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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
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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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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
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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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1/16/2026
OpenStax Studies | OpenStax Textbooks & Study Resources Page 4 of 328 OpenStax Studies | OpenStax Textbooks & Study Resources
