EXAM 1: COMPREHENSIVE 100-QUESTION TEST BANK
WITH EVIDENCE-BASED RATIONALES
1. A nurse is caring for a patient who has just been diagnosed with
terminal cancer. The patient is crying and states, "I don't want to die."
Which nursing action best demonstrates the role of advocate?
A. Telling the patient that everything will be okay
B. Leaving the patient alone to process emotions
C. Contacting the physician to discuss the patient's concerns and wishes
D. Administering a sedative to help the patient relax
Correct Answer: C. Contacting the physician to discuss the patient's
concerns and wishes
Rationale: As an advocate, the nurse intercedes or works on behalf of
the client. This involves identifying the client's needs and problems and
communicating them to other members of the health team. Contacting
the physician to discuss the patient's concerns demonstrates advocacy
by ensuring the patient's voice is heard in treatment decisions.
2. A nursing student is performing a physical assessment. According to
Benner's theory, which characteristic describes a novice nurse?
A. Intuitive grasp of clinical situations
B. Flexible and able to modify care plans
,C. Governed by rules and usually inflexible
D. Able to perceive situations without evidence
Correct Answer: C. Governed by rules and usually inflexible
Rationale: A novice nurse is governed by rules and usually inflexible,
following established protocols without the ability to adapt based on
experience. Expert nurses develop intuition and can perceive situations
without further evidence. Competent nurses plan nursing care
consciously, and advanced beginners demonstrate acceptable
performance.
3. A community health nurse is conducting health screenings for
hypertension at a local mall. This activity is an example of which level
of prevention?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Health promotion
Correct Answer: B. Secondary prevention
Rationale: Secondary prevention focuses on early detection and early
treatment of disease. Health screenings, such as blood pressure checks,
mammograms, and TB testing, are examples of secondary prevention
aimed at identifying disease in its early stages when treatment is most
effective.
,4. A nurse in the intensive care unit is caring for a patient on a
ventilator. The nurse notices the patient's oxygen saturation dropping
and immediately assesses the patient's airway. The nurse is
functioning in which role?
A. Advocate
B. Caregiver
C. Change agent
D. Communicator
Correct Answer: B. Caregiver
Rationale: The role of a nurse as caregiver helps clients promote,
restore, and maintain dignity, health, and wellness by viewing a person
holistically. The nurse who assesses the patient's airway and intervenes
to maintain oxygenation is functioning as a caregiver, providing direct
nursing care to meet the patient's physiological needs.
5. A patient with diabetes is learning to self-administer insulin. The
nurse teaches the patient how to rotate injection sites to prevent
lipodystrophy. According to Benner's theory, a nurse who can modify
care plans based on patient responses is at which level?
A. Novice
B. Advanced beginner
C. Competent
D. Expert
Correct Answer: C. Competent
Rationale: Competent nurses are planning nursing care consciously and
can modify care based on patient responses. They have developed the
, ability to anticipate patient needs and adjust care plans accordingly,
demonstrating a higher level of clinical judgment than advanced
beginners.
6. A patient's chart contains the following nursing diagnosis: "Risk for
Impaired Skin Integrity related to immobility." This is an example of
which type of nursing diagnosis?
A. Wellness nursing diagnosis
B. Actual nursing diagnosis
C. Syndrome nursing diagnosis
D. Risk nursing diagnosis
Correct Answer: D. Risk nursing diagnosis
Rationale: A risk nursing diagnosis is based on clinical judgment that the
client may develop vulnerability to the problem. It describes a problem
that does not currently exist but for which the client has risk factors.
This diagnosis is written as "Risk for [problem] related to [risk factors]."
7. A nurse is converting a patient's temperature from Celsius to
Fahrenheit. The patient's temperature is 37.5°C. What is the
equivalent Fahrenheit temperature?
A. 99.5°F
B. 100.1°F
C. 98.6°F
D. 101.3°F
Correct Answer: A. 99.5°F