TEST BANK FOR ADULT
HEALTH NURSING
ADVANCED EXAM
QUESTIONS AND
ANSWERS
1. In the past three to four decades, nursing has moved into the forefront in providing care for the
dying. Which phenomenon has most contributed to this increased focus of care of the dying?
A) Increased incidence of infections and acute illnesses
B) Increased focus of health care providers on disease prevention
C)Larger numbers of people dying in hospital settings
D) Demographic changes in the population - CORRECT ANSWER -D
2. A nurse who works in the specialty of palliative care frequently encounters issues and
situations that constitute ethical dilemmas. What issue has most often presented challenging
ethical issues, especially in the context of palliative care? A) The increase in cultural diversity
in the United States B) Staffing shortages in health care and questions concerning quality of
care C) Increased costs of health care coupled with inequalities in access D) Ability of
technology to prolong life beyond meaningful quality of life - CORRECT ANSWER -D
The nurse is caring for a patient who has been recently diagnosed with late stage pancreatic
cancer. The patient refuses to accept the diagnosis and refuses to adhere to treatment. What is
the most likely psychosocial purpose of this patients strategy? A) The patient may be trying to
protect loved ones from the emotional effects of the illness. B) The patient is being noncompliant
in order to assert power over caregivers. C) The patient may be skeptical 0of 0the 0benefits 0of
0the 0Western 0biomedical 0model 0of 0health.
D) 0The 0patient 0thinks 0that 0treatment 0does 0not 0provide 0him 0comfort. 0- 0CORRECT
0ANSWER 0-A
,4. A 0nurse 0who 0sits 0on 0the 0hospitals 0ethics 0committee 0is 0reviewing 0a 0complex 0case
0that 0has 0many 0of 0the 0hallmarks 0of 0assisted 0suicide. 0Which 0of 0the 0following 0would 0be
0an 0example 0of 0assisted 0suicide? 0A) 0Administering 0a 0lethal 0dose 0of 0medication 0to 0a
0patient 0whose 0death 0is 0imminent 0B) 0Administering 0a 0morphine 0infusion 0without
0assessing 0for 0respiratory 0depression 0C) 0Granting 0a 0patients 0request 0not 0to 0initiate
0enteral 0feeding 0when 0the 0patient 0is 0unable 0to 0eat 0D) 0Neglecting 0to 0resuscitate 0a
0patient 0with 0a 0do 0not 0resuscitate 0order 0- 0CORRECT 0ANSWER 0-A
5. A 0medical 0nurse 0is 0providing 0palliative 0care 0to 0a 0patient 0with 0a 0diagnosis 0of 0end-
stage 0chronic 0obstructive 0pulmonary 0disease 0(COPD). 0What 0is 0the 0primary 0goal 0of 0this
0nurses 0care? 0A) 0To 0improve 0the 0patients 0and 0familys 0quality 0of 0life 0Test 0Bank 0-
0Brunner 0& 0Suddarth's 0Textbook 0of 0Medical-Surgical 0Nursing 014e 0(Hinkle 02017) 0320 0B)
0To 0support 0aggressive 0and 0innovative 0treatments 0for 0cure 0C) 0To 0provide 0physical
0support 0for 0the 0patient 0D) 0To 0help 0the 0patient 0develop 0a 0separate 0plan 0with 0each
0discipline 0of 0the 0health 0care 0team 0- 0CORRECT 0ANSWER 0-A
After 0contributing 0to 0the 0care 0of 0several 0patients 0who 0died 0in 0the 0hospital, 0the 0nurse
0has 0identified 0some 0lapses 0in 0the 0care 0that 0many 0of 0these 0patients 0received 0toward
0the 0end 0of 0their 0lives. 0What 0have 0research 0studies 0identified 0as 0a 0potential 0deficiency
0in 0the 0care 0of 0the 0dying 0in 0hospital 0settings? 0A) 0Families 0needs 0for 0information 0and
0support 0often 0go 0unmet. 0B) 0Patients 0are 0too 0sedated 0to 0achieve 0adequate 0pain
0control. 0C) 0Patients 0are 0not 0given 0opportunities 0to 0communicate 0with 0caregivers. 0D)
0Patients 0are 0ignored 0by 0the 0care 0team 0toward 0the 0end 0of 0life. 0- 0CORRECT 0ANSWER
0-A
An 0adult 0oncology 0patient 0has 0a 0diagnosis 0of 0bladder 0cancer 0with 0metastasis 0and 0the
0patient 0has 0asked 0the 0nurse 0about 0the 0possibility 0of 0hospice 0care. 0Which 0principle 0is
0central 0to 0a 0hospice 0setting? 0A) 0The 0patient 0and 0family 0should 0be 0viewed 0as 0a 0single
0unit 0of 0care. 0B) 0Persistent 0symptoms 0of 0terminal 0illness 0should 0not 0be 0treated. 0C)
0Each 0member 0of 0the 0interdisciplinary 0team 0should 0develop 0an 0individual 0plan 0 of 0care.
0Test 0Bank 0- 0Brunner 0& 0Suddarth's 0Textbook 0of 0Medical-Surgical 0Nursing 014e 0(Hinkle
02017) 0321 0D) 0Terminally 0ill 0patients 0should 0die 0in 0the 0hospital 0whenever 0possible. 0-
0CORRECT 0ANSWER 0-A
A 0clinic 0nurse 0is 0providing 0patient 0education 0prior 0to 0a 0patients 0scheduled 0palliative
0radiotherapy 0to 0her 0spine. 0At 0the 0completion 0of 0the 0patient 0teaching, 0the 0patient
0continues 0to 0ask 0the 0same 0questions 0that 0the 0nurse 0has 0already 0addressed. 0What 0is
0the 0plausible 0conclusion 0that 0the 0nurse 0should 0draw 0from 0this?
A) The 0patient 0is 0not 0listening 0effectively. 0B) 0The 0patient 0is 0noncompliant 0with 0the
0plan 0of 0care. 0C) 0The 0patient 0may 0have 0a 0low 0intelligence 0quotient 0or 0a 0cognitive
0deficit. 0D) 0The 0patient 0has 0not 0achieved 0the 0desired 0learning 0outcomes. 0- 0CORRECT
0ANSWER 0-D
, The 0nurse 0is 0part 0of 0the 0health 0care 0team 0at 0an 0oncology 0center. 0A 0patient 0has 0been
0diagnosed 0with 0leukemia 0and 0the 0prognosis 0is 0poor, 0but 0the 0patient 0is 0not 0yet 0aware 0of
0the 0prognosis. 0How 0can 0the 0bad 0news 0best 0be 0conveyed 0to 0the 0patient? 0A) 0Family
0should 0be 0given 0the 0prognosis 0first. 0B) 0The 0prognosis 0should 0be 0delivered 0with 0the
0patient 0at 0eye 0level. 0C) 0The 0physician 0should 0deliver 0the 0news 0to 0the 0patient 0alone. 0D)
0The 0appointment 0should 0be 0scheduled 0at 0the 0end 0of 0the 0day 0- 0CORRECT 0ANSWER 0-
B
A 0patient 0has 0just 0been 0told 0that 0her 0illness 0is 0terminal. 0The 0patient 0tearfully 0states,
0I 0cant 0believe 0I 0am 0going 0to 0die. 0Why 0me? 0What 0is 0your 0best 0response? 0A) 0I
0know 0how 0you 0are 0feeling. 0B) 0You 0have 0lived 0a 0long 0life. 0C) 0This 0must 0be 0very
0difficult 0for 0you. 0D) 0Life 0can 0be 0so 0unfair. 0- 0CORRECT 0ANSWER 0-C
The 0nurse 0has 0observed 0that 0an 0older 0adult 0patient 0with 0a 0diagnosis 0of 0end-stage 0renal
0failure 0seems 0to 0prefer 0to 0have 0his 0eldest 0son 0make 0all 0of 0his 0health 0care 0decisions.
0While 0the 0family 0is 0visiting, 0the 0patient 0explains 0to 0you 0that 0this 0is 0a 0cultural 0practice
0and 0very 0important 0to 0him. 0How 0should 0you 0respond? 0A) 0Privately 0ask 0the 0son 0to 0allow
0the 0patient 0to 0make 0his 0own 0health 0care 0decisions. 0B) 0Explain 0to 0the 0patient 0that 0he 0is
0responsible 0for 0his 0own 0decisions. 0C) 0Work 0with 0the 0team 0to 0negotiate 0informed
0consent. 0D) 0Avoid 0divulging 0information 0to 0the 0eldest 0son 0- 0CORRECT 0ANSWER 0-C
One 0aspect 0of 0the 0nurses 0comprehensive 0assessment 0when 0caring 0for 0the 0terminally 0ill
0is 0the 0assessment 0of 0hope. 0The 0nurse 0is 0assessing 0a 0patient 0with 0liver 0failure 0for 0the
0presence 0of 0hope. 0What 0would 0the 0nurse 0identify 0as 0a 0hope-fostering 0category? 0A)
0Uplifting 0memories 0B) 0Ignoring 0negative 0outcomes 0C) 0Envisioning 0one 0specific 0outcome
0D) 0Avoiding 0an 0actual 0or 0potential 0threat 0- 0CORRECT 0ANSWER 0-A
A 0medical 0nurse 0is 0providing 0end-of-life 0care 0for 0a 0patient 0with 0metastatic 0bone 0cancer.
0The 0nurse 0notes 0that 0the 0patient 0has 0been 0receiving 0oral 0analgesics 0for 0her 0pain 0with
0adequate 0effect, 0but 0is 0now 0having 0difficulty 0swallowing 0the 0medication. 0What 0should
0the 0nurse 0do? 0A) 0Request 0the 0physician 0to 0order 0analgesics 0by 0an 0alternative 0route. 0B)
0Crush 0the 0medication 0in 0order 0to 0aid 0swallowing 0and 0absorption. 0C) 0Administer 0the
0patients 0medication 0with 0the 0meal 0tray. 0D) 0Administer 0the 0medication 0rectally 0-
0CORRECT 0ANSWER 0-A
A 066-year-old 0patient 0is 0in 0a 0hospice 0receiving 0palliative 0care 0for 0lung 0cancer 0which
0has 0metastasized 0to 0the 0patients 0liver 0and 0bones. 0For 0the 0past 0several 0hours, 0the
0patient 0has 0been 0experiencing 0dyspnea.
What 0nursing 0action 0is 0most 0appropriate 0to 0help 0to 0relive 0the 0dyspnea 0the 0patient 0is
0experiencing? 0Test 0Bank 0- 0Brunner 0& 0Suddarth's 0Textbook 0of 0Medical-Surgical 0Nursing
014e 0(Hinkle 02017) 0324 0A) 0Administer 0a 0bolus 0of 0normal 0saline, 0as 0ordered. 0B) 0Initiate
0high-flow 0oxygen 0therapy. 0C) 0Administer 0high 0doses 0of 0opioids. 0D) 0Administer
HEALTH NURSING
ADVANCED EXAM
QUESTIONS AND
ANSWERS
1. In the past three to four decades, nursing has moved into the forefront in providing care for the
dying. Which phenomenon has most contributed to this increased focus of care of the dying?
A) Increased incidence of infections and acute illnesses
B) Increased focus of health care providers on disease prevention
C)Larger numbers of people dying in hospital settings
D) Demographic changes in the population - CORRECT ANSWER -D
2. A nurse who works in the specialty of palliative care frequently encounters issues and
situations that constitute ethical dilemmas. What issue has most often presented challenging
ethical issues, especially in the context of palliative care? A) The increase in cultural diversity
in the United States B) Staffing shortages in health care and questions concerning quality of
care C) Increased costs of health care coupled with inequalities in access D) Ability of
technology to prolong life beyond meaningful quality of life - CORRECT ANSWER -D
The nurse is caring for a patient who has been recently diagnosed with late stage pancreatic
cancer. The patient refuses to accept the diagnosis and refuses to adhere to treatment. What is
the most likely psychosocial purpose of this patients strategy? A) The patient may be trying to
protect loved ones from the emotional effects of the illness. B) The patient is being noncompliant
in order to assert power over caregivers. C) The patient may be skeptical 0of 0the 0benefits 0of
0the 0Western 0biomedical 0model 0of 0health.
D) 0The 0patient 0thinks 0that 0treatment 0does 0not 0provide 0him 0comfort. 0- 0CORRECT
0ANSWER 0-A
,4. A 0nurse 0who 0sits 0on 0the 0hospitals 0ethics 0committee 0is 0reviewing 0a 0complex 0case
0that 0has 0many 0of 0the 0hallmarks 0of 0assisted 0suicide. 0Which 0of 0the 0following 0would 0be
0an 0example 0of 0assisted 0suicide? 0A) 0Administering 0a 0lethal 0dose 0of 0medication 0to 0a
0patient 0whose 0death 0is 0imminent 0B) 0Administering 0a 0morphine 0infusion 0without
0assessing 0for 0respiratory 0depression 0C) 0Granting 0a 0patients 0request 0not 0to 0initiate
0enteral 0feeding 0when 0the 0patient 0is 0unable 0to 0eat 0D) 0Neglecting 0to 0resuscitate 0a
0patient 0with 0a 0do 0not 0resuscitate 0order 0- 0CORRECT 0ANSWER 0-A
5. A 0medical 0nurse 0is 0providing 0palliative 0care 0to 0a 0patient 0with 0a 0diagnosis 0of 0end-
stage 0chronic 0obstructive 0pulmonary 0disease 0(COPD). 0What 0is 0the 0primary 0goal 0of 0this
0nurses 0care? 0A) 0To 0improve 0the 0patients 0and 0familys 0quality 0of 0life 0Test 0Bank 0-
0Brunner 0& 0Suddarth's 0Textbook 0of 0Medical-Surgical 0Nursing 014e 0(Hinkle 02017) 0320 0B)
0To 0support 0aggressive 0and 0innovative 0treatments 0for 0cure 0C) 0To 0provide 0physical
0support 0for 0the 0patient 0D) 0To 0help 0the 0patient 0develop 0a 0separate 0plan 0with 0each
0discipline 0of 0the 0health 0care 0team 0- 0CORRECT 0ANSWER 0-A
After 0contributing 0to 0the 0care 0of 0several 0patients 0who 0died 0in 0the 0hospital, 0the 0nurse
0has 0identified 0some 0lapses 0in 0the 0care 0that 0many 0of 0these 0patients 0received 0toward
0the 0end 0of 0their 0lives. 0What 0have 0research 0studies 0identified 0as 0a 0potential 0deficiency
0in 0the 0care 0of 0the 0dying 0in 0hospital 0settings? 0A) 0Families 0needs 0for 0information 0and
0support 0often 0go 0unmet. 0B) 0Patients 0are 0too 0sedated 0to 0achieve 0adequate 0pain
0control. 0C) 0Patients 0are 0not 0given 0opportunities 0to 0communicate 0with 0caregivers. 0D)
0Patients 0are 0ignored 0by 0the 0care 0team 0toward 0the 0end 0of 0life. 0- 0CORRECT 0ANSWER
0-A
An 0adult 0oncology 0patient 0has 0a 0diagnosis 0of 0bladder 0cancer 0with 0metastasis 0and 0the
0patient 0has 0asked 0the 0nurse 0about 0the 0possibility 0of 0hospice 0care. 0Which 0principle 0is
0central 0to 0a 0hospice 0setting? 0A) 0The 0patient 0and 0family 0should 0be 0viewed 0as 0a 0single
0unit 0of 0care. 0B) 0Persistent 0symptoms 0of 0terminal 0illness 0should 0not 0be 0treated. 0C)
0Each 0member 0of 0the 0interdisciplinary 0team 0should 0develop 0an 0individual 0plan 0 of 0care.
0Test 0Bank 0- 0Brunner 0& 0Suddarth's 0Textbook 0of 0Medical-Surgical 0Nursing 014e 0(Hinkle
02017) 0321 0D) 0Terminally 0ill 0patients 0should 0die 0in 0the 0hospital 0whenever 0possible. 0-
0CORRECT 0ANSWER 0-A
A 0clinic 0nurse 0is 0providing 0patient 0education 0prior 0to 0a 0patients 0scheduled 0palliative
0radiotherapy 0to 0her 0spine. 0At 0the 0completion 0of 0the 0patient 0teaching, 0the 0patient
0continues 0to 0ask 0the 0same 0questions 0that 0the 0nurse 0has 0already 0addressed. 0What 0is
0the 0plausible 0conclusion 0that 0the 0nurse 0should 0draw 0from 0this?
A) The 0patient 0is 0not 0listening 0effectively. 0B) 0The 0patient 0is 0noncompliant 0with 0the
0plan 0of 0care. 0C) 0The 0patient 0may 0have 0a 0low 0intelligence 0quotient 0or 0a 0cognitive
0deficit. 0D) 0The 0patient 0has 0not 0achieved 0the 0desired 0learning 0outcomes. 0- 0CORRECT
0ANSWER 0-D
, The 0nurse 0is 0part 0of 0the 0health 0care 0team 0at 0an 0oncology 0center. 0A 0patient 0has 0been
0diagnosed 0with 0leukemia 0and 0the 0prognosis 0is 0poor, 0but 0the 0patient 0is 0not 0yet 0aware 0of
0the 0prognosis. 0How 0can 0the 0bad 0news 0best 0be 0conveyed 0to 0the 0patient? 0A) 0Family
0should 0be 0given 0the 0prognosis 0first. 0B) 0The 0prognosis 0should 0be 0delivered 0with 0the
0patient 0at 0eye 0level. 0C) 0The 0physician 0should 0deliver 0the 0news 0to 0the 0patient 0alone. 0D)
0The 0appointment 0should 0be 0scheduled 0at 0the 0end 0of 0the 0day 0- 0CORRECT 0ANSWER 0-
B
A 0patient 0has 0just 0been 0told 0that 0her 0illness 0is 0terminal. 0The 0patient 0tearfully 0states,
0I 0cant 0believe 0I 0am 0going 0to 0die. 0Why 0me? 0What 0is 0your 0best 0response? 0A) 0I
0know 0how 0you 0are 0feeling. 0B) 0You 0have 0lived 0a 0long 0life. 0C) 0This 0must 0be 0very
0difficult 0for 0you. 0D) 0Life 0can 0be 0so 0unfair. 0- 0CORRECT 0ANSWER 0-C
The 0nurse 0has 0observed 0that 0an 0older 0adult 0patient 0with 0a 0diagnosis 0of 0end-stage 0renal
0failure 0seems 0to 0prefer 0to 0have 0his 0eldest 0son 0make 0all 0of 0his 0health 0care 0decisions.
0While 0the 0family 0is 0visiting, 0the 0patient 0explains 0to 0you 0that 0this 0is 0a 0cultural 0practice
0and 0very 0important 0to 0him. 0How 0should 0you 0respond? 0A) 0Privately 0ask 0the 0son 0to 0allow
0the 0patient 0to 0make 0his 0own 0health 0care 0decisions. 0B) 0Explain 0to 0the 0patient 0that 0he 0is
0responsible 0for 0his 0own 0decisions. 0C) 0Work 0with 0the 0team 0to 0negotiate 0informed
0consent. 0D) 0Avoid 0divulging 0information 0to 0the 0eldest 0son 0- 0CORRECT 0ANSWER 0-C
One 0aspect 0of 0the 0nurses 0comprehensive 0assessment 0when 0caring 0for 0the 0terminally 0ill
0is 0the 0assessment 0of 0hope. 0The 0nurse 0is 0assessing 0a 0patient 0with 0liver 0failure 0for 0the
0presence 0of 0hope. 0What 0would 0the 0nurse 0identify 0as 0a 0hope-fostering 0category? 0A)
0Uplifting 0memories 0B) 0Ignoring 0negative 0outcomes 0C) 0Envisioning 0one 0specific 0outcome
0D) 0Avoiding 0an 0actual 0or 0potential 0threat 0- 0CORRECT 0ANSWER 0-A
A 0medical 0nurse 0is 0providing 0end-of-life 0care 0for 0a 0patient 0with 0metastatic 0bone 0cancer.
0The 0nurse 0notes 0that 0the 0patient 0has 0been 0receiving 0oral 0analgesics 0for 0her 0pain 0with
0adequate 0effect, 0but 0is 0now 0having 0difficulty 0swallowing 0the 0medication. 0What 0should
0the 0nurse 0do? 0A) 0Request 0the 0physician 0to 0order 0analgesics 0by 0an 0alternative 0route. 0B)
0Crush 0the 0medication 0in 0order 0to 0aid 0swallowing 0and 0absorption. 0C) 0Administer 0the
0patients 0medication 0with 0the 0meal 0tray. 0D) 0Administer 0the 0medication 0rectally 0-
0CORRECT 0ANSWER 0-A
A 066-year-old 0patient 0is 0in 0a 0hospice 0receiving 0palliative 0care 0for 0lung 0cancer 0which
0has 0metastasized 0to 0the 0patients 0liver 0and 0bones. 0For 0the 0past 0several 0hours, 0the
0patient 0has 0been 0experiencing 0dyspnea.
What 0nursing 0action 0is 0most 0appropriate 0to 0help 0to 0relive 0the 0dyspnea 0the 0patient 0is
0experiencing? 0Test 0Bank 0- 0Brunner 0& 0Suddarth's 0Textbook 0of 0Medical-Surgical 0Nursing
014e 0(Hinkle 02017) 0324 0A) 0Administer 0a 0bolus 0of 0normal 0saline, 0as 0ordered. 0B) 0Initiate
0high-flow 0oxygen 0therapy. 0C) 0Administer 0high 0doses 0of 0opioids. 0D) 0Administer
