Chapter 1 Nursing Foundations
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The medical-surgical nurse identifies a clinical practice issue and
wants to determine if there is sufficient evidence to support a change in practice.
Which type of study provides the strongest evidence to support a practice change?
• Randomized control study
• Quasi-experimental study
• Case-control study
• Cohort study
2. The medical-surgical unit recently implemented a patient-centered
care model. Which action implemented by the nurse supports this model?
• Evaluating care
• Assessing needs
• Diagnosing problems
• Providing compassion
3. Which action should the nurse implement when providing patient care in order
to support The Joint
Commission’s (TJC) National Patient Safety Goals (NPSG)?
• Silencing a cardiorespiratory monitor
• Identifying each patient using one source
• Determining patient safety issues upon admission
• Decreasing the amount of pain medication administered
4. Which interprofessional role does the nurse often assume
when providing patient care in an acute care setting?
• Social worker
• Client advocate
• Care coordinator
• Massage therapist
5. The medical-surgical nurse wants to determine if a policy change is needed for
an identified clinical problem.
Which is the first action the nurse should implement?
• Developing a question
• Disseminating the findings
• Conducting a review of the literature
• Evaluating outcomes of practice change
, 6. The nurse is evaluating the level of evidence found during a q q q q q q q q q q q
recent review of the literature. Which evidence carries the lowest level of support
q q q q q q q q q q q q
qfor a practice change?
q q q
• Level IV q
• Level V q
• Level VI q
• Level VII q
7. The nurse is reviewing evidence from a quasi-experimental q q q q q q q q
research study. Which level of evidence should the nurse identify for this
q q q q q q q q q q q q
research study? q
• Level I q
• Level II q
• Level III q
• Level IV q
8. Which level of evidence should the nurse identify when q q q q q q q q q
reviewing evidence from a single descriptive research study?
q q q q q q q
• Level IV q
• Level V q
• Level VI q
• Level VII q
9. Which statement should the nurse make when communicating the “S” in q q q q q q q q q q q
the SBAR approach for effective
q q q q
communication?
• “The patient presented to the emergency department at 0200 with lower left
q q q q q q q q q q q q
abdominal pain.” q
• “The patient rated the pain upon admission as a 9 on a 10-point numeric scale.”
q q q q q q q q q q q q q q
• “The patient has no significant issues in the medical history.”
q q q q q q q q q
• “The patient was given a prescribed opioid analgesic at 0300.”
q q q q q q q q q
10. The staff nurse is communicating with the change nurse about
q q q q q q q q q q
the change of status of the patient. The nurse would begin her
q q q q q q q q q q q q
communication with which statement if correctly using the SBAR format?
q q q q q q q q q
• “The patient’s heartrate is 110.”
q q q q
• “I think this patient needs to be transferred to the critical care unit.”
q q q q q q q q q q q q
• “The patient is a 68-year-old male patient admitted last night.”
q q q q q q q q q
• “The patient is complaining of chest pain.”
q q q q q q
11. Which nursing action exemplifies the Quality and Safety q q q q q q q q
Education for Nursing (QSEN) competency of safety?
q q q q q q
• Advocating for a patient who is experiencing pain q q q q q q q
• Considering the patient’s culture when planning care q q q q q q
• Evaluating patient learning style prior to implementing discharge instructions
q q q q q q q q
• Assessing the right drug prior to administering a prescribed patient medication
q q q q q q q q q q
12. Which type of nursing is the root of all other nursing practice areas?
q q q q q q q q q q q q
• Pediatric nursing q
, • Geriatric nursing q
• Medical-surgical nursing q
• Mental health-psychiatric nursing q q
13. Which did the Nursing Executive Center of The Advisory Board q q q q q q q q q q
identify as an academic-practice gap for new graduate nurses?
q q q q q q q q
• Patient advocacy q
• Patient education q
• Disease pathophysiology q
• Therapeutic communication q
14. Which statement regarding the use of the nursing process in clinical
q q q q q q q q q q q
practice is accurate? q q
• “The nursing process is closely related to clinical decision-making.”
q q q q q q q q
• “The nursing process is used by all members of the interprofessional team to plan
q q q q q q q q q q q q q q
care.”
• “The nursing process has 4 basic steps: assessment, planning,
q q q q q q q q q
implementation, evaluation.” q
• “The nursing process is being replaced by the implementation of evidence-
q q q q q q q q q q
based practice.” q
15. Which is the basis of nursing care practices and protocols? q q q q q q q q q
• Assessment
• Evaluation
• Diagnosis
• Research
16. Which is a common theme regarding patient dissatisfaction related to care
q q q q q q q q q q q
provided in the hospital setting?
q q q q
• Space in hospital rooms q q q
• Medications received to treat pain q q q q
• Time spent with the health-care team
q q q q q
• Poor quality food received from dietary
q q q q q
17. The nurse manager is preparing a medical-surgical unit for The Joint
q q q q q q q q q q
qCommission (TJC) visit With the nurse manager presenting staff education
q q q q q q q q q q
focusing on TJC benchmarks, which of the following topics would be most
q q q q q q q q q q q q
appropriate?
• Implementation of evidence-based practice q q q
• Implementation of patient-centered care q q q
• Implementation of medical asepsis practices q q q q
• Implementation of interprofessional care q q q
18. Which aspect of patient-centered care should the nurse managerq q q q q q q q q
evaluate prior to The Joint Commission site visit for accreditation?
q q q q q q q q q
• Visitation rights q
• Education level of staff q q q
• Fall prevention protocol
q q
• Infection control practices q q
, 19. The medical-surgical nurse is providing patient care. Which circumstance
q q q q q q q q q
would necessitate the nurse q q q
verifying the patient’s identification using at least two sources?
q q q q q q q q
• Prior to delivering a meal tray
q q q q q
• Prior to passive range of motion
q q q q q
• Prior to medication administration
q q q
• Prior to documenting in the medical record
q q q q q q
20. The nurse is providing care to several patients on a medical-
q q q q q q q q q q
surgical unit. Which situation would necessitate the nurse to use SBAR during
q q q q q q q q q q q q
the hand-off process?
q q
• Wound care q
• Discharge to home q q
• Transfer to radiology q q
• Medication q
education Multiple q q
Response
Identify one or more choices that best complete the statement or answer the question.
q q q q q q q q q q q q q
21. The staff nurse is teaching a group of student nurses the situations that
q q q q q q q q q q q q q
necessitate hand-off communication. q q
Which student responses indicate the need for further education related to this
q q q q q q q q q q q q
procedure? Select all that apply. q q q q
• “A hand-off is required prior to administering a medication.”
q q q q q q q q
• “A hand-off is required during change of shift.”
q q q q q q q
• “A hand-off is required for a patient is transferred to the surgical suite.”
q q q q q q q q q q q q
• “A hand-off is required whenever the nurse receives a new patient assignment.”
q q q q q q q q q q q
• “A hand-off is required prior to family visitation.”
q q q q q q q
22. Which actions by the nurse enhance patient safety during q q q q q q q q q
medication administration? Select all that apply. q q q q q
• Answering the call bell while transporting medications for a different patient
q q q q q q q q q q
• Identifying the patient using two sources prior to administering the medication
q q q q q q q q q q
• Holding a medication if the patient’s diagnosis does not support its use
q q q q q q q q q q q
• Administering the medication two hours after the scheduled time q q q q q q q q
• Having another nurse verify the prescribed dose of insulin the patient is to receive
q q q q q q q q q q q q q
23. The medical-surgical nurse assumes care for a patient who
q q q q q q q q
qis receiving continuous cardiopulmonary monitoring. Which actions
q q q q q q q
by the nurse enhance safety for this patient? Select all that apply.
q q q q q q q q q q q
• Silencing the alarm during family visitation q q q q q
• Assessing the alarm parameters at the start of the shift q q q q q q q q q
• Responding to the alarm in a timely fashion q q q q q q q
• Decreasing the alarm volume to enhance restful sleep q q q q q q q
• Adjusting alarm parameters based on specified practitioner prescription
q q q q q q q