final for theory
A patient with diabetes is controlling the disease with insulin and diet. The nursing
health care provider is focusing efforts to teach the patient self-management. Which of
the following nursing theories is useful in promoting self management? Select all that
apply. - Answer orem
Which critical thinking attitude should the nurse possess to come up with new solutions
to patient-related problems? - Answer creativity
#10.
A nurse observes a student nurse caring for a patient with diarrhea. Which quality in the
student nurse reflects cognitive maturity? - Answer Considering multiple solutions for
the patient's condition
(has to do with critical thinking) #10.
A diabetic patient has come to the nurse with symptoms suggestive of hypoglycemia.
What would be the first appropriate nursing intervention? - Answer Offer foods rich in
glucose
#5 have to do with implementation.
A patient who has undergone an appendectomy complains of pain. On assessment, the
nurse finds that the patient is anxious and this condition is increasing the pain
perception. What nursing intervention is appropriate in this situation? - Answer
Administer drugs that relieve anxiety per standing orders.
#13.
The nurse sits down to talk with a patient who lost her sister 2 weeks ago. The patient
reports she is unable to sleep, feels very fatigued during the day, and is having trouble
at work. The nurse asks her to clarify the type of trouble. The patient explains she can't
concentrate or even solve simple problems. The nurse records the results of the
assessment, describing the patient as having ineffective coping. This is an example of: -
Answer Clinical reasoning.
#10.
Which process helps in linking the thoughts and ideas to make a solution - Answer
Reasoning
During a home health visit the nurse prepares to instruct a patient in how to perform
range-of-motion (ROM) exercises for an injured shoulder. The nurse verifies that the
patient took an analgesic 30 minutes before arrival at the patient's home. After
discussing the purpose for the exercises and demonstrating each one, the nurse has
the patient perform them. After two attempts with only the second of three exercises, the
patient stops and says, "This hurts too much. I don't see why I have to do this so many
times." The nurse applies the critical thinking attitude of integrity in which of the
following actions?" - Answer "I understand your reluctance, but the exercises are
necessary for you to regain function in your shoulder. Let's go a bit more slowly and try
to relax."
,final for theory
#10.
An elderly debilitated patient is bed ridden. The patient has reduced libido, is unable to
eat, and is incontinent of urine. Which intervention would be the priority for this patient?
- Answer measures to improve skin integrtiy
#18?
Which outcome allows you to measure a patient's response to care more precisely? -
Answer The patient's wound will reduce in size to less than 4 cm (1 1/2 inches) by day
4.
#14
What should the nurse know about evaluation in the nursing process? - Answer
Evaluation is dynamic and ever changing.
#5
Setting a time frame for outcomes of care serves which of the following purposes? -
Answer Indicates when the patient is expected to respond in the desired manner
#14
A patient diagnosed with pancreatitis complains of pain in the abdomen. The patient has
vomited three times, and has a temperature of 101 degrees Fahrenheit. Following an
initial interview and assessment; the nurse prepares a nursing care plan. The nurse
formulates a diagnosis of acute pain. What could be the related factor for this diagnostic
label? - Answer Inflammation of the pancreas'
#12
The nurse is determining the short-term and long-term goals for a patient. What point
should the nurse consider to differentiate between a short-term goal and a long-term
goal? - Answer A short-term goal is achieved in a week
#14
The nurse observes during a physical assessment that the patient's right knee is
swollen and is larger than the left knee. The patient reports pain in the swollen area as
well. Which assessment technique does the nurse need to use in this case? - Answer
Palpation
#
what is the purpose of risk nursing diagnoses? - Answer To identify potential problems
of the patient
#12
What does the nurse recognize as a "related factor" in the nursing diagnosis? - Answer
Etiological factors
#12
,final for theory
The nurse formulates a nursing diagnostic statement for a patient with severe pain due
to a femur fracture as evidenced by grimacing. What should the nurse include in the
"defining characteristics" segment of the nursing diagnosis? - Answer grimacing
What should the nurse include when writing an actual nursing diagnosis? - Answer
Diagnosis label, related factors, and defining characteristics
#12
What is a health promotion diagnosis, according to the North American Nursing
Diagnosis Association International (NANDA-I)? - Answer It describes a person's
readiness to enhance specific health behaviors for well-being.
#12
A nurse is assessing patients in a medical unit. What priority level is assigned to the
patient diagnosed with impaired gas exchange? - Answer high priority
Which situation would require the most collaboration with the health care team? -
Answer When the patient is being transferred to a long-term care facility
##9
What is the measurable criterion used to evaluate goal achievement? - Answer
expected outcome
#14
The nurse writes an expected-outcome statement in measurable terms. An example is:
- Answer Patient will report pain acuity less than 4 on a scale of 0 to 10.
#14
A goal describes a desired change in a patient's condition or behavior. Identify the
patient for whom a short-term goal is appropriate. - Answer A patient who has acute
pain related to incisional trauma
#14
A patient is admitted to the hospital for acute exacerbation of asthma. The patient
outcomes include that the patient will be able to walk for 100 meters by the second day
and will not report breathlessness during walking. The patient's respiratory rate will
remain normal during walking; the patient needs to be observed for breathlessness
during walking. Which of these is an evaluative measure? - Answer The patient needs
to be observed for breathlessness during walking.
A patient is admitted to the hospital for the management of chest pain. At the time of
admission, the patient's BP was 180/100 mm of Hg. Six hours after receiving
antihypertensive drugs and other medications, the BP decreased to 130/82 mm of Hg.
What should the nurse interpret this response as? - Answer Evaluative measure
, final for theory
The nurse writes a change-of-shift report, which includes the complete patient data and
the interventions provided. Which documentation system does the nurse use to write
patient data? - Answer narrative charting
#24
Which organization sets the standards for bedside clinical nursing documentation? -
Answer american nurses association
Which documentation system includes realistic patient- and family-centered outcomes?
- Answer case management charting
#24
A nurse is planning care for a patient going to surgery. Who is responsible for informing
the patient about the surgery along with possible risks, complications, and benefits? -
Answer Surgeon
#27
the registered nurse (RN) is caring for three patients in a medical unit. The RN takes
instructions from the nurse practitioner regarding treatment. The RN receives help from
the unlicensed assistive personnel (UAP) when providing care and comfort to the
patients. In this instance, what is the role of the RN while caring for the patients with the
other health care personnel? - Answer Nurse collaborator
A nurse is working in a hospital that has been awarded Magnet Recognition by the
American Nurses Credentialing Center (ANCC). What is the criterion for awarding
Magnet Recognition? - Answer Excellence and innovation in nursing
Evidence-based practice is defined as: - Answer A problem-solving approach that
integrates best current evidence with clinical practice
A nurse is caring for an older-adult couple in a community-based assisted living facility.
During the family assessment he notes that the couple has many expired medications
and multiple medications for their respective chronic illnesses. They note that they go to
two different health care providers. The nurse begins to work with the couple to
determine what they know about their medications and helps them decide on one care
provider rather than two. This is an example of which Quality and Safety in the Ed
ucation of Nurses (QSEN) competency? - Answer safety
A patient is admitted to an acute care area. The patient is an active business man who
is worried about getting back to work. He has had severe diarrhea and vomiting for the
last week. He is weak, and his breathing is labored. Using Maslow's hierarchy of needs,
identify this patient's immediate priority. - Answer Air, water, and nutrition
Theory-based nursing practice uses a theoretical approach for nursing care. This
approach moves nursing forward as a science. This suggests that: - Answer Theories
will be tested to describe or predict patient outcomes.
A patient with diabetes is controlling the disease with insulin and diet. The nursing
health care provider is focusing efforts to teach the patient self-management. Which of
the following nursing theories is useful in promoting self management? Select all that
apply. - Answer orem
Which critical thinking attitude should the nurse possess to come up with new solutions
to patient-related problems? - Answer creativity
#10.
A nurse observes a student nurse caring for a patient with diarrhea. Which quality in the
student nurse reflects cognitive maturity? - Answer Considering multiple solutions for
the patient's condition
(has to do with critical thinking) #10.
A diabetic patient has come to the nurse with symptoms suggestive of hypoglycemia.
What would be the first appropriate nursing intervention? - Answer Offer foods rich in
glucose
#5 have to do with implementation.
A patient who has undergone an appendectomy complains of pain. On assessment, the
nurse finds that the patient is anxious and this condition is increasing the pain
perception. What nursing intervention is appropriate in this situation? - Answer
Administer drugs that relieve anxiety per standing orders.
#13.
The nurse sits down to talk with a patient who lost her sister 2 weeks ago. The patient
reports she is unable to sleep, feels very fatigued during the day, and is having trouble
at work. The nurse asks her to clarify the type of trouble. The patient explains she can't
concentrate or even solve simple problems. The nurse records the results of the
assessment, describing the patient as having ineffective coping. This is an example of: -
Answer Clinical reasoning.
#10.
Which process helps in linking the thoughts and ideas to make a solution - Answer
Reasoning
During a home health visit the nurse prepares to instruct a patient in how to perform
range-of-motion (ROM) exercises for an injured shoulder. The nurse verifies that the
patient took an analgesic 30 minutes before arrival at the patient's home. After
discussing the purpose for the exercises and demonstrating each one, the nurse has
the patient perform them. After two attempts with only the second of three exercises, the
patient stops and says, "This hurts too much. I don't see why I have to do this so many
times." The nurse applies the critical thinking attitude of integrity in which of the
following actions?" - Answer "I understand your reluctance, but the exercises are
necessary for you to regain function in your shoulder. Let's go a bit more slowly and try
to relax."
,final for theory
#10.
An elderly debilitated patient is bed ridden. The patient has reduced libido, is unable to
eat, and is incontinent of urine. Which intervention would be the priority for this patient?
- Answer measures to improve skin integrtiy
#18?
Which outcome allows you to measure a patient's response to care more precisely? -
Answer The patient's wound will reduce in size to less than 4 cm (1 1/2 inches) by day
4.
#14
What should the nurse know about evaluation in the nursing process? - Answer
Evaluation is dynamic and ever changing.
#5
Setting a time frame for outcomes of care serves which of the following purposes? -
Answer Indicates when the patient is expected to respond in the desired manner
#14
A patient diagnosed with pancreatitis complains of pain in the abdomen. The patient has
vomited three times, and has a temperature of 101 degrees Fahrenheit. Following an
initial interview and assessment; the nurse prepares a nursing care plan. The nurse
formulates a diagnosis of acute pain. What could be the related factor for this diagnostic
label? - Answer Inflammation of the pancreas'
#12
The nurse is determining the short-term and long-term goals for a patient. What point
should the nurse consider to differentiate between a short-term goal and a long-term
goal? - Answer A short-term goal is achieved in a week
#14
The nurse observes during a physical assessment that the patient's right knee is
swollen and is larger than the left knee. The patient reports pain in the swollen area as
well. Which assessment technique does the nurse need to use in this case? - Answer
Palpation
#
what is the purpose of risk nursing diagnoses? - Answer To identify potential problems
of the patient
#12
What does the nurse recognize as a "related factor" in the nursing diagnosis? - Answer
Etiological factors
#12
,final for theory
The nurse formulates a nursing diagnostic statement for a patient with severe pain due
to a femur fracture as evidenced by grimacing. What should the nurse include in the
"defining characteristics" segment of the nursing diagnosis? - Answer grimacing
What should the nurse include when writing an actual nursing diagnosis? - Answer
Diagnosis label, related factors, and defining characteristics
#12
What is a health promotion diagnosis, according to the North American Nursing
Diagnosis Association International (NANDA-I)? - Answer It describes a person's
readiness to enhance specific health behaviors for well-being.
#12
A nurse is assessing patients in a medical unit. What priority level is assigned to the
patient diagnosed with impaired gas exchange? - Answer high priority
Which situation would require the most collaboration with the health care team? -
Answer When the patient is being transferred to a long-term care facility
##9
What is the measurable criterion used to evaluate goal achievement? - Answer
expected outcome
#14
The nurse writes an expected-outcome statement in measurable terms. An example is:
- Answer Patient will report pain acuity less than 4 on a scale of 0 to 10.
#14
A goal describes a desired change in a patient's condition or behavior. Identify the
patient for whom a short-term goal is appropriate. - Answer A patient who has acute
pain related to incisional trauma
#14
A patient is admitted to the hospital for acute exacerbation of asthma. The patient
outcomes include that the patient will be able to walk for 100 meters by the second day
and will not report breathlessness during walking. The patient's respiratory rate will
remain normal during walking; the patient needs to be observed for breathlessness
during walking. Which of these is an evaluative measure? - Answer The patient needs
to be observed for breathlessness during walking.
A patient is admitted to the hospital for the management of chest pain. At the time of
admission, the patient's BP was 180/100 mm of Hg. Six hours after receiving
antihypertensive drugs and other medications, the BP decreased to 130/82 mm of Hg.
What should the nurse interpret this response as? - Answer Evaluative measure
, final for theory
The nurse writes a change-of-shift report, which includes the complete patient data and
the interventions provided. Which documentation system does the nurse use to write
patient data? - Answer narrative charting
#24
Which organization sets the standards for bedside clinical nursing documentation? -
Answer american nurses association
Which documentation system includes realistic patient- and family-centered outcomes?
- Answer case management charting
#24
A nurse is planning care for a patient going to surgery. Who is responsible for informing
the patient about the surgery along with possible risks, complications, and benefits? -
Answer Surgeon
#27
the registered nurse (RN) is caring for three patients in a medical unit. The RN takes
instructions from the nurse practitioner regarding treatment. The RN receives help from
the unlicensed assistive personnel (UAP) when providing care and comfort to the
patients. In this instance, what is the role of the RN while caring for the patients with the
other health care personnel? - Answer Nurse collaborator
A nurse is working in a hospital that has been awarded Magnet Recognition by the
American Nurses Credentialing Center (ANCC). What is the criterion for awarding
Magnet Recognition? - Answer Excellence and innovation in nursing
Evidence-based practice is defined as: - Answer A problem-solving approach that
integrates best current evidence with clinical practice
A nurse is caring for an older-adult couple in a community-based assisted living facility.
During the family assessment he notes that the couple has many expired medications
and multiple medications for their respective chronic illnesses. They note that they go to
two different health care providers. The nurse begins to work with the couple to
determine what they know about their medications and helps them decide on one care
provider rather than two. This is an example of which Quality and Safety in the Ed
ucation of Nurses (QSEN) competency? - Answer safety
A patient is admitted to an acute care area. The patient is an active business man who
is worried about getting back to work. He has had severe diarrhea and vomiting for the
last week. He is weak, and his breathing is labored. Using Maslow's hierarchy of needs,
identify this patient's immediate priority. - Answer Air, water, and nutrition
Theory-based nursing practice uses a theoretical approach for nursing care. This
approach moves nursing forward as a science. This suggests that: - Answer Theories
will be tested to describe or predict patient outcomes.
