N204, Fall 2018 - Midterm Practice Questions

Which action of the nurse would be inappropriate in the context of critical thinking skills for making clinical decisions in nursing practice? A. The nurse should observe changes in clients. B. The nurse should identify new problems when they arise. C. The nurse should follow direction in completing identified aspects of care. D. The nurse should rely on his or her knowledge and experience when planning and implementing a client care plan.

D. The nurse should rely on his or her knowledge and experience when planning and implementing a client care plan.

Which would the nurse state is an example of a natural disaster? A. Floods B. Terrorism C. Fire explosion D. Building collapse

A. Floods

A nursing student is giving examples of healthcare settings and services. Which scenario is a perfect example of tertiary care? A. Preparing a client for an X-ray who has sustained a leg fracture in an accident B. Teaching community members about the importance of using seat belts in cars C. Caring for a postoperative client in the intensive care unit who is suffering from respiratory distress D. Advising a client with stage 1 Parkinson's disease to include exercise in his or her daily routine

C. Caring for a postoperative client in the intensive care unit who is suffering from respiratory distress

A nurse understands that value clarification is a technique useful in therapeutic communication because initially it helps clients do what? A. Become aware of their personal values B. Gain information related to their needs C. Make correct decisions related to their health D. Alter their value systems to make them more socially acceptable

A. Become aware of their personal values

A nurse is explaining the nursing process to a nursing assistant. Which step of the nursing process should include interpretation of data collected about the client? A. Evaluation B. Assessment C. Nursing interventions D. Proposed nursing care

B. Assessment

What activities would the nurse state are involved in providing a secondary level of preventive care? Select all that apply. A. Using specific immunizations B. Preventing the spread of communicable disease C. Providing facilities to limit disability and prevent death D. Providing adequate treatment to arrest the disease process E. Educating the public and industry to use rehabilitated individuals to the fullest possible extent

B. Preventing the spread of communicable disease C. Providing facilities to limit disability and prevent death D. Providing adequate treatment to arrest the disease process

A registered nurse is teaching a nursing student about the nurse's professional roles and responsibilities. When does the nurse play the role of an educator? A. "A client requests the nurse to pray with him or her for quick recovery and the nurse complies with the request." B. "A client is unable to sleep due to back pain. The nurse provides a back massage, which helps the client to fall asleep." C. "A client with dementia refuses to take baths and loudly protests. The nurse consoles the client and provides the bath later." D. "A client is being discharged from the hospital setting with an implanted port. The nurse describes the routine care activities to prevent any complications."

D. "A client is being discharged from the hospital setting with an implanted port. The nurse describes the routine care activities to prevent any complications."

A nursing student is listing the professional responsibilities and roles of the nurse. Who is the most independently functioning nurse? A. Nurse educator B. Nurse researcher C. Nurse administrator D. Advanced practice registered nurse

D. Advanced practice registered nurse

A nursing student is noting information about the National Database of Nursing Quality Indicators (NDNQI). Which point noted by the nursing student needs correction? A. The National Database of Nursing Quality Indicators (NDNQI) was developed by the American Nurses Association (ANA). B. The National Database of Nursing Quality Indicators (NDNQI) reports quarterly results on nursing outcomes at the nursing unit level. C. The National Database of Nursing Quality Indicators (NDNQI) reports provide a database for individual hospitals to compare their performance against nursing performance internationally. D. The National Database of Nursing Quality Indicators (NDNQI) was developed to measure and evaluate nursing-sensitive outcomes with the purpose of improving client safety and quality care.

C. The National Database of Nursing Quality Indicators (NDNQI) reports provide a database for individual hospitals to compare their performance against nursing performance internationally.

The registered nurse (RN) provides nursing care based on the critical thinking model known as the nursing process. What is the correct order of steps in the nursing process? A. Diagnosis B. Planning C. Evaluation D. Assessment E. Implementation

D. Assessment A. Diagnosis B. Planning E. Implementation C. Evaluation

The nurse is hired to work in a Magnet hospital. What should the nurse expect when providing care in this organization? A. Salaries planned according to education level B. Physician input with annual performance appraisals C. Assignments made according to years of experience D. Attend clinical care conferences to discuss client care needs

D. Attend clinical care conferences to discuss client care needs

While assessing an older adult, the nurse observes visual impairment in the client. Which technique should the nurse use to communicate? A. Face the caregiver while speaking B. Provide bright, diffuse, glare lighting C. Stand or sit far away from the client while remaining in the client's full view D. Encourage the older adult to use assistive devices such as glasses

D. Encourage the older adult to use assistive devices such as glasses

A nursing student is examining the health services pyramid. Keeping in mind that care services begin at the bottom of this pyramid, in which order should care services be arranged? A. Primary health care B. Tertiary health care C. Secondary health care D. Clinical preventive services E. Population-based health care services

E. Population-based health care services D. Clinical preventive services A. Primary health care C. Secondary health care B. Tertiary health care

A nurse is educating a patient about Maslow's hierarchy of needs by citing examples. Which examples mentioned by the nurse belong to the third level of needs? Select all that apply. A. "A client is depressed because his/her spouse has passed away." B. "A client is constipated due to excess loss of fluids from the body." C. "A client wants to reconnect with old friends after being diagnosed with cancer." D. "A client has to live in a rat-infested apartment due to lack of financial resources." E. "A client never goes to family gatherings because he/she is not accepted by family members."

A. "A client is depressed because his/her spouse has passed away." C. "A client wants to reconnect with old friends after being diagnosed with cancer." E. "A client never goes to family gatherings because he/she is not accepted by family members."

A nursing student is listing points that make nursing a profession and not just a job. Which points have been correctly stated? Select all that apply. A. "Nursing provides a specific service." B. "Nursing requires a basic liberal foundation and an advanced education." C. "Nursing has a theoretical body of knowledge leading to defined skills, abilities, and norms." D. "Members of a profession do not have any autonomy in decision-making and practice." E. "The profession as a whole lacks a code of ethics for practice and simply follows the state rules and regulations."

A. "Nursing provides a specific service." B. "Nursing requires a basic liberal foundation and an advanced education." C. "Nursing has a theoretical body of knowledge leading to defined skills, abilities, and norms."

What does a community-based nurse do as a change agent? Select all that apply. A. The nurse empowers clients and their families to creatively solve problems. B. The nurse works with clients to solve problems and helps clients identify an alternative care facility. C. The nurse helps clients gain the skills and knowledge needed to provide self-care. D. The nurse empowers clients to become instrumental in creating change within a health care agency. E. The nurse does not make decisions but rather helps clients reach decisions that are best for them.

A. The nurse empowers clients and their families to creatively solve problems. B. The nurse works with clients to solve problems and helps clients identify an alternative care facility. D. The nurse empowers clients to become instrumental in creating change within a health care agency.

A nurse is working with a client who has emotional problems. During what stage of the therapeutic nurse-client relationship does the nurse anticipate that most of the client's problem solving will occur? A. Working stage B. Planning stage C. Orientation stage D. Termination stage

A. Working stage

What instruction would the nurse be most likely to give a client with reduced sensory perception to prevent injury from scalding? A. "Apply moisturizers." B. "Use a bath thermometer." C. "Dress warmly in cold weather." D. "Avoid frequent bathing with hot water."

B. "Use a bath thermometer."

A nurse develops a relationship with a client who has bipolar disorder with episodes of mania. The nurse concludes that their therapeutic interaction has entered the working stage when the client does what? A. Identifies goals for the client-nurse interaction B. Explores the effect of bipolar behavior on the family C. Expresses ambivalence about meeting with the nurse D. Informs the nurse that other family members are bipolar

B. Explores the effect of bipolar behavior on the family

The registered nurse is teaching a student nurse about preparedness when responding to a fire in the healthcare facility. Which statements made by the student nurse indicates the need for further teaching? Select all that apply. A. "I will direct the stable clients to walk to a safe location on their own." B. "I will ask ambulatory clients to help push wheelchair clients out of danger." C. "I will endanger myself while moving and protecting the clients from the fire." D. "I will continue to provide oxygen to the clients that can breathe on their own." E. "I will move bedridden clients from the fire area in a bed, stretcher, or wheelchair."

C. "I will endanger myself while moving and protecting the clients from the fire." D. "I will continue to provide oxygen to the clients that can breathe on their own."

What are the similarities between Medicare and Medicaid? Select all that apply. A. Both programs assist older clients. B. Both programs pay for home care services. C. Both programs pay the full cost of services provided. D. Both programs take care of low-income families. E. Both programs finance poor pregnant women.

A. Both programs assist older clients. B. Both programs pay for home care services.

A team is sent to care for earthquake victims. Which basic professional certification is most desirable in the nurse to become the member of this team? A. Certification in Emergency Care B. Certification in Basic Life Support C. Certification in Advanced Cardiac Life Support D. Certification in Pediatric Advanced Life Support

A. Certification in Emergency Care

What are the purposes of public health laws? Select all that apply. A. Advocating for the rights of people B. Prohibiting the purchase or sale of organs C. Regulating health care and healthcare financing D. Ensuring professional accountability for the care provided E. Encouraging healthcare professionals to assist in emergencies

A. Advocating for the rights of people C. Regulating health care and healthcare financing D. Ensuring professional accountability for the care provided

A nurse is caring for a client who belongs to a different cultural community. The client is not very fluent in the language that the nurse is communicating. What would the nurse say to the client to initiate appropriate communication? Select all that apply. A. "Please tell me about the healthcare practices and beliefs of your community." B. "Let me bring in an interpreter to help you understand the medical procedures better." C. "I would like to know your personal beliefs regarding healthcare traditions and practices." D. "Please let me explain our traditions and cultural practices to help you understand our healthcare practices." E. "I have read up extensively about the healthcare practices of your community and have designed a care plan accordingly."

A. "Please tell me about the healthcare practices and beliefs of your community." B. "Let me bring in an interpreter to help you understand the medical procedures better." C. "I would like to know your personal beliefs regarding healthcare traditions and practices."

A registered nurse is teaching a nursing student about the components of the magnet model. What information should the registered nurse provide about exemplary professional practice according to the revised magnet model? A. "Strong professional practice is established, and accomplishments of the practice are demonstrated." B. "A vision for the future and the systems and resources to achieve the vision are created by nursing leaders." C. "Focus is on structure and processes and demonstration of positive clinical, work force, and client and organizational outcomes." D. "Structures and processes provide an innovative environment in which staff are developed and empowered and professional practice flourishes."

A. "Strong professional practice is established, and accomplishments of the practice are demonstrated."

An older client whose spouse has died is sitting alone in a lounge in the nursing home and says, "I'm all alone; no one has any use for me." Which response by the nurse is most therapeutic? A. "You seem upset. Let's talk about what's bothering you." B. "We need to be alone sometimes. It helps us get to know ourselves better." C. "Try doing something to avoid feeling lonely. I think you should socialize more." D. "You should focus on ways to change this. Let's play some games to improve your morale."

A. "You seem upset. Let's talk about what's bothering you."

What purpose does a community health center serve in preventive and primary care services? A. Community health centers are outpatient clinics that provide primary care to a specific population. B. Community health centers aim to increase worker productivity, decrease absenteeism, and reduce the use of costly medical care. C. Community health centers emphasize program management, interdisciplinary collaboration, and community health principles. D. Community health centers include a complete program designed for health promotion and accident or illness prevention in the workplace.

A. Community health centers are outpatient clinics that provide primary care to a specific population.

A client who only speaks Spanish is being cared for at a hospital in which nursing personnel only speak English. What communication technique would be appropriate for the nurse to use when discussing healthcare decisions with the client? A. Contact an interpreter provided by the hospital. B. Contact the client's family member to translate for the client. C. Communicate with the client using Spanish phrases the nurse learned in a college course. D. Communicate with the client with the use of a hospital-approved Spanish dictionary.

A. Contact an interpreter provided by the hospital.

The nurse is communicating with an older adult who has a hearing disability. Which intervention by the nurse is beneficial to promote communication? Select all that apply. A. Giving the client a chance to speak B. Assuming the client is being uncooperative C. Chewing gum while talking to the client D. Making sure that the client knows you are speaking E. Keeping the communication concise

A. Giving the client a chance to speak D. Making sure that the client knows you are speaking E. Keeping the communication concise

A nursing student is recalling the definition of Nurse Practice Acts. What do the Nurse Practice Acts do? A. Nurse Practice Acts describe and define the legal boundaries of nursing practice within each state. B. Nurse Practice Acts reflect the knowledge and skills possessed by nurses practicing in their profession. C. Nurse Practice Acts are legal requirements that describe the minimum acceptable nursing care. D. Nurse Practice Acts protect individuals from losing their health insurance when changing jobs by providing portability.

A. Nurse Practice Acts describe and define the legal boundaries of nursing practice within each state.

A nursing student is listing the different aspects of the healthcare services pyramid. Under which type of healthcare services should the nursing student include family planning? A. Primary care B. Continuing care C. Restorative care D. Secondary Acute care

A. Primary care

A foreign language-speaking client needs to undergo chemotherapy; a signed consent form is required. What should the nurse do to explain the terms of the consent to the client? A. Seek the help of an official interpreter. B. Seek the help of the primary healthcare provider to assist the client. C. Seek help from the client's family friend who speaks the client's language. D. Seek help from the client's caregiver who speaks the same language as the client.

A. Seek the help of an official interpreter.

What professional responsibility does the nurse display as a client's advocate? A. The nurse protects the client's human and legal rights and provides assistance in asserting said rights. B. The nurse actively collaborates with other healthcare professionals to follow the best treatment plan for a client. C. The nurse explains concepts and facts about health, describes the reason for routine care activities, and demonstrates procedures. D. The nurse establishes an environment for collaborative client-centered care to provide safe, quality care with positive client outcomes.

A. The nurse protects the client's human and legal rights and provides assistance in asserting said rights.

An elderly adult with Parkinson's disease falls while going to the bathroom and gets injured. The nurse taking care of the client informs the primary healthcare provider. What step should the nurse take to alert the risk management system? A. The nurse should document the incident in the occurrence report tool. B. The nurse should provide information in the medical record about the occurrence. C. The nurse should document in the client's medical report that an occurrence report has been filed. D. The nurse should document in the client's medical report that the primary healthcare provider has been contacted.

A. The nurse should document the incident in the occurrence report tool.

A nurse understands that the effects of different variables on client's health beliefs and practices can help healthcare providers to plan and deliver individualized care. Which statement made by the client is a socioeconomic influence on the client's health beliefs? A. "I am a vegetarian; I cannot eat meat because it is against my tradition." B. "I cannot afford expensive medications because I have to take care of my family." C. "My family members always pray before a meal because it is important to thank God." D. "I believe that giving vaccinations to infants is sinful."

B. "I cannot afford expensive medications because I have to take care of my family."

A client who uses a complex ritual says to the nurse, "I feel so guilty. None of this makes any sense. Everyone must really think I'm crazy." What is the most therapeutic response by the nurse? A. "Your behavior is bizarre, but it serves a useful purpose." B. "You're concerned about what other people are thinking about you." C. "I am sure people understand that you can't help this behavior right now." D. "Guilt serves no useful purpose. It just helps you stay stuck where you are."

B. "You're concerned about what other people are thinking about you."

A registered nurse is explaining the importance of capitation to a nursing student. What information should the nurse provide? Select all that apply. A. Capitation is used to review the quality, quantity, and cost of hospital care. B. Capitation influences the way healthcare providers deliver care in all types of settings. C. Capitation means that primary healthcare providers are paid a fixed amount per client of a health care plan. D. Capitation identifies and eliminates the overuse of diagnostic and treatment services ordered by primary healthcare providers for Medicare. E. Capitation aims to build a payment plan for select diagnoses or surgical procedures that consists of the best standards of care at the lowest cost.

B. Capitation influences the way healthcare providers deliver care in all types of settings. C. Capitation means that primary healthcare providers are paid a fixed amount per client of a health care plan. E. Capitation aims to build a payment plan for select diagnoses or surgical procedures that consists of the best standards of care at the lowest cost.

A registered nurse is teaching a nursing student about types of nursing theories. Which information provided by the registered nurse is accurate? A. Prescriptive theories do not provide guidance for specific nursing interventions. B. Descriptive theories describe, relate, and in some situations predict, nursing phenomena. C. Middle-range theories provide the structural framework for broad, abstract ideas about nursing. D. Grand theories are action-oriented and test the validity and predictability of a nursing intervention.

B. Descriptive theories describe, relate, and in some situations predict, nursing phenomena.

Which group benefits from Medicare? A. Self-insured employers B. People who are 65 years or older C. Members of low-income families D. Children who are not poor enough for Medicaid

B. People who are 65 years or older

A registered nurse is teaching a nursing student about the characteristics of various healthcare plans. Which statements about preferred provider organizations (PPOs) by the nursing student need correction? Select all that apply. A. Preferred provider organizations are focused on health maintenance. B. Preferred provider organizations reimburse nursing home payments. C. Preferred provider organizations cover children who are not poor enough for Medicaid. D. Preferred provider organizations have deductibles that clients must meet before the insurance pays. E. In a preferred provider organization, a contractual agreement exists between a set of providers and one or more purchasers.

B. Preferred provider organizations reimburse nursing home payments. C. Preferred provider organizations cover children who are not poor enough for Medicaid. D. Preferred provider organizations have deductibles that clients must meet before the insurance pays.

What is the role of a nurse administrator in a healthcare setting? A. Providing surgical anesthesia under the guidance and supervision of an anesthesiologist B. Preparing the budget, staffing, strategic planning of programs and services, employee evaluations, and employee development C. Providing comprehensive care by directly managing the medical care of clients who are healthy or who have chronic conditions D. Providing knowledge about current nursing practices, trends, theories, and necessary skills in laboratories and clinical settings

B. Preparing the budget, staffing, strategic planning of programs and services, employee evaluations, and employee development

Which points have been correctly stated regarding prescriptive theories? Select all that apply. A. Prescriptive theories do not predict the consequences. B. Prescriptive theories address nursing interventions for a phenomenon. C. Prescriptive theories describe the conditions under which the prescription occurs. D. Prescriptive theories guide nursing research to develop and test specific nursing interventions. E. Prescriptive theories are not action-oriented and do not test the validity and predictability of a nursing intervention.

B. Prescriptive theories address nursing interventions for a phenomenon. C. Prescriptive theories describe the conditions under which the prescription occurs. D. Prescriptive theories guide nursing research to develop and test specific nursing interventions.

What services do nurse-managed clinics provide in preventive and primary care services? Select all that apply. A. Crisis intervention B. Wellness counseling C. Health risk appraisal D. Employment readiness E. Communicable disease control

B. Wellness counseling C. Health risk appraisal D. Employment readiness

A registered nurse is teaching a nursing student about Nightingale's theory, which is an initial model for nursing. Which statements of a nursing student indicate an understanding of the theory? Select all that apply. A. "Nightingale's theory suggests that nurses need to know all about the disease process." B. "Nightingale's theory posits the idea that nursing is limited only to the administration of medications and treatments." C. "Nightingale's theory deals with visionary principles that include areas of practice, research, and education." D. "Nightingale's theory deals with descriptive theories that provides nurses with a way to think about clients and their environment." E. "Nightingale's theory focuses on the fact that nursing is caring through the environment and helping the client deal with symptoms related to illness."

C. "Nightingale's theory deals with visionary principles that include areas of practice, research, and education." D. "Nightingale's theory deals with descriptive theories that provides nurses with a way to think about clients and their environment." E. "Nightingale's theory focuses on the fact that nursing is caring through the environment and helping the client deal with symptoms related to illness."

A nurse is evaluating different situations related to addressing different levels of client needs. According to Maslow's hierarchy of needs, in which order should the nurse prioritize his or her actions? A. Encouraging the client to talk about his or her fears and feelings B. Praising the client for administering insulin accurately C. Providing a warm bath to the client to promote a good night's sleep D. Assisting the client in getting out of bed to join family members for meals

C. Providing a warm bath to the client to promote a good night's sleep A. Encouraging the client to talk about his or her fears and feelings D. Assisting the client in getting out of bed to join family members for meals B. Praising the client for administering insulin accurately

The Institute of Medicine (IOM) identified five interrelated competencies for all health care workers in the twenty-first century. What should the nurse do to provide patient-centered care? A. Participate in research activities. B. Identify errors and hazards in care. C. Share decision-making and management. D. Use information technology to reduce error.

C. Share decision-making and management.

At the beginning phase of a therapeutic relationship, why is a clear understanding of participants' roles important? A. The client should understand what will be discussed. B. The client will know that the nurse is trying to be helpful. C. The client needs to know what to expect from the relationship. D. The client will be able to be prepared for termination of the relationship.

C. The client needs to know what to expect from the relationship.

A nurse uses therapeutic communication techniques in order to achieve desired client outcomes. Which communication technique is a part of therapeutic communication? A. Asking for explanations B. Showing sympathy to the client C. Asking personal questions of the client D. Providing relevant information to the client

D. Providing relevant information to the client

Which statement is applicable to Watson's theory of transpersonal caring? Watson's theory A. Views the client as an adaptive system. B. Is based on stress and the client's reaction to the stressor. C. Focuses on providing the client with culturally specific nursing care. D. Defines the outcome of nursing activity in relation to the humanistic aspects of life.

D. Defines the outcome of nursing activity in relation to the humanistic aspects of life.