NUR 100 FINAL QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS
A 34-year-old single father who is anxious, tearful, and tired
from caring for his three young children tells the nurse that he
feels depressed and doesn't see how he can go on much longer.
Which of the following would be the nurse's best response?
A. "Are you thinking of suicide?"
B. "You've been doing a good job raising your children. You
can do it!"
C. "Is there someone who can help you during the evenings and
weekends?"
D. "What do you mean when you say you can't go on any
longer?" Correct Answer D. "What do you mean when you say
you can't go on any longer?"
A 44-year-old male patient has just been told that his wife and
child were killed in an auto accident while coming to visit him
in the hospital. Which of the following statements are defining
characteristics that support a nursing diagnosis of Spiritual
Distress related to loss of family members? (Select all that
apply.)
a. "I need to call my sister for support."
b. "I have nothing to live for now."
c.. "Why would my God do this to me?"
d. "I need to pray for a miracle."
e. "I want to be more involved in my church." Correct Answer
b. "I have nothing to live for now."
c.. "Why would my God do this to me?"
Patients most likely to have a diagnosis of spiritual distress are
facing loss or terminal or serious illness and have poor personal
,relationships. Indicating that there is nothing to live for now and
wondering why God would do this to him reflect dispiritedness
(e.g., expressing lack of hope, meaning, or purpose in life; anger
toward God). The other responses show a potential for
enhancement of spiritual well-being.
A 62-year-old patient had a portion of the large colon removed
and a colostomy created for drainage of stool. The nurse has had
repeated problems with the patient's colostomy bag not adhering
to the skin and thus leaking. The nurse wants to consult with the
wound care nurse specialist. Which of the following should the
nurse do? (Select all that apply.)
a. Assess condition of skin before making the call
b. Rely on the nurse specialist to know the type of surgery the
patient likely had
c. Explain the patient's response emotionally to the repeated
leaking of stool
d. Describe the type of bag being used and how long it lasts
before leaking
e. Order extra colostomy bags currently being used Correct
Answer a. Assess condition of skin before making the call
c. Explain the patient's response emotionally to the repeated
leaking of stool
d. Describe the type of bag being used and how long it lasts
before leaking
A 72-year-old male patient comes to the health clinic for an
annual follow-up. The nurse enters the patient's room and
notices him to be diaphoretic, holding his chest and breathing
with difficulty. The nurse immediately checks the patient's heart
rate and blood pressure and asks him, "Tell me where your pain
,is." Which of the following assessment approaches does this
scenario describe?
a. Review of systems approach
b. Use of a structured database format
c. Back channeling
d. A problem-oriented approach Correct Answer d. A problem-
oriented approach
This is an example of a problem-focused approach. The nurse
focuses on assessing one body system (cardiovascular) to
determine the nature of the patient's pain and other presenting
symptoms.
A child's immunization may cause discomfort during
administration, but the benefits of protection from disease, both
for the individual and society, outweigh the temporary
discomforts. Which principle is involved in this situation?
a.Fidelity
b.Beneficence
c.Nonmaleficence
d.Respect for autonomy Correct Answer b.Beneficence
Beneficence means "doing well" by taking positive actions. It
implies that the best interest of the patient (and society)
outweighs self-interest.
A confused patient who fell out of bed because side rails were
not used is an example of which type of liability?
1. Felony
2. Battery
3. Assault
4. Negligence Correct Answer 4. Negligence
, A crisis intervention nurse is working with a mother whose
Down syndrome child has been hospitalized with pneumonia
and who has lost her child's disability payment while the child is
hospitalized. The mother worries that her daughter will fall
behind in special-school classes during hospitalization. Which
strategies are effective in helping this mother cope with these
stressors? (Select all that apply.)
A. Referral to social service process reestablishing the child's
disability payment
B. Sending the child home in 72 hours and having the child
return to school
C. Coordinating hospital-based and home-based schooling with
the child's teacher
D. Teaching the mother signs and symptoms of a respiratory
tract infection
E. Telling the mother that the stress will decrease in 6 weeks
when everything is back to normal Correct Answer A. Referral
to social service process reestablishing the child's disability
payment
C. Coordinating hospital-based and home-based schooling with
the child's teacher
D. Teaching the mother signs and symptoms of a respiratory
tract infection
A faculty member is reviewing a nursing student's plan of care,
including the interventions the student provided for a patient
with dementia. The student reviewed clinical guidelines on a
professional website to identify interventions successful in
reducing wandering in patients with dementia. The faculty
member should evaluate which of the following? (Select all that
apply.)
COMPLETE SOLUTIONS
A 34-year-old single father who is anxious, tearful, and tired
from caring for his three young children tells the nurse that he
feels depressed and doesn't see how he can go on much longer.
Which of the following would be the nurse's best response?
A. "Are you thinking of suicide?"
B. "You've been doing a good job raising your children. You
can do it!"
C. "Is there someone who can help you during the evenings and
weekends?"
D. "What do you mean when you say you can't go on any
longer?" Correct Answer D. "What do you mean when you say
you can't go on any longer?"
A 44-year-old male patient has just been told that his wife and
child were killed in an auto accident while coming to visit him
in the hospital. Which of the following statements are defining
characteristics that support a nursing diagnosis of Spiritual
Distress related to loss of family members? (Select all that
apply.)
a. "I need to call my sister for support."
b. "I have nothing to live for now."
c.. "Why would my God do this to me?"
d. "I need to pray for a miracle."
e. "I want to be more involved in my church." Correct Answer
b. "I have nothing to live for now."
c.. "Why would my God do this to me?"
Patients most likely to have a diagnosis of spiritual distress are
facing loss or terminal or serious illness and have poor personal
,relationships. Indicating that there is nothing to live for now and
wondering why God would do this to him reflect dispiritedness
(e.g., expressing lack of hope, meaning, or purpose in life; anger
toward God). The other responses show a potential for
enhancement of spiritual well-being.
A 62-year-old patient had a portion of the large colon removed
and a colostomy created for drainage of stool. The nurse has had
repeated problems with the patient's colostomy bag not adhering
to the skin and thus leaking. The nurse wants to consult with the
wound care nurse specialist. Which of the following should the
nurse do? (Select all that apply.)
a. Assess condition of skin before making the call
b. Rely on the nurse specialist to know the type of surgery the
patient likely had
c. Explain the patient's response emotionally to the repeated
leaking of stool
d. Describe the type of bag being used and how long it lasts
before leaking
e. Order extra colostomy bags currently being used Correct
Answer a. Assess condition of skin before making the call
c. Explain the patient's response emotionally to the repeated
leaking of stool
d. Describe the type of bag being used and how long it lasts
before leaking
A 72-year-old male patient comes to the health clinic for an
annual follow-up. The nurse enters the patient's room and
notices him to be diaphoretic, holding his chest and breathing
with difficulty. The nurse immediately checks the patient's heart
rate and blood pressure and asks him, "Tell me where your pain
,is." Which of the following assessment approaches does this
scenario describe?
a. Review of systems approach
b. Use of a structured database format
c. Back channeling
d. A problem-oriented approach Correct Answer d. A problem-
oriented approach
This is an example of a problem-focused approach. The nurse
focuses on assessing one body system (cardiovascular) to
determine the nature of the patient's pain and other presenting
symptoms.
A child's immunization may cause discomfort during
administration, but the benefits of protection from disease, both
for the individual and society, outweigh the temporary
discomforts. Which principle is involved in this situation?
a.Fidelity
b.Beneficence
c.Nonmaleficence
d.Respect for autonomy Correct Answer b.Beneficence
Beneficence means "doing well" by taking positive actions. It
implies that the best interest of the patient (and society)
outweighs self-interest.
A confused patient who fell out of bed because side rails were
not used is an example of which type of liability?
1. Felony
2. Battery
3. Assault
4. Negligence Correct Answer 4. Negligence
, A crisis intervention nurse is working with a mother whose
Down syndrome child has been hospitalized with pneumonia
and who has lost her child's disability payment while the child is
hospitalized. The mother worries that her daughter will fall
behind in special-school classes during hospitalization. Which
strategies are effective in helping this mother cope with these
stressors? (Select all that apply.)
A. Referral to social service process reestablishing the child's
disability payment
B. Sending the child home in 72 hours and having the child
return to school
C. Coordinating hospital-based and home-based schooling with
the child's teacher
D. Teaching the mother signs and symptoms of a respiratory
tract infection
E. Telling the mother that the stress will decrease in 6 weeks
when everything is back to normal Correct Answer A. Referral
to social service process reestablishing the child's disability
payment
C. Coordinating hospital-based and home-based schooling with
the child's teacher
D. Teaching the mother signs and symptoms of a respiratory
tract infection
A faculty member is reviewing a nursing student's plan of care,
including the interventions the student provided for a patient
with dementia. The student reviewed clinical guidelines on a
professional website to identify interventions successful in
reducing wandering in patients with dementia. The faculty
member should evaluate which of the following? (Select all that
apply.)
