Test Bank for Fundamental Concepts & Skills for Nursing 4th Edition by DeWit.

Test-Bank-for-Fundamental-Concepts-Skills-for-Nursing-4th-Edition. Nursing and the Health Care System 1. Florence Nightingale’s contributions to nursing practice and education: a. are historically important but have no validity for nursing today. b. were neither recognized nor appreciated in her own time. c. were a major factor in reducing the death rate in the Crimean War. d. were limited only to the care of severe traumatic wounds. 2. Early nursing education and care in the United States: a. were directed at community health. b. provided independence for women through education and employment. c. were an educational model based in institutions of higher learning. d. have continued to be entirely focused on hospital nursing. 3. In order to fulfill the common goals defined by nursing theorists (promote wellness, prevent illness, facilitate coping, and restore health), the LPN must take on the roles of: a. caregiver, educator, and collaborator. b. nursing assistant, delegator, and environmental specialist. c. medication dispenser, collaborator, and transporter. d. dietitian, manager, and housekeeper. 4. Although nursing theories differ in their attempts to define nursing, all of them base their beliefs on common concepts concerning: a. self-actualization, fundamental needs, and belonging. b. stress reduction, self-care, and a systems model. c. curative care, restorative care, and terminal care. d. human relationships, the environment, and health. 5. Standards of care for the nursing practice of the LPN are established by the: a. Boards of Nursing Examiners in each state. b. National Council of States Boards of Nursing (NCSBN). c. American Nurses Association (ANA). d. National Federation of Licensed Practical Nurses. 6. The LPN demonstrates an evidence-based practice by: a. using a drug manual to check compatibility of drugs. b. using scientific information to guide decision making. c. using medical history of a patient to direct nursing interventions. d. basing nursing care on advice from an experienced nurse. 7. Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New York in 1893 in order to: a. offer a shelter to injured war veterans. b. found a nursing apprenticeship. c. provide health care to poor persons living in tenements. d. offer better housing to low-income families. 8. An educational pathway for an LPN refers to an LPN: a. learning on the job and being promoted to a higher level of responsibility. b. moving from a maternity unit to a more complicated surgical unit. c. obtaining additional education to move from one level of nursing to another. d. learning that advancement requires consistent work and commitment. 9. When diagnosis-related groups (DRGs) were established by Medicare in 1983, the purpose was to: a. put patients with the same diagnosis on the same unit. b. attempt to contain the costs of health care. c. increase availability of medical care to the elderly. d. identify a patient’s condition more quickly. 10. The advent of diagnosis-related groups (DRGs) required that nurses working in health care agencies: a. record supportive documentation to confirm a patient’s need for care in order to qualify for reimbursement. b. use the DRG rather than their own observations for patient assessment. c. be aware of the specific drugs related to the diagnosis. d. acquire cross-training to make staffing more flexible. Chapter 02: Concepts of Health, Illness, Stress, and Health Promotion 1. The nurse is aware that any description of health would include the concept that: a. health is the absence of illness, and illness is the presence of chronic disease. b. culture, education, and socioeconomic status influence one’s definition of health or illness. c. illness is a biologic malfunction, and health is biologic soundness. d. lifestyle factors are the major determinant of health or illness. 2. The nurse takes into consideration that the patient with an admitting diagnosis of type 2 diabetes mellitus and influenza is described as having: a. two chronic illnesses. b. two acute illnesses. c. one chronic and one acute illness. d. one acute and one infectious illness. 3. The nurse explains that an idiopathic disease is one that: a. is caused by inherited characteristics. b. develops suddenly, related to new viruses. c. results from injury during labor or delivery. d. has an unknown cause. 4. The nurse assesses a terminal illness in a: a. 76 year old admitted to a nursing home with Alzheimer’s disease who is pacing and asking to go home. b. 43 year old with Lou Gehrig’s disease who is refusing food and fluid. c. 2 year old child who burned her esophagus by drinking drain cleaner and who is being fed by a tube. d. 52 year old diagnosed with lung cancer who had part of one lung removed and has a closed chest drainage device in place. 5. The nurse clarifies to a patient who now has an abscess following a ruptured appendix that the abscess is considered to be: a. a secondary illness. b. a life threatening complication. c. an expected event following any surgery. d. a disorder easily treated with antibiotics. 6. The nurse uses a diagram to demonstrate how Dunn’s theory of health and illness can be compared with a: a. plant that grows from a seed, blossoms, wilts, and dies. b. continuum, with peak wellness and death at opposite ends; the person moves back and forth in a dynamic state of change. c. ladder; from birth to death the individual moves progressively downward a ladder to eventual death. d. state of mind dependent on the individual perception of their own health or illness. 7. A patient has been advised by the physician to take medication for high cholesterol and to change eating habits after discharge home. The home health nurse discovered that the patient refused to follow the medical and nutritional directions. The nurse’s best initial response to this situation is to: a. emphasize to the patient how important it is to follow the doctor’s advice. b. determine whether any cultural, socioeconomic, or religious values conflict, thus interfering with the patient’s compliance. c. explain that without diet and medication the condition will worsen and serious problems will develop. d. inform the physician that the patient is unable to understand the instructions. 8. A nurse practicing a holistic approach to nursing care must: a. recognize that a change in one aspect of the person’s life can alter the whole of that person’s life. b. take responsibility for health care decisions. c. promote state of the art technology. d. discourage the use of more natural remedies and alternative methods of health care. 9. According to Maslow’s hierarchy, physiological needs are those that: a. nurture intimacy. b. foster independence. c. encourage social interaction. d. are essential to human life. 10. The factors involved in assessing the importance the patient attaches to the relief of a particular deficit include: a. needs that the nurse must assess to prioritize care, because they may be different from person to person. b. ordering needs according to Maslow’s hierarchy, with lower level needs being least compelling. c. needs based on a hierarchy in which higher level needs are more prominent and demand attention before lower level needs. d. needs that are usually not known to the patient and that must be determined by the nurse. Chapter 03: Legal and Ethical Aspects of Nursing 1. A student nurse who is not yet licensed: a. may not perform nursing actions until he or she has passed the licensing examination. b. is not responsible for his or her actions as a student under the state licensing law. c. may perform nursing actions only under the supervision of a licensed nurse. d. must apply for a temporary student nurse permit to practice as a student. 2. During an employment interview, the interviewer asks the nurse applicant about HIV status. The nurse applicant can legally respond: a. “No,” even though he or she has a positive HIV test. b. “I don’t know, but I would be willing to be tested.” c. “I don’t know, and I refuse to be tested.” d. “You do not have a right to ask me that question.” 3. An example of a violation of criminal law by a nurse is: a. taking a controlled substance from agency supply for personal use. b. accidentally administering a drug to the wrong patient, who then has a serious reaction. c. advising a patient to sue the doctor for a supposed mistake the doctor made. d. writing a letter to the newspaper outlining questionable or unsafe hospital practices. 4. The LPN (LVN) assigns part of the care for her patients to a nursing assistant. The LPN is legally required to perform which of the following for the residents assigned to the assistant? a. Toilet the residents every 2 hours and as needed. b. Feed breakfast to one of the residents who needs assistance. c. Give medications to the residents at the prescribed times. d. Transport the residents to the physical therapy department. 5. If a nurse is reported to a state board of nursing for repeatedly making medication errors, it is most likely that: a. the nurse will immediately have his or her license revoked. b. the nurse will have to take the licensing examination again. c. a course in legal aspects of nursing care will be required. d. there will be a hearing to determine whether the charges are true. 6. A nurse co-worker arrives at work 30 minutes late, smelling strongly of alcohol. The fellow nurses’ legal course of action is to: a. have the nurse lie down in the nurses’ lounge and sleep while others do the work. b. state that, if this happens again, it will be reported. c. report the condition of the nurse to the nursing supervisor. d. offer a breath mint and instruct the nurse co-worker to work. 7. When a student nurse performs a nursing skill, it is expected that the student: a. perform the skill as quickly as the licensed nurse. b. achieve the same result as the licensed nurse. c. not be held to the same standard as the licensed nurse. d. always be directly supervised by an instructor. 8. If a nurse receives unwelcome sexual advances from a nursing supervisor, the first step the nurse should take is to: a. send an anonymous letter to the nursing administration to alert them to the situation. b. tell the nursing supervisor that she is uncomfortable with the sexual advances and ask the supervisor to refrain from this behavior. c. report the nursing supervisor to the state board for nursing. d. resign and seek employment in a more comfortable environment. 9. A person who has been brought to the emergency room after being struck by a car insists on leaving, although the doctor has advised him to be hospitalized overnight. The nurse caring for this patient should: a. have him sign a Leave Against Medical Advice (AMA) form. b. tell him that he cannot leave until the doctor releases him. c. immediately begin the process of involuntary committal. d. contact the person’s health care proxy to assist in the decision-making process. 10. The information in a patient’s chart may legally be: a. copied by students for use in school reports or case studies. b. provided to lawyers or insurers without the patient’s permission. c. shared with other health care providers at the patient’s request. d. withheld from the patient, because it is the property of the doctor or agency. Chapter 04: Nursing Process and Critical Thinking 1. The nurse who uses the nursing process will: a. help reduce the obvious signs of discomfort. b. help the patient adhere to the physician’s treatment protocol. c. approach the patient’s disorder in a step-by-step method. d. make all significant nursing care decisions involving patient care. 2. A nurse will arrive at a nursing diagnosis through the nursing process step of: a. planning. b. evaluation. c. research. d. assessment. 3. In the collaborative process of delivering care based on the nursing process, the responsibility of the LPN/LVN is to: a. collect data of health status. b. select a nursing diagnosis. c. organize data to help the RN evaluate patient progress. d. prioritize nursing diagnoses for more effective care. 4. The participants of the planning stage of the nursing process during which the health goals are defined include the: a. RN. b. health team led by the RN. c. health team, the patient, and the patient’s family. d. health team as directed by the physician. 5. When a resident in the nursing home complains of constipation, the nurse performs a digital rectal examination and finds a hard fecal mass. This is an example of: a. implementation. b. nursing diagnosis. c. assessment. d. evaluation. 6. The nurse completing morning assessments on a patient who is sitting up in bed is told by the patient, “I’m having trouble breathing—I can’t seem to get enough air.” The best nursing response is to: a. notify the doctor as soon as he or she comes in later in the morning. b. finish the vital signs for the assigned patients, and then notify the charge nurse. c. reassure the patient, if his blood pressure and pulse are normal. d. notify the charge nurse immediately of the patient’s statement. 7. The order in which the nursing process is approached is: a. planning, assessment, implementation, nursing diagnosis, evaluation. b. nursing diagnosis, evaluation, assessment, implementation, planning. c. assessment, nursing diagnosis, planning, implementation, evaluation. d. evaluation, nursing diagnosis, planning, implementation, assessment. 8. Once the nursing plan has been initiated, the nursing care plan will: a. stay in place until all nursing goals have been met. b. change as the patient’s condition changes. c. remain on the patient record to show progress. d. be given to the patient for final approval. 9. When a patient states, “I can’t walk very well,” the first problem-solving step would be to: a. consider alternatives such as a wheelchair or walker. b. find out what the problem is, such as weakness or poor balance. c. choose the alternative with the best chance of success. d. consider the outcomes of the choices, such as danger of falling with a walker. 10. A student nurse can begin to develop critical thinking skills by means of: a. working with a more experienced nurse. b. questioning every statement made by instructors to be sure of its correctness. c. memorizing class notes for tests and studying all night for big tests. d. listening attentively and focusing on the speaker’s words and meaning. Chapter 05: Assessment, Nursing Diagnosis, and Planning 1. When the patient complains of nausea and dizziness, the nurse recognizes these complaints as _______ data. a. objective b. medical c. subjective d. adjunct 2. The major goal of the admission interview (usually performed by the RN) is to: a. establish rapport. b. help the patient understand the objectives of care. c. identify the patient’s major complaints. d. initiate nursing care plan forms. 3. An example of a structured format for gathering data that aids in forming a database is: a. North American Nursing Diagnosis Association–International (NANDA-I). b. Maslow’s hierarchy. c. following the information in the history and physical. d. Gordon’s 11 Health Patterns. 4. During the assessment phase of the nursing process, the nurse a. develops a care plan to meet the patient’s nursing needs. b. begins to formulate plans for providing nursing intervention. c. establishes a nursing diagnosis for the nursing care plan. d. gathers, organizes, and documents data in a logical database. 5. After the admission assessment is completed, on subsequent shifts or days, the nurse: a. does not assess the patient again unless the condition changes. b. refers only to the admission assessment during the hospitalization. c. performs a complete physical examination every day. d. assesses the patient briefly in the first hour of the shift. 6. The nurse performing an admission interview on an elderly person should: a. rush through the interview to avoid tiring the patient. b. direct questions to the family rather than the patient. c. allow more time for a response to questions. d. prompt the patient to speed recall. 7. A nursing diagnosis consists of: a. the physician’s medical diagnosis listed as the nursing diagnosis. b. diagnostic labels formulated by the North American Nursing Diagnosis Association–International (NANDA-I). c. the patient’s explanation of his or her “chief complaint” or “current complaint.” d. the results of the nursing assessment without consideration of doctor’s orders. 8. An elderly patient with a medical diagnosis of chronic lung disease has developed pneumonia. She is coughing frequently and expectorating thick, sticky secretions. She is very short of breath, even with oxygen running, and she is exhausted and says she “can’t breathe.” Based on this information, an appropriately worded nursing diagnosis for this patient is a. Airway clearance, ineffective, related to lung secretions as evidenced by cough and shortness of breath. b. Pneumonia, cough, and shortness of breath related to chronic lung disease. c. Difficulty breathing not relieved by oxygen and evidenced by shortness of breath. d. Cough and shortness of breath caused by pneumonia, chronic lung disease, advanced age, and exhaustion. 9. If a patient has several nursing diagnoses, the nurse will first: a. consult with the doctor regarding which diagnosis is most important. b. devise nursing interventions for the most quickly solved problems. c. prioritize the nursing problems according to Maslow’s hierarchy of needs. d. review the patient’s medical prescriptions and other drugs being taken. 10. A patient has a nursing diagnosis of Imbalanced nutrition: less than body requirements, related to mental impairment and decreased intake, as evidenced by increasing confusion and weight loss of more than 30-pounds over the last 6 months. An appropriate short-term goal for this patient is to: a. eat 50% of six small meals each day by the end of 1 week. b. demonstrate progressive weight gain over 6 months. c. eat all of the meals prepared during admission. d. verbalize understanding of caloric needs and intention to eat. Chapter 06: Implementation and Evaluation 1. The nurse is aware that one of the time-flexible tasks to be accomplished would be: a. administering daily insulin 30 minutes before breakfast. b. taking the patient’s vital signs once a day. c. weighing the patient before breakfast. d. monitoring a critical patient’s vital signs every 15 minutes. 2. Prior to the nurse implementing a nursing procedure for a patient, the nurse should initially: a. question the rationale for the procedure. b. perform a physical assessment of the patient. c. check the agency manual for the procedure. d. mentally review the procedure. 3. At the 7:00 AM change-of-shift report, the nurse receives the report that patient A had a sleepless night related to pain and just fell asleep after an increased pain medication administration onehalf hour ago. Patient B, who is scheduled for surgery at 8:30 AM, is also sleeping. How would an organized nurse plan the early morning activities? a. Wake patient A for breakfast. b. Perform time-flexible tasks that can be done while both patients sleep. c. Prep patient B now; allow patient A to sleep. d. Assign a nursing assistant to wake and help feed patient A. 4. Preparing a patient for a diagnostic test, and telling the patient what to expect during and after the test, is considered: a. an independent nursing action. b. the doctor’s responsibility. c. a dependent nursing action that requires the doctor’s authorization. d. an interdependent nursing action. 5. The nurse explains that a multidisciplinary step-by-step approach to patient care is: a. documented in the nursing care plan in the patient’s chart. b. not used often since managed care became part of health care. c. referred to as a clinical pathway and is used instead of a nursing care plan. d. more expensive than the traditional separation of health care services. 6. The nurse documents interventions periodically during the shift in nurses’ notes primarily to: a. validate the number of non-licensed personnel who interact with the patient. b. indicate that the nursing care plan has been implemented. c. briefly summarize activities during the shift. d. confirm that the nursing diagnoses in the care plan are appropriate. 7. The nurse compares actual nursing outcomes to the expected nursing outcomes in order to: a. prepare the patient to be discharged from the facility. b. determine if the patient’s health problems have been treated. c. calculate charges for nursing services during the patient’s hospital stay. d. determine if progress is made or to determine if revisions are needed. 8. The general rule is that the initial care plan for a patient is: a. developed by an RN in an acute care setting. b. used as the basis of care throughout a hospital stay without alteration. c. completed on the day of admission. d. developed by the physician and incorporated into the nursing care. 9. The nurse is aware that the nursing audit is a valuable process used to: a. determine whether a particular patient received the care indicated in the nursing care plan. b. evaluate whether nursing care for a group of patients meets the standards of care in that facility. c. determine the cost of nursing care in the hospital in order to set rates for daily care. d. identify careless or negligent nursing care to protect the facility from lawsuits. 10. The nurse evaluates that the patient has met the outcome of feeding himself independently. The nurse should: a. inactivate the nursing diagnosis from the care plan. b. notify the physician that the patient can now feed himself. c. document the ability to self-feed and mark the nursing diagnosis as resolved. d. inform the RN to document the self-feeding and to cancel the nursing diagnosis. Chapter 07: Documentation of Nursing Care 1. The nurse with a patient who complains of severe pain documents every 15 minutes about the steps taken to try to relieve the pain (without success). The nurse also documents the time and content of two calls made to the patient’s physician requesting that the physician examine the patient for unexpected complications. This documentation by the nurse is likely to: a. cause the physician to come to the attention of the hospital administration. b. be questioned by the nurse’s supervisor for time inefficiency. c. be used against the nurse if a lawsuit results, because it proves the nurse was not able to relieve the pain. d. justify insurance reimbursement for an extended duration of hospitalization for the patient. 2. A patient who is very angry and is leaving the hospital against medical advice (AMA) demands to have the medical chart to take, because it is her personal property. An appropriate response would be: a. “Certainly. This hospital doesn’t need to keep it if you are leaving and will not be returning here.” b. “You are entitled to the information in your chart, but the chart is the property of the hospital. I will see about having a copy made for you.