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 enters a client's room and finds the client sitting on the
floor next to the bed. What is the nurse's priority action?
A. Assist the client back into bed immediately.
B. Assess the client for injuries and level of consciousness.
C. Notify the provider before assessing the client.
D. Complete an incident report before documenting the event.
Correct Answer: B
Rationale:
The priority is to assess the client for injuries, level of
consciousness, pain, and other signs of harm before moving the
client. Assessment guides subsequent interventions and helps
prevent further injury. The client should not be moved until it is
safe to do so. The provider should be notified after the
assessment, and the incident report is completed according to
facility policy but is not part of the medical record.
Question 2
A nurse is preparing to administer a prescribed medication.
Which action best promotes medication safety?
A. Compare the medication label with the medication
administration record each time the medication is handled.
B. Prepare medications for multiple clients at the same time.
,C. Leave medications at the bedside if the client is sleeping.
D. Ask another client to verify the medication identity.
Correct Answer: A
Rationale:
Comparing the medication label with the medication
administration record during preparation and before
administration helps reduce medication errors. Preparing
medications for multiple clients increases the risk of errors.
Medications should not be left unattended unless specifically
permitted, and another client should never participate in
patient identification.
Question 3
A client tells the nurse, "I'm afraid my surgery won't go well."
Which response by the nurse is most therapeutic?
A. "You shouldn't worry because your surgeon is excellent."
B. "Everything will be fine."
C. "Tell me more about what concerns you most."
D. "Many people feel this way before surgery."
Correct Answer: C
Rationale:
Inviting the client to discuss specific concerns encourages
expression of feelings and helps the nurse assess anxiety.
Offering false reassurance or minimizing concerns can
, discourage communication. Acknowledging feelings is
appropriate, but exploring the client's concerns provides the
greatest therapeutic benefit.
Question 4
The nurse is caring for a client who has been on bed rest for
several days. Which assessment finding requires the most
immediate intervention?
A. Mild muscle weakness
B. Blanchable redness over the sacrum
C. Decreased appetite
D. Dry lips
Correct Answer: B
Rationale:
Blanchable redness is an early indicator of pressure injury risk
and requires prompt interventions such as repositioning,
pressure redistribution, and skin protection. Although the other
findings also require nursing care, preventing skin breakdown is
a priority because pressure injuries can develop rapidly in
immobile clients.
Question 5
A nurse is teaching a client how to reduce the risk of infection
after returning home with a surgical incision. Which statement
by the client indicates correct understanding?
12TH EDITION
• AUTHOR(S)PATRICIA A. POTTER;
ANNE G. PERRY; PATRICIA A.
STOCKERT; AMY HALL; WENDY
R. OSTENDORF
TEST BANK
,Question 1
A nurse enters a client's room and finds the client sitting on the
floor next to the bed. What is the nurse's priority action?
A. Assist the client back into bed immediately.
B. Assess the client for injuries and level of consciousness.
C. Notify the provider before assessing the client.
D. Complete an incident report before documenting the event.
Correct Answer: B
Rationale:
The priority is to assess the client for injuries, level of
consciousness, pain, and other signs of harm before moving the
client. Assessment guides subsequent interventions and helps
prevent further injury. The client should not be moved until it is
safe to do so. The provider should be notified after the
assessment, and the incident report is completed according to
facility policy but is not part of the medical record.
Question 2
A nurse is preparing to administer a prescribed medication.
Which action best promotes medication safety?
A. Compare the medication label with the medication
administration record each time the medication is handled.
B. Prepare medications for multiple clients at the same time.
,C. Leave medications at the bedside if the client is sleeping.
D. Ask another client to verify the medication identity.
Correct Answer: A
Rationale:
Comparing the medication label with the medication
administration record during preparation and before
administration helps reduce medication errors. Preparing
medications for multiple clients increases the risk of errors.
Medications should not be left unattended unless specifically
permitted, and another client should never participate in
patient identification.
Question 3
A client tells the nurse, "I'm afraid my surgery won't go well."
Which response by the nurse is most therapeutic?
A. "You shouldn't worry because your surgeon is excellent."
B. "Everything will be fine."
C. "Tell me more about what concerns you most."
D. "Many people feel this way before surgery."
Correct Answer: C
Rationale:
Inviting the client to discuss specific concerns encourages
expression of feelings and helps the nurse assess anxiety.
Offering false reassurance or minimizing concerns can
, discourage communication. Acknowledging feelings is
appropriate, but exploring the client's concerns provides the
greatest therapeutic benefit.
Question 4
The nurse is caring for a client who has been on bed rest for
several days. Which assessment finding requires the most
immediate intervention?
A. Mild muscle weakness
B. Blanchable redness over the sacrum
C. Decreased appetite
D. Dry lips
Correct Answer: B
Rationale:
Blanchable redness is an early indicator of pressure injury risk
and requires prompt interventions such as repositioning,
pressure redistribution, and skin protection. Although the other
findings also require nursing care, preventing skin breakdown is
a priority because pressure injuries can develop rapidly in
immobile clients.
Question 5
A nurse is teaching a client how to reduce the risk of infection
after returning home with a surgical incision. Which statement
by the client indicates correct understanding?
