HUMAN CASE STUDY FINAL PAPER 2026
QUESTIONS WITH ANSWERS DETAILED
SOLUTION FILE
▶ The Institute for Healthcare Improvement (IHI) identified interventions to save client
lives. Which actions are within the scope of nursing practice to improve quality of care?
A) Prescribe aspirin for a client who presents with an acute myocardial infarction
B) Insert a central line to give intravenous fluid to a dehydrated client.
C) Use sterile technique when changing dressings on a new surgical site.
D) Intubate a client whose oxygen saturation is 92%. Answer: C
The only intervention identified within the scope of nursing practice is to use sterile
technique. Central line insertion, intubation, and prescription are functions of the
physician.
▶ Which is most indicative of pain in an older client who is confused? (Select all that
apply).
A) Screaming
B) Decreased blood pressure
C) Crying
D) Decreased respirations
E) Facial grimace
F) Restlessness Answer: A,C,E,F
No one scale has been found to be the best tool to use in pain assessment for adults
with cognitive impairment. Facial expression, motor behavior, mood, socialization, and
vocalization are common indicators of pain in cognitively impaired adults. In acute pain,
nonverbal indicators of pain could include increased blood pressure and respirations.
▶ The nursery nurse identifies a newborn at significant risk for hypothermic alteration in
thermoregulation because the patient is:
A) large for gestational age.
B) well nourished.
C) born at term.
D) low birth weight. Answer: D
Low birth weight and poorly nourished infants (particularly premature infants) and
children are at greatest risk for hypothermia. A large for gestational age infant would not
be malnourished. An infant born at term is not considered at significant risk. A well
nourished infant is not at significant risk.
,▶ The nurse is assessing a patient's functional ability. Which activities most closely
match the definition of functional ability?
A) Healthy individual, college educated, travels frequently, can balance a checkbook
B) Healthy individual, works out, reads well, cooks and cleans house
C) Healthy individual, volunteers at church, works part time, takes care of family and
house
D) Healthy individual, works outside the home, uses a cane, well groomed Answer: C
Functional ability refers to the individual's ability to perform the normal daily activities
required to meet basic needs; fulfill usual roles in the family, workplace, and community;
and maintain health and well-being. The other options are good; however, each option
has advanced or independent activities in the context of the option.
▶ Which action demonstrates that the nurse understands the purpose of the Rapid
Response Team?
A) Documenting all changes observed in the client and maintaining a postoperative flow
sheet
B) Monitoring the client for changes in postoperative status such as wound infection
C) Notifying the physician of the client's change in blood pressure from 140 to 88 mm
Hg systolic
D) Notifying the physician of the client's increase in restlessness after medication
change Answer: C
The Rapid Response Team (RRT) saves lives and decreases the risk for harm by
providing care to clients before a respiratory or cardiac arrest occurs. Although the RRT
does not replace the Code Team, which responds to client arrests, it intervenes rapidly
for those who are beginning to decline clinically. It would be appropriate for the RRT to
intervene when the client has experienced a 52-point drop in blood pressure. Monitoring
the client's postoperative status, maintaining a postoperative flow sheet, and notifying
the physician of a change in the client's status after a medication change would not be
considered activities of the Rapid Response Team.
▶ An older client just returned from surgery and is rating pain as "8" on a 0 to 10 scale.
Which medications are unsafe choices for treatment of severe pain in this older adult?
(Select all that apply.)
A) Morphine (Durmorph)
B) Meperidine (Demerol)
C) Propoxyphene (Darvocet)
D) Methadone (Dolophine)
E) Codeine Answer: B,C,D,E
,Meperidine, propoxyphene, and codeine are not recommended for older clients
because toxic metabolites may accumulate. Codeine may cause constipation as well.
Methadone has an extremely long half-life (24 to 36 hours) and has a high potential for
sedation and respiratory depression. Morphine is considered the gold standard and may
be used in the older adult while monitoring for sedation and respiratory depression is
conducted.
▶ An emergency department (ED) nurse gives report on a client who is being
transferred to the medical-surgical floor. Because of an identified risk for suicide, the ED
nurse suggests that the floor nurse contact a sitter and behavioral health. This
statement represents which part of the SBAR hand-off?
A) Situation
B) Recommendation
C) Background
D) Assessment Answer: B
The ED nurse is giving recommendations to the medical-surgical floor nurse about
interventions to start for the client who is being transferred. No communication is
provided in the SBAR report about the situation, background, or assessment.
▶ Understanding classifications of pain helps nurses develop a plan of care. A 62-year-
old male has fallen while trimming tree branches sustaining tissue injury. He describes
his condition as an aching, throbbing back. This is characteristic of:
A) mixed pain syndrome.
B) chronic pain.
C) neuropathic pain.
D) nociceptive pain. Answer: D
Nociceptive pain refers to the normal functioning of physiological systems that leads to
the perception of noxious stimuli (tissue injury) as being painful. Patients describe this
type of pain as aching, cramping, or throbbing. Neuropathic pain is pathologic and
results from abnormal processing of sensory input by the nervous system as a result of
damage to the brain, spinal cord, or peripheral nerves. Patients describe this type of
pain as burning, sharp, and shooting. Chronic pain is constant and unrelenting such as
pain associated with cancer. Mixed pain syndrome is not easily recognized, is unique
with multiple underlying and poorly understood mechanisms like fibromyalgia and low
back pain.
▶ The new nurse is caring for a client with a high temperature. Which action should the
nurse perform FIRST?
A) Obtaining a fan from central supply for the client's room
B) Monitoring the client's temperature more often than ordered
C) Sponging the client while monitoring for shivering
, D) Apply cool packs to the client's axillae and groin Answer: D
The use of fans is discouraged to promote cooling in a febrile client because the fan can
disperse pathogens. The other actions are appropriate.
▶ A patient has been newly diagnosed with hypertension. The nurse assesses the need
to develop a collaborative plan of care that includes a goal of adhering to the prescribed
regimen. When the nurse is planning teaching for the patient, which is the most
important initial learning goal?
A) The patient will demonstrate coping skills needed to manage hypertension.
B) The patient will verbalize the side effects of treatment.
C) The patient will select the type of learning materials they prefer.
D) The patient will verbalize an understanding of the importance of following the
regimen. Answer: C
Adults learn best when given information they can understand that is tailored to their
learning styles and needs. Verbalizing an understanding is important; however, the
nurse will first need to teach the patient.
▶ When reviewing the purposes of a family assessment, the nurse educator would
identify a need for further teaching if the student responded that family assessment is
used to gain an understanding of the family.
A) development.
B) function.
C) structure.
D) political views. Answer: D
An understanding of the political views of family members is not a primary purpose of a
family assessment. A family assessment provides the nurse with information and an
understanding of family dynamics. This is important to nurses for the provision of quality
health care. A family assessment provides an understanding of family development,
function, and structure.
▶ The client was given 15 mg of morphine IM for postsurgical pain. When the nurse
checks the client for pain relief 1 hour later, the client is sleeping and has a respiratory
rate of 10 breaths/min. What is the nurse's first action?
A) Administering oxygen by nasal cannula
B) Documenting the findings and continuing to monitor
C) Arousing the client by calling his or her name
D) Administering naloxone (Narcan) IV push Answer: C
QUESTIONS WITH ANSWERS DETAILED
SOLUTION FILE
▶ The Institute for Healthcare Improvement (IHI) identified interventions to save client
lives. Which actions are within the scope of nursing practice to improve quality of care?
A) Prescribe aspirin for a client who presents with an acute myocardial infarction
B) Insert a central line to give intravenous fluid to a dehydrated client.
C) Use sterile technique when changing dressings on a new surgical site.
D) Intubate a client whose oxygen saturation is 92%. Answer: C
The only intervention identified within the scope of nursing practice is to use sterile
technique. Central line insertion, intubation, and prescription are functions of the
physician.
▶ Which is most indicative of pain in an older client who is confused? (Select all that
apply).
A) Screaming
B) Decreased blood pressure
C) Crying
D) Decreased respirations
E) Facial grimace
F) Restlessness Answer: A,C,E,F
No one scale has been found to be the best tool to use in pain assessment for adults
with cognitive impairment. Facial expression, motor behavior, mood, socialization, and
vocalization are common indicators of pain in cognitively impaired adults. In acute pain,
nonverbal indicators of pain could include increased blood pressure and respirations.
▶ The nursery nurse identifies a newborn at significant risk for hypothermic alteration in
thermoregulation because the patient is:
A) large for gestational age.
B) well nourished.
C) born at term.
D) low birth weight. Answer: D
Low birth weight and poorly nourished infants (particularly premature infants) and
children are at greatest risk for hypothermia. A large for gestational age infant would not
be malnourished. An infant born at term is not considered at significant risk. A well
nourished infant is not at significant risk.
,▶ The nurse is assessing a patient's functional ability. Which activities most closely
match the definition of functional ability?
A) Healthy individual, college educated, travels frequently, can balance a checkbook
B) Healthy individual, works out, reads well, cooks and cleans house
C) Healthy individual, volunteers at church, works part time, takes care of family and
house
D) Healthy individual, works outside the home, uses a cane, well groomed Answer: C
Functional ability refers to the individual's ability to perform the normal daily activities
required to meet basic needs; fulfill usual roles in the family, workplace, and community;
and maintain health and well-being. The other options are good; however, each option
has advanced or independent activities in the context of the option.
▶ Which action demonstrates that the nurse understands the purpose of the Rapid
Response Team?
A) Documenting all changes observed in the client and maintaining a postoperative flow
sheet
B) Monitoring the client for changes in postoperative status such as wound infection
C) Notifying the physician of the client's change in blood pressure from 140 to 88 mm
Hg systolic
D) Notifying the physician of the client's increase in restlessness after medication
change Answer: C
The Rapid Response Team (RRT) saves lives and decreases the risk for harm by
providing care to clients before a respiratory or cardiac arrest occurs. Although the RRT
does not replace the Code Team, which responds to client arrests, it intervenes rapidly
for those who are beginning to decline clinically. It would be appropriate for the RRT to
intervene when the client has experienced a 52-point drop in blood pressure. Monitoring
the client's postoperative status, maintaining a postoperative flow sheet, and notifying
the physician of a change in the client's status after a medication change would not be
considered activities of the Rapid Response Team.
▶ An older client just returned from surgery and is rating pain as "8" on a 0 to 10 scale.
Which medications are unsafe choices for treatment of severe pain in this older adult?
(Select all that apply.)
A) Morphine (Durmorph)
B) Meperidine (Demerol)
C) Propoxyphene (Darvocet)
D) Methadone (Dolophine)
E) Codeine Answer: B,C,D,E
,Meperidine, propoxyphene, and codeine are not recommended for older clients
because toxic metabolites may accumulate. Codeine may cause constipation as well.
Methadone has an extremely long half-life (24 to 36 hours) and has a high potential for
sedation and respiratory depression. Morphine is considered the gold standard and may
be used in the older adult while monitoring for sedation and respiratory depression is
conducted.
▶ An emergency department (ED) nurse gives report on a client who is being
transferred to the medical-surgical floor. Because of an identified risk for suicide, the ED
nurse suggests that the floor nurse contact a sitter and behavioral health. This
statement represents which part of the SBAR hand-off?
A) Situation
B) Recommendation
C) Background
D) Assessment Answer: B
The ED nurse is giving recommendations to the medical-surgical floor nurse about
interventions to start for the client who is being transferred. No communication is
provided in the SBAR report about the situation, background, or assessment.
▶ Understanding classifications of pain helps nurses develop a plan of care. A 62-year-
old male has fallen while trimming tree branches sustaining tissue injury. He describes
his condition as an aching, throbbing back. This is characteristic of:
A) mixed pain syndrome.
B) chronic pain.
C) neuropathic pain.
D) nociceptive pain. Answer: D
Nociceptive pain refers to the normal functioning of physiological systems that leads to
the perception of noxious stimuli (tissue injury) as being painful. Patients describe this
type of pain as aching, cramping, or throbbing. Neuropathic pain is pathologic and
results from abnormal processing of sensory input by the nervous system as a result of
damage to the brain, spinal cord, or peripheral nerves. Patients describe this type of
pain as burning, sharp, and shooting. Chronic pain is constant and unrelenting such as
pain associated with cancer. Mixed pain syndrome is not easily recognized, is unique
with multiple underlying and poorly understood mechanisms like fibromyalgia and low
back pain.
▶ The new nurse is caring for a client with a high temperature. Which action should the
nurse perform FIRST?
A) Obtaining a fan from central supply for the client's room
B) Monitoring the client's temperature more often than ordered
C) Sponging the client while monitoring for shivering
, D) Apply cool packs to the client's axillae and groin Answer: D
The use of fans is discouraged to promote cooling in a febrile client because the fan can
disperse pathogens. The other actions are appropriate.
▶ A patient has been newly diagnosed with hypertension. The nurse assesses the need
to develop a collaborative plan of care that includes a goal of adhering to the prescribed
regimen. When the nurse is planning teaching for the patient, which is the most
important initial learning goal?
A) The patient will demonstrate coping skills needed to manage hypertension.
B) The patient will verbalize the side effects of treatment.
C) The patient will select the type of learning materials they prefer.
D) The patient will verbalize an understanding of the importance of following the
regimen. Answer: C
Adults learn best when given information they can understand that is tailored to their
learning styles and needs. Verbalizing an understanding is important; however, the
nurse will first need to teach the patient.
▶ When reviewing the purposes of a family assessment, the nurse educator would
identify a need for further teaching if the student responded that family assessment is
used to gain an understanding of the family.
A) development.
B) function.
C) structure.
D) political views. Answer: D
An understanding of the political views of family members is not a primary purpose of a
family assessment. A family assessment provides the nurse with information and an
understanding of family dynamics. This is important to nurses for the provision of quality
health care. A family assessment provides an understanding of family development,
function, and structure.
▶ The client was given 15 mg of morphine IM for postsurgical pain. When the nurse
checks the client for pain relief 1 hour later, the client is sleeping and has a respiratory
rate of 10 breaths/min. What is the nurse's first action?
A) Administering oxygen by nasal cannula
B) Documenting the findings and continuing to monitor
C) Arousing the client by calling his or her name
D) Administering naloxone (Narcan) IV push Answer: C
