NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
MULTIPLE CHOICE
1. The nurse is caring for a Chinese patient diagnosed with cancer who is suffering from pain, yet refuses
analgesia administration. What type of health disparities is this patient exhibiting?
a. Avoidable and acceptable
b. Avoidable and unacceptable
c. Unavoidable and acceptable
d. Unavoidable and unacceptable
ANS: B
Health disparities that are avoidable and unacceptable unfortunately occur in healthcare settings and these are the targets
of interventions. For example, a disparity in cancer pain management exists between Asians and Whites. This difference is
attributable to Asian cultural values and attitudes related to cancer pain and pain medication distinguished from the
cultural values of Whites. The disparity is avoidable if Asian cancer patients are adequately educated and instructed on
cancer pain management strategies including pain medication and complementary and alternative medicine. Also, this
disparity is unacceptable because this gives an unnecessary burden of pain to Asian cancer patients that could be easily
managed by using existing strategies.
REF: Page 504 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
2. An experienced nurse tells the student nurse, “I have found that most Hispanic immigrants live in
unsanitary conditions but are hard workers.” How should the student nurse best classify this statement?
a. Stereotyping
b. Prejudice
c. Discrimination
d. Misinformed
ANS: A
Stereotyping often leads to biased clinical decision-making. Stereotyping refers to the process by which people use social
categories (e.g., gender or race/ethnicity) in acquiring, processing, and recalling information about others. Both implicit
and explicit negative attitudes and stereotypes of healthcare providers significantly shape interactions with patients,
influence how information is recalled, and guide expectations and inferences in systematic ways. Stereotyping often
occurs subconsciously, unlike prejudice or discrimination. Prejudice, which refers to unjustified negative attitudes based
on a person’s group membership, is another source of biased clinical decision-making. Discrimination refers to the actual
mistreatment of individuals based on race, gender, ethnicity, etc. The nurse is not misinformed as the nurse has practiced
for some time and made a statement based on observation and experience.
REF: Page 506 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
3. Which type of health disparities are most frequently encountered by nurses in clinical and community
settings?
a. Avoidable and acceptable
b. Avoidable and unacceptable
c. Unavoidable and acceptable
d. Unavoidable and unacceptable
ANS: B
Although there are many types of health disparities, the avoidable and unacceptable health disparities are the ones that
healthcare providers, including nurses, frequently encounter in clinical and community settings. Furthermore, these are
the health disparities that healthcare providers need to target to intervene.
REF: Page 504 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
4. The nurse is caring for diverse population groups at a health clinic. Which of the following patients
demonstrates a potential health disparity group?
a. A 26-year-old woman who is receiving follow-up after a car accident.
b. A 30-year-old immigrant who does not speak English.
c. A 28-year-old man who needs a tetanus booster.
d. A 12-month-old with an appointment for immunizations.
ANS: B
NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
,NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
Poor health literacy skills are an example of a health disparity that limits an individual’s ability to access or communicate
about health care needs. Patients who are receiving needed care are not experiencing a gap between health need and
actual care.
REF: Page 506 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
5. Which is the best strategy the nurse manager should include when working to reduce health care
disparities on a medical-surgical unit?
a. Less diverse workforce
b. Increase interpreter availability
c. Authoritarian leadership
d. Annual staff training
ANS: B
Key elements are cultural competence that can reduce health disparities include: a diverse workforce; interpreter
availability; finding common ground versus authoritarian leadership; frequent staff training and updating staff as needed
throughout the year.
REF: Page 506 |Page 507
OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
6. A new nurse requires further teaching when failing to identify which practice as a health disparity?
a. Annual mammogram
b. Early prenatal care
c. Blood pressure screening
d. Frequent fast food meals
ANS: D
Preventive care, screening, and health promotion activities are not considered health disparities. Examples include
mammograms, prenatal care, and blood pressure checks. Frequent fast food meals, containing high fat content, is
considered a health disparity due to possible lack of money or access to healthy meals.
REF: Page 504 |Page 505
OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
7. Before beginning work on a culturally diverse hospital unit, the nurse should perform which action
first?
a. Improve self-awareness of one’s own biases
b. Attend an anti-discrimination rally or march
c. Build rapport and trust with the patients
d. Take a foreign language class
ANS: A
Before working with culturally diverse groups, the nurse should first identify own biases and assumptions in order to
objectively and competently care for patients. Attending a rally or march may not raise awareness of various biases. The
nurse should establish rapport and trust when working with patients, after self-awareness is appreciated. Taking a foreign
language may be helpful; however the first step is self-awareness.
REF: Page 506 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
8. The nurse who has been hired to work on an oncology unit identifies which group of women as being at
highest risk of developing breast cancer?
a. African
b. Caucasian
c. Asian
d. Hispanic
ANS: C
Breast cancer is the most common cancer in Asian women in the U.S., but Asian women have relatively lower rates of
breast cancer screening than African American and white women in the U.S. Furthermore, disparities in breast cancer
screening reportedly result from: low income, lack of a local mammography center, lack of transportation to a
NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
,NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
mammography center, lack of a usual healthcare provider, lack of a recommendation from a healthcare provider to get
mammography screening, lack of awareness of breast cancer risks and screening methods, and cultural and language
differences.
REF: Page 506 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
MULTIPLE RESPONSE
1. A healthcare provider whose native country is India is explaining the treatment plan to a patient. The
patient tells the nurse she is having trouble understanding the provider but is embarrassed about asking to repeat the
information over and over. The nurse should assess for which results due to this disparity in provider-patient
communication? (Select all that apply.)
a. Patient dissatisfaction
b. Optimal health outcome
c. Poor adherence
d. Increased patient confidence
e. Improved communication
ANS: A, C
When sociocultural differences between healthcare providers and patients are not appreciated or communicated
effectively in clinical encounters, patient dissatisfaction, poor adherence, poorer health outcomes, and racial/ethnic
disparities in healthcare easily happen.
REF: Page 507 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
2. The nurse in the immunization clinic should place emphasis on educating and reaching which groups
about the disease preventing effects of immunizations? (Select all that apply.)
a. Caucasian
b. African American
c. Low income
d. Middle income
e. High income
ANS: B, C, D
The 2013 National Healthcare Disparities Report documented that African American children or children from poor, low-
income, and middle-income households were less likely to receive all the recommended vaccinations compared with white
children or children from high-income households in 2011.
REF: Page 507 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
Chapter 14: Delegation in the Clinical Setting
Zerwekh: Evolve Resources for Nursing Today, 9th Edition
MULTIPLE CHOICE
1. Which task could a staff nurse delegate to a certified nursing assistant (CNA)?
a. Evaluating a patient’s response to pain
b. Making rounds with a physician
c. Feeding a stroke patient who has minimal dysphagia
d. Assessing a patient’s central venous line site
ANS: C
Feeding a stroke patient who has minimal dysphagia is an appropriate delegation of a nursing intervention to a CNA. The
nurse cannot delegate the task of assessing the patient or making rounds with the physician to the CNA. Nursing
interventions such as assessment and evaluation of pain, management of central line sites, or performing tracheotomy or
colostomy care are within the scope of professional nursing, as is making rounds with a physician.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 306 |p. 308 OBJ: Delegate tasks successfully based on outcomes.
TOP: Delegation in the clinical setting
NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
, NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
MSC: NCLEX®: Safe and effective care environment—management of care
2. The nurse has just given a patient an opioid medication for pain relief. Because the nurse must leave
the unit for lunch and a 1-hour meeting, the task of evaluating the patient’s response to the pain medication must be
delegated. To whom should the nurse delegate this responsibility?
a. Nursing assistant
b. Student nurse
c. Licensed practical nurse
d. Nurse manager
ANS: D
Evaluating the patient’s response to pain medication is an activity within the scope of the registered professional nurse
(who in this situation is the nurse manager). The licensed practical nurse can administer the pain medication. The student
nurse could assist the professional nurse in the evaluation of the patient’s response to the pain medication; however, the
nurse leaving the unit cannot delegate this responsibility to a student. This nursing intervention is outside the scope of
practice of the nursing assistant.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 308 OBJ: Delegate tasks successfully based on outcomes.
TOP: Delegation in the clinical setting
MSC: NCLEX®: Safe and effective care environment—management of care
3. The nurse has a full assignment. The charge nurse adds a newly admitted patient who will require close
monitoring. Which task can the nurse delegate to the CNA who is co-assigned to the same patients?
a. Teaching insulin self-administration
b. Updating a care plan
c. Evaluating goal attainment for a patient who is learning to walk with a below-the-knee prosthesis
d. Bathing an unconscious patient
ANS: D
Bathing a patient is an appropriate nursing intervention within the role and responsibilities and scope of practice of the
CNA. Teaching clients, updating nursing care plans, and evaluating patient responses to treatment plans are within the
scope of practice of the registered professional nurse.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 306 |p. 308 OBJ: Delegate tasks successfully based on outcomes.
TOP: Delegation in the clinical setting
MSC: NCLEX®: Safe and effective care environment—management of care
4. Based on the goal of making optimal use of the level of preparation of the licensed practical nurse
(LPN), which task should the nurse (RN) delegate to the LPN?
a. Assisting with a lumbar puncture
b. Transporting a patient to the radiology department
c. Restocking the sterile supplies
d. Distributing afternoon nutrition supplements
ANS: A
Assisting with a procedure, such as a lumbar puncture, is within the scope of practice of the LPN. Transporting clients,
restocking supplies, and distributing nutrition supplements are nursing interventions that can be carried out by a certified
nursing assistant (CNA).
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 307 OBJ: Delegate tasks successfully based on outcomes.
TOP: Delegation in the clinical setting
MSC: NCLEX®: Safe and effective care environment—management of care
5. There is a temporary agency registered nurse assigned to the nursing unit. You have no knowledge of
this nurse’s skills, and you want to assign the nurse to a patient who has a fresh tracheostomy. How should you handle
this situation?
a. Assign the nurse to the patient with the tracheostomy and hope for the best.
b. Ask the nurse about his or her competency to care for the patient with the tracheostomy.
c. Assign the patient to another nurse, and use the temporary agency nurse to do simple care tasks.
d. Call the agency and ask for a nurse skilled in the care of a patient with a tracheostomy.
NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
nursing practice latest update 2022
MULTIPLE CHOICE
1. The nurse is caring for a Chinese patient diagnosed with cancer who is suffering from pain, yet refuses
analgesia administration. What type of health disparities is this patient exhibiting?
a. Avoidable and acceptable
b. Avoidable and unacceptable
c. Unavoidable and acceptable
d. Unavoidable and unacceptable
ANS: B
Health disparities that are avoidable and unacceptable unfortunately occur in healthcare settings and these are the targets
of interventions. For example, a disparity in cancer pain management exists between Asians and Whites. This difference is
attributable to Asian cultural values and attitudes related to cancer pain and pain medication distinguished from the
cultural values of Whites. The disparity is avoidable if Asian cancer patients are adequately educated and instructed on
cancer pain management strategies including pain medication and complementary and alternative medicine. Also, this
disparity is unacceptable because this gives an unnecessary burden of pain to Asian cancer patients that could be easily
managed by using existing strategies.
REF: Page 504 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
2. An experienced nurse tells the student nurse, “I have found that most Hispanic immigrants live in
unsanitary conditions but are hard workers.” How should the student nurse best classify this statement?
a. Stereotyping
b. Prejudice
c. Discrimination
d. Misinformed
ANS: A
Stereotyping often leads to biased clinical decision-making. Stereotyping refers to the process by which people use social
categories (e.g., gender or race/ethnicity) in acquiring, processing, and recalling information about others. Both implicit
and explicit negative attitudes and stereotypes of healthcare providers significantly shape interactions with patients,
influence how information is recalled, and guide expectations and inferences in systematic ways. Stereotyping often
occurs subconsciously, unlike prejudice or discrimination. Prejudice, which refers to unjustified negative attitudes based
on a person’s group membership, is another source of biased clinical decision-making. Discrimination refers to the actual
mistreatment of individuals based on race, gender, ethnicity, etc. The nurse is not misinformed as the nurse has practiced
for some time and made a statement based on observation and experience.
REF: Page 506 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
3. Which type of health disparities are most frequently encountered by nurses in clinical and community
settings?
a. Avoidable and acceptable
b. Avoidable and unacceptable
c. Unavoidable and acceptable
d. Unavoidable and unacceptable
ANS: B
Although there are many types of health disparities, the avoidable and unacceptable health disparities are the ones that
healthcare providers, including nurses, frequently encounter in clinical and community settings. Furthermore, these are
the health disparities that healthcare providers need to target to intervene.
REF: Page 504 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
4. The nurse is caring for diverse population groups at a health clinic. Which of the following patients
demonstrates a potential health disparity group?
a. A 26-year-old woman who is receiving follow-up after a car accident.
b. A 30-year-old immigrant who does not speak English.
c. A 28-year-old man who needs a tetanus booster.
d. A 12-month-old with an appointment for immunizations.
ANS: B
NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
,NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
Poor health literacy skills are an example of a health disparity that limits an individual’s ability to access or communicate
about health care needs. Patients who are receiving needed care are not experiencing a gap between health need and
actual care.
REF: Page 506 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
5. Which is the best strategy the nurse manager should include when working to reduce health care
disparities on a medical-surgical unit?
a. Less diverse workforce
b. Increase interpreter availability
c. Authoritarian leadership
d. Annual staff training
ANS: B
Key elements are cultural competence that can reduce health disparities include: a diverse workforce; interpreter
availability; finding common ground versus authoritarian leadership; frequent staff training and updating staff as needed
throughout the year.
REF: Page 506 |Page 507
OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
6. A new nurse requires further teaching when failing to identify which practice as a health disparity?
a. Annual mammogram
b. Early prenatal care
c. Blood pressure screening
d. Frequent fast food meals
ANS: D
Preventive care, screening, and health promotion activities are not considered health disparities. Examples include
mammograms, prenatal care, and blood pressure checks. Frequent fast food meals, containing high fat content, is
considered a health disparity due to possible lack of money or access to healthy meals.
REF: Page 504 |Page 505
OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
7. Before beginning work on a culturally diverse hospital unit, the nurse should perform which action
first?
a. Improve self-awareness of one’s own biases
b. Attend an anti-discrimination rally or march
c. Build rapport and trust with the patients
d. Take a foreign language class
ANS: A
Before working with culturally diverse groups, the nurse should first identify own biases and assumptions in order to
objectively and competently care for patients. Attending a rally or march may not raise awareness of various biases. The
nurse should establish rapport and trust when working with patients, after self-awareness is appreciated. Taking a foreign
language may be helpful; however the first step is self-awareness.
REF: Page 506 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
8. The nurse who has been hired to work on an oncology unit identifies which group of women as being at
highest risk of developing breast cancer?
a. African
b. Caucasian
c. Asian
d. Hispanic
ANS: C
Breast cancer is the most common cancer in Asian women in the U.S., but Asian women have relatively lower rates of
breast cancer screening than African American and white women in the U.S. Furthermore, disparities in breast cancer
screening reportedly result from: low income, lack of a local mammography center, lack of transportation to a
NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
,NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
mammography center, lack of a usual healthcare provider, lack of a recommendation from a healthcare provider to get
mammography screening, lack of awareness of breast cancer risks and screening methods, and cultural and language
differences.
REF: Page 506 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
MULTIPLE RESPONSE
1. A healthcare provider whose native country is India is explaining the treatment plan to a patient. The
patient tells the nurse she is having trouble understanding the provider but is embarrassed about asking to repeat the
information over and over. The nurse should assess for which results due to this disparity in provider-patient
communication? (Select all that apply.)
a. Patient dissatisfaction
b. Optimal health outcome
c. Poor adherence
d. Increased patient confidence
e. Improved communication
ANS: A, C
When sociocultural differences between healthcare providers and patients are not appreciated or communicated
effectively in clinical encounters, patient dissatisfaction, poor adherence, poorer health outcomes, and racial/ethnic
disparities in healthcare easily happen.
REF: Page 507 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
2. The nurse in the immunization clinic should place emphasis on educating and reaching which groups
about the disease preventing effects of immunizations? (Select all that apply.)
a. Caucasian
b. African American
c. Low income
d. Middle income
e. High income
ANS: B, C, D
The 2013 National Healthcare Disparities Report documented that African American children or children from poor, low-
income, and middle-income households were less likely to receive all the recommended vaccinations compared with white
children or children from high-income households in 2011.
REF: Page 507 OBJ: NCLEX® Client Needs Category: Safe and Effective Care Environment
Chapter 14: Delegation in the Clinical Setting
Zerwekh: Evolve Resources for Nursing Today, 9th Edition
MULTIPLE CHOICE
1. Which task could a staff nurse delegate to a certified nursing assistant (CNA)?
a. Evaluating a patient’s response to pain
b. Making rounds with a physician
c. Feeding a stroke patient who has minimal dysphagia
d. Assessing a patient’s central venous line site
ANS: C
Feeding a stroke patient who has minimal dysphagia is an appropriate delegation of a nursing intervention to a CNA. The
nurse cannot delegate the task of assessing the patient or making rounds with the physician to the CNA. Nursing
interventions such as assessment and evaluation of pain, management of central line sites, or performing tracheotomy or
colostomy care are within the scope of professional nursing, as is making rounds with a physician.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 306 |p. 308 OBJ: Delegate tasks successfully based on outcomes.
TOP: Delegation in the clinical setting
NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
, NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
MSC: NCLEX®: Safe and effective care environment—management of care
2. The nurse has just given a patient an opioid medication for pain relief. Because the nurse must leave
the unit for lunch and a 1-hour meeting, the task of evaluating the patient’s response to the pain medication must be
delegated. To whom should the nurse delegate this responsibility?
a. Nursing assistant
b. Student nurse
c. Licensed practical nurse
d. Nurse manager
ANS: D
Evaluating the patient’s response to pain medication is an activity within the scope of the registered professional nurse
(who in this situation is the nurse manager). The licensed practical nurse can administer the pain medication. The student
nurse could assist the professional nurse in the evaluation of the patient’s response to the pain medication; however, the
nurse leaving the unit cannot delegate this responsibility to a student. This nursing intervention is outside the scope of
practice of the nursing assistant.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 308 OBJ: Delegate tasks successfully based on outcomes.
TOP: Delegation in the clinical setting
MSC: NCLEX®: Safe and effective care environment—management of care
3. The nurse has a full assignment. The charge nurse adds a newly admitted patient who will require close
monitoring. Which task can the nurse delegate to the CNA who is co-assigned to the same patients?
a. Teaching insulin self-administration
b. Updating a care plan
c. Evaluating goal attainment for a patient who is learning to walk with a below-the-knee prosthesis
d. Bathing an unconscious patient
ANS: D
Bathing a patient is an appropriate nursing intervention within the role and responsibilities and scope of practice of the
CNA. Teaching clients, updating nursing care plans, and evaluating patient responses to treatment plans are within the
scope of practice of the registered professional nurse.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 306 |p. 308 OBJ: Delegate tasks successfully based on outcomes.
TOP: Delegation in the clinical setting
MSC: NCLEX®: Safe and effective care environment—management of care
4. Based on the goal of making optimal use of the level of preparation of the licensed practical nurse
(LPN), which task should the nurse (RN) delegate to the LPN?
a. Assisting with a lumbar puncture
b. Transporting a patient to the radiology department
c. Restocking the sterile supplies
d. Distributing afternoon nutrition supplements
ANS: A
Assisting with a procedure, such as a lumbar puncture, is within the scope of practice of the LPN. Transporting clients,
restocking supplies, and distributing nutrition supplements are nursing interventions that can be carried out by a certified
nursing assistant (CNA).
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 307 OBJ: Delegate tasks successfully based on outcomes.
TOP: Delegation in the clinical setting
MSC: NCLEX®: Safe and effective care environment—management of care
5. There is a temporary agency registered nurse assigned to the nursing unit. You have no knowledge of
this nurse’s skills, and you want to assign the nurse to a patient who has a fresh tracheostomy. How should you handle
this situation?
a. Assign the nurse to the patient with the tracheostomy and hope for the best.
b. Ask the nurse about his or her competency to care for the patient with the tracheostomy.
c. Assign the patient to another nurse, and use the temporary agency nurse to do simple care tasks.
d. Call the agency and ask for a nurse skilled in the care of a patient with a tracheostomy.
NURS 2nd edition final semester exam-concepts for
nursing practice latest update 2022
