of Medicine.

A. Practice is determined by state regulatory boards.

An advertisement at a local church reads, "New Mothers: Join us Friday evening at 7 for an informal discussion about your baby. Find out when you can expect the first smile, the first word, the first step." Which of the following is an appropriate description of the topic? A. Developmental level B. Developmental delay C. Developmental milestones D. Developmental age

C. Developmental milestones

To plan early intervention and care for an infant with Down syndrome, the nurse considers knowledge of other physical development exemplars such as A. cerebral palsy. B. autism. C. attention deficit hyperactivity disorder (ADHD). D. failure to thrive.

D. failure to thrive.

The school nurse talking with a high school class about the difference between growth and development would best describe growth as A. processes by which early cells specialize. B. psychosocial and cognitive changes. C. qualitative changes associated with aging. D. quantitative changes in size or weight.

D. quantitative changes in size or weight.

An exemplar of a social/emotional developmental delay is A. developmental dyspraxia. B. fragile X syndrome. C. mental retardation. D. separation anxiety disorder.

D. separation anxiety disorder.

Which of the following components are included in health policy at the state level? A. Americans with Disabilities Act of 1990 B. Scope of nursing practice C. Health Insurance Portability and Accountability Act (HIPAA) of 1996 D. Patient Safety and Quality Improvement Act of 2005

B. Scope of nursing practice

Stages of Erikson

1. Trust vs Mistrust 2. Autonomy vs Shame and Doubt 3. Initiative vs Guilt 4. Industry vs Inferiority 5. Identity vs Role Confusion 6. Intimacy vs Isolation 7. Generativity vs Self-Absorption and Stagnation 8. Integrity vs Despair

A nurse manager is describing the type of employee typically employed by a health care organization. In addition to knowledge and skills, which of the following characteristics is common in health care professionals? A. A strong allegiance to professional values. B. A strong desire to meet organizational goals. C. A strong ability to follow lines of authority. D. A strong preference for following rules.

A. A strong allegiance to professional values.

A nurse in a home setting is assessing a 79-year-old male patient's risk for malnutrition. The nurse suspects malnutrition when reviewing which laboratory results? (Select all that apply.) A. Body mass index (BMI) of 17 B. Waist-to-hip ratio of 1.0 C. Weight loss of 6% since last month's visit D. Prealbumin level of 16 mg/dL E. Hematocrit level of 50% F. Hemoglobin level of 8.2 g/dL

A. Body mass index (BMI) of 17 C. Weight loss of 6% since last month's visit F. Hemoglobin level of 8.2 g/dL

Which level of government is responsible for the regulation of a nurse's license? A. Federal government B. State government C. Local government D. International coalition

B. State government

Developmental Stage/Age

-Infancy (birth to 18 months) -Early-Childhood/toddler (18 months to 3 years) -Preschool (3-5 years) -Middle Childhood (6-12 years) -Adolescence (12-19 years) -Young Adult -Adult -Old Adult

Which patient is most at risk of developing permanently impaired mobility? A. A 72-year-old woman hospitalized for anemia associated with diabetic nephropathy (kidney disease) B. A 55-year-old woman with mental illness who had become malnourished C. An 11-year-old boy who sustained a fractured pelvis during a fall from his tree house D. A 79-year-old man recovering from surgery to release a contracture of the connective tissue in his hand

A. A 72-year-old woman hospitalized for anemia associated with diabetic nephropathy (kidney disease)

What will the nurse instruct nursing assistive personnel (NAP) to do regarding the management of a patient's pain? A. "Let me know at least 30 minutes before you transport her so I can administer her analgesics." B. "Be sure to keep the room temperature high and the TV on at all times." C. "Be sure to tell me if you notice grimacing, guarding, or any unusual behavior." D. "I've given her some medication; please report to me whether it seems to have relieved her pain within an hour or so."

A. "Let me know at least 30 minutes before you transport her so I can administer her analgesics."

A nurse and a student nurse are talking about health care coordination. Which of the following statements would the nurse make about the subject? A. "Patients have needs beyond the health care system." B. "Patients should coordinate their own care." C. "Physicians are the only ones who coordinate care." D. "Community health nurses coordinate care for the patient."

A. "Patients have needs beyond the health care system."

The nurse is directing nursing assistive personnel (NAP) to make an occupied bed. What will the nurse say to minimize the risk of disease transmission to staff and patient during the bed change? A. "You'll need to apply Standard Precautions during this task." B. "Soiled linen should be rolled toward your uniform." C. "Soiled linen should be kept away from your uniform." D. "Keep the linen bag at the foot of the bed."

A. "You'll need to apply Standard Precautions during this task."

When preparing to administer a new medication, what would the nurse do first to ensure the patient's safety? A. Perform hand hygiene. B. Compare the written order with the medication administration record (MAR). C. Inform the patient about the medication. D. Review appropriate nursing considerations.

A. Perform hand hygiene.

What is the best way for the nurse to ensure that a patient receives the correct dose of a medication? A. Compare the prescriber's order with the MAR before dispensing the medication. B. Ask the patient if he would like a larger dose of pain medication. C. Assess the patient's ability to swallow oral medications without difficulty. D. Check the name of the medication three times against the MAR.

A. Compare the prescriber's order with the MAR before dispensing the medication.

To which position would the nurse assist the patient who is experiencing difficulty with breathing? A. Fowler's position B. 30-degree lateral position C. Sims' position D. Prone position

A. Fowler's position

During a physical examination, the nurse notes that the patient's skin is dry and flaking. What additional data would the nurse expect to find to confirm the suspicion of a nutritional deficiency? A. Hair loss and hair that is easily removed from the scalp B. Inflammation of the tongue and fissured tongue C. Inflammation of peripheral nerves and numbness and tingling in extremities D. Fissures and inflammation of the mouth

A. Hair loss and hair that is easily removed from the scalp

While reviewing a new medication order, the nurse notes that the frequency of administration has been omitted. What is the nurse's best response? A. Immediately contact the prescriber to complete the order. B. Refer to a current drug book for the most commonly prescribed dosage. C. Call the pharmacy to determine the frequency. D. Ask a registered nurse who is familiar with the prescriber to identify the usual frequency ordered.

A. Immediately contact the prescriber to complete the order.

Nurses play a critical role in controlling patient care costs. Which of the following care measures do nurses perform that decrease health care costs? (Select all that apply.) A. Initiating fall precautions for a patient on admission B. Discarding a Foley catheter that was contaminated on the patient's leg C. Reviewing admitted patients for insurance coverage D. Keeping immobile patients in an uninterrupted setting when they are resting in order to promote increased rest E. Waiting for a coworker to return from dinner to double check blood for transfusion

A. Initiating fall precautions for a patient on admission B. Discarding a Foley catheter that was contaminated on the patient's leg E. Waiting for a coworker to return from dinner to double check blood for transfusion

What is the most prominent goal of palliative care? A. Integrate into chronic disease management sooner rather than later. B. Enroll the patient into the Medicare Hospice Benefit. C. Ensure that the patient has a 6-month prognosis. D. Reserve this type of care until the patient is actively dying.

A. Integrate into chronic disease management sooner rather than later.

Coordination of health care services is complicated by which of the following? (Select all that apply.) A. Involving one or more services B. Too many community resources C. Poorly funded social programs D. Authority for managing services E. Too many nurses F. Lack of health care systems

A. Involving one or more services C. Poorly funded social programs D. Authority for managing services F. Lack of health care systems

In which way is the concept of family dynamics unique among the concepts with significant relationships to development? A. It both affects and is affected by developmental status. B. It potentially affects all five areas of development. C. Its effect on development is reversible to a degree. D. Its effect on development varies with age.

A. It both affects and is affected by developmental status.

The nurse is preparing to make an occupied bed for a patient who is on aspiration precautions. What will the nurse do to ensure the safety of this patient during the bed change? A. Keep the head of the bed no lower than a 30-degree angle. B. Fold a pillow in half and place it under the patient's head. C. Lower the bed to a flat position and place two pillows beneath the patient's head. D. Ask another caregiver to hold the patient's head during the bed change.

A. Keep the head of the bed no lower than a 30-degree angle.

A nursing student is preparing a care plan for an assigned patient. When accessing the electronic medical record, what is acceptable information to view? (Select all that apply.) A. Laboratory data of the assigned patient B. Admission diagnosis for a patient who is a former neighbor C. The patient's age, date of birth, and gender D. The history and physical of the assigned patient E. A classmate's brother's chest x-ray report

A. Laboratory data of the assigned patient C. The patient's age, date of birth, and gender D. The history and physical of the assigned patient

Which nursing action is most therapeutic in response to a cognitively impaired patient who demands to know when his daughter is coming to visit? A. Marking the date of the visit on the patient's wall calendar B. Evaluating the patient's understanding of the concept of time and date C. Telling the patient when his daughter will be visiting and ensuring that he verbalizes his understanding D. Calling the daughter to suggest that she visit sooner than she had planned

A. Marking the date of the visit on the patient's wall calendar

The nurse understands that which of the following is true regarding health insurance coverage in the United States? A. Millions of people in the United States are without health insurance. B. The poor in the United States are as healthy as persons with higher incomes. C. Persons with money or health insurance are less likely to seek health care. D. The poor are more likely to receive health care through private agencies.

A. Millions of people in the United States are without health insurance.

The nurse understand that which characteristic has the greatest effect on health? A. Obesity B. Marital status C. Health insurance D. Age

A. Obesity

What are the most important reasons for considering the use of palliative care in patient care management? (Select all that apply.) A. Patients live with multiple chronic diseases several years before dying. B. Patients live with debilitating symptoms that interfere with the quality of life. C. Palliative care is reserved for those patients who are considered terminally ill. D. Palliative care is used to reduce the symptoms associated with chronic disease. E. Palliative care is recommended until cures for illnesses are discovered.

A. Patients live with multiple chronic diseases several years before dying. B. Patients live with debilitating symptoms that interfere with the quality of life. D. Palliative care is used to reduce the symptoms associated with chronic disease.

A new nurse manager is reviewing the attributes of a health care organization. Which of the following attributes would be expected for a health care organization? (Select all that apply.) A. Providing care for underserved minority patients B. Providing transportation to work sites C. Providing child care for unemployed parents seeking work D. The organizational chart of staffing breakdowns from each department E. Usage of the facility by surrounding residents

A. Providing care for underserved minority patients D. The organizational chart of staffing breakdowns from each department E. Usage of the facility by surrounding residents

Appropriate approaches used by the long-term care nurse to provide education for a 73-year-old who has just been diagnosed with diabetes include which of the following? (Select all that apply.) A. Schedule a visit by another resident who is diabetic. B. Demonstrate food choices using food photographs. C. Avoid discussion of the patient's favorite foods. D. Remind the patient that a lot of damage has already occurred. E. Encourage the patient's family to participate in teaching sessions. F. Ask the patient about past experiences with lifestyle changes.

A. Schedule a visit by another resident who is diabetic. B. Demonstrate food choices using food photographs. E. Encourage the patient's family to participate in teaching sessions. F. Ask the patient about past experiences with lifestyle changes.

Which stages of Piaget do these stages of Erikson correspond with? 1. Trust vs Mistrust 2. Autonomy vs Shame and Doubt 3. Initiative vs Guilt 4. Industry vs Inferiority 5. Identity vs Role Confusion

A. Sensorimotor (Progress from Reflex activity to simple repetitive actions) B. Prepoerational (Thinking Using Symbols Egocentric) C. Use of Symbols (Egocentric) D.Concrete Operations (Logical Thinking) E. Formal Operations (Abstract Thinking)

Stages of Piaget

A. Sensorimotor Period: Progress from Reflex activity to simple repetitive actions B. Prepoerational Period: Thinking Using Symbols Egocentric C. Use of Symbols Egocentric D.Concrete Operations: Logical Thinking E. Formal Operations: Abstract Thinking

Which of the following are examples of health care organizations (HCO)? A. State and county hospitals B. State board of nursing C. National Institute of Health (NIH) D. United States Department of Health and Human Services (USDHHS)

A. State and county hospitals

In which position will the nurse place the patient to move him or her up in bed? A. Supine with the head of the bed flat B. Sitting in the bed C. Supine with the head of the bed at a 30-degree angle D. Prone with the head of the bed flat

A. Supine with the head of the bed flat

Nurses can be health advocates in which of the following ways? (Select all that apply.) A. Supporting their professional nursing organization when discussing upcoming legislation B. Discussing the upcoming classes with a neighbor C. Rallying for coverage for childhood immunizations D. Arranging for a patient to meet with case management for home health care E. Discussing a patient they are concerned about with a fellow student in the public cafeteria

A. Supporting their professional nursing organization when discussing upcoming legislation C. Rallying for coverage for childhood immunizations D. Arranging for a patient to meet with case management for home health care

Which is one of the biggest challenges facing current nursing practice? A. The number of aging Americans living with chronic disease. B. The number of patients entering into hospice programs. C. The number of cancer patients receiving supportive care. D. Reduced length of stay in hospice care.

A. The number of aging Americans living with chronic disease.

A nurse is caring for a patient who has just had major abdominal surgery to resect a portion of his colon. What is the most reliable sign that the patient has significant postoperative pain? A. The patient rates his pain a 7 on a scale of 0 to 10. B. The patient winces and guards the area as the nurse gently palpates the abdomen. C. The patient is having trouble sleeping and has become irritable. D. The patient is moaning softly and frowning, with a pinched expression on his face.

A. The patient rates his pain a 7 on a scale of 0 to 10.

During a nutritional assessment, the nurse calculates that a female patient's BMI is 27. The nurse would advise the patient to follow which of these recommendations? A. This measurement indicates that the patient is overweight and should follow a plan of diet and exercise to lose weight. B. This measurement indicates that the patient is underweight and will need to take measures to gain weight. C. This measurement indicates that the patient is morbidly obese and may be a candidate for bariatric surgery. D. This measurement indicates that the patient is of normal weight and should continue with current lifestyle.

A. This measurement indicates that the patient is overweight and should follow a plan of diet and exercise to lose weight.

The nurse is caring for a patient diagnosed with peptic ulcer disease (PUD). The patient was prescribed the proton pump inhibitor Prevacid (lansoprazole). Which of the following supplements may be prescribed to prevent deficiency? A. Vitamin B12 B. Vitamin C C. Vitamin D D. Omega-3 fatty acids

A. Vitamin B12

An African American is at an increased risk for which of the following? (Select all that apply.) A. Vitamin D deficiency B. Type 1 diabetes C. Celiac disease D. Type 2 diabetes E. Hypertension F. Metabolic syndrome

A. Vitamin D deficiency D. Type 2 diabetes E. Hypertension F. Metabolic syndrome

A local chapter of a state nurses' association is encouraging nurses to be part of participative governance. Which of the following behaviors are examples of participative governance? (Select all that apply.) A. Voting in a school board election B. Attending a session of the state legislature debate C. Monitoring hospital readmission rates D. Volunteering at a clinic that gives free health care E. Campaigning for a political candidate

A. Voting in a school board election B. Attending a session of the state legislature debate E. Campaigning for a political candidate

The nurse manager of a pediatric clinic could confirm that the new nurse recognized the purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it is used to assess for needs related to A. anticipatory guidance. B. low-risk adolescents. C. physical development. D. sexual development.

A. anticipatory guidance.

Which statement or question best illustrates the nurse's understanding of the role of nursing assistive personnel (NAP) in medication administration? A. "Does the patient need her pain medication?" B. "Let me know if she complains of any nausea." C. "What is the quality of her pain now?" D. "Tell her she doesn't have an order for the drug she's asking for."

B. "Let me know if she complains of any nausea."

Which statement best illustrates the nurse's understanding of the role of nursing assistive personnel (NAP) in documenting medication administration? A. "Make a note that the patient just received her PM dose of pain medication." B. "Let me know if the patient says her nausea is getting worse." C. "Can you check the MAR and see when this patient had her pain medication last?" D. "Ask the patient if I need to get another order from the provider."

B. "Let me know if the patient says her nausea is getting worse."

A nurse is answering questions about health care at a community health fair. An elderly visitor asks why health care is so expensive. Which of the following is the best response by the nurse? A. "There are a decreasing number of patients needing long-term health care, so there are fewer health care providers." B. "Patients without health care coverage use emergency departments, where it is more expensive to provide care." C. "We are not developing equipment and technology fast enough to keep medical costs down." D. "Many patients are only using nonprescription medications, so the cost of other cares has gone up."

B. "Patients without health care coverage use emergency departments, where it is more expensive to provide care."

The nurse wants to offer some diversional activity to a patient with dementia. The patient's family has told the nurse that he is a bit of a loner who enjoyed a 40-year career as an aircraft mechanic. The patient seems frustrated and bored. What is the best activity for the nurse to offer him? A. Weekly pet therapy with a golden retriever B. A jigsaw puzzle of an appropriate level of difficulty C. A crossword puzzle book of an appropriate level of difficulty D. Frequent card games with other patients

B. A jigsaw puzzle of an appropriate level of difficulty

The nurse is assessing a group of patients to determine their risk of vitamin D deficiency. Which of the following patients has the highest risk for vitamin D deficiency? A. A Caucasian female who is 39 weeks gestation. B. An African-American female who is breastfeeding. C. An Asian female diagnosed with hypoglycemia. D. A Hispanic female who has a BMI of 24.1.

B. An African-American female who is breastfeeding.

When preparing to move a patient in bed, what will the nurse do first? A. Assemble adequate help to move the patient. B. Assess the patient's ability to help with moving. C. Determine the patient's weight. D. Decide on the most effective means of moving the patient.

B. Assess the patient's ability to help with moving.

The nurse is evaluating the economic aspects of having a smoking cessation program. Of which of the following is this an example? A. Cost-effectiveness analysis B. Cost-benefit analysis C. Supply and demand D. Microeconomic theory

B. Cost-benefit analysis

Which of the following is considered a major disadvantage to group decision making? A. Autonomous conclusion B. Disruptive conflicts C. Group synergy D. Inaccurate data interpretation

B. Disruptive conflicts

The nurse is discussing palliative care with a patient's family. Which statement by the nurse best exemplifies the Macmillan nurse model of palliative care: A. Even though the patient is diagnosed with a terminal disease, I will help manage her symptoms for the next 6 months and throughout the dying process. B. Even though the patient has been diagnosed with a chronic disease, I will help manage her symptoms with the medical team during the next year. C. The physician has ordered weekly laboratory tests for the patient and her urine is being tested for a kidney infection. Once we get the results back the patient can follow up with her primary care physician. D. The patient is actively dying. I will notify the chaplain and social worker that you request their support.

B. Even though the patient has been diagnosed with a chronic disease, I will help manage her symptoms with the medical team during the next year.

The nurse understands that the structure of HCOs consists of which of the following? A. Informal rules B. Formal rules C. Bureaucracy D. Systems theory

B. Formal rules

End-of-life care is most synonymous with which of the following types of care? A. Palliative care B. Hospice care C. Supportive care D. Quality of life

B. Hospice care

A nurse manager recognizes that an individual can affect health policy. Which of the following actions by the nurse indicates the step of agenda setting in affecting health policy? A. Planning a fund-raising campaign to raise money for a nutrition program B. Identifying increased malnutrition in preschool children C. Evaluating daycare meal plans D. Implementing a home meal plan for preschool children

B. Identifying increased malnutrition in preschool children

What is the nurse's best response after noticing that the route of administration has been omitted from a medication order? A. Ask which route the patient prefers. B. Immediately notify the prescriber to request that the order be completed. C. Refer to a current drug book to determine the most commonly prescribed route. D. Contact the pharmacy to determine the most appropriate route for this patient.

B. Immediately notify the prescriber to request that the order be completed.

The nurse is completing a nutritional assessment on a patient with hypertension. What foods would be recommended for this patient? A. Regular diet B. Low sodium diet C. Pureed diet D. Low sugar diet

B. Low sodium diet

The interprofessional core team includes members from which disciplines? A. Nursing, medicine, volunteers, and nutrition B. Medicine, nursing, social work, and clergy C. Medicine, nursing, physical therapists, and volunteers D. Nursing, home health aides, volunteers, and clergy

B. Medicine, nursing, social work, and clergy

The patient refuses a scheduled dose of an antibiotic, saying that the medication makes him feel nauseated. What it the nurse's best response? A. Inform the patient why the medication is necessary. B. Notify the prescriber of the patient's reason for refusing the medication. C. Offer to administer the medication with the patient's favorite snack food. D. Note the patient's refusal in the MAR.

B. Notify the prescriber of the patient's reason for refusing the medication.

A hospital system is opening a new hospital in a rural setting. Under the principle of supply and demand, which of the following should happen when there is a shortage of employable nurses? A. Patient care becomes more efficient. B. Nursing wages will increase. C. More nurses will seek advanced education opportunities. D. Hospital admissions will decrease.

B. Nursing wages will increase.

Palliative care used in the management of a patient with symptomatic chronic obstructive pulmonary disease (COPD) is an example of which of the following? A. Palliative care is used when the patient is beginning to die. B. Palliative care is used to help manage the symptoms that often accompany COPD. C. Hospice nurses must be involved to provide palliative care in a cancer patient. D. Patient must be enrolled into the Medicare Hospice Benefit to receive palliative care.

B. Palliative care is used to help manage the symptoms that often accompany COPD.

The nurse notes that a patient's left elbow is resistant to extension and flexion while performing range of motion exercises. What is the appropriate nursing action? A. Move the joint through the full range of motion exercises. B. Perform range of motion to the left elbow until resistance is met. C. Omit all the range of motion exercises until the health care provider is notified. D. Inform the health care provider that the patient is uncooperative with exercising.

B. Perform range of motion to the left elbow until resistance is met.

When considering the trajectory of a specific disease, what is the most important concept? A. Hospital admissions B. Physical functioning C. Quality of life D. Symptom management

B. Physical functioning

When repositioning a patient, what can the nurse do to prevent the patient's hips from rolling outward? A. Apply therapeutic boots to the feet. B. Place sandbags along the legs. C. Place a small pillow at the lumbar region of the back. D. Place a pillow under the calves.

B. Place sandbags along the legs.

The nurse is caring for an 82-year-old resident of a skilled nursing facility with a diagnosis of Alzheimer disease. Last week the resident, who has an unsteady gait, fell and injured his leg, and this week the resident has become combative. The nurse is reviewing the resident's medical records and notices that some weeks are more difficult than others for the resident and require more care from the nursing staff to keep the resident safe. The nurse knows that this resident is more than likely following which disease trajectory: A. Short period of evident decline B. Prolonged dwindling C. Long term limitations with intermittent episodes D. Cancer disease trajectory

B. Prolonged dwindling

The nurse is caring for a 50-year-old man who has a body mass index (BMI) of 31 kg/m2, a normal C-reactive protein level, and low serum transferrin and albumin levels. The nurse will plan patient teaching to increase the patient's intake of foods that is high in: A. Iron B. Protein C. Calories D. Carbohydrate

B. Protein

The nurse is changing the bed linen of a patient on bed rest. When the nurse is ready to make the other side of the bed, what will the nurse do before having the patient turn onto the side that has already been made? A. Lower the head of the bed B. Raise the side rails C. Apply the topsheet D. Discard the soiled linen in the linen bag

B. Raise the side rails

The home care nurse is assessing an older patient diagnosed with mild cognitive impairment (MCI) in the home setting. Which information is of concern? A. The patient's son uses a marked pillbox to set up the patient's medications weekly. B. The patient has lost 10 pounds (4.5 kg) during the last month. C. The patient is cared for by a daughter during the day and stays with a son at night. D. The patient tells the nurse that a close friend recently died.

B. The patient has lost 10 pounds (4.5 kg) during the last month.

Which observation indicates that a patient's analgesic has been effective in managing pain that she rated a 6 out of 10 on a pain rating scale before the intervention? A. The patient is seen quietly reading a magazine. B. The patient rates her current pain as 3 out of 10 on the pain rating scale. C. The patient is overheard telling her family that she is "feeling better today." D. The patient is observed sleeping, with a respiratory rate assessed at 18/minute, compared with 22/minute before the intervention.

B. The patient rates her current pain as 3 out of 10 on the pain rating scale.

Which factors differentiate developmental disability from developmental anomaly? Select all that apply. A. Severity B. Time of onset C. Level of care demand D. Developmental area involved E. Duration

B. Time of onset E. Duration

When positioning a hemiplegic patient in the supported Fowler's position, what is the primary reason a trochanter roll is placed alongside the patient's legs? A. To reduce the risk of a fall while the side rails are down B. To reduce the risk of contracture C. To control pain D. To cushion the legs

B. To reduce the risk of contracture

When coordination and continuity of health care are transferred between different locations or different levels of care within the same location, this is identified as which type of care coordination? A. Health care doctrine B. Transitional care C. Transactional care D. Multilevel care

B. Transitional care

An person of Northern heritage is at an increased risk for which of the following: (Select all that apply.) A. Vitamin c deficiency B. Type 1 diabetes C. Celiac disease D. Type 2 diabetes E. Hypertension F. Metabolic syndrome

B. Type 1 diabetes C. Celiac disease

A mother complains to the nurse at the pediatric clinic that her 4-year-old child always talks to her toys and makes up stories. The mother wants her child to have a psychological evaluation. The nurse's best initial response is to A. refer the child to a psychologist immediately. B. explain that playing make believe is normal at this age. C. complete a developmental screening using a validated tool. D. separate the child from the mother to get more information.

B. explain that playing make believe is normal at this age.

The geriatric nurse practitioner preparing to assess an 84-year-old whose daughter is concerned about her ability to live alone would complete a A. developmental assessment. B. functional assessment. C. life experiences survey. D. recent life changes questionnaire.

B. functional assessment.

The mother of a 2-year-old asks the nurse about her child's cognitive development. The best response of the nurse is that her child A. is beginning to think intuitively. B. is using magical thinking. C. can solve concrete problems. D. is using abstract thinking.

B. is using magical thinking.

The nurse understands that which of the following is the main purpose of the Patient Protection and Affordable Care Act: A. Create a government-funded insurance program for all Americans. B. Make health insurance affordable for the middle class and small businesses. C. Decrease the rates of chronic disease in the United States. D. Increase the funding for public health agencies.

C. Decrease the rates of chronic disease in the United States.

The nurse is admitting a patient from a country with universal health care provided by the government. The patient has traveled to the United States for a complicated surgery that will be done by a specialist. Which of the following statements most likely describes why the patient has traveled so far for the surgery? A. "I wanted to come to a country that had no competition among health agencies." B. "It is too bad that there is so little rationing of health care in your country." C. "Having a choice of care providers and hospitals is a strength of your health system." D. "I appreciate that everyone has access to health care in your country."

C. "Having a choice of care providers and hospitals is a strength of your health system."

Which of the following statements made by a mother would raise concerns about a developmental delay? A. "My 3-month-old raises her head and chest when lying down." B. "My 7-month-old transfers blocks from one hand to the other." C. "My 7-month-old never seems to smile." D. "My 1-year-old seems shy or anxious with strangers."

C. "My 7-month-old never seems to smile."

A child uses two- to four-word sentences. The nurse interprets this data as expected development for a child the age of A. 2 months. B. 1 year. C. 2 years. D. 3 years.

C. 2 years.

The nurse has one bed alarm available and can use it for any of the following patients, all of whom have dementia. Having an alarm is most important for which patient? A. A patient who has refused most meals for the past week and whose weight has dropped by 10% in the past month. B. A patient who has become verbally combative with staff in recent weeks. C. A patient who was returned to the unit last week by staff in an adjacent assisted living facility. D. A patient whose abdominal feeding tube is covered with an abdominal binder.

C. A patient who was returned to the unit last week by staff in an adjacent assisted living facility.

Which action ensures that a patient will not have unnecessary pain during a linen change? A. Discontinue the bed change if the patient expresses or displays physical signs of pain. B. Explain the procedure to the patient before beginning the linen change. C. Administer a prescribed analgesic 30 to 60 minutes before the bed change if needed. D. Postpone the bed change if the patient reports having physical pain before you begin.

C. Administer a prescribed analgesic 30 to 60 minutes before the bed change if needed.

Which insurance program is expected to extend health insurance coverage to an additional 25 million people by 2019? A. Medicaid B. Medicare C. Affordable Care Act D. United Healthcare

C. Affordable Care Act

A nurse manager is reviewing patient satisfaction surveys and notices several comments that the unit environment is "cold" and "uncaring." Which of the following actions by the manager would best help the organization to improve its image with the public? A. Forward the surveys to housekeeping with a request to keep the rooms less cluttered. B. Request that patients be admitted to newer sections of the hospital. C. Ask staff for suggestions to improve the unit environment. D. Send copies of the surveys to the administration and wait for directions on how what to do.

C. Ask staff for suggestions to improve the unit environment.

A patient who weighs 200 lbs. needs to be moved up in bed with the aid of a friction-reducing device. The nurse will prepare for this move by assembling how many caregivers? A. A minimum of two B. None, since the device does all the lifting during the move C. At least three D. The nurse can carry out this move without assistance

C. At least three

The nurse is teaching a patient how to use the automatic blood pressure cuff. How can the nurse be assured that the patient understood the information? A. By speaking slowly and clearly in the patient's native language B. By asking the family members whether the patient understands C. By obtaining feedback from the patient that indicates accurate comprehension D. By checking for signs of hearing loss or aphasia before communicating

C. By obtaining feedback from the patient that indicates accurate comprehension

What is the most important step the nurse can take to ensure that the patient is getting the correct medication? A. Assess the patient's ability to swallow oral medications without difficulty. B. Question the patient about his or her experience with this or similar medications. C. Compare the medication label with the MAR three times. D. Evaluate the patient's understanding of the safety issues related to the specific drug.

C. Compare the medication label with the MAR three times.

The nurse is preparing to logroll a patient in bed. Why are two assistants needed on the side toward which the patient is being turned? A. To position the pillows B. To ease the patient back onto the support pillows C. To keep the spine in alignment D. To roll the patient as a unit

D. To roll the patient as a unit

Which of the following programs is overseen by the state health department services? A. Administration of Medicare reimbursement rates and eligibility determination B. Programs involving citizens in the local community, including sanitation and communicable disease contact tracing C. Disaster response, health care financing and administration of programs such as Medicaid, and establishment of health codes D. Monitoring of drugs and over-the-counter products available for sale and use by consumers

C. Disaster response, health care financing and administration of programs such as Medicaid, and establishment of health codes

Which of the following are basic guidelines when assisting a patient with passive range of motion? A. Exercises should be continued until the point of fatigue and pain. B. Exercises should be done frequently to lessen pain for the patient. C. Each joint is exercised to the point of resistance but not pain. D. Exercises should be performed without the support to each joint.

C. Each joint is exercised to the point of resistance but not pain.

During a physical examination, the nurse notes that the patient's skin is dry and flaking, with patches of eczema. Which nutritional deficiency might be present? A. Vitamin C B. Vitamin B C. Essential fatty acid D. Protein

C. Essential fatty acid

Optimal symptom management is primarily based upon which type of care? A. Physician-directed care B. Nurse-directed care C. Evidence-based practice D. Hospice-directed care

C. Evidence-based practice

Which branch of government is responsible for the execution of laws passed by legislatures? A. Legislative B. Judicial C. Executive D. Local

C. Executive

A nurse is reviewing outcomes of a large health clinic after the clinic instituted pay-for-performance protocols. Which of the following would be an unintended outcome of this type of economic system that may be revealed during the review? A. An increase in prescribing generic medications instead of name brand medications B. The implementation of an online patient education system instead of using staff to educate patients C. Fewer referrals to interdisciplinary team members from top care performers D. The introduction of an electronic health record system

C. Fewer referrals to interdisciplinary team members from top care performers

When preparing to move a patient in bed with the help of an assistant, which posture will both caregivers use to ensure their own safety? A. Stand with the knees locked. B. Stand with the feet together. C. Flex the hips and knees. D. Shift the body weight from the back leg to the front leg.

C. Flex the hips and knees.

A patient presents to the emergency department of a hospital with a respiratory rate of 36 and pulse of 115, and is nonresponsive. The patient is diagnosed with acute respiratory failure and is actively dying. The patient's spouse tells the nurse that she wants her husband to be kept comfortable and does not want any aggressive interventions performed. The patient's medical records show a signed do not resuscitate (DNR) form. The following consult is appropriate for the nurse to request: A. Social work consult B. Palliative care consult C. Hospice care consult D. Chaplain consult

C. Hospice care consult

The nurse is reviewing current health care policies for newly hired employees. Which of the following topics will the nurse include in the presentation? A. Hospital infection control measures B. Hospital dress code expectations C. Hospital HIPAA (Health Information Portability and Accountability Act) protections D. Hospital annual evaluation processes

C. Hospital HIPAA (Health Information Portability and Accountability Act) protections

The nurse is caring for a 25-year-old woman who is requesting information to lose weight. What information will the nurse include in a weight-loss plan? A. Weigh yourself at the same time every morning and evening. B. Stick to a 600- to 800-calorie diet for the most rapid weight loss. C. Low carbohydrate diets lead to rapid weight loss but are difficult to maintain. D. Weighing all foods on a scale is necessary to choose appropriate portion sizes.

C. Low carbohydrate diets lead to rapid weight loss but are difficult to maintain.

A patient with a herniated disk is scheduled for surgery to fuse two vertebrae in her cervical spine. Which activity is most likely to be a palliative factor for this patient? A. Repainting her new apartment B. Lifting moving boxes on and off of a truck C. Performing neck, back, and shoulder exercises prescribed by a physical therapist D. Performing yoga exercises from the patient's favorite set of videotapes

C. Performing neck, back, and shoulder exercises prescribed by a physical therapist

The nurse is preparing to move a patient with hemiplegia into the prone position. What action should the nurse take when rolling the patient onto her side? A. Place a small pillow under the shoulder. B. Use the affected arm as a guide during rolling. C. Place a pillow on the abdomen. D. Place rolled bath blankets along the dependent leg.

C. Place a pillow on the abdomen.

The nurse knows that which of the following are goals related to palliative care: A. Finding the cause of the disease and treating it as soon as possible B. Informing all patients diagnosed with chronic diseases that they should choose hospice care C. Preventing or treating as early as possible the symptoms of a disease or the side effects caused by the treatment of a disease D. Treating the side effects associated only with cancer therapies such as radiation

C. Preventing or treating as early as possible the symptoms of a disease or the side effects caused by the treatment of a disease

A teenager about to drive a car for the first time says, "I don't want to drive in the empty parking lot; I want to drive to the mall." His father replies "You have to crawl before you can walk." Which attributes of development are most clearly reflected in the father's response? A. Growth and differentiation B. Maturation and refinement C. Progression and sequence D. Organization and duration

C. Progression and sequence

The practices of nursing is outlined by which of the following? A. Health Resource and Services Administration (HRSA) B. State board of nursing C. Scope of practice D. United States Department of Health and Human Services

C. Scope of practice

Two nurses are discussing the important attributes of care coordination. They both know that care coordination should be based on which type of care coordination? A. Community based B. Hospital based C. Team based D. Health insurance based

C. Team based

As the nurse is administering medication to a patient, the patient states, "I've never seen that pill before." What is the nurse's most appropriate response? A. Reassure the patient that the pharmacy sent the right medication. B. Tell the patient that it is probably a different brand than what he takes at home and not to worry. C. Tell the patient that you will review the physician's order to clarify any discrepancies. D. Tell the patient that the doctor probably ordered a new medication.

C. Tell the patient that you will review the physician's order to clarify any discrepancies.

The nurse notices that his patient has none of the signs and symptoms normally associated with pain, such as diaphoresis, tachycardia, and hypertension. The patient does, however, seem moody and a bit uncooperative. What conclusion does the nurse draw? A. It is likely the patient is a drug seeker and has little or no pain. B. The patient's problem is more mental than physical. C. The absence of physiological signs and symptoms is associated with chronic pain. D. The patient's pain cannot be accurately assessed until the patient has been treated for anxiety.

C. The absence of physiological signs and symptoms is associated with chronic pain.

Why would the nurse ask a physical therapist to perform passive ROM exercises for a patient with lower extremity injuries sustained in a motor vehicle crash? A. The patient is an older adult or has a chronic condition. B. The patient is reluctant to perform the exercises because he is worried about reinjury. C. The patient has orthopedic trauma. D. The patient has pain exacerbated by exercise.

C. The patient has orthopedic trauma.

When caring for a patient with Alzheimer's disease, why does the nurse cover the external urinary collection catheter? A. To protect the bed from being soiled B. To avoid offending visitors who would otherwise see the device C. To reduce the patient's access to the device D. To keep the patient from trying to get out of bed alone

C. To reduce the patient's access to the device

To plan early intervention and care for a child with a developmental delay, the nurse would consider knowledge of the concepts most significantly impacted by development, including A. culture. B. environment. C. functional status. D. nutrition.

C. functional status.

The most appropriate response of the nurse when a mother asks what the Denver II does is that it A. can diagnose developmental disabilities. B. identifies a need for physical therapy. C. is a developmental screening tool. D. provides a framework for health teaching.

C. is a developmental screening tool.

The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, the expected stage of development for a preschooler is A. concrete operational. B. formal operational. C. preoperational. D. sensorimotor.

C. preoperational.

A 17-year-old girl is hospitalized for appendicitis, and her mother asks the nurse why she is so needy and acting like a child. The best response of the nurse is that in the hospital, adolescents A. have separation anxiety. B. rebel against rules. C. regress because of stress. D. want to know everything.

C. regress because of stress.

A student nurse asks why care coordination is now a top priority for health system redesign. What is the nursing instructor's best response? A. "Patients like to be cared for by more than one service agency." B. "Care coordination increases confusion about who is responsible for the patient." C. "Community services are lacking, and care coordination helps to fill the void." D. "Every patient will need coordinated care services at some time in life."

D. "Every patient will need coordinated care services at some time in life."

Which statement made by nursing assistive personnel (NAP) assigned to care for a patient with dementia requires the nurse to follow up? A. "I encouraged his son and daughter-in-law to stay with him during visiting hours, if possible, even if they run out of things to talk about." B. "He can't see his Foley because it's covered by his boxer shorts." C. "I'll ask the patient every hour or so whether he needs to use the bathroom." D. "He doesn't understand much of what anyone says to him today, so I didn't put in his hearing aids."

D. "He doesn't understand much of what anyone says to him today, so I didn't put in his hearing aids."

The student demonstrates a lack of understanding of palliative care when making which statement? A. "Palliative care is designed to promote comfort." B. "Palliative care is designed to reduce disease exacerbations." C. "Palliative care is designed to decrease acute care hospital admissions." D. "Palliative care is designed to promote a cure for chronic disease."

D. "Palliative care is designed to promote a cure for chronic disease."

The nurse is assisting a 79-year-old patient with information about diet and weight loss. The patient has a body mass index (BMI) of 31. How should the nurse instruct this patient? A. "Your weight is within normal limits. Continue maintaining with current lifestyle choices." B. "You are a little overweight. Cut down on calories and increase your activity, and you should be fine." C. "You are morbidly obese, and we would like to schedule you an appointment to speak with a bariatric specialist about surgery." D. "You are considered obese and will need to consult with your doctor about a plan that includes exercises, not diet, to decrease weight."

D. "You are considered obese and will need to consult with your doctor about a plan that includes exercises, not diet, to decrease weight."

During an interview, the nurse is discussing dietary habits with a patient. Which tool would be the best choice to use as a quick screening tool to assess dietary intake? A. Food diary B. Calorie count C. Comprehensive diet history D. 24-hour recall

D. 24-hour recall

A nurse manager feels that the overall work environment of his hospital is positive, and he recommends that the organization apply for Magnet© status, which recognizes excellence in nursing practice. Which of the following is an internal environmental factor present in a unit that would need to be changed to qualify for Magnet status? A. A setting where staff are creative in meeting quality care indicators. B. A unit where new programs are researched, implemented, and evaluated by staff. C. A unit where collaboration among disciplines is encouraged and reinforced in evaluations. D. A unit where feedback on staff concerns is given anonymously.

D. A unit where feedback on staff concerns is given anonymously.

Which of the following are considered national goals from the Future of Nursing Report regarding the profession of nursing? A. Remove scope-of-practice barriers. B. Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. C. Implement nurse residency programs. D. All of the above.

D. All of the above.

Acquisition of which skill is representative of adaptive development? A. Drawing with chalk on a blackboard B. Smiling in response to being stroked on the cheek C. Cooperating with playmates in picking up toys D. Crossing the street safely

D. Crossing the street safely

Which example reflects effective documentation of medication administration by a nurse? A. Comparing the written order with the medication administration record (MAR) three times B. Providing patient education regarding a medication C. Obtaining a BP before giving a blood pressure medication D. Including the location of an injection site on the MAR

D. Including the location of an injection site on the MAR

Which of the following is the intent of HIPAA? A. Release of patient information for purposes of insurance reimbursement. B. Prevent health care providers from billing for procedures done for the insured person. C. Protect patients from reviewing their own medical records. D. Limit the ability of health care providers to sell patient information to outside sources

D. Limit the ability of health care providers to sell patient information to outside sources

Comfort care is an intervention carried out by which of the following professional disciplines? A. Medicine B. Clergy C. Volunteers D. Nursing

D. Nursing

Today most patients are living for several years before dying with multiple chronic conditions, such as COPD, congestive heart failure, diabetes, and obesity. These concomitant diseases contribute to multiple symptoms that interfere with the patient's quality of life. What type of care would you consider for this patient? A. End-of-life care B. Supportive care C. Comfort care D. Palliative care

D. Palliative care

A definition of health policy includes which of the following elements? A. Funding for public education B. Appropriation of funds for roadwork C. Selection of congressional members of committees D. Public policy made to support health-related goals

D. Public policy made to support health-related goals

What will the nurse do right after placing a clean topsheet on the patient? A. Make a cuff with the top of the sheet. B. Make a horizontal toe pleat. C. Tuck the remaining portion of the sheet under the foot of the mattress. D. Remove the bath blanket.

D. Remove the bath blanket.

A patient will be moved up in bed with the use of a friction-reducing device. How will the nurse place this device under the patient? A. Lift the patient to place the device directly under him or her. B. Remove the drawsheet, and replace it with the device. C. Sit the patient up in the bed, and place the device behind the shoulders. D. Roll the patient from side to side, and place the device under the drawsheet.

D. Roll the patient from side to side, and place the device under the drawsheet.

The provision of guidance or direction, evaluation, and follow-up by the licensed nurse for accomplishment of a nursing task delegated to unlicensed assistive personnel (UAP) is: A. Authorization B. Delegation C. Observation D. Supervision

D. Supervision

The nurse is caring for a 68-year-old patient who has recently been diagnosed with breast cancer. The patient tells the nurse that she wants to be kept comfortable, but also wishes to aggressively treat the cancer. The patient asks for specific interventions aimed at palliating the side effects of chemotherapy and radiation that the doctor has prescribed. The nurse knows that the patient wishes to receive which kind of care: A. End-of-life care B. Symptom management C. Comfort care D. Supportive care

D. Supportive care

The nurse is performing passive shoulder and elbow exercises for a patient who is recovering from surgery to remove a soft-tissue tumor in her upper arm. Why does the nurse cup one hand around the patient's elbow and support the forearm and wrist during the ROM exercises? A. To keep the arm above the level of the heart B. To assess the patient's muscle tension C. To listen for crepitus in the joint D. To ensure stability while exercising the joint

D. To ensure stability while exercising the joint