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 a patient who is 8 hours postoperative
following abdominal surgery. Which assessment finding
requires the most immediate nursing action?
A. Pain rating of 6 on a 0–10 scale
B. Respiratory rate of 10 breaths/min and difficult to arouse
C. Temperature of 37.8°C (100°F)
D. Blood pressure of 138/82 mm Hg
Correct Answer: B
Rationale:
A respiratory rate of 10 breaths/min accompanied by decreased
responsiveness may indicate opioid-induced respiratory
depression and requires immediate intervention to protect
airway and breathing. Pain, mild postoperative fever, and a
slightly elevated blood pressure are expected findings and are
less urgent than impaired ventilation.
Question 2
A nurse is preparing to administer a medication and notices
that the prescribed dose appears significantly higher than the
usual dose. What is the nurse's best action?
A. Administer the medication as prescribed
B. Ask another nurse to administer the medication
,C. Verify the prescription with the provider before
administration
D. Reduce the dose to the usual amount
Correct Answer: C
Rationale:
When a medication dose appears unusual or potentially unsafe,
the nurse should verify the prescription with the provider
before administration. Administering the medication without
clarification may harm the patient. Changing the dose
independently is outside the nurse's scope of practice.
Question 3
A patient tells the nurse, "I don't think this treatment is helping
me." Which response by the nurse demonstrates therapeutic
communication?
A. "You shouldn't feel that way."
B. "The provider knows what is best for you."
C. "Tell me more about what concerns you regarding the
treatment."
D. "Many patients have the same complaint."
Correct Answer: C
Rationale:
Inviting the patient to elaborate encourages expression of
concerns and facilitates assessment. Therapeutic
, communication focuses on understanding the patient's
perspective. The other responses dismiss, minimize, or redirect
the patient's feelings.
Question 4
A nurse is assessing a patient who suddenly develops shortness
of breath while ambulating. What is the nurse's priority action?
A. Assist the patient to sit down and assess oxygenation
B. Document the event
C. Obtain a routine set of vital signs in 30 minutes
D. Encourage the patient to continue walking
Correct Answer: A
Rationale:
The priority is to stop the activity, ensure patient safety, and
assess airway, breathing, and circulation. Assisting the patient
to sit and evaluating oxygenation addresses an immediate
physiological concern. Documentation occurs after
interventions are completed.
Question 5
A nurse is caring for a patient at risk for pressure injuries. Which
intervention is most effective in reducing this risk?
A. Limiting fluid intake
B. Repositioning the patient regularly
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 a patient who is 8 hours postoperative
following abdominal surgery. Which assessment finding
requires the most immediate nursing action?
A. Pain rating of 6 on a 0–10 scale
B. Respiratory rate of 10 breaths/min and difficult to arouse
C. Temperature of 37.8°C (100°F)
D. Blood pressure of 138/82 mm Hg
Correct Answer: B
Rationale:
A respiratory rate of 10 breaths/min accompanied by decreased
responsiveness may indicate opioid-induced respiratory
depression and requires immediate intervention to protect
airway and breathing. Pain, mild postoperative fever, and a
slightly elevated blood pressure are expected findings and are
less urgent than impaired ventilation.
Question 2
A nurse is preparing to administer a medication and notices
that the prescribed dose appears significantly higher than the
usual dose. What is the nurse's best action?
A. Administer the medication as prescribed
B. Ask another nurse to administer the medication
,C. Verify the prescription with the provider before
administration
D. Reduce the dose to the usual amount
Correct Answer: C
Rationale:
When a medication dose appears unusual or potentially unsafe,
the nurse should verify the prescription with the provider
before administration. Administering the medication without
clarification may harm the patient. Changing the dose
independently is outside the nurse's scope of practice.
Question 3
A patient tells the nurse, "I don't think this treatment is helping
me." Which response by the nurse demonstrates therapeutic
communication?
A. "You shouldn't feel that way."
B. "The provider knows what is best for you."
C. "Tell me more about what concerns you regarding the
treatment."
D. "Many patients have the same complaint."
Correct Answer: C
Rationale:
Inviting the patient to elaborate encourages expression of
concerns and facilitates assessment. Therapeutic
, communication focuses on understanding the patient's
perspective. The other responses dismiss, minimize, or redirect
the patient's feelings.
Question 4
A nurse is assessing a patient who suddenly develops shortness
of breath while ambulating. What is the nurse's priority action?
A. Assist the patient to sit down and assess oxygenation
B. Document the event
C. Obtain a routine set of vital signs in 30 minutes
D. Encourage the patient to continue walking
Correct Answer: A
Rationale:
The priority is to stop the activity, ensure patient safety, and
assess airway, breathing, and circulation. Assisting the patient
to sit and evaluating oxygenation addresses an immediate
physiological concern. Documentation occurs after
interventions are completed.
Question 5
A nurse is caring for a patient at risk for pressure injuries. Which
intervention is most effective in reducing this risk?
A. Limiting fluid intake
B. Repositioning the patient regularly
