FUNDAMENTALS OF NURSING
12TH EDITION
• AUTHOR(S)PATRICIA A. POTTER;
ANNE G. PERRY; PATRICIA A.
STOCKERT; AMY HALL; WENDY
R. OSTENDORF
TEST BANK
,Question 1
A nurse is caring for four clients at the beginning of the shift.
Which client should the nurse assess first?
A. A client reporting new-onset shortness of breath after
ambulating to the bathroom
B. A client requesting pain medication for chronic back pain
rated 6/10
C. A client awaiting discharge instructions
D. A client asking for assistance with morning hygiene
Correct Answer: A
Rationale:
New-onset shortness of breath may indicate a life-threatening
respiratory problem requiring immediate assessment. The
nurse should prioritize airway and breathing concerns before
addressing pain, discharge teaching, or hygiene needs. Prompt
assessment allows early identification and intervention for
potential deterioration.
Question 2
A nurse enters a client's room and notices the client attempting
to get out of bed without assistance despite being identified as
a high fall risk. What is the nurse's priority action?
,A. Apply wrist restraints immediately.
B. Assist the client safely back to bed and determine why the
client attempted to get up.
C. Notify the healthcare provider.
D. Complete an incident report.
Correct Answer: B
Rationale:
The priority is preventing injury by safely assisting the client and
assessing the reason for the behavior, such as toileting needs or
pain. Restraints require a provider's order except in
emergencies and should not be the first intervention.
Notification and documentation may be appropriate later
depending on the assessment findings.
Question 3
A nurse prepares to administer an oral medication. The client
states, "That pill doesn't look like the one I usually take." What
should the nurse do first?
A. Tell the client the pharmacy occasionally changes
manufacturers.
B. Verify the medication against the medication administration
record before giving it.
C. Administer the medication because it matches the scheduled
time.
D. Document the client's refusal.
, Correct Answer: B
Rationale:
The nurse should stop and verify the medication before
administration whenever there is a concern. This action
supports safe medication practice and prevents potential errors.
Assumptions about manufacturer changes should never replace
verification.
Question 4
A nurse is teaching a client how to use an incentive spirometer
after surgery. Which client statement indicates correct
understanding?
A. "I will use the device only when I feel short of breath."
B. "I should inhale slowly and deeply through the mouthpiece."
C. "I will exhale forcefully into the device."
D. "I only need to use it once each day."
Correct Answer: B
Rationale:
The client should inhale slowly and deeply to promote lung
expansion and reduce postoperative pulmonary complications.
The device is used regularly as prescribed, not only when
symptoms occur, and exhalation is not performed into the
mouthpiece.
Question 5
12TH EDITION
• AUTHOR(S)PATRICIA A. POTTER;
ANNE G. PERRY; PATRICIA A.
STOCKERT; AMY HALL; WENDY
R. OSTENDORF
TEST BANK
,Question 1
A nurse is caring for four clients at the beginning of the shift.
Which client should the nurse assess first?
A. A client reporting new-onset shortness of breath after
ambulating to the bathroom
B. A client requesting pain medication for chronic back pain
rated 6/10
C. A client awaiting discharge instructions
D. A client asking for assistance with morning hygiene
Correct Answer: A
Rationale:
New-onset shortness of breath may indicate a life-threatening
respiratory problem requiring immediate assessment. The
nurse should prioritize airway and breathing concerns before
addressing pain, discharge teaching, or hygiene needs. Prompt
assessment allows early identification and intervention for
potential deterioration.
Question 2
A nurse enters a client's room and notices the client attempting
to get out of bed without assistance despite being identified as
a high fall risk. What is the nurse's priority action?
,A. Apply wrist restraints immediately.
B. Assist the client safely back to bed and determine why the
client attempted to get up.
C. Notify the healthcare provider.
D. Complete an incident report.
Correct Answer: B
Rationale:
The priority is preventing injury by safely assisting the client and
assessing the reason for the behavior, such as toileting needs or
pain. Restraints require a provider's order except in
emergencies and should not be the first intervention.
Notification and documentation may be appropriate later
depending on the assessment findings.
Question 3
A nurse prepares to administer an oral medication. The client
states, "That pill doesn't look like the one I usually take." What
should the nurse do first?
A. Tell the client the pharmacy occasionally changes
manufacturers.
B. Verify the medication against the medication administration
record before giving it.
C. Administer the medication because it matches the scheduled
time.
D. Document the client's refusal.
, Correct Answer: B
Rationale:
The nurse should stop and verify the medication before
administration whenever there is a concern. This action
supports safe medication practice and prevents potential errors.
Assumptions about manufacturer changes should never replace
verification.
Question 4
A nurse is teaching a client how to use an incentive spirometer
after surgery. Which client statement indicates correct
understanding?
A. "I will use the device only when I feel short of breath."
B. "I should inhale slowly and deeply through the mouthpiece."
C. "I will exhale forcefully into the device."
D. "I only need to use it once each day."
Correct Answer: B
Rationale:
The client should inhale slowly and deeply to promote lung
expansion and reduce postoperative pulmonary complications.
The device is used regularly as prescribed, not only when
symptoms occur, and exhalation is not performed into the
mouthpiece.
Question 5
