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 hospitalized patient's room and finds the
patient unresponsive. After confirming the environment is safe,
what is the nurse's priority action?
A. Check for responsiveness and activate the emergency
response system if indicated.
B. Obtain the patient's medical record before intervening.
C. Raise the head of the bed to improve breathing.
D. Administer oxygen using a nasal cannula.
Correct Answer: A
Rationale:
The first priority is to assess responsiveness while ensuring
scene safety. If the patient is unresponsive, the nurse should
activate the emergency response system and begin the
appropriate assessment and resuscitation sequence according
to current guidelines. Retrieving records, positioning the
patient, or administering oxygen may become appropriate later
but should not delay recognition of cardiac or respiratory arrest.
Question 2
A nurse is preparing to administer prescribed medication.
Which action best demonstrates adherence to safe medication
administration principles?
,A. Administer the medication immediately after another nurse
identifies the patient.
B. Compare the medication label with the medication
administration record during preparation and before
administration.
C. Prepare medications for multiple patients at the same time
to improve efficiency.
D. Ask the patient to state only the room number for
identification.
Correct Answer: B
Rationale:
Comparing the medication label with the medication
administration record during preparation and before
administration helps reduce medication errors. Patient
identification should use at least two approved identifiers.
Preparing medications for multiple patients simultaneously
increases the risk of errors.
Question 3
A postoperative patient reports increasing pain despite
receiving prescribed analgesics. What should the nurse do first?
A. Notify the provider immediately.
B. Assess the characteristics, intensity, and location of the pain.
C. Encourage the patient to tolerate the discomfort.
D. Document that the medication was ineffective.
, Correct Answer: B
Rationale:
Assessment always precedes intervention. The nurse should
determine the pain's location, quality, intensity, timing, and
associated symptoms before deciding on further interventions
or notifying the provider. Comprehensive assessment guides
safe and individualized pain management.
Question 4
A nurse delegates the task of obtaining routine vital signs for a
stable patient to an assistive personnel (AP). Which
responsibility remains with the nurse?
A. Measuring the blood pressure
B. Recording the temperature
C. Interpreting the vital sign results and determining
appropriate interventions
D. Counting the respiratory rate
Correct Answer: C
Rationale:
Although AP may obtain and document routine vital signs for
stable patients, the nurse remains responsible for interpreting
assessment findings, identifying abnormalities, planning
interventions, and evaluating outcomes. Clinical judgment
cannot be delegated.
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 hospitalized patient's room and finds the
patient unresponsive. After confirming the environment is safe,
what is the nurse's priority action?
A. Check for responsiveness and activate the emergency
response system if indicated.
B. Obtain the patient's medical record before intervening.
C. Raise the head of the bed to improve breathing.
D. Administer oxygen using a nasal cannula.
Correct Answer: A
Rationale:
The first priority is to assess responsiveness while ensuring
scene safety. If the patient is unresponsive, the nurse should
activate the emergency response system and begin the
appropriate assessment and resuscitation sequence according
to current guidelines. Retrieving records, positioning the
patient, or administering oxygen may become appropriate later
but should not delay recognition of cardiac or respiratory arrest.
Question 2
A nurse is preparing to administer prescribed medication.
Which action best demonstrates adherence to safe medication
administration principles?
,A. Administer the medication immediately after another nurse
identifies the patient.
B. Compare the medication label with the medication
administration record during preparation and before
administration.
C. Prepare medications for multiple patients at the same time
to improve efficiency.
D. Ask the patient to state only the room number for
identification.
Correct Answer: B
Rationale:
Comparing the medication label with the medication
administration record during preparation and before
administration helps reduce medication errors. Patient
identification should use at least two approved identifiers.
Preparing medications for multiple patients simultaneously
increases the risk of errors.
Question 3
A postoperative patient reports increasing pain despite
receiving prescribed analgesics. What should the nurse do first?
A. Notify the provider immediately.
B. Assess the characteristics, intensity, and location of the pain.
C. Encourage the patient to tolerate the discomfort.
D. Document that the medication was ineffective.
, Correct Answer: B
Rationale:
Assessment always precedes intervention. The nurse should
determine the pain's location, quality, intensity, timing, and
associated symptoms before deciding on further interventions
or notifying the provider. Comprehensive assessment guides
safe and individualized pain management.
Question 4
A nurse delegates the task of obtaining routine vital signs for a
stable patient to an assistive personnel (AP). Which
responsibility remains with the nurse?
A. Measuring the blood pressure
B. Recording the temperature
C. Interpreting the vital sign results and determining
appropriate interventions
D. Counting the respiratory rate
Correct Answer: C
Rationale:
Although AP may obtain and document routine vital signs for
stable patients, the nurse remains responsible for interpreting
assessment findings, identifying abnormalities, planning
interventions, and evaluating outcomes. Clinical judgment
cannot be delegated.
