, OpenStax Fundamentals of Nursing
Instructor Answer Guide
Chapter 1: Introduction to the Nursing Profession: Evolution, Theories, and Practice..................3
Chapter 2: Communication...........................................................................................................14
Chapter 3: Healthcare Delivery Systems ...................................................................................... 19
Chapter 4: Health, Wellness, and Community-Based Health Care...............................................24
Chapter 5: Cultural Competence..................................................................................................32
Chapter 6: Promoting Individualized Care....................................................................................39
Chapter 7: Vital Signs....................................................................................................................43
Chapter 8: Admission, Transfer, and Discharge............................................................................51
Chapter 9: Safety and Security.....................................................................................................58
Chapter 10: Infection Control and Prevention ............................................................................. 64
Chapter 11: Medication Administration.......................................................................................71
Chapter 12: Assessment: Recognizing Cues ................................................................................. 80
Chapter 13: Diagnosis and Planning: Analyzing, Prioritizing, and Generating Solutions..............95
Chapter 14: Implementation and Evaluation: Taking Action, Evaluating Outcomes, and
Documentation...........................................................................................................................102
Chapter 15: Evidence-Based Research, Quality Improvement, and Collaborative Practice.......119
Chapter 16: Legal and Ethical Considerations............................................................................127
Chapter 17: Patient and Family Education.................................................................................135
Chapter 18: Leadership and Management in Nursing................................................................141
Chapter 19: Oxygenation and Perfusion.....................................................................................152
Chapter 20: Fluid, Electrolyte, and Acid-Base Balance...............................................................158
Chapter 21: Nutrition ................................................................................................................. 162
Chapter 22: Activity....................................................................................................................168
Chapter 23: Neuromuscular Function ........................................................................................ 175
Chapter 24: Skin Integrity...........................................................................................................181
Chapter 25: Hygiene...................................................................................................................187
Chapter 26: Urinary Elimination.................................................................................................192
Chapter 27: Bowel Elimination...................................................................................................202
2
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, OpenStax Fundamentals of Nursing Instructor Answer Guide
Chapter 28: Sleep and Rest ........................................................................................................ 211
Chapter 29: Sensory Alterations.................................................................................................217
Chapter 30: Pain Assessment.....................................................................................................226
Chapter 31: Perioperative Nursing Care.....................................................................................233
Chapter 32: Self-Concept............................................................................................................243
Chapter 33: Sexuality..................................................................................................................249
Chapter 34: Stress, Adaptation, and Homeostasis.....................................................................255
Chapter 35: Spirituality...............................................................................................................262
Chapter 36: Grief, Loss, Death, and Dying..................................................................................267
Chapter 37: Family Dynamics.....................................................................................................274
Chapter 38: Growth and Development......................................................................................280
Chapter 39: Conception Through Adolescence..........................................................................286
Chapter 40: Young and Middle-Aged Adults .............................................................................. 292
Chapter 41: Older Adults............................................................................................................299
Chapter 42: Caring for Patients with Disability and Chronic Illness............................................306
Chapter 43: Clinical Judgment and Critical Thinking .................................................................. 312
Chapter 1: Introduction to the Nursing Profession: Evolution, Theories,
and Practice
Review Questions
1. During the Middle Ages, who primarily undertook nursing duties, and where did they
provide care?
a. family members in their homes
b. monks and nuns in monasteries and convents
c. herbalists in communities
d. military personnel in wartime hospitals
[Answer: B]
2. What advancements occurred in the nursing profession during the mid-twentieth century?
a. expansion of nursing roles during World War II
b. establishment of the first nursing school
c. embrace of EHRs and telehealth
d. recognition of nurse practitioners as primary care providers
[Answer: A]
3. What milestone marked Florence Nightingale’s influence on the formalization and
professionalization of nursing education?
a. establishment of the ANA
b. creation of the first nursing school
3
, c. introduction of evidence-based practice
d. development of specialized nursing fields
[Answer: B]
4. What does the “art of nursing” primarily emphasize in patient care?
a. application of evidence-based knowledge
b. technical expertise in medical procedures
c. proficiency in administering medications
d. interpersonal and compassionate dimensions of care
[Answer: D]
5. What nursing program is designed to prepare individuals for entry-level positions in health
care and requires graduates to pass the NCLEX-PN for licensure?
a. Associate degree in nursing (ADN)
b. Bachelor of Science in nursing (BSN)
c. Master of Science in nursing (MSN)
d. Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN)
[Answer: D]
6. What is a common prerequisite for obtaining licensure as a registered nurse (RN) for both
ADN and BSN graduates?
a. completion of a clinical practicum
b. passing the NCLEX-PN
c. completion of a doctoral program
d. passing the NCLEX-RN
[Answer: D]
7. What is the primary goal of the Doctor of Nursing practice (DNP) program?
a. preparation for leadership roles in academia
b. research-focused doctoral education
c. emphasis on advanced clinical practice, leadership, and evidence-based decision-making
d. integration of theory, research, and public health in nursing practice
[Answer: C]
8. What distinguishes BSN-prepared nurses from ADN-prepared nurses?
a. broader education including leadership, research, and public health
b. shorter duration of education
c. limited involvement in patient care
d. increased focus on practical nursing skills
[Answer: A]
9. Which global organization significantly influences the development of the nursing
profession on a global scale and offers guidance regarding the scope of practice for nurses
around the world?
a. state BONs
b. QSEN
c. ICN
d. ANA
4
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10/24/2024
, OpenStax Fundamentals of Nursing Instructor Answer Guide
[Answer: C]
10. Which organization primarily oversees the regular review and updating of guidelines within
a given jurisdiction to align with advances in health care, changes in legislation, and evolving
societal needs related to nursing practice within a specific state or jurisdiction?
a. ANA
b. QSEN
c. state BONs
d. ICN
[Answer: C]
11. The nurse is precepting a nursing student during a clinical rotation. What statement made
by the student would warrant further education?
a. “Nursing standards serve as a framework for providing safe, quality care.”
b. “Nursing standards align with the overarching principles of the nursing profession.”
c. “Nursing standards articulate the expectations and ethical conduct required of nurses.”
d. “Nursing standards may be incorporated into practice if the nurse chooses to do so.”
[Answer: D]
12. The nurse takes proactive measures to prevent falls, such as using bed alarms and assisting
patients with mobility. What ethical principle do these measures emphasize?
a. autonomy
b. privacy
c. nonmaleficence
d. justice
[Answer: C]
13. What is the primary purpose of nursing theories?
a. to dictate medical interventions
b. to provide a framework for nursing practice
c. to establish healthcare policies
d. to replace medical guidelines
[Answer: B]
14. How did nursing theories contribute to the historical development of the nursing
profession?
a. by focusing on task-oriented practices
b. by discouraging research in nursing
c. by offering a basis for nursing interventions
d. by limiting the roles of nurses
[Answer: C]
15. In the late twentieth century, what shift occurred in the development of nursing theories?
a. a decline in the emphasis on evidence-based practice
b. a move toward task-oriented approaches
c. a decrease in the importance of research integration
d. a proliferation of theories addressing various aspects of nursing, health, and care
[Answer: D]
16. How do assumptions contribute to the theoretical framework in nursing?
a. by providing empirical evidence
5
, b. by establishing shared understanding
c. by forming foundational beliefs
d. by guiding research design
[Answer: C]
17. What does the term “environment” in nursing philosophy encompass?
a. a multifaceted combination of physical, social, cultural, economic, and global factors
b. solely individualized influences
c. physical surroundings without cultural implications
d. exclusively cultural values and customs without broader influences
[Answer: A]
18. Who emphasized the nurse-patient relationship as a therapeutic and collaborative
partnership in psychiatric nursing?
a. Jean Watson
b. Patricia Benner
c. Hildegard Peplau
d. Dorothea Orem
[Answer: C]
19. Who defined nursing as helping individuals achieve their highest level of independence in
activities of daily living?
a. Faye Abdellah
b. Patricia Benner
c. Florence Nightingale
d. Virginia Henderson
[Answer: D]
20. What type of nursing theory provides recommendations, interventions, or strategies for
achieving specific nursing goals?
a. adaptation theory
b. descriptive theory
c. developmental theories
d. prescriptive theory
[Answer: D]
21. What nursing theory views individuals as open, infinite energy fields that interact with the
environment in continuous and evolving patterns?
a. Orem’s self-care deficit nursing theory
b. Roger’s science of unitary human beings theory
c. Leininger’s culture care theory
d. Watson’s theory of human caring
[Answer: B]
22. In what phase of Peplau’s theory of interpersonal relations does the patient utilize the help
offered by the nurse to address problems and gain a better understanding of their
situation?
a. orientation phase
6
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, OpenStax Fundamentals of Nursing Instructor Answer Guide
b. identification phase
c. exploitation phase
d. resolution phase
[Answer: C]
23. A nursing instructor is talking with a student about the link between theory and knowledge
in nursing practice. What statement made by the nursing student would warrant further
education?
a. “Nursing theory benefits theoretical knowledge, and theoretical knowledge benefits
nursing theory.”
b. “Theoretical knowledge is derived from theory and provides a framework for critical
thinking.”
c. “Theories are applied within clinical practice as experiential knowledge.”
d. “Although reflection impacts knowledge in nursing practice, it does not impact the basic
nursing theories.”
[Answer: D]
24. What is the foundational role of nursing theory in the practice of nursing?
a. providing hands-on clinical experience
b. guiding patient communication
c. shaping the approach to patient care
d. offering administrative insights
[Answer: C]
25. What comment from a nursing student reflects the need for further education regarding
how incorporating nursing theory into research enhances the evidence base of the nursing
profession?
a. “Nursing theories ensure studies align with the core principles and values of the
profession.”
b. “The alignment of EBP with the core principles of the nursing profession is not
contingent upon the incorporation of nursing theory into research.”
c. “The integration of nursing theory in research ensures research outcomes are relevant
and applicable to the practical realities of nursing practice.”
d. “Understanding how nursing theory informs research priorities is key to advancing the
evidence base and promoting evidence-based practice in nursing.”
[Answer: B]
Check Your Understanding Questions
1. List three current trends in nursing.
[Answers will vary but may include continued nursing shortage, higher education
requirements, increased online nursing programs, rise of telehealth and technology in
health care, and the essential need for nurses’ self-care.]
2. What is the difference between soft skills and hard skills in nursing?
[Answer: Soft skills in nursing refer to interpersonal abilities and personal attributes that
enhance interactions with patients, families, and colleagues, such as communication,
empathy, and adaptability. In contrast, hard skills encompass technical and clinical
7
, competencies crucial for providing safe and effective patient care, such as conducting
clinical assessments, administering medications, and using medical equipment.]
3. Why is there an increasing emphasis on higher education requirements for entry into the
nursing profession?
[Answer: The emphasis on higher education requirements is to align nursing education with
the complexities of modern health care.]
4. What is the primary purpose of licensure in nursing?
[Answer: The primary purpose of licensure in nursing is to ensure that individuals practicing
nursing meet established standards of competency and adhere to ethical and legal
guidelines, providing a legal framework for accountability and protection of the public.]
5. What is the primary advantage of ADN-prepared nurses over LPNs/LVNs?
[Answer: ADN-prepared nurses have a broader scope of practice and involvement in patient
care decisions.]
6. What is the primary purpose of defining the scope of practice for nurses?
[Answer: The primary purpose is to ensure uniformity, safety, and quality in patient care.]
7. What are the six QSEN core competencies that align with nursing standards and guide
nursing education?
[Answer: The six core competencies are patient-centered care, teamwork and collaboration,
EBP, quality improvement, safety, and informatics.]
8. Name and define at least three of the key elements that comprise nursing theories.
[Answers will vary but may include concepts, phenomena, definitions, and assumptions. A
concept is an abstract and generalized idea that serves as a foundational element,
contributing to the overall structure and understanding of the theory. A phenomenon refers
to a specific aspect of interest or an observable occurrence that is the focus of theoretical
exploration and study. Definitions are clear and precise explanations of the meanings
attributed to specific concepts or terms within the theoretical framework. Assumptions are
foundational beliefs or propositions that are accepted without direct empirical evidence.]
9. What are the four domains that make up the nursing metaparadigm?
[Answer: The nursing metaparadigm is composed of person, health, environment, and
nursing.]
10. Why is Florence Nightingale referred to as the founder of modern nursing?
[Answer: Based on her work during the Crimean War, Florence Nightingale emphasized the
importance of cleanliness, fresh air, and proper nutrition in patient care, leading to a
revolution in how nurses viewed their job and laying the foundation for the
professionalization of nursing. She also established the first school of nursing and wrote a
textbook that is still used today.]
11. List three carative factors from Jean Watson’s theory of human caring.
[Answers will vary but should include any three of the following carative factors:
the formation of a humanistic-altruistic system of values
instillation of faith-hope
cultivation of sensitivity to self and others
development of a helping-trusting relationship
8
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promotion and acceptance of the expression of positive and negative feelings
systematic use of the scientific problem-solving method for decision-making
promotion of interpersonal teaching-learning
provision for a supportive, protective, and corrective mental, physical, sociocultural, and
spiritual environment
assistance with the gratification of human needs
allowance for existential-phenomenological forces]
12. How do theories help to define nursing as a profession?
[Answer: Theories delineate the fundamental principles and values of nursing practice.]
13. In directing future research, how do nursing theories contribute to the formulation of
research questions?
[Answer: Nursing theories provide a lens through which to explore and understand complex
phenomena.]
Reflection Questions
1. How has the COVID-19 pandemic influenced the rise of telehealth in nursing?
[Answer: The COVID-19 pandemic accelerated the integration of telehealth in nursing by
necessitating remote patient care delivery, leading to an increased reliance on digital
communication technologies for virtual consultations and monitoring, ensuring continuity
of care during times of unprecedented challenges.]
2. How does continuing education contribute to the professional growth and development of
nurses?
[Answers will vary but should include that continuing education contributes to the
professional growth and development of nurses by ensuring they stay current with evolving
medical knowledge, technological advancements, and best practices in patient care,
fostering ongoing competency, adaptability, and integration of evidence-based practices
into their clinical care.]
3. How do cultural competence and diversity play a role in your responsibilities as a caregiver?
[Answers will vary but should include that cultural competence and diversity are integral
aspects of the nurse’s responsibilities as a caregiver. Recognizing and respecting the diverse
backgrounds, beliefs, and values of patients is crucial in providing person-centered and
holistic care. In practice, this means tailoring one’s approach to care to accommodate
individual cultural preferences, ensuring the care provided is not only clinically effective but
also sensitive to the unique needs of each patient.]
4. How does the QSEN competency of teamwork and collaboration align with the standards of
nursing practice?
[Answer: Teamwork and collaboration in QSEN align with nursing practice standards by
promoting effective communication and interdisciplinary teamwork to enhance patient
outcomes and ensure the delivery of safe and coordinated care.]
5. How do concepts, phenomena, definitions, and assumptions collectively contribute to the
development of a nursing theory?
[Answer: Concepts, phenomena, definitions, and assumptions collectively contribute to the
development of a nursing theory by providing a structured framework. Concepts offer
foundational ideas, while phenomena focus on specific aspects of nursing practice. Clear
9
, definitions ensure a shared understanding, and assumptions, though not directly tested,
form foundational beliefs guiding the exploration and explanation of nursing phenomena
within the dynamic field of health care. Together, these elements shape the theory,
facilitating a comprehensive understanding and application of nursing principles.]
6. How can Dorothea Orem’s self-care deficit nursing theory be applied to promote patient
empowerment in contemporary nursing practice?
[Answers will vary but should include that Dorothea Orem’s self-care deficit nursing theory
can be applied to promote patient empowerment by assessing individual self-care abilities,
collaboratively setting goals, educating patients on self-care, and implementing tailored
interventions. The approach emphasizes fostering patient independence, adapting care to
individual needs, and continuously evaluating and adjusting the care plan to enhance self-
efficacy and encourage preventive health measures.]
What Should the Nurse Do?
1. A patient is expressing emotional distress and requires empathetic support. How should the
nurse demonstrate the soft skill of empathy to establish trust and understanding with the
patient?
[Answer: The nurse should employ active listening and provide verbal and nonverbal cues
that convey understanding and support. The nurse should acknowledge the patient’s
feelings, validate their emotions, and offer words of comfort. Maintaining eye contact, using
a calm and soothing tone, and displaying a compassionate demeanor are crucial in
establishing trust and understanding. Additionally, the nurse should refrain from judgment,
show genuine concern, and encourage the patient to express their emotions openly. This
empathetic approach fosters a therapeutic relationship, making the patient feel heard,
valued, and supported in their emotional well-being.]
2. A nurse working in a specialized area is considering pursuing specialty certification. What
steps should the nurse take to achieve certification?
[Answer: The nurse should start by researching the specific certification requirements for
their chosen field. This involves exploring educational criteria, clinical experience, and any
other eligibility requirements set by the certifying body. Once eligibility is confirmed, the
nurse should review the content outline, study relevant topics, and practice with sample
questions. After thorough preparation, the next step is to complete the application process
for certification. Once the application is approved, the nurse can schedule and take the
certification exam at a designated testing center.]
3. A nurse witnesses a colleague making inappropriate comments about a patient’s cultural
background. What should the nurse do to uphold standards of professionalism and person-
centered care?
[Answer: The nurse should address the issue privately, expressing concerns and
emphasizing the importance of cultural sensitivity. Encouraging cultural competence
education for both the nurse and the colleague can help foster awareness and
understanding. If the problem persists, reporting the incident to a supervisor and providing
10
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Instructor Answer Guide
Chapter 1: Introduction to the Nursing Profession: Evolution, Theories, and Practice..................3
Chapter 2: Communication...........................................................................................................14
Chapter 3: Healthcare Delivery Systems ...................................................................................... 19
Chapter 4: Health, Wellness, and Community-Based Health Care...............................................24
Chapter 5: Cultural Competence..................................................................................................32
Chapter 6: Promoting Individualized Care....................................................................................39
Chapter 7: Vital Signs....................................................................................................................43
Chapter 8: Admission, Transfer, and Discharge............................................................................51
Chapter 9: Safety and Security.....................................................................................................58
Chapter 10: Infection Control and Prevention ............................................................................. 64
Chapter 11: Medication Administration.......................................................................................71
Chapter 12: Assessment: Recognizing Cues ................................................................................. 80
Chapter 13: Diagnosis and Planning: Analyzing, Prioritizing, and Generating Solutions..............95
Chapter 14: Implementation and Evaluation: Taking Action, Evaluating Outcomes, and
Documentation...........................................................................................................................102
Chapter 15: Evidence-Based Research, Quality Improvement, and Collaborative Practice.......119
Chapter 16: Legal and Ethical Considerations............................................................................127
Chapter 17: Patient and Family Education.................................................................................135
Chapter 18: Leadership and Management in Nursing................................................................141
Chapter 19: Oxygenation and Perfusion.....................................................................................152
Chapter 20: Fluid, Electrolyte, and Acid-Base Balance...............................................................158
Chapter 21: Nutrition ................................................................................................................. 162
Chapter 22: Activity....................................................................................................................168
Chapter 23: Neuromuscular Function ........................................................................................ 175
Chapter 24: Skin Integrity...........................................................................................................181
Chapter 25: Hygiene...................................................................................................................187
Chapter 26: Urinary Elimination.................................................................................................192
Chapter 27: Bowel Elimination...................................................................................................202
2
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Chapter 28: Sleep and Rest ........................................................................................................ 211
Chapter 29: Sensory Alterations.................................................................................................217
Chapter 30: Pain Assessment.....................................................................................................226
Chapter 31: Perioperative Nursing Care.....................................................................................233
Chapter 32: Self-Concept............................................................................................................243
Chapter 33: Sexuality..................................................................................................................249
Chapter 34: Stress, Adaptation, and Homeostasis.....................................................................255
Chapter 35: Spirituality...............................................................................................................262
Chapter 36: Grief, Loss, Death, and Dying..................................................................................267
Chapter 37: Family Dynamics.....................................................................................................274
Chapter 38: Growth and Development......................................................................................280
Chapter 39: Conception Through Adolescence..........................................................................286
Chapter 40: Young and Middle-Aged Adults .............................................................................. 292
Chapter 41: Older Adults............................................................................................................299
Chapter 42: Caring for Patients with Disability and Chronic Illness............................................306
Chapter 43: Clinical Judgment and Critical Thinking .................................................................. 312
Chapter 1: Introduction to the Nursing Profession: Evolution, Theories,
and Practice
Review Questions
1. During the Middle Ages, who primarily undertook nursing duties, and where did they
provide care?
a. family members in their homes
b. monks and nuns in monasteries and convents
c. herbalists in communities
d. military personnel in wartime hospitals
[Answer: B]
2. What advancements occurred in the nursing profession during the mid-twentieth century?
a. expansion of nursing roles during World War II
b. establishment of the first nursing school
c. embrace of EHRs and telehealth
d. recognition of nurse practitioners as primary care providers
[Answer: A]
3. What milestone marked Florence Nightingale’s influence on the formalization and
professionalization of nursing education?
a. establishment of the ANA
b. creation of the first nursing school
3
, c. introduction of evidence-based practice
d. development of specialized nursing fields
[Answer: B]
4. What does the “art of nursing” primarily emphasize in patient care?
a. application of evidence-based knowledge
b. technical expertise in medical procedures
c. proficiency in administering medications
d. interpersonal and compassionate dimensions of care
[Answer: D]
5. What nursing program is designed to prepare individuals for entry-level positions in health
care and requires graduates to pass the NCLEX-PN for licensure?
a. Associate degree in nursing (ADN)
b. Bachelor of Science in nursing (BSN)
c. Master of Science in nursing (MSN)
d. Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN)
[Answer: D]
6. What is a common prerequisite for obtaining licensure as a registered nurse (RN) for both
ADN and BSN graduates?
a. completion of a clinical practicum
b. passing the NCLEX-PN
c. completion of a doctoral program
d. passing the NCLEX-RN
[Answer: D]
7. What is the primary goal of the Doctor of Nursing practice (DNP) program?
a. preparation for leadership roles in academia
b. research-focused doctoral education
c. emphasis on advanced clinical practice, leadership, and evidence-based decision-making
d. integration of theory, research, and public health in nursing practice
[Answer: C]
8. What distinguishes BSN-prepared nurses from ADN-prepared nurses?
a. broader education including leadership, research, and public health
b. shorter duration of education
c. limited involvement in patient care
d. increased focus on practical nursing skills
[Answer: A]
9. Which global organization significantly influences the development of the nursing
profession on a global scale and offers guidance regarding the scope of practice for nurses
around the world?
a. state BONs
b. QSEN
c. ICN
d. ANA
4
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10/24/2024
, OpenStax Fundamentals of Nursing Instructor Answer Guide
[Answer: C]
10. Which organization primarily oversees the regular review and updating of guidelines within
a given jurisdiction to align with advances in health care, changes in legislation, and evolving
societal needs related to nursing practice within a specific state or jurisdiction?
a. ANA
b. QSEN
c. state BONs
d. ICN
[Answer: C]
11. The nurse is precepting a nursing student during a clinical rotation. What statement made
by the student would warrant further education?
a. “Nursing standards serve as a framework for providing safe, quality care.”
b. “Nursing standards align with the overarching principles of the nursing profession.”
c. “Nursing standards articulate the expectations and ethical conduct required of nurses.”
d. “Nursing standards may be incorporated into practice if the nurse chooses to do so.”
[Answer: D]
12. The nurse takes proactive measures to prevent falls, such as using bed alarms and assisting
patients with mobility. What ethical principle do these measures emphasize?
a. autonomy
b. privacy
c. nonmaleficence
d. justice
[Answer: C]
13. What is the primary purpose of nursing theories?
a. to dictate medical interventions
b. to provide a framework for nursing practice
c. to establish healthcare policies
d. to replace medical guidelines
[Answer: B]
14. How did nursing theories contribute to the historical development of the nursing
profession?
a. by focusing on task-oriented practices
b. by discouraging research in nursing
c. by offering a basis for nursing interventions
d. by limiting the roles of nurses
[Answer: C]
15. In the late twentieth century, what shift occurred in the development of nursing theories?
a. a decline in the emphasis on evidence-based practice
b. a move toward task-oriented approaches
c. a decrease in the importance of research integration
d. a proliferation of theories addressing various aspects of nursing, health, and care
[Answer: D]
16. How do assumptions contribute to the theoretical framework in nursing?
a. by providing empirical evidence
5
, b. by establishing shared understanding
c. by forming foundational beliefs
d. by guiding research design
[Answer: C]
17. What does the term “environment” in nursing philosophy encompass?
a. a multifaceted combination of physical, social, cultural, economic, and global factors
b. solely individualized influences
c. physical surroundings without cultural implications
d. exclusively cultural values and customs without broader influences
[Answer: A]
18. Who emphasized the nurse-patient relationship as a therapeutic and collaborative
partnership in psychiatric nursing?
a. Jean Watson
b. Patricia Benner
c. Hildegard Peplau
d. Dorothea Orem
[Answer: C]
19. Who defined nursing as helping individuals achieve their highest level of independence in
activities of daily living?
a. Faye Abdellah
b. Patricia Benner
c. Florence Nightingale
d. Virginia Henderson
[Answer: D]
20. What type of nursing theory provides recommendations, interventions, or strategies for
achieving specific nursing goals?
a. adaptation theory
b. descriptive theory
c. developmental theories
d. prescriptive theory
[Answer: D]
21. What nursing theory views individuals as open, infinite energy fields that interact with the
environment in continuous and evolving patterns?
a. Orem’s self-care deficit nursing theory
b. Roger’s science of unitary human beings theory
c. Leininger’s culture care theory
d. Watson’s theory of human caring
[Answer: B]
22. In what phase of Peplau’s theory of interpersonal relations does the patient utilize the help
offered by the nurse to address problems and gain a better understanding of their
situation?
a. orientation phase
6
For more free, peer-reviewed, openly licensed resources visit OpenStax.org.
10/24/2024
, OpenStax Fundamentals of Nursing Instructor Answer Guide
b. identification phase
c. exploitation phase
d. resolution phase
[Answer: C]
23. A nursing instructor is talking with a student about the link between theory and knowledge
in nursing practice. What statement made by the nursing student would warrant further
education?
a. “Nursing theory benefits theoretical knowledge, and theoretical knowledge benefits
nursing theory.”
b. “Theoretical knowledge is derived from theory and provides a framework for critical
thinking.”
c. “Theories are applied within clinical practice as experiential knowledge.”
d. “Although reflection impacts knowledge in nursing practice, it does not impact the basic
nursing theories.”
[Answer: D]
24. What is the foundational role of nursing theory in the practice of nursing?
a. providing hands-on clinical experience
b. guiding patient communication
c. shaping the approach to patient care
d. offering administrative insights
[Answer: C]
25. What comment from a nursing student reflects the need for further education regarding
how incorporating nursing theory into research enhances the evidence base of the nursing
profession?
a. “Nursing theories ensure studies align with the core principles and values of the
profession.”
b. “The alignment of EBP with the core principles of the nursing profession is not
contingent upon the incorporation of nursing theory into research.”
c. “The integration of nursing theory in research ensures research outcomes are relevant
and applicable to the practical realities of nursing practice.”
d. “Understanding how nursing theory informs research priorities is key to advancing the
evidence base and promoting evidence-based practice in nursing.”
[Answer: B]
Check Your Understanding Questions
1. List three current trends in nursing.
[Answers will vary but may include continued nursing shortage, higher education
requirements, increased online nursing programs, rise of telehealth and technology in
health care, and the essential need for nurses’ self-care.]
2. What is the difference between soft skills and hard skills in nursing?
[Answer: Soft skills in nursing refer to interpersonal abilities and personal attributes that
enhance interactions with patients, families, and colleagues, such as communication,
empathy, and adaptability. In contrast, hard skills encompass technical and clinical
7
, competencies crucial for providing safe and effective patient care, such as conducting
clinical assessments, administering medications, and using medical equipment.]
3. Why is there an increasing emphasis on higher education requirements for entry into the
nursing profession?
[Answer: The emphasis on higher education requirements is to align nursing education with
the complexities of modern health care.]
4. What is the primary purpose of licensure in nursing?
[Answer: The primary purpose of licensure in nursing is to ensure that individuals practicing
nursing meet established standards of competency and adhere to ethical and legal
guidelines, providing a legal framework for accountability and protection of the public.]
5. What is the primary advantage of ADN-prepared nurses over LPNs/LVNs?
[Answer: ADN-prepared nurses have a broader scope of practice and involvement in patient
care decisions.]
6. What is the primary purpose of defining the scope of practice for nurses?
[Answer: The primary purpose is to ensure uniformity, safety, and quality in patient care.]
7. What are the six QSEN core competencies that align with nursing standards and guide
nursing education?
[Answer: The six core competencies are patient-centered care, teamwork and collaboration,
EBP, quality improvement, safety, and informatics.]
8. Name and define at least three of the key elements that comprise nursing theories.
[Answers will vary but may include concepts, phenomena, definitions, and assumptions. A
concept is an abstract and generalized idea that serves as a foundational element,
contributing to the overall structure and understanding of the theory. A phenomenon refers
to a specific aspect of interest or an observable occurrence that is the focus of theoretical
exploration and study. Definitions are clear and precise explanations of the meanings
attributed to specific concepts or terms within the theoretical framework. Assumptions are
foundational beliefs or propositions that are accepted without direct empirical evidence.]
9. What are the four domains that make up the nursing metaparadigm?
[Answer: The nursing metaparadigm is composed of person, health, environment, and
nursing.]
10. Why is Florence Nightingale referred to as the founder of modern nursing?
[Answer: Based on her work during the Crimean War, Florence Nightingale emphasized the
importance of cleanliness, fresh air, and proper nutrition in patient care, leading to a
revolution in how nurses viewed their job and laying the foundation for the
professionalization of nursing. She also established the first school of nursing and wrote a
textbook that is still used today.]
11. List three carative factors from Jean Watson’s theory of human caring.
[Answers will vary but should include any three of the following carative factors:
the formation of a humanistic-altruistic system of values
instillation of faith-hope
cultivation of sensitivity to self and others
development of a helping-trusting relationship
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, OpenStax Fundamentals of Nursing Instructor Answer Guide
promotion and acceptance of the expression of positive and negative feelings
systematic use of the scientific problem-solving method for decision-making
promotion of interpersonal teaching-learning
provision for a supportive, protective, and corrective mental, physical, sociocultural, and
spiritual environment
assistance with the gratification of human needs
allowance for existential-phenomenological forces]
12. How do theories help to define nursing as a profession?
[Answer: Theories delineate the fundamental principles and values of nursing practice.]
13. In directing future research, how do nursing theories contribute to the formulation of
research questions?
[Answer: Nursing theories provide a lens through which to explore and understand complex
phenomena.]
Reflection Questions
1. How has the COVID-19 pandemic influenced the rise of telehealth in nursing?
[Answer: The COVID-19 pandemic accelerated the integration of telehealth in nursing by
necessitating remote patient care delivery, leading to an increased reliance on digital
communication technologies for virtual consultations and monitoring, ensuring continuity
of care during times of unprecedented challenges.]
2. How does continuing education contribute to the professional growth and development of
nurses?
[Answers will vary but should include that continuing education contributes to the
professional growth and development of nurses by ensuring they stay current with evolving
medical knowledge, technological advancements, and best practices in patient care,
fostering ongoing competency, adaptability, and integration of evidence-based practices
into their clinical care.]
3. How do cultural competence and diversity play a role in your responsibilities as a caregiver?
[Answers will vary but should include that cultural competence and diversity are integral
aspects of the nurse’s responsibilities as a caregiver. Recognizing and respecting the diverse
backgrounds, beliefs, and values of patients is crucial in providing person-centered and
holistic care. In practice, this means tailoring one’s approach to care to accommodate
individual cultural preferences, ensuring the care provided is not only clinically effective but
also sensitive to the unique needs of each patient.]
4. How does the QSEN competency of teamwork and collaboration align with the standards of
nursing practice?
[Answer: Teamwork and collaboration in QSEN align with nursing practice standards by
promoting effective communication and interdisciplinary teamwork to enhance patient
outcomes and ensure the delivery of safe and coordinated care.]
5. How do concepts, phenomena, definitions, and assumptions collectively contribute to the
development of a nursing theory?
[Answer: Concepts, phenomena, definitions, and assumptions collectively contribute to the
development of a nursing theory by providing a structured framework. Concepts offer
foundational ideas, while phenomena focus on specific aspects of nursing practice. Clear
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, definitions ensure a shared understanding, and assumptions, though not directly tested,
form foundational beliefs guiding the exploration and explanation of nursing phenomena
within the dynamic field of health care. Together, these elements shape the theory,
facilitating a comprehensive understanding and application of nursing principles.]
6. How can Dorothea Orem’s self-care deficit nursing theory be applied to promote patient
empowerment in contemporary nursing practice?
[Answers will vary but should include that Dorothea Orem’s self-care deficit nursing theory
can be applied to promote patient empowerment by assessing individual self-care abilities,
collaboratively setting goals, educating patients on self-care, and implementing tailored
interventions. The approach emphasizes fostering patient independence, adapting care to
individual needs, and continuously evaluating and adjusting the care plan to enhance self-
efficacy and encourage preventive health measures.]
What Should the Nurse Do?
1. A patient is expressing emotional distress and requires empathetic support. How should the
nurse demonstrate the soft skill of empathy to establish trust and understanding with the
patient?
[Answer: The nurse should employ active listening and provide verbal and nonverbal cues
that convey understanding and support. The nurse should acknowledge the patient’s
feelings, validate their emotions, and offer words of comfort. Maintaining eye contact, using
a calm and soothing tone, and displaying a compassionate demeanor are crucial in
establishing trust and understanding. Additionally, the nurse should refrain from judgment,
show genuine concern, and encourage the patient to express their emotions openly. This
empathetic approach fosters a therapeutic relationship, making the patient feel heard,
valued, and supported in their emotional well-being.]
2. A nurse working in a specialized area is considering pursuing specialty certification. What
steps should the nurse take to achieve certification?
[Answer: The nurse should start by researching the specific certification requirements for
their chosen field. This involves exploring educational criteria, clinical experience, and any
other eligibility requirements set by the certifying body. Once eligibility is confirmed, the
nurse should review the content outline, study relevant topics, and practice with sample
questions. After thorough preparation, the next step is to complete the application process
for certification. Once the application is approved, the nurse can schedule and take the
certification exam at a designated testing center.]
3. A nurse witnesses a colleague making inappropriate comments about a patient’s cultural
background. What should the nurse do to uphold standards of professionalism and person-
centered care?
[Answer: The nurse should address the issue privately, expressing concerns and
emphasizing the importance of cultural sensitivity. Encouraging cultural competence
education for both the nurse and the colleague can help foster awareness and
understanding. If the problem persists, reporting the incident to a supervisor and providing
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