FUN test 4

4

The nurse is assessing a patient admitted with a newly diagnosed bleeding duodenal ulcer. The patient is exhibiting physiological signs of anxiety and seems to have difficulty concentrating. During the interview, the patient tells the nurse that he is often "short of breath" and states, "I lie awake nights worrying about everything." The patient has been unable to work or care for family for the past 6 months. Which is the nurse's priority after documenting this information in the nurses' notes? 1. Provide emotional support for the patient using reflective listening technique. 2. Do nothing; people with duodenal ulcers typically cannot work. 3. Question the patient's family about the information received from the patient. 4. Notify the primary care provider, and ask for a referral to a mental health professional.

4

The nurse is assigned to provide care to a patient who developed septicemia following an abortion. The nurse believes abortion is murder of the unborn child. Which concept most specifically requires the nurse to provide high-quality patient care regardless of personal beliefs? 1. Ethics 2. Moral beliefs 3. Bioethics 4. Nursing ethics

1

The nurse is assigned to provide care to an unconscious, mechanically ventilated patient who is receiving palliative treatment. The patient is receiving an intravenous morphine infusion. The primary care provider's orders include discontinuing the patient's mechanical ventilation and increasing the morphine infusion rate, as needed, to maintain the patient's comfort. The nurse refuses to implement the orders based on a belief that implementing the orders would be equivalent to killing the patient. The nurse's decision illustrates which concept? 1. Ethical agency 2. Morals 3. Bioethics 4. Clinical decision making

1

The nurse is aware of many terms related to culture. Which is considered a "practice" (as opposed to a "belief" or "value")? 1. Always drinking water after exercise 2. Thinking often about cleanliness 3. Placing an emphasis on success 4. Maintaining youth

1

The nurse is caring for a Native American patient. Which action should the nurse take? 1. Discuss health as harmony with nature. 2. Keep silence to a minimum. 3. Take notes during an assessment. 4. Encourage focus on "nirvana."

4

The nurse is caring for a patient recently diagnosed with cancer. The patient states, "I really never believed in a god or followed any religion. Should I do something now?" What is the most appropriate response by the nurse? 1. "Religion and spirituality are not for everyone. If you've not had it in your life to this point, you may not need it." 2. "I am a Catholic and it works for me. Would you like me to tell you about my religion?" 3. "It is important to have some religion or spirituality in your life as it can help you get through difficult times." 4. "It is up to you. If you would like, I can arrange for one of our nondenominational chaplains to come and speak with you."

3

The nurse is performing an assessment on an adult patient who appears to be of Asian descent. As part of the nurse's cultural assessment, which question is most appropriate for the nurse to ask prior to documenting the patient's race? 1. "You appear to be Asian. Am I correct?" 2. "Can you tell me a little about your oriental background?" 3. "What race do you identify with and what name do you call it?" 4. "Which Asian country are you from?"

1

The nurse is providing care for a client newly diagnosed with anxiety. Which outcome is most realistic and appropriate in planning care for this client? 1. Describes coping strategies for anxious situations 2. Discusses the reasons for episodes with significant others 3. Establishes two new social relationships 4. Verbalizes the client has been episode free

4

The nurse is providing care for a group of patients in an acute care setting. Which comment by one of the patients demonstrates an internal locus of control? 1. "My blood sugar wouldn't be out of control if my wife prepared better foods." 2. "I knew I shouldn't have come to this hospital; I'd be better if I hadn't." 3. "God must be getting even with me for some of my past behavior." 4. "I'm just glad to be alive; my accident could've been a lot worse."

1

The nurse is providing care for a patient admitted with severe depression and identifies a nursing diagnosis of Hopelessness on the patient's plan of care. Which outcome is appropriate for this diagnosis? 1. Displays stabilization and control of mood 2. Sleeps 6 to 8 hours per night with report of feeling rested 3. Does not engage in risky, self-injurious behavior 4. Eats a well-balanced diet to prevent weight change

3

The nurse is providing care for a patient diagnosed with clinical depression. Which statement by the nurse is best when communicating with this patient? 1. "It's a beautiful day today; you'll feel better if you look out the window." 2. "You're having a bad day; I'm sure you'll feel better soon." 3. "Life seems overwhelming at times; would you like to discuss how you're feeling?" 4. "You are very lucky to have such a supportive family."

2

The nurse is providing care for a patient who emigrated from Puerto Rico. Which information about the patient will enable the nurse to best care for this patient? 1. Practices of the patient's ethnic group 2. Patient's individual cultural beliefs 3. Values of the nurse's own culture 4. Patient's Spanish-speaking culture

2

The nurse is providing care for a patient with cancer who is receiving chemotherapy. Based on Maslow's Hierarchy of Needs, which nursing intervention is the first priority? 1. Assess for and treat pain. 2. Determine if the patient is hungry or thirsty. 3. Explore feelings about dying. 4. Observe client's self-care abilities.

3

The nurse is providing care for patient who comes to the emergency department experiencing headache, palpitations, nausea, and dizziness. After determining that the patient has tachycardia and trembling, the nurse suspects anxiety. Which level of anxiety does the nurse recognize? 1. Mild 2. Moderate 3. Severe 4. Panic

4

The nurse is providing care for several patients on a medical-surgical unit. To which patient statement is the nurse most alerted for making a mental health referral? 1. "Since finding out I have cancer, I feel nervous and uneasy all the time." 2. "I can feel down about my job, but if I go to the gym and exercise, I feel better." 3. "When things really bother me, I just put them right out of my head and go on." 4. "Things at home are just piling up. I just feel so alone and empty inside of me."

2

The nurse is providing care to a patient who had surgery 8 hours ago and has not voided. The physician has prescribed an indwelling urinary catheter be inserted. Which of the following statements should the nurse use to describe the procedure to the patient? 1. "I will put a Foley in you because you haven't voided since your surgical procedure." 2. "I will insert a tube into your bladder to drain the urine because you haven't urinated since surgery." 3. "The physician has prescribed catheterization because you haven't urinated since having your surgery." 4. "I need to place a catheter in your bladder because you haven't voided since surgery."

3

The nurse is seeing a home-care client with a history of mental illness. The client is home after undergoing a mastectomy for breast cancer, which requires regular dressing changes. The client states, "Every time I have a nurse come here, they do this dressing differently. I can't seem to have a nurse that does it right." Which is the best response by the nurse? 1. "I don't know how other nurses do your dressing change, but I will do it correctly." 2. "I have done this type of dressing many times, so you don't need to worry." 3. "How would you like this dressing change done? Tell me how you think it should be done." 4. "It seems you have some concerns about our agency. You may need to talk to the supervisor."

4

The nurse is speaking with a 40-year-old woman at a fund-raiser. The woman states, "I have never had a mammogram. I am a Buddhist and I believe if I get cancer, then that is what my fate will be." What is the most appropriate response by the nurse? 1. "You are 40 years old and really should start thinking about having a mammogram." 2. "This type of religion does not give you an opportunity to think about your own health." 3. "I don't know of any religion that just allows people to die. You may need to rethink this." 4. "This is certainly your decision and I respect that. If you have any questions, I'll help."

2

The nurse is updating a plan of care for a patient who with a nursing diagnosis of Anxiety. Which patient behavior indicates to the nurse that the problem is resolving? 1. Pacing in the hallway at intervals 2. Using relaxation techniques 3. Speaking rapidly when spoken to 4. Avoiding eye contact

4

The nurse is updating the plan of care for a patient scheduled to undergo a mastectomy for breast cancer. Which nursing diagnosis does the nurse anticipate in expectation of the body changes associated with the upcoming surgery? 1. Deficient Knowledge 2. Impaired Adjustment 3. Hopelessness 4. Grieving

3

The nurse is working in a pediatric intensive care unit. A young couple has just been informed that their 6-year-old son has died after being in the unit for 1 month. The couple is grief stricken and says to the nurse, "We can't believe this has happened. He was too young. God is watching over him. Do you believe he is with God?" What is the most appropriate response by the nurse? 1. "It was his time. He is in a better place." 2. "He suffered enough. He is at peace now." 3. "I believe he is with angels, but tell me what you think." 4. "Even though he is gone, you can have more children later."

1

The nurse manager's goals include allowing staff members to schedule vacation while still ensuring that an adequate number of staff members are present to deliver safe patient care. To determine the minimum number of staff members who must be scheduled to work during holidays, the nurse manager performs a risk-benefit analysis. Which ethical framework best describes the nurse manager's problem-solving approach? 1. Utilitarianism 2. Deontology 3. Categorical imperative 4. Feminist ethics

4

The nurse on a psychiatric unit is providing care for a client with severe depression. The client states, "I just cannot go on. It is hopeless for me, and there is no end in sight. My family would be better off without me burdening them." For which condition does nurse recognize this client as being most likely at risk? 1. Ineffective coping 2. Denial 3. Impaired recovery 4. Suicide

3

The nurse preceptor observes a novice nurse preparing to insert an intravenous (IV) access device into a patient's antecubital vein. Prior to inserting the IV, the novice nurse tells the patient, "You won't feel a thing." The nurse preceptor recognizes the novice nurse's violation of which ethical principle? 1. Beneficence 2. Nonmaleficence 3. Veracity 4. Confidentiality

4

The nurse provides care to a 12-year-old patient who is diagnosed with leukemia. The patient's parents refuse to allow the patient to receive chemotherapy, saying they will not ruin what is left of his life with drugs that will make him feel sicker. Which solution represents an integrity-producing compromise? 1. Supporting the parents' refusal to include chemotherapy as a patient treatment 2. Instructing the parents that the child will die without chemotherapy 3. Seeking a court order to ensure that chemotherapy is administered 4. Discussing administration of a chemotherapy agent that causes the fewest side effects

4

The nurse provides care to a patient who is admitted to the hospital for management of severe migraines. After administering a prescribed pain medication, the nurse states, "I will return in 20 minutes to reassess your pain." By following through on the commitment to return at the specified time, which ethical principle does the nurse display? 1. Nonmaleficence 2. Autonomy 3. Beneficence 4. Fidelity

4

The nurse provides care to an alert, oriented patient who is prescribed a blood transfusion for treatment of severe anemia. The patient refuses the treatment. The primary care provider explains to the patient that the blood transfusion is necessary for survival; however, the patient continues to refuse the transfusion. Which action does the nurse anticipate implementing? 1. Document the patient's confusion and administer the blood. 2. Request a psychological evaluation to ensure that the patient understands the risks. 3. Ask family members to persuade the patient to consent to receiving blood. 4. Follow the patient's wishes and do not administer the blood

1

The nurse shares with the nurse manager, "My patient is Jewish, and when I tried to teach her about her antihypertensive medication, she said, 'I'd rather eat chicken soup than take those medications.'" Which is the most appropriate response by the nurse manager? 1. "This is common folk medicine among some Jewish people. You can talk to her about taking her medications and eating chicken soup." 2. "There is no scientific evidence to support chicken soup as a substitute for antihypertensive medications. Maybe you should do some research on this." 3. "The patient can make her own choices and decisions, and there is nothing we can do about this." 4. "You can tell the patient she can eat her soup, but she needs to understand that she has to take her medications first."

3

The nurse states, "I believe nurses who do not regularly exercise should not talk to patients about the importance of physical activity. Nurses should practice what they teach." Which term best relates to the content of the nurse's statement? 1. Morals 2. Ethics 3. Values 4. Compromise

1

The nurse understands that which is the best description of personal identity? 1. It is a continually evolving sense of individuality and uniqueness. 2. It involves the same information as the demographic data. 3. It is a part of the person's genetic and cultural heritage. 4. It includes individual information guarded to avoid identity theft.

4

The nurse, a Christian, is caring for a Jewish patient who has asked the nurse to offer a prayer at the bedside. The nurse feels comfortable doing so. Which action by the nurse is appropriate? 1. Offer a prayer for healing using the nurse's usual words and format. 2. Begin the prayer with "Jehovah God," while avoiding the name of Jesus. 3. Avoid saying any name for the Supreme Being while praying, and quote an Old Testament Bible scripture as the prayer. 4. Say, "What name would you like for me to use to address the Supreme Being when I am praying for you?"

4

The nursing diagnosis Disturbed Personal Identity is identified for a newly admitted patient. Which is an example of an individualized goal for that patient? 1. Distorted Thought Control 2. Anxiety Level 3. Self-Mutilation Restraint 4. No Self-Injury, Consistently Demonstrated

2

The nursing student asks the nurse educator to explain the American Nurses Association (ANA) Code of Ethics for Nurses. Which statement does the nurse educator include in the explanation? 1. "The ANA Code of Ethics is not subject to public scrutiny." 2. "The ANA Code of Ethics is not legally binding." 3. "Nursing codes cannot be used to determine the legality of nursing actions." 4. "Laws related to nursing practice usually exceed ethical obligations."

4

The nursing student is completing her clinical rotation in the intensive care unit. While caring for a patient, she says to the primary nurse, "This family is bringing in all kinds of beads and medals and putting them on the patient and bed. This is intensive care! What should I do?" What is the most appropriate response by the primary nurse? 1. "Remove the medals from the patient so they don't get in the way of your work." 2. "Take the beads off the bed so they don't distract or interfere with care." 3. "Explain to the family that these objects cannot be brought into intensive care as our work is too intricate and these things can get in the way." 4. "This is not uncommon in intensive care. Try to work around this as best you can, as these objects are important to the family and patient."

1

The nursing student is delivering a classroom presentation about professional values identified by the American Association of Colleges of Nursing (AACN). Which example does the nursing student use to illustrate the value of integrity? 1. Acting in accordance with an appropriate code of ethics and standards of practice 2. Treating others fairly regardless of disability 3. Ensuring equal access to quality healthcare 4. Respecting the inherent worth and uniqueness of individuals and populations

4

The patient is struggling with deciding whether or not to receive experimental treatment. To support the patient's decision-making process, which action does the nurse take? 1. Offer recommended solutions. 2. Teach the patient how to apply logic to resolve the situation. 3. Advocate for the patient with the primary healthcare provider. 4. Ask the patient questions.

2

The postoperative care unit (PACU) nurse provides care to a patient who underwent a total hip replacement. The nurse is aware that the patient is a practicing Jehovah's Witness. The primary care provider orders administration of blood for treatment of severe postoperative anemia. The patient is still very drowsy following general anesthesia and is unable to discuss the plan of care. The nurse understands the blood transfusion is necessary for the patient's survival. However, the nurse is also aware that the patient's religious beliefs may prohibit the patient from receiving blood products. Which term best describes the conflict the nurse is experiencing? 1. Ethical agency 2. Ethical dilemma 3. Moral outrage 4. Moral distress

2

The primary care provider orders limited treatments for patients who are diagnosed with a terminal illness and distributes the majority of resources to patients who have a high likelihood of survival. The primary care provider's intention is to serve the greater good. Which ethical principle best describes the primary care provider's approach to allocation of resources? 1. Ethics of care 2. Utilitarianism 3. Deontology 4. Categorical imperative

3

Which issue represents an internal constraint that may prevent the implementation of ethical decisions? 1. Nurse administrators are viewed by staff nurses as being primarily a source of punishment. 2. Nurses view other staff nurses as being unsupportive on ethical issues. 3. Nursing students are socialized to follow orders and not to question them. 4. Nurses fear retaliation from primary care providers who disagree with nursing decisions.

2

Which nursing intervention specifically helps reduce a patient's anxiety? 1. Teaching the importance of adequate nutrition and hydration 2. Giving clear facts pertaining to the patient's circumstances 3. Promoting small-group activities to improve self-esteem 4. Monitoring the patient for the risk of suicide

4

Which question is most important to ask of a newly admitted patient to effectively incorporate spiritual care in the nursing care plan? 1. "What is your family's religious background?" 2. "With what organized religion are you affiliated?" 3. "Do you go to church, and if so, how often?" 4. "What are your personal spiritual beliefs?"

1

Which special consideration may the nurse need to make when caring for a female Rastafarian patient? 1. Allow the patient to wear her own clothing. 2. Provide a diet that is caffeine-free. 3. Allow the patient to wear jewelry with religious symbols. 4. Provide free-flowing water for bathing.

1

Which statement is most reflective of Madeleine Leininger's theory of cultural care? 1. The goal of the theory is to guide research that will assist nurses to provide culturally congruent care. 2. The model for cultural competence stresses teamwork in providing culturally sensitive and competent care to improve outcomes for individuals, families, and communities. 3. The model focuses on five components of cultural competence: awareness, skills, knowledge, encounters, and desire. 4. The theory focuses on increasing levels of one's consciousness to improve the possibilities to provide culturally competent care.

3

Which statement made by the student nurse to a Jehovah's Witness patient indicates a need for further learning? 1. "I documented in your medical records that you do not want blood transfusions or blood products." 2. "I am your nurse and I will help prepare you for a corneal transplant." 3. "Happy Birthday. I will have the dietary department send up a cake for you." 4. "The organ procurement (donation) center was notified that you did not want to donate an organ."

1

Which type of medicine do those of the Hindu faith typically practice? 1. Ayurvedic medicine 2. Western medicine 3. Chiropractic medicine 4. Tribal medicine

4

The nurse is assessing a patient for depression. Which sets of behavioral symptoms may indicate depression to the nurse? 1. Preoccupation with loss, self-blame, and ambivalence 2. Anger, helplessness, guilt, and sadness 3. Anorexia, insomnia, headache, and constipation 4. Tearfulness, withdrawal, and present substance abuse

4

The nurse is aware a client incorporates alternative healthcare into regular health practices. The nurse self-identifies as being culturally competent. For which alternative therapy is the nurse aware that the patient visits a formally trained practitioner? 1. Use of herbs and roots 2. Application of oils and poultices 3. Burning of dried plants 4. Acupuncture

1

The nurse is caring for a 68-year-old patient who has terminal cancer. Which specific assessment tool would the nurse use for this patient? 1. JAREL 2. SPIRIT 3. HOPE 4. LOVE

2

The nurse is developing a plan of care for a patient of Aleut descent who sustained a hip fracture. Which intervention by the nurse recognizes the patient's indigenous healthcare system and should be included in the plan of care? 1. Asking the family to bring in medals and amulets 2. Scheduling a visit from the local shaman 3. Providing the patient with a favorite herbal tea 4. Requesting the physician consult the patient's acupuncturist

3

The nurse is developing a plan of care for a patient who has been admitted with a serious acute illness, which is likely to continue long term. The patient is the parent of three small children. The nurse writes the following intervention: "Facilitate communication between patient and significant other regarding the sharing of responsibilities to accommodate changes brought on by illness." Which purpose does this intervention address? 1. Promotes self-esteem 2. Increases positive body image 3. Facilitates role enhancement 4. Prevents depersonalization

3

The nurse is teaching a clinic patient about hypertension. Which statement by the patient suggests the patient is present-oriented? 1. "I know I need to lose weight; I'll have to begin an exercise program right away." 2. "If I change my diet and begin exercising, maybe I can control my blood pressure without medications." 3. "I know I need to give up foods that contain a lot of salt, but with teenagers in the house it is very difficult." 4. "I will reduce the amount of calories, salt, and fat that I eat; I certainly do not want to have a stroke."

4

The nurse is working with a group of clients who recently experienced health alterations that impacted physical and psychosocial functioning. When the nurse addresses self-concept, which statement best describes self-esteem? 1. View of oneself as a unique human being 2. One's mental image of one's physical self 3. One's overall view of oneself 4. How well one likes oneself

2

The nurse understands the necessity of focusing nursing care on the entire person. Which focus is considered most appropriate for the nursing profession? 1. Biomedical focus 2. Psychosocial focus 3. Biopsychosocial focus 4. Physical focus

2

The nurse witnesses the patient's signature on a consent form to participate in a physician's research study. After the physician leaves the room, the patient tells the nurse, "I don't really want to participate, but I'm afraid my doctor will be upset with me if I say no." To advocate for the patient, which nursing action is most appropriate? 1. Tell the patient the physician will not be upset if she declines to participate. 2. Inform the physician about why the patient agreed to participate. 3. Explain the importance of the research study to the patient. 4. Ask the patient to tell the nurse whether or not any action should be taken.

2

There are many theories and treatments for depression. Based on current research, which is considered to be the most effective treatment for serious depression? 1. Psychotherapy 2. Antidepressant medications 3. Education 4. Social support networks

1

. The nurse is providing care for a patient with a history of depression. The patient states, "Sometimes I just don't believe in using all the medications the doctor orders for me, so I use a lot of over-the-counter herbal medications." Which is the most appropriate response by the nurse? 1. "Yes, there are many good herbal therapies, but you'll want to let your doctor know about these therapies in addition to the medications ordered for you." 2. "Some over-the-counter medications work very well for depression; however, you cannot take them without your doctor's permission." 3. "You shouldn't be treating yourself because you don't know how these medications work with your depression." 4. "I think it's a great idea! If they make you feel better, then continue doing what you're doing."

2

A female patient tells the charge nurse that she does not want a male nurse caring for her. Which intervention by the charge nurse is best? 1. Explain that hospital policy does not allow nursing assignments based on the gender of the nurse. 2. Explore with the patient her beliefs and determine which might have caused her to make this statement. 3. Assure the patient that each nurse is capable of providing professional nursing care, regardless of gender. 4. Immediately comply with the patient's request and assign a female nurse to care for the patient.

4

A frail, older adult patient admitted with dehydration to a medical-surgical unit is exhibiting confusion, distractibility, memory loss, and irritability. Which is the most important action for the nurse? 1. Recognize these symptoms as signs of normal, physiologic aging. 2. Obtain a urine specimen before notifying the primary care provider. 3. Be sure the patient is placed in a room occupied with another patient. 4. Interview the patient in order to perform screening for clinical depression.

2

A nurse is preparing a Mormon female for surgery. Which statement made or question asked by the nurse indicates an understanding of the patient's religious practices or beliefs? 1. "This is a new gown. No one else has worn it." 2. "How would you like me to handle your undergarments?" 3. "I will let your surgical team know that only females can touch you." 4. "Would you like me to pray with you?"

4

A patient admitted with depression has a nursing diagnosis of Chronic Low Self-Esteem. Which Nursing Outcomes Classification (NOC) outcome is essential for this nursing diagnosis? 1. Decision Making 2. Distorted Thought Content 3. Role Performance 4. Depression Level

4

A patient diagnosed with testicular cancer is undergoing chemotherapy, which leaves him unable to help care for his young children. As a result, his spouse misses work whenever the children are ill. The spouse is becoming increasingly distressed over the situation. Which experience does the nurse identify? 1. Role strain 2. Interpersonal role conflict 3. Role performance 4. Interrole conflict

4

A patient of Asian heritage avoids asking for narcotics for pain relief. The nurse writes a nursing diagnosis of "Pain related to reluctance to take medication secondary to cultural beliefs." Which possible patient view of pain is reflected as a cultural archetype in the nursing diagnosis? 1. A punishment for immoral behavior 2. An expected, normal part of life 3. Best treated with herbal teas and prayer 4. A virtue and a matter of family honor

4

A patient of Orthodox Jewish faith is admitted to the hospital with heart failure on Yom Kippur. The physician prescribes digoxin 0.25 mg to be given orally to this patient. Based on the patient's religious affiliation, which action should the nurse take? 1. Administer the medication as prescribed. 2. Hold the medication until after Yom Kippur. 3. Explain the importance of taking the medication despite the holiday. 4. Ask the physician to change the route of administration.

1

A patient tells the nurse, "I feel that God has abandoned me. I am so angry that I can't even pray." The patient refuses to see the minister. Which nursing diagnosis is most appropriate for this patient? 1. Spiritual Distress 2. Risk for Spiritual Distress 3. Impaired Religiosity 4. Moral Distress

2

A patient undergoing fertility treatments for the past 9 months learns that despite in vitro fertilization she still is not pregnant. This patient is at risk for experiencing a crisis in which component of self-concept? 1. Body image 2. Self-esteem 3. Personal identity 4. Role performance

2

A patient who lost their job last month has now been told that the patient's spouse wants a divorce. The patient states, "I know I don't have much to offer a spouse who wants more from life, and now I'm not even bringing home any money." Which nursing diagnosis is most appropriate for the patient? 1. Chronic Low Self-Esteem 2. Situational Low Self-Esteem 3. Disturbed Personal Identity 4. Disturbed Body Image

3

A patient who speaks a different language is being prepared for surgery and needs to sign the surgical consent form. Existing regulations determine the healthcare organization's responsibility for obtaining informed consent from this patient. Which action is the healthcare organization required to do? 1. Provide a licensed interpreter 2. Provide a translator approved by the organization 3. Ensure adequate resources necessary to comply with patient needs 4. Choose an interpreter, a translator, or a family member to interpret

1

An adolescent female patient sustained facial fractures and a 6-inch laceration on the left side of her face in a motor vehicle accident. The patient tells the nurse that she does not want anyone to see her "looking this way." Which statement by the nurse is most appropriate? 1. "Tell me what you mean by 'looking this way.'" 2. "Okay, I'll restrict your visitors until your face heals." 3. "Your friends and family love you no matter what." 4. "You're young; your face will heal quickly."

1

An adolescent patient is admitted to the hospital. The nurse is aware the patient has no medical restriction on visitation. Which group of potential visitors is it most important for the nurse to encourage to help maintain the patient's social identity while hospitalized? 1. Peers 2. Grandparents 3. Siblings 4. Parents

1

An adult patient is diagnosed with lung cancer, and surgery to remove the right lung is recommended. The patient is uncertain about consenting to the surgery because of the risks involved. Which nursing diagnosis is most appropriate for this patient? 1. Decisional Conflict 2. Death Anxiety 3. Powerlessness 4. Ineffective Denial

3

An adult patient of Hispanic heritage is admitted for observation after sustaining injuries in a motor vehicle accident. Which view of pain by patient the does the nurse consider when assessing the patient's injuries? 1. Embraces the taboos against narcotic use to relieve pain 2. Expects immediate and effective treatment to relieve pain 3. Endures pain longer and reports it less frequently than other patients 4. Uses herbal teas, heat application, and prayers to manage the pain

2

An alert, oriented, 87-year-old patient has just been diagnosed with cancer. According to the patient's durable power of attorney, the patient's son serves as the patient's surrogate decision maker. The patient's son tells the nurse he is refusing chemotherapy treatment on the patient's behalf due to concerns about medication side effects and quality of life. Meanwhile, the patient states, "I want to receive chemotherapy." Which action does the nurse take? 1. Assist the patient and her son with reaching a compromise. 2. Administer the patient's chemotherapy treatment as ordered. 3. Advise the patient's son to consult with the hospital legal department for guidance. 4. Ask the patient's son to share more information about his decision to refuse the treatment.

3

An alert, oriented, competent 87-year-old patient requests a Do Not Attempt Resuscitation/Allow Natural Death (AND) prescription. The patient's family members oppose the patient's decision and ask the hospital's ethics committee to intervene on their behalf. Which framework is the ethics committee most likely as a guide for their decision making process? 1. Social justice 2. Patient benefit 3. Autonomy 4. Consequentialist

2

An alert, oriented, competent older adult patient is diagnosed with a terminal illness. The patient requests a Do Not Attempt Resuscitation/Allow Natural Death (AND) prescription. The patient's family members oppose the patient's decision and ask the healthcare team to ignore the request. Despite lengthy discussions among the patient, physician, nurse, and family, the conflict is unresolved. The nurse asks the hospital chaplain to help the family and healthcare team members understand each other's opposing views. Which step of the MORAL model is the nurse implementing? 1. M—Massage the dilemma 2. O—Outline the options 3. R—Resolve the dilemma 4. L—Look back and evaluate

1

An older adult patient is admitted from a skilled nursing residence to a medical-surgical unit is exhibiting confusion, distractibility, memory loss, and irritability. The patient has a medical diagnosis of Dehydration. Which finding leads the nurse to suspect dementia, rather than depression or dehydration, as the source of the symptoms? 1. Rambles, speaks incoherently, answers questions inappropriately 2. Speaks slowly with delayed response to questions, but responds appropriately 3. Awakens early in the day yet sleeps almost constantly during the day 4. Sometimes has difficulty concentrating on details of the present situation

3

An older female patient tells the charge nurse that she wants a change in the nurse providing her care. When the charge nurse questions the patient, the patient states, "I don't want a man taking care of me." Which cultural barrier is this patient exhibiting? 1. Ethnocentrism 2. Racism 3. Sexism 4. Chauvinism

3

A 15-year-old patient who is at 39 weeks gestation is transported by her mother to the emergency department (ED) of a private hospital. The patient reports she is in active labor. The patient's mother states, "We don't have any money or insurance, but this hospital is closer than the public hospital." Which action does the ED nurse implement? 1. Arrange for an ambulance to transport the patient to the nearest public hospital. 2. Explain to the patient and her mother that the hospital only accepts patients who have health insurance. 3. Examine the patient to determine whether her condition is stable or whether she requires immediate medical attention. 4. Advise the patient's mother to transport the patient to the nearest public hospital.

3

A 60-year-old patient who is diagnosed with a treatable form of breast cancer chooses not to pursue radiation or chemotherapy. The nurse persuades the patient to receive treatment by continuing to remind the patient about her responsibilities toward her children and grandchildren. The nurse's behavior best illustrates which principle? 1. Nonmaleficence 2. Autonomy 3. Paternalism 4. Beneficence

2

A 75-year-old patient is admitted to the emergency department (ED) for evaluation of confusion and memory loss. The initial patient assessment reveals bruises and scratches in various stages of healing on the patient's arms, legs, and torso. Based on the assessment findings, the nurse suspects the patient may be a victim of physical abuse. Which legislation requires the nurse to notify a designated authority about the suspected abuse? 1. Good Samaritan laws 2. Mandatory reporting laws 3. Nurse practice act 4. Nursing standards of practice

3

A client is at the clinic and tells the nurse, "I was taking my blood pressure medications and watching my diet, but that didn't help my blood pressure. So now I have stopped the medication and will just eat whatever I want." Which is the most appropriate nursing diagnosis for this client? 1. Anxiety 2. Risk for Hopelessness 3. Ineffective health maintenance 4. Depression

3

A client who is 45 years of age has a history of anxiety and comes into the emergency department with chest pain. The patient is diagnosed with a myocardial infarction (MI). The patient tells the nurse, "This is the most ridiculous thing I've ever heard of. I eat well, exercise, and am too young to have a heart attack." Which reaction does the nurse recognize the patient is most likely experiencing? 1. Fear related to the diagnosis 2. Decisional conflict 3. Ineffective denial 4. Overreaction

4

A female client tells the nurse, "I see how people look at me with my crooked back and short leg. No one has to tell me that I'm not pretty." Which conclusion does the nurse draw from the client's statements? 1. The client has an overinflated sense of self-esteem. 2. The client possesses a well-developed self-concept. 3. The client is dealing with an overactive imagination. 4. The client is experiencing a state of low self-concept.

3

At a clinical postconference, a nursing student states, "I had a Chinese patient today and while I understand some of her cultural practices, she needs to understand that she is in the United States now and should follow our practices because we use scientific evidence." Which cultural barrier is the student demonstrating? 1. Racism 2. Archetyping 3. Ethnocentrism 4. Stereotyping

4

Confidentiality will be maintained by the nurse who believes in and values the ethical principle of: 1. Fidelity 2. Veracity 3. Beneficence 4. Autonomy

3

The nurse admits a patient to the hospital medical-surgical unit of the hospital. During the admission process, the nurse asks whether or not the patient has an advance directive. The basis for the nurse's inquiry is: 1. The International Council of Nurses (ICN) Code of Ethics for Nurses 2. Values clarification 3. Patient advocacy 4. The Health Insurance Portability and Accountability Act (HIPAA)

1

The nurse applies the MORAL model to decision making. After recognizing a problem, which action does the nurse take next? 1. Define the main issues associated with the dilemma. 2. Consult a member of the organization's ethics committee. 3. Outline available options for all involved parties. 4. View the situation using alternate ethical frameworks.

3

Nurses encounter many patients from diverse cultures. When caring for a culturally diverse patient, which initial question does the nurse ask a patient that best assists the nurse with improving cultural competency? 1. "Can you tell me about your culture and cultural practices?" 2. "Do you understand how we do things here in the United States?" 3. "What matters most to you about your illness and treatment?" 4. "Can you please make me a list of your cultural preferences?"

3

Over the past few centuries, nurses have placed less attention on spiritual care primarily because of which aspect? 1. Nurses providing care are less religious and spiritual now. 2. Spirituality and religion are unproven with regard to influencing health. 3. Greater emphasis has been placed on science and scientific evidence. 4. Nurses are uncomfortable when discussing spiritual aspects of care.

3

The nurse asks the patient to talk about the spiritual significance of being baptized in the Jordan River. Which spiritual technique is the nurse using? 1. Hope inspiration 2. Forgiveness facilitation 3. Reminiscence therapy 4. Feelings expression

3

The nurse is asking the patient reflective, clarifying questions to help the patient make a list of what is important and unimportant in life and the time commitment for each. Which standardized (Nursing Interventions Classification [NIC]) intervention does this action represent? 1. Spiritual Support 2. Self-Esteem Enhancement 3. Values Clarification 4. Hope Inspiration

3

The charge nurse lists the nurses' patient assignments and the patients' diagnoses on a whiteboard located at the nurse's station. The charge nurse's practice represents a violation of which federal regulation? 1. Americans with Disabilities Act (ADA) 2. Patient Self-Determination Act (PSDA) 3. Health Insurance Portability and Accountability Act (HIPAA) 4. Health Emergency Medical Treatment and Active Labor Act (EMTALA)

3

The emergency department nurse is providing discharge teaching to a patient. The patient asks the nurse, "I appreciate everything you've done for me and I really like you. Can I take you out for dinner?" Which response does the nurse choose? 1. "Yes, that would be nice. It is really great to be appreciated." 2. "No, and please do not ask again. Your request is inappropriate." 3. "I appreciate your kindness, but I will have to decline your offer." 4. "We cannot socialize until 3 days following your hospital discharge."

1

The emergency department nurse provides care to a 17-year-old patient who is diagnosed with cervical cancer secondary to human papillomavirus. The patient declines treatment and states, "I don't want my parents to know I have been sexually active. If they find out about the cancer, they'll know I have been having sex." When planning a course of action, the nurse recognizes a conflict between the ethical principles of nonmaleficence and __________. 1. Autonomy 2. Veracity 3. Fidelity 4. Justice

2

Through application of the MORAL model to decision making, the nurse who opposes abortion determines that caring for patients who undergo an abortion is still an ethical duty. Which outcome is the best indicator that the nurse effectively applied the MORAL model to the decision making process? 1. The patient is discharged without experiencing complications from the procedure. 2. The nurse believes quality care was delivered and feels satisfied with the decision. 3. The nurse manager commends the nurse for providing excellent patient care. 4. The patient thanks the nurse for being supportive during a difficult time.

4

Vulnerable populations are those most likely to develop health problems and experience poorer outcomes because of limited access to care and a wide variety of other stressors. Which is most important for the nurse to focus on when caring for a patient from a vulnerable group? 1. Methods to connect the patient with a social worker 2. Interactions of family members in planning care 3. Consideration of the patient's difficulties and risks 4. Identification of the patient's strengths and resources

3

When faced with a true ethical dilemma, the nurse plans implementation of a variety of strategies to resolve the issue. Which outcome does the nurse anticipate? 1. A satisfying solution will be found if the nurse logically applies more than one strategy for decision making. 2. If the nurse involves other members of the healthcare team in the decision-making process, a compromise will be reached that satisfies everyone. 3. The nurse will probably not find any course of action to be satisfactory, regardless of the strategy, model, or type of reasoning used. 4. A satisfactory decision can be reached that is comfortable for the nurse if the nurse applies a decision model to the dilemma.

2

Which action is included in Step 3 of the MORAL decision-making model? 1. Realizing information gaps 2. Resolving the dilemma 3. Requesting a review of opposing viewpoints 4. Recognizing the values and options of all major players

4

Which action is most effective for the female nurse to take when delivering spiritual care to a patient of the same religion as the nurse? 1. Understanding that the patient shares the same beliefs 2. Striving to meet the patient's spiritual needs independently 3. Explaining her own religious beliefs to the patient 4. Developing a greater awareness of her own spirituality

4

Which aspect of patient care is guaranteed by the American Nurses Association (ANA) Code of Ethics for Nurses? 1. Helping a patient with billing claims 2. Assisting a patient who is leaving the hospital 3. Ensuring a clean and safe environment 4. Protecting the patient from misrepresentation

3

Which concept refers to conflicts that arise between two or more ethical principles in patient care scenarios? 1. Nursing ethics 2. Bioethics 3. Ethical dilemma 4. Moral distress