NCLEX Review Part 1
An adult patient will be receiving outpatient intravenous antibiotic therapy for the treatment of endocarditis. The nurse is preparing to perform health education to ensure the patients adherence to the course of treatment. Which of the following assessments should be the nurses immediate priority? A) Patients understanding of the teaching plan B) Quality of the patients relationships C) Patients previous medical history D) Characteristics of the patients culture
Characteristics of the patients culture
Nurses have different educational backgrounds and function under many titles in their practice setting. If a nurse practicing in an oncology clinic had the goal of improving patient outcomes and nursing care by influencing the patient, the nurse, and the health care system, what would most accurately describe this nurses title? A) Nursing care expert B) Clinical nurse specialist C) Nurse manager D) Staff nurse
Clinical nurse specialist
Nurses now have the option to practice in a variety of settings and one of the fastest growing venues of practice for the nurse in todays health care environment is home health care. What is the main basis for the growth in this health care setting? A) Chronic nursing shortage B) Western focus on treatment of disease C) Nurses preferences for day shifts instead of evening or night shifts D) Discharge of patients who are more critically ill
Discharge of patients who are more critically ill
The nursing instructor has given an assignment to a group of certified nurse practitioner (CNP) students. They are to break into groups of four and complete a health-promotion teaching project and present a report to their fellow students. What project most clearly demonstrates the principles of health- promotion teaching? A) Demonstrating an injection technique to a patient for anticoagulant therapy B) Explaining the side effects of a medication to an adult patient C) Discussing the importance of preventing sexually transmitted infections (STI) to a group of high school students D) Instructing an adolescent patient about safe and nutritious food preparation
Discussing the importance of preventing sexually transmitted infections (STI) to a group of high school students
A public health nurse is planning educational interventions that are based on Beckers Health Belief Model. When identifying the variables that affect local residents health promotion behaviors, what question should the nurse seek to answer? A) Do residents believe that they have ready access to health promotion resources? B) Why have previous attempts at health promotion failed? C) How much funding is available for health promotion in the community? D) Who is available to provide health promotion education in the local area?
Do residents believe that they have ready access to health promotion resources?
A patient who has a 40 pack-year history of smoking may have dysplasia of the epithelial cells in her bronchi. What would the nurse tell the patient about dysplastic cells in the bronchi? A) This is a benign process that occurs as lung tissue regenerates. B) Dysplastic cells have a high potential to become malignant. C) This process involves a rapid increase in number of cells. D) Dysplasia may cause uncontrolled growth of scar tissue.
Dysplastic cells have a high potential to become malignant.
The role of the certified nurse practitioner (CNP) has become a dominant role for nurses in all levels of health care. Which of the following activities are considered integral to the CNP role? Select all that apply. A) Educating patients and family members B) Coordinating care with other disciplines C) Using direct provision of interventions D) Educating registered nurses and practical nurses E) Coordinating payment plans for patients
Educating patients and family members Coordinating care with other disciplines Using direct provision of interventions
Advanced practice nursing roles have grown in number and in visibility in recent years. What characteristic sets these nurses apart from the registered nurse? A) Collaboration with other health care providers B) Education that goes beyond that of the RN C) Advanced documentation skills D) Ability to provide care in the surgical context
Education that goes beyond that of the RN
You are caring for an older female patient who is being treated for acute anxiety. She has a nursing diagnosis of Ineffective Coping related to a feeling of helplessness. What would be the most appropriate nursing intervention? A) Put the primary onus for planning care on the patient herself. B) Assess and provide constructive outlets for anger and hostility. C) Assess the patients sources of social support. D) Encourage an attitude of realistic hope to help her deal with helpless feelings.
Encourage an attitude of realistic hope to help her deal with helpless feelings.
A nurse is working with a male patient who has recently received a diagnosis of human immunodeficiency virus (HIV). When performing patient education during discharge planning, what goal should the nurse emphasize most strongly? A) Encourage the patient to exercise within his limitations. B) Encourage the patient to adhere to his therapeutic regimen. C) Appraise the patients level of nutritional awareness. D) Encourage a disease-free state,
Encourage the patient to adhere to his therapeutic regimen.
A nurse has integrated the principles of evidence-based practice into care. EBP has the potential to help the nurse achieve what goal? A) Increasing career satisfaction B)Obtaining federal grant money C) Ensuring high quality patient care D) Enhancing the publics esteem for nursing
Ensuring high quality patient care
The ANA has identified central characteristics of nursing practice that are applicable across the wide variety of contexts in which nurses practice. A nurse can best demonstrate these principles by performing which of the following actions? A) Teaching the public about the role of nursing B) Taking action to control the costs of health care C) Ensuring that all of his or her actions exemplify caring D) Making sure to carry adequate liability insurance
Ensuring that all of his or her actions exemplify caring
Your patient tells you that he has just been told that his computed tomography results were abnormal. You can expect that his sympathetic nervous system has stimulated his adrenal gland to release what? A) Endorphins B) Dopamine C) Epinephrine D) Testosterone
Epinephrine
With the changing population of health care consumers, it has become necessary for nurses to work more closely with other nurses, as when acute care nurses collaborate with public health and home health nurses. What nursing function has increased in importance because of this phenomenon? A) Prescribing medication B) Performing discharge planning C) Promoting family involvement D) Forming collegial relationships
Performing discharge planning
A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslows hierarchy of needs, what dimension of care should the nurse consider primary in importance when caring for a dying patient? A) Spiritual B) Social C) Physiologic D) Emotional
Physiologic
A nurse is planning care for an older adult who lives with a number of chronic health problems. For which of the following nursing diagnoses would education of the patient be the nurses highest priority? A) Risk for impaired physical mobility related to joint pain B) Functional urinary incontinence related decreased mobility C) Activity intolerance related to contractures D) Risk for ineffective health maintenance related to nonadherence to therapeutic regimen
Risk for ineffective health maintenance related to nonadherence to therapeutic regimen
The home health nurse is assisting a patient and his family in planning the patients return to work after surgery and the development of postsurgical complications. The nurse is preparing a plan of care that addresses the patients multifaceted needs. To which level of Maslows hierarchy of basic needs does the patients need for self-fulfillment relate? A) Physiologic B) Transcendence C) Love and belonging D) Self-actualization
Self-actualization
A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse. What is one characteristic the nurse would cite as necessary to possess to be an effective nurse? A) Sensitivity to cultural differences B) Team-focused approach to problem-solving C) Strict adherence to routine D) Ability to face criticism
Sensitivity to cultural differences
A nurse has planned a teaching learning interaction that is aimed at middle school-aged students. To foster successful health education, the nurses planning should prioritize which of the following components? A) Pretesting B) Social and cultural patterns C) Patient awareness D) Measurable interventions
Social and cultural patterns
A nurse recognizes that individuals of different ages have specific health promotion needs. When planning to promote health among young adults, what subject is most likely to meet this demographic groups learning needs? A) Family planning B) Management of risky behaviors C) Physical fitness D) Relationship skills training
Family planning
The ANA has identified several phenomena toward which the focus of nursing care should be directed, and a nurse is planning care that reflects these priorities. Which of the nurses actions best demonstrates these priorities? A) Encouraging the patients dependence on caregivers B) Fostering the patients ability to make choices C) Teaching the patient about nurses roles in the health care system D) Assessing the patients adherence to treatment
Fostering the patients ability to make choices
Health promotion ranks high on the list of health-related concerns of the American public. Based on current knowledge, what factor should the nurse prioritize in an effort to promote health, longevity, and weight control in patients? A) Good nutrition B) Stress reduction C) Use of vitamins D) Screening for health risks
Good nutrition
Middle-aged adults are part of an age group that is known to be interested in health and health promotion, and the nurse is planning health promotion activities accordingly. To what suggestions do members of this age group usually respond with enthusiasm? Select all that apply. A) How lifestyle practices can improve health B) How to eat healthier C) How exercise can improve your life D) Strategies for adhering to prescribed therapy E) Exercise for the aging
How lifestyle practices can improve health How to eat healthier How exercise can improve your life
A patient presents to the health center and the nurse practitioners assessment reveals an enlarged thyroid. The nurse practitioner believes the thyroid cells may be undergoing hyperplasia. How would the nurse practitioner explain this condition to the patient? A) Hyperplasia is the abnormal decrease in cell and organ size and is a precursor to cancer. B) Hyperplasia is an abnormal increase in new cells and is reversible with the stimulus for cell growth removed. C) Hyperplasia is the change in appearance of the thyroid due to a chronic irritation and will reverse with the stimulus removed. D) Hyperplasia is a cancerous growth and will be removed surgically.
Hyperplasia is an abnormal increase in new cells and is reversible with the stimulus for cell growth removed.
A teenage boy who was the victim of a near drowning has been admitted to the emergency department. The patient was submerged for several minutes and remains unconscious. What pathophysiological process has occurred as a result of the submersion? A) Atrophy of brain cells B) Cellular lysis C) Hypoxia to the brain D) Necrosis to the brain
Hypoxia to the brain
You are admitting a patient to your medical unit after the patient has been transferred from the emergency department. What is your priority nursing action at this time? A) Identifying the immediate needs of the patient B) Checking the admitting physicians orders C) Obtaining a baseline set of vital signs D) Allowing the family to be with the patient
Identifying the immediate needs of the patient
The IOM Report Health Professions Education: A Bridge to Quality issued a number of challenges to the educational programs that teach nurses and members of other health professions. According to this report, what activity should educational institutions prioritize? A) More clearly delineate each professions scope of practice during education B) Move toward developing a single health curriculum that can be adapted for any health profession C) Include interdisciplinary core competencies into curricula D) Elicit input from patients and families into health care curricula
Include interdisciplinary core competencies into curricula
Your older adult patient has been diagnosed with urosepsis and has a temperature of 103.4F. You should be aware that the oxygen demands of the patients body would change in which direction and why? A) Increase due to an increase in metabolism B) Decrease due to a decrease in metabolism C)Increase due to a decrease in metabolism D) Decrease due to an increase in metabolism
Increase due to an increase in metabolism
An elderly man tells you that his wife died 14 months ago and that he cannot stop grieving over his loss. What should you encourage the patient to consider? A) Improve his nutritional intake. B) Make an appointment at a wellness clinic. C) Walk on a daily basis. D) Increase his interaction with his social network.
Increase his interaction with his social network.
The nurse is assessing a patient and finds two enlarged supraclavicular lymph nodes. The nurse asks the patient how long these nodes have noticeably enlarged. The patient states, I cant remember. A long time I think. Do I have cancer? Which of the following is an immediate physiologic response to stress the nurse would expect this patient to experience? A) Vasodilation of peripheral blood vessels B) Increased blood pressure C) Decrease in blood glucose levels D) Pupil constriction
Increased blood pressure
A case manager has been hired at a rural hospital that has a combined medical-surgical unit. When defining this new role, which of the following outcomes should be prioritized by the hospitals leadership? A) Decreased need for physician services B) Improved patient and family education C) Increased adherence to the principles of EBP D) Increased coordination of health services
Increased coordination of health services
Professional nursing expands and grows because of factors driven by the changing needs of health care consumers. Which of the following is a factor that nurses should reflect in the planning and provision of health care? A) Decreased access to health care information by individuals B) Gradual increases in the cultural unity of the American population C) Increasing mean and median age of the American population D) Decreasing consumer expectations related to health care outcomes
Increasing mean and median age of the American population
The nurse is working with a male patient who has diagnoses of coronary artery disease and angina pectoris. During a clinic visit, the nurse learns that he has only been taking his prescribed antiplatelet medication when he experiences chest pain and fatigue. What nursing diagnosis is most relevant to this assessment finding? A) Acute pain related to myocardial ischemia B) Confusion related to mismanagement of drug regimen C) Ineffective health maintenance related to inappropriate medication use D) Ineffective role performance related to inability to manage medications
Ineffective health maintenance related to inappropriate medication use
A 35-year-old woman comes to the local health center with a large mass in her right breast. She has felt the lump for about a year, but was afraid to come to the clinic because she was sure it was cancer. What is the most appropriate nursing diagnosis for this patient? A) Self-esteem disturbance related to late diagnosis B) Ineffective individual coping related to reluctance to seek care C) Altered family process related to inability to obtain treatment D) Ineffective denial related to reluctance to seek care
Ineffective individual coping related to reluctance to seek care
You are admitting a patient who presents with inflammation of his right ankle. When planning this patients care, which of the following statements regarding acute inflammation should you recognize? A) Inflammation is essentially synonymous with infection. B) Inflammation may impair the healing process. C) Inflammation is a defensive reaction intended to remove an offending agent. D) Inflammation inhibits the release of histamines in the tissues.
Inflammation is a defensive reaction intended to remove an offending agent.
The nursing profession and nurses as individuals have a responsibility to promote activities that foster well-being. What factor has most influenced nurses abilities to play this vital role? A) Nurses are seen as nurturing professionals. B) Nurses possess a baccalaureate degree as the entry to practice. C) Nurses possess an authentic desire to help others. D) Nurses have long-established credibility with the public.
Nurses have long-established credibility with the public.
You walk into your patients room and find her sobbing uncontrollably. When you ask what the problem is, your patient responds, I am so scared. I have never known anyone who goes into a hospital and comes out alive. On this patients care plan you note a pre-existing nursing diagnosis of Ineffective Coping related to stress. What is the best outcome you can expect for this patient? A) Patient will adopt coping mechanisms to reduce stress. B) Patient will be stress free for the duration of treatment. C) Patient will avoid all stressful situations. D) Patient will be treated with an antianxiety agent.
Patient will adopt coping mechanisms to reduce stress.
A 20-year-old man newly diagnosed with type 1 diabetes needs to learn how to self-administer insulin. When planning the appropriate educational interventions and considering variables that will affect his learning, the nurse should prioritize which of the following factors? A) Patients expected lifespan B) Patients gender C) Patients occupation D) Patients culture
Patients culture
A mother has brought her young son to the emergency department (ED). The mother tells the triage nurse that the boy was stung by a bee about an hour ago. The mother explains to the nurse, It hurts him so bad and it looks swollen, red, and infected. What can the triage nurse teach the mother? A) The pain, redness, and swelling are part of the inflammatory process, but it is probably too early for an infection. B) Bee stings frequently cause infection, pain, and swelling, and, with treatment, the infection should begin to subside late today. C) The infection was probably caused by the stinger, which may still be in the wound. D) The mothers assessment is accurate and the ED doctor will probably prescribe antibiotics to fix the problem.
The pain, redness, and swelling are part of the inflammatory process, but it is probably too early for an infection.
You are the oncoming nurse and you have just taken end-of-shift report on your patients. One of your patients newly diagnosed with diabetes was admitted with diabetic ketoacidosis. Which behavior best demonstrates this patients willingness to learn? A) The patient requests a visit from the hospitals diabetic educator. B) The patient sets aside a dessert brought in by a family member. C) The patient wants a family member to meet with the dietician to discuss meals. D) The patient readily allows the nurse to measure his blood glucose level.
The patient requests a visit from the hospitals diabetic educator.
A public health nurse is assessing the nutritional awareness of a group of women who are participating in a prenatal health class. What outcome would most clearly demonstrate that the women possess nutritional awareness? A) The women demonstrate an understanding of the importance of a healthy diet. B) The women are able to describe the importance of vitamin supplements during pregnancy. C) The women can list the minerals nutrients that should be consumed daily. D) The women can interpret the nutrition facts listed on food packaging
The women demonstrate an understanding of the importance of a healthy diet.
A nurse on a medical-surgical unit has asked to represent the unit on the hospitals quality committee. When describing quality improvement programs to nursing colleagues and members of other health disciplines, what characteristic should the nurse cite? A) These programs establish consequences for health care professionals actions. B) These programs focus on the processes used to provide care. C) These programs identify specific incidents related to quality. D) These programs seek to justify health care costs and systems.
These programs focus on the processes used to provide care.
Nurses in acute care settings must work with other health care team members to maintain quality care while facing pressures to care for patients who are hospitalized for shorter periods of time than in the past. To ensure positive health outcomes when patients return to their homes, what action should the nurse prioritize? A) Promotion of health literacy during hospitalization B) Close communication with insurers C) Thorough and evidence-based discharge planning D) Participation in continuing education initiatives
Thorough and evidence-based discharge planning
A community health nurse has been asked to participate in a health fair that is being sponsored by the local senior center. The nurse should select educational focuses in the knowledge that older adults benefit most from what kind of activities? A) Those that help them eat well B) Those that help them maintain independence C) Those that preserve their social interactions D)Those that promote financial stability
Those that help them maintain independence
A school nurse is facilitating a health screening program among junior high school students. What purpose of health screening should the nurse prioritize when planning this program? A) To teach students about health risks that they can expect as they grow and develop B) To evaluate the treatment of students current health problems C) To identify the presence of infectious diseases D) To detect health problems at an early age so they can be treated promptly
To detect health problems at an early age so they can be treated promptly
A nurse who provides care at the campus medical clinic of a large university focuses many of her efforts on health promotion. What purpose of health promotion should guide the nurses efforts? A) To teach people how to act within the limitations of their health B) To teach people how to grow in a holistic manner C) To change the environment in ways that enhance cultural expectations D) To influence peoples behaviors in ways that reduce risks
To influence peoples behaviors in ways that reduce risks
A recent nursing graduate is aware that the nursing scope of practice goes far beyond what is characterized as bedside care. Which of the following is a nurses primary responsibility? A) To promote activities that enhance community cohesion B) To encourage individuals self-awareness C) To promote activities that foster well-being D) To influence individuals social interactions
To promote activities that foster well-being
A community health nurse has witnessed significant shifts in patterns of disease over the course of a four-decade career. Which of the following focuses most clearly demonstrates the changing pattern of disease in the United States? A) Type 1 diabetes management B) Treatment of community-acquired pneumonia C) Rehabilitation from traumatic brain injuries D) Management of acute Staphylococcus aureus infections
Type 1 diabetes management
Leadership of a medical unit have been instructed to integrate the principles of the Quality and Safety Education for Nurses (QSEN) competency of quality improvement. What action should the units leaders take? A) Provide access to online journals and Web-based clinical resources for nursing staff. B) Use flow charts to document the processes of care that are used on the unit. C) Enforce continuing education requirements for all care providers. D) Reduce the use of chemical and physical restraints on the unit.
Use flow charts to document the processes of care that are used on the unit.
A group of nursing students are learning about recent changes in the pattern of disease in the United States. Which of the following statements best describes these current changes? A) Infectious diseases continue to decrease in incidence and prevalence. B) Chronic illnesses are becoming increasingly resistant to treatment. C) Most acute, infectious diseases have been eradicated. D) Most, but not all, communicable diseases are declining.
Most, but not all, communicable diseases are declining.
A nurse has been working with Mrs. Griffin, a 71-year-old patient whose poorly controlled type 1 diabetes has led to numerous health problems. Over the past several years Mrs. Griffin has had several admissions to the hospital medical unit, and the nurse has often carried out health promotion interventions. Who is ultimately responsible for maintaining and promoting Mrs. Griffins health? A) The medical nurse B) The community health nurse who has also worked with Mrs. Griffin C) Mrs. Griffins primary care provider D) Mrs. Griffin
Mrs. Griffin
Health care professionals are involved in the promotion of health as much as in the treatment of disease. Health promotion has evolved as a part of health care for many reasons. Which of the following factors has most influenced the growing emphasis on health promotion? A) A changing definition of health B) An awareness that wellness exists C) An expanded definition of chronic illness D) A belief that disease is preventable
A changing definition of health
A medical-surgical nurse is aware of the scope of practice as defined in the state where the nurse provides care. This nurses compliance with the nurse practice act demonstrates adherence to which of the following? A) National Council of Nursings guidelines for care B) National League for Nursings Code of Conduct C) American Nurses Associations Social Policy Statement D) Department of Health and Human Services White Paper on Nursing
American Nurses Associations Social Policy Statement
The nurse is preparing discharge teaching for a 51-year-old woman diagnosed with urinary retention secondary to multiple sclerosis. The nurse will teach the patient to self-catheterize at home upon discharge. What teaching method is most likely to be effective for this patient? A) A list of clear instructions written at a sixth-grade level B) A short video providing useful information and demonstrations C) An audio-recorded version of discharge instructions that can be accessed at home D) A discussion and demonstration between the nurse and the patient
A discussion and demonstration between the nurse and the patient
A team of public health nurses are doing strategic planning and are discussing health promotion activities for the next year. Which of the following initiatives best exemplifies the principles of health promotion? A) A blood pressure clinic at a local factory B) A family planning clinic at a community center C) An immunization clinic at the largest local mall D) A workplace safety seminar
A family planning clinic at a community center
A public health nurse is preparing to hold a series of health-promotion classes for middle-aged adults that will address a variety of topics. Which site would best meet the learning needs of this population? A) A well-respected physicians office B) A large, local workplace C) The local hospital D) An ambulatory clinic
A large, local workplace
Nurses who are providing patient education often use motivators for learning with patients who are struggling with behavioral changes necessary to adhere to a treatment regimen. When working with a 15-year-old boy who has diabetes, which of the following motivators is most likely to be effective? A) A learning contract B) A star chart C) A point system D) A food-reward system
A learning contract
The view that health and illness are not static states but that they exist on a continuum is central to professional health care systems. When planning care, this view aids the nurse in appreciating which of the following? A) Care should focus primarily on the treatment of disease. B) A persons state of health is ever-changing. C) A person can transition from health to illness rapidly. D) Care should focus on the patients compliance with interventions.
A persons state of health is ever-changing.
A nurse is meeting with a young woman who has recently lost her job after moving with her husband to a new city. She describes herself as being anxious and pretty depressed. What principle of stress and adaptation should be integrated into the nurses plan of care for this patient? A) Adaptation often fails during stressful events and results in homeostasis. B) Stress is a part of all lives, and, eventually, this young woman will adapt. C) Acute anxiety and depression can be adaptations that alleviate stress in some individuals. D) An accumulation of stressors can disrupt homeostasis and result in disease.
An accumulation of stressors can disrupt homeostasis and result in disease.
Research has shown that patient adherence to prescribed regimens is generally low, especially when the patient will have to follow the regimen for a long time. Which of the following individuals would most likely benefit from health education that emphasizes adherence? A) An older adult who is colonized with methicillin-resistant Staphylococcus aureus (MRSA) B) An 80-year-old man who has a small bowel obstruction C) A 52-year-old woman who has a new diagnosis of multiple sclerosis D) A child who fractured her humerus in a playground accident
A 52-year-old woman who has a new diagnosis of multiple sclerosis
A team of community health nurses are planning to draft a proposal for a program that will increase the community alignment with the principles contained in the Healthy People 2020report. Which of the following activities would best demonstrate the priorities identified in this report? A) Addressing determinants of health such as clean environments and safety in the community B) Lobbying for increased funding to the county hospital where many residents receive primary care C) Collaborating with health professionals in neighboring communities to pool resources and increase efficiencies D) Creating clinical placements where nursing students and members of other health disciplines can gain experience in a community setting
Addressing determinants of health such as clean environments and safety in the community
A nurse is planning a medical patients care with consideration of Maslows hierarchy of needs. Within this framework of understanding, what would be the nurses first priority? A) Allowing the family to see a newly admitted patient B) Ambulating the patient in the hallway C) Administering pain medication D) Teaching the patient to self-administer insulin safely
Administering pain medication
A nurse is providing care for a patient who is postoperative day one following a bowel resection for the treatment of colorectal cancer. How can the nurse best exemplify the QSEN competency of quality improvement? A) By liaising with the members of the interdisciplinary care team B) By critically appraising the outcomes of care that is provided C) By integrating the patients preferences into the plan of care D) By documenting care in the electronic health record in a timely fashion
By critically appraising the outcomes of care that is provided
A public health nurse understands that health promotion should continue across the lifespan. When planning health promotion initiatives, when in the lifespan should health promotion begin? A) Adolescence B) School age C) Preschool D) Before birth
Before birth
The nurse is assessing a newly admitted patient who is an 84-year-old woman. The nurse learns that the patient has simultaneously experienced a hip fracture and the exacerbation of her chronic heart failure. What is an example of a bodily function that restores homeostasis by negative feedback when conditions shift out of normal range? A) Body temperature B) Pupil dilation C) Diuresis D) Blood clotting
Body temperature
Our world is connected by a sophisticated communication system that makes much health information instantly accessible, no matter where the patient is being treated. This instant access to health information has impacted health care delivery strategies, including the delivery of nursing care. What is one way the delivery of health care has been impacted by this phenomenon? A) Brisk changes as well as swift obsolescence B) Rapid change that is nearly permanent C) Limitations on the settings where care can be provided D) Increased need for social acceptance
Brisk changes as well as swift obsolescence
A hospitals current quality improvement program has integrated the principles of the Institute for Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the campaign goals of reducing preventable harm and death? A) By adhering to EBP guidelines B) By reducing nurse-to-patient ratios and increasing accountability C) By having researchers from outside the facility evaluate care D) By involving patients and families in their care planning
By adhering to EBP guidelines
The Joint Commission and the Centers for Medicare and Medicaid Services (CMS) are evaluating a large, university medical center according to core measures. Evaluators should perform this evaluation in what way? A) By auditing the medical centers electronic health records B) By performing focus groups and interviews with care providers from numerous disciplines C) By performing statistical analysis of patient satisfaction surveys D) By comparing the centers patient outcomes to best practice indicators
By comparing the centers patient outcomes to best practice indicators
Staff nurses in an ICU setting have noticed that their patients required lower and fewer doses of analgesia when noise levels on the unit were consciously reduced. They informed an advanced practice RN of this and asked the APRN to quantify the effects of noise on the pain levels of hospitalized patients. How does this demonstrate a role of the APRN? A) Involving patients in their care while hospitalized B) Contributing to the scientific basis of nursing practice C) Critiquing the quality of patient care D) Explaining medical studies to patients and RNs
Contributing to the scientific basis of nursing practice
An elderly female patient has come to the clinic for a scheduled follow-up appointment. The nurse learns from the patients daughter that the patient is not following the instructions she received upon discharge from the hospital last month. What is the most likely factor causing the patient not to adhere to her therapeutic regimen? A) Ethnic background of health care provider B) Costs of the prescribed regimen C) Presence of a learning disability D) Personality of the physician
Costs of the prescribed regimen
A nurse is aware that an increasing emphasis is being placed on health, health promotion, wellness, and self-care. Which of the following activities would best demonstrate the principles of health promotion? A) A discharge planning initiative between acute care and community care nurses B) Collaboration between several schools of nursing in an urban area C) Creation of a smoking prevention program undertaken in a middle school D) Establishment of a website where patients can check emergency department wait-times
Creation of a smoking prevention program undertaken in a middle school
A nurse is working with a teenage boy who was recently diagnosed with asthma. During the current session, the nurse has taught the boy how to administer his bronchodilator by metered-dose inhaler. How should the nurse evaluate the teaching learning process? A) Ask the boy specific questions about his medication. B) Ask the boy whether he now understands how to use his inhaler. C) Directly observe the boy using his inhaler to give himself a dose. D) Assess the boys respiratory health at the next scheduled visit.
Directly observe the boy using his inhaler to give himself a dose.
A parish nurse is describing the relationships between health and physical fitness to a group of older adults who all attend the same church. What potential benefits of a regular exercise program should the nurse describe? Select all that apply. A) Decreased cholesterol levels B) Delayed degenerative changes C) Improved sensory function D) Improved overall muscle strength E) Increased blood sugar levels
Decreased cholesterol levels Delayed degenerative changes Improved overall muscle strength
A gerontologic nurse has observed that patients often fail to adhere to a therapeutic regimen. What strategy should the nurse adopt to best assist an older adult in adhering to a therapeutic regimen involving wound care? A) Demonstrate a dressing change and allow the patient to practice. B) Provide a detailed pamphlet on a dressing change. C) Verbally instruct the patient how to change a dressing and check for comprehension. D) Delegate the dressing change to a trusted family member.
Demonstrate a dressing change and allow the patient to practice.
You are the nurse planning to teach tracheostomy care to a patient who will be discharged home following a spinal cord injury. When preparing your teaching, which of the following is the most important component of your teaching plan? A) Citing the evidence that underlies each of your teaching points B) Alleviating the patients guilt associated with not knowing appropriate self-care C) Determining the patients readiness to learn new information D) Including your nursing colleagues in the planning process
Determining the patients readiness to learn new information
As the nurse working in a gerontology clinic, you know that some elderly people do not adhere to therapeutic regimens because of chronic illnesses that require long-term treatment by several health care providers. What is the most important consideration when dealing with this segment of the population? A) Health care professionals must know all the dietary supplements the patient is taking. B) Health care professionals must work together to provide coordinated care. C) Health care professionals may negate the efforts of another health care provider. D) Health care professionals must have a peer witness their interactions with the patient.
Health care professionals must work together to provide coordinated care.
Positive patient outcomes are the ultimate goal of nurse patient interactions, regardless of the particular setting. Which of the following factors has the most direct influence on positive patient-care outcomes? A) Patients age B) Patients ethnic heritage C) Health education D) Outcome evaluation
Health education
A nursing student is collaborating with a public health nurse on a local health promotion initiative and they recognize the need for a common understanding of health. How should the student and the nurse best define health? A) Health is an outcome systematically maximizing wellness. B) Health is a state that is characterized by a lack of disease. C) Health is a condition that enables people to function at their optimal potential. D) Health is deliberate attempt to mitigate the effects of disease.
Health is a condition that enables people to function at their optimal potential.
The public health nurse is presenting a health promotion class to a group of new mothers. How should the nurse best define health? A) Health is being disease free. B) Health is having fulfillment in all domains of life. C) Health is having psychological and physiological harmony. D) Health is being connected in body, mind, and spirit.
Health is being connected in body, mind, and spirit.
A nurse is planning an educational event for a local group of citizens who live with a variety of physical and cognitive disabilities. What variable should the nurse prioritize when planning this event? A) Health-promotion needs of the group B) Relationships between participants and caregivers C) Wellness state of each individual D) Learning needs of caregivers
Health-promotion needs of the group
A nurse has accepted a position as a clinical nurse leader (CNL), a new role that has been launched within the past decade. In this role, the nurse should prioritize which of the following activities? A) Acting as a spokesperson for the nursing profession B) Generating and disseminating new nursing knowledge C) Diagnosing and treating health problems that have a predictable course D) Helping patients to navigate the health care system
Helping patients to navigate the health care system
A nurse on a postsurgical unit is providing care based on a clinical pathway. When performing assessments and interventions with the aid of a pathway, the nurse should prioritize what goal? A) Helping the patient to achieve specific outcomes B) Balancing risks and benefits of interventions C) Documenting the patients response to therapy D) Staying accountable to the interdisciplinary team
Helping the patient to achieve specific outcomes
A group of nursing students are participating in a community health clinic. When providing care in this context, what should the students teach participants about disease prevention? A) It is best achieved through attending self-help groups. B) It is best achieved by reducing psychological stress. C) It is best achieved by being an active participant in the community. D) It is best achieved by exhibiting behaviors that promote health.
It is best achieved by exhibiting behaviors that promote health.
The nurse is assessing a patient and learns that the patient and his wife were married just 3 weeks earlier. Which of the following statements should underlie the nurses care planning for this patient? A) The patient and spouse should seek counseling to ease their transition. B) The patient will have better coping skills being in a stable relationship. C) Happy events do not normally cause stress. D) Marriage causes transition, which has the potential to cause stress.
Marriage causes transition, which has the potential to cause stress.
The nurse is planning to teach a 75-year-old patient with coronary artery disease about administering her prescribed antiplatelet medication. How can the nurse best enhance the patients ability to learn? A) Provide links to Web sites that contain evidence-based information. B) Exclude family members from the session to prevent distraction. C) Use color-coded materials that are succinct and engaging. D) Make the information directly relevant to the patients condition.
Make the information directly relevant to the patients condition.
A public health nurse has been commissioned to draft a health promotion program that meets the health care needs and expectations of the community. Which of the following focuses is most likely to influence the nurses choice of interventions? A) Management of chronic conditions and disability B) Increasing need for self-care among a younger population C) A shifting focus to disease management D) An increasing focus on acute conditions and rehabilitation
Management of chronic conditions and disability
With increases in longevity, people have had to become more knowledgeable about their health and the professional health care that they receive. One outcome of this phenomenon is the development of organized self-care education programs. Which of the following do these programs prioritize? A) Adequate prenatal care B) Government advocacy and lobbying C) Judicious use of online communities D) Management of illness
Management of illness
CNPs are educated as specialists in areas such as family care, pediatrics, or geriatrics. In most states, what right do CNPs have that RNs do not possess? A) Perform health interventions independently B) Make referrals to members of other health disciplines C) Prescribe medications D) Perform surgery independently
Prescribe medications
The nurse is teaching a local community group about the importance of disease prevention. Why is the nurse justified in emphasizing disease prevention as a component of health promotion? A) Prevention is emphasized as the link between personal behavior and health. B) Most Americans die of preventable causes. C) Health maintenance organizations (HMOs) now emphasize prevention as the main criterion of health care. D) External environment affects the outcome of most disease processes.
Prevention is emphasized as the link between personal behavior and health.
A nurse has been studying research that examines the association between stress levels and negative health outcomes. Which relationship should underlie the educational interventions that the nurse chooses to teach? A) Stress impairs sleep patterns. B) Stress decreases immune function. C) Stress increases weight. D) Stress decreases concentration.
Stress decreases immune function.
The nurse is with a patient who has learned that he has glioblastoma multiforme, a brain tumor associated with an exceptionally poor prognosis. His heart rate increases, his eyes dilate, and his blood pressure increases. The nurse recognizes these changes as being attributable to what response? A) Part of the limbic system response B) Sympathetic nervous response C) Hypothalamic-pituitary response D) Local adaptation syndrome
Sympathetic nervous response
An occupational health nurse is in the planning stages of a new health promotion campaign in the workplace. When appraising the potential benefits of the program, the nurse should consider that success depends primarily on what quality in the participants? A) Desire to expand knowledge B) Self-awareness C) Adequate time- and task-management D) Taking responsibility for oneself
Taking responsibility for oneself
You are the nurse caring for a 72-year-old woman who is recovering from a hemicolectomy on the postsurgical unit. The surgery was very stressful and prolonged, and you note on the chart that her blood sugars are elevated, yet diabetes does not appear in her previous medical history. To what do you attribute this elevation in blood sugars? A) It is a temporary result of increased secretion of antidiuretic hormone. B) She must have had diabetes prior to surgery that was undiagnosed. C) She has suffered pancreatic trauma during her abdominal surgery. D) The blood sugars are probably a result of the fight-or-flight reaction.
The blood sugars are probably a result of the fight-or-flight reaction.
A patient tells the nurse that she does not like to go to the doctor and is feeling anxious about being in this place. When the nurse checks her blood pressure, it is elevated along with her heart rate. The nurse rechecks her blood pressure about 10 minutes later and it is normal. The patient asks the nurse if she should be concerned that she may have hypertension. What statement should guide the nurses response? A) She should not worry; it was stress related and her regular blood pressure is good. B) The first blood pressure was part of a simple stress response; our long-term blood pressure is controlled by negative feedback systems. C) Blood pressure is only one measure of hypertension; she should review this with the doctor and plan to recheck it on a regular basis. D) The respiratory infection is the probably the cause of the elevated blood pressure, and, with treatment, her blood pressure should remain normal.
The first blood pressure was part of a simple stress response; our long-term blood pressure is controlled by negative feedback systems.
Nursing is, by necessity, a flexible profession. It has adapted to meet both the expectations and the changing health needs of our aging population. What is one factor that has impacted the need for certified nurse practitioners (CNPs)? A) The increased need for primary care providers B) The need to improve patient diagnostic services C) The push to drive institutional excellence D) The need to decrease the number of medical errors
The increased need for primary care providers
The nurse at the student health center is seeing a group of students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What will be included in the nurses intervention? A) The use of progressive tensing and relaxing of muscles to release tension in each muscle group B) Using a positive self-image to increase and intensify physical exercise, which decreases stress C) The mindful use of a word, phrase, or visual, which allows oneself to be distracted and temporarily escape from stressful situations D) The use of music and humor to create a calm and relaxed demeanor, which allows escape from stressful situations
The mindful use of a word, phrase, or visual, which allows oneself to be distracted and temporarily escape from stressful situations
Over the past several decades, nursing roles have changed and expanded in many ways. Which of the following factors has provided the strongest impetus for this change? A) The need to decrease the cost of health care B) The need to improve the quality of nursing education C) The need to increase the number of nursing jobs available D) The need to increase the public perception of nursing
The need to decrease the cost of health care
Nursing continues to recognize and participate in collaboration with other health care disciplines to meet the complex needs of the patient. Which of the following is the best example of a collaborative practice model? A) The nurse and the physician jointly making clinical decisions. B) The nurse accompanying the physician on rounds. C) The nurse making a referral on behalf of the patient. D) The nurse attending an appointment with the patient.
The nurse and the physician jointly making clinical decisions.
You are the clinic nurse providing patient education to a teenage girl who was diagnosed 6 months ago with type 1 diabetes. Her hemoglobin A1C results suggest she has not been adhering to her prescribed treatment regimen. As the nurse, what variables do you need to assess to help this patient better adhere to her treatment regimen? Select all that apply. A) Variables that affect the patients ability to obtain resources B) Variables that affect the patients ability to teach her friends about diabetes C) Variables that affect the patients ability to cure her disease D) Variables that affect the patients ability to maintain a healthy social environment E) Variables that affect the patients ability to adopt specific behaviors
Variables that affect the patients ability to obtain resources Variables that affect the patients ability to maintain a healthy social environment Variables that affect the patients ability to adopt specific behaviors
