1
NUR55T FINAL EXAM REVIEW EVIDENCE-BASED
PRACTICE AND ETHICAL NURSING ISSUES
THEORETICAL AND CONCEPTUAL FOUNDATIONS
OF NURSING 2026-27 VERSION
1. A nurse using Roy’s Adaptation Model identifies that a patient has withdrawn from family
activities after a new diagnosis of heart failure. This withdrawn behavior is best classified
as:
A. An adaptive response
B. An ineffective response
C. A focal stimulus
D. A contextual stimulus
Answer: B. An ineffective response
Rationale: Withdrawal that neither promotes integrity nor adaptation is an ineffective
behavior per Roy. (A is wrong — adaptive would promote integrity; C/D are types of
stimuli, not behaviors.)
2. A nurse documents that a patient’s anxiety increased immediately after being told of a
new diagnosis. According to Roy, this immediate source that precipitated the behavior is
called:
A. Residual stimulus
B. Contextual stimulus
C. Focal stimulus
D. Adaptive stimulus
Answer: C. Focal stimulus
Rationale: The focal stimulus is the internal/external stimulus immediately confronting a
person and provoking the response (the diagnosis). (A is wrong — residual is unclear
influence; B is wrong — contextual are other contributing stimuli; D is not a Roy stimulus
type.)
Objective: Differentiate adaptive vs ineffective responses
3. A patient recovering from stroke consistently performs daily exercises and verbalizes
motivation to regain independence. The nurse observes poor posture and difficulty
swallowing. According to Roy’s model, which describes adaptive vs ineffective responses?
A. Exercises is ineffective and poor posture is adaptive
B. Exercises is adaptive and poor posture is ineffective
C. Verbal motivation is ineffective, and difficulty swallowing is adaptive
D. Both adaptive
,2
Answer: B
Rationale: Adaptive responses promote health and integrity (exercises), while ineffective
responses do not contribute to adaptation (poor posture, swallowing difficulty).
4. A nurse is assessing a patient admitted with acute abdominal pain. The patient is
grimacing, guarding their abdomen, and refusing to eat. According to the Roy Adaptation
Model, these observations represent:
A. Adaptive responses during second-level assessment.
B. Ineffective responses during first-level assessment.
C. Focal stimuli during second-level assessment.
D. Contextual stimuli during first-level assessment.
Correct Answer: B
Rationale: The first-level assessment in the Roy Adaptation Model involves observing a
patient's behaviors, which are categorized as either adaptive (promoting integrity) or
ineffective (not promoting integrity). Grimacing, guarding, and refusing to eat are
observable behaviors indicating an ineffective response to the pain.
Objective Covered: Identify Roy 1st level and 2nd level assessment; Describe difference
between adaptive response and ineffective response
Chapter: Roy Adaptation Model
5. A patient with chronic obstructive pulmonary disease (COPD) expresses frustration about
their inability to perform daily activities without becoming short of breath. This frustration
significantly impacts their self-esteem. This primarily reflects an issue within which
adaptive mode of the Roy Adaptation Model?
A. Physiological Mode
B. Self-Concept Mode
C. Role Function Mode
D. Interdependence Mode
Correct Answer: B
Rationale: The Self-Concept Mode focuses on a person's beliefs and feelings about
themselves, including their physical self and moral-ethical-spiritual self. Feelings of
frustration and impact on self-esteem due to physical limitations directly relate to this
mode.
Objective Covered: Differentiates the human adaptive modes /system defined by the Roy
Adaptation Model.
Chapter: Roy Adaptation Model
6. A patient is recovering from a severe burn injury. While the burn itself is the focal
stimulus, the patient's concerns about body image, prolonged hospitalization, and potential
job loss are considered:
A. Residual stimuli
B. Intrinsic stimuli
, 3
C. Contextual stimuli
D. Extraneous stimuli
Correct Answer: C
Rationale: Contextual stimuli are all other stimuli present in the situation that contribute to
the effect of the focal stimulus. Body image concerns, hospitalization, and job loss are
influencing factors surrounding the burn injury.
Objective Covered: Explain the 3 forms of stimuli.
Chapter: Roy Adaptation Model
7. A nurse is developing a nursing diagnosis using the Roy Adaptation Model. For a patient
with newly diagnosed diabetes, which option correctly formats the diagnosis according to
the model's principles?
A. Impaired Glucose Regulation as evidenced by high blood sugar.
B. Ineffective Coping related to newly diagnosed diabetes as evidenced by verbalized fear
and non-adherence to diet.
C. Diabetes Mellitus Type 2 as the primary diagnosis.
D. Risk for Infection due to compromised immune system.
Correct Answer: B
Rationale: A Roy-based nursing diagnosis often links an ineffective response (e.g.,
Ineffective Coping) to the identified stimuli/causes (e.g., newly diagnosed diabetes – a focal
stimulus), as evidenced by observable behaviors (first-level assessment data, e.g.,
verbalized fear, non-adherence). This aligns with the model's structure of stimuli/etiology
as evidenced by behavior.
Objective Covered: Explain the rationale for the nurse’s behavior of identifying the causes
of the patient’s “ineffective behavior” according to the Roy Adaptation Model.
Chapter: Roy Adaptation Model
8. A nurse is performing a second-level assessment for a patient struggling with chronic
insomnia. The patient mentions various stressors but also states, "I've always had trouble
sleeping, even as a child, though I'm not sure why." This long-standing, vaguely understood
factor is an example of a/an:
A. Focal stimulus.
B. Contextual stimulus.
C. Residual stimulus.
D. Primary stimulus.
Correct Answer: C
Rationale: Residual stimuli are factors whose effects in the current situation are unclear or
have an indeterminate effect. A long-standing, unexplainable sleep issue fits this
description.
Objective Covered: Explain the 3 forms of stimuli.; Identify Roy 1st level and 2nd level
assessment
Chapter: Roy Adaptation Model
NUR55T FINAL EXAM REVIEW EVIDENCE-BASED
PRACTICE AND ETHICAL NURSING ISSUES
THEORETICAL AND CONCEPTUAL FOUNDATIONS
OF NURSING 2026-27 VERSION
1. A nurse using Roy’s Adaptation Model identifies that a patient has withdrawn from family
activities after a new diagnosis of heart failure. This withdrawn behavior is best classified
as:
A. An adaptive response
B. An ineffective response
C. A focal stimulus
D. A contextual stimulus
Answer: B. An ineffective response
Rationale: Withdrawal that neither promotes integrity nor adaptation is an ineffective
behavior per Roy. (A is wrong — adaptive would promote integrity; C/D are types of
stimuli, not behaviors.)
2. A nurse documents that a patient’s anxiety increased immediately after being told of a
new diagnosis. According to Roy, this immediate source that precipitated the behavior is
called:
A. Residual stimulus
B. Contextual stimulus
C. Focal stimulus
D. Adaptive stimulus
Answer: C. Focal stimulus
Rationale: The focal stimulus is the internal/external stimulus immediately confronting a
person and provoking the response (the diagnosis). (A is wrong — residual is unclear
influence; B is wrong — contextual are other contributing stimuli; D is not a Roy stimulus
type.)
Objective: Differentiate adaptive vs ineffective responses
3. A patient recovering from stroke consistently performs daily exercises and verbalizes
motivation to regain independence. The nurse observes poor posture and difficulty
swallowing. According to Roy’s model, which describes adaptive vs ineffective responses?
A. Exercises is ineffective and poor posture is adaptive
B. Exercises is adaptive and poor posture is ineffective
C. Verbal motivation is ineffective, and difficulty swallowing is adaptive
D. Both adaptive
,2
Answer: B
Rationale: Adaptive responses promote health and integrity (exercises), while ineffective
responses do not contribute to adaptation (poor posture, swallowing difficulty).
4. A nurse is assessing a patient admitted with acute abdominal pain. The patient is
grimacing, guarding their abdomen, and refusing to eat. According to the Roy Adaptation
Model, these observations represent:
A. Adaptive responses during second-level assessment.
B. Ineffective responses during first-level assessment.
C. Focal stimuli during second-level assessment.
D. Contextual stimuli during first-level assessment.
Correct Answer: B
Rationale: The first-level assessment in the Roy Adaptation Model involves observing a
patient's behaviors, which are categorized as either adaptive (promoting integrity) or
ineffective (not promoting integrity). Grimacing, guarding, and refusing to eat are
observable behaviors indicating an ineffective response to the pain.
Objective Covered: Identify Roy 1st level and 2nd level assessment; Describe difference
between adaptive response and ineffective response
Chapter: Roy Adaptation Model
5. A patient with chronic obstructive pulmonary disease (COPD) expresses frustration about
their inability to perform daily activities without becoming short of breath. This frustration
significantly impacts their self-esteem. This primarily reflects an issue within which
adaptive mode of the Roy Adaptation Model?
A. Physiological Mode
B. Self-Concept Mode
C. Role Function Mode
D. Interdependence Mode
Correct Answer: B
Rationale: The Self-Concept Mode focuses on a person's beliefs and feelings about
themselves, including their physical self and moral-ethical-spiritual self. Feelings of
frustration and impact on self-esteem due to physical limitations directly relate to this
mode.
Objective Covered: Differentiates the human adaptive modes /system defined by the Roy
Adaptation Model.
Chapter: Roy Adaptation Model
6. A patient is recovering from a severe burn injury. While the burn itself is the focal
stimulus, the patient's concerns about body image, prolonged hospitalization, and potential
job loss are considered:
A. Residual stimuli
B. Intrinsic stimuli
, 3
C. Contextual stimuli
D. Extraneous stimuli
Correct Answer: C
Rationale: Contextual stimuli are all other stimuli present in the situation that contribute to
the effect of the focal stimulus. Body image concerns, hospitalization, and job loss are
influencing factors surrounding the burn injury.
Objective Covered: Explain the 3 forms of stimuli.
Chapter: Roy Adaptation Model
7. A nurse is developing a nursing diagnosis using the Roy Adaptation Model. For a patient
with newly diagnosed diabetes, which option correctly formats the diagnosis according to
the model's principles?
A. Impaired Glucose Regulation as evidenced by high blood sugar.
B. Ineffective Coping related to newly diagnosed diabetes as evidenced by verbalized fear
and non-adherence to diet.
C. Diabetes Mellitus Type 2 as the primary diagnosis.
D. Risk for Infection due to compromised immune system.
Correct Answer: B
Rationale: A Roy-based nursing diagnosis often links an ineffective response (e.g.,
Ineffective Coping) to the identified stimuli/causes (e.g., newly diagnosed diabetes – a focal
stimulus), as evidenced by observable behaviors (first-level assessment data, e.g.,
verbalized fear, non-adherence). This aligns with the model's structure of stimuli/etiology
as evidenced by behavior.
Objective Covered: Explain the rationale for the nurse’s behavior of identifying the causes
of the patient’s “ineffective behavior” according to the Roy Adaptation Model.
Chapter: Roy Adaptation Model
8. A nurse is performing a second-level assessment for a patient struggling with chronic
insomnia. The patient mentions various stressors but also states, "I've always had trouble
sleeping, even as a child, though I'm not sure why." This long-standing, vaguely understood
factor is an example of a/an:
A. Focal stimulus.
B. Contextual stimulus.
C. Residual stimulus.
D. Primary stimulus.
Correct Answer: C
Rationale: Residual stimuli are factors whose effects in the current situation are unclear or
have an indeterminate effect. A long-standing, unexplainable sleep issue fits this
description.
Objective Covered: Explain the 3 forms of stimuli.; Identify Roy 1st level and 2nd level
assessment
Chapter: Roy Adaptation Model
