NURSING 300 Fundamentals of Nursing Theory Concepts and Applications 4th Edition.

NURSING 300 Fundamentals of Nursing Theory Concepts and Applications 4th Edition. Chapter 1 Evolution of Nursing Thought & Action 1. Which of the following statements accurately describe an element of nursing? Select all that apply. A) The skills involved in nursing are primarily technical in nature. B) The primary focus of nursing is to assist individuals to recover from illness. C) The science of nursing is the knowledge base for the care that is given. D) The art of nursing is the collection of knowledge through research. E) Nursing is considered to be both an art and a science. F) Nursing is a profession that used specialized knowledge and skills. 2. Which of the following set of terms best describes nursing at the end of the Middle Ages? A) continuity, caring, critical thinking B) purpose, direction, leadership C) assessment, interventions, outcomes D) advocacy, research, education 3. Which of the following is a characteristic of nursing practiced from early civilization to the 16th century? A) Most early civilizations believed that illness had supernatural causes. B) The physician was the priest who treated disease with prayer. C) The nurse was a nun committed to caring for the needy and homeless. D) Nursing changed from a spiritual focus to an emphasis on knowledge expansion. 4. In what time period did nursing care as we now know it begin? A) pre-civilization B) early civilization to 16th century C) 16th to 17th century D) 18th to 19th century 5. Who is considered to be the founder of professional nursing? A) Dorothea Dix B) Lillian Wald C) Florence Nightingale D) Clara Barton 6. Which of the following nursing pioneers established the Red Cross in the United States in 1882? A) Florence Nightingale B) Clara Barton C) Dorothea Dix D) Jane Addams 7. What was one barrier to the development of the nursing profession in the United States after the Civil War? A) lack of educational standards B) hospital-based schools of nursing C) lack of influence from nursing leaders D) independence of nursing orders 8. Which of the following individuals provided community-based care and founded public health nursing? A) Adelaide Nutting B) Lillian Wald C) Sojourner Truth D) Clara Barton 9. Which of the following nursing groups provides a definition and scope of practice for nursing? A) ICN B) AAN C) ANA D) The Joint Commission 10. Teaching a woman about breast self-examination is an example of what broad aim of nursing? A) promoting health B) preventing illness C) restoring health D) facilitating coping with disability and death 11. What nursing activity would meet the broad nursing aim of facilitating coping with disability and death? Select all that apply. A) conducting a blood pressure screening program B) teaching testicular self-examination C) referring to a community diabetic support group D) administering intravenous fluids E) admitting a patient to a hospice program F) performing a physical assessment on a patient 12. A nurse caring for a patient with diabetes chooses an appropriate plan of care and devises interventions to accomplish the desired outcomes. This is an example of using which of the following type of nursing skills? A) Technical B) Cognitive C) Interpersonal D) Ethical/Legal 13. Which one of the following examples of nursing actions would be considered an ethical/legal skill? A) A nurse helps a patient prepare a living will. B) A nurse obtains a urine sample for a urinalysis. C) A nurse explains the rationale for a patients plan of care. D) A nurse holds the hand of a woman whose baby died in childbirth. 14. A nurse practitioner is caring for a couple who are the parents of an infant diagnosed with Downs Syndrome. The nurse makes referrals for a parent support group for the family. This is an example of which nursing role? A) Teacher/Educator B) Leader C) Counselor D) Collaborator 15. A nurse is providing nursing care in a neighborhood clinic to single pregnant teens. Which of the following actions is the best example of using the collaborator role as a nurse? A) Discussing the legal aspects of adoption for teens wishing to place their infants with a family B) Searching the Internet for information on child care for the teens who wish to return to school C) Conducting a patient interview and documenting the information on the patients chart D) Referring a teen who admits having suicidal thoughts to a mental healthcare specialist 16. A nurse instructor explains the concept of health to her students. Which of the following statements accurately describes this state of being? A) Health is a state of optimal functioning. B) Health is an absence of illness. C) Health is always an objective state. D) Health is not determined by the patient. 17. A nurse incorporates the health promotion guidelines established by the U.S. Department of Health document: Healthy People 2010. Which of the following is a health indicator discussed in this document? A) cancer B) obesity C) diabetes D) hypertension 18. A nurse conducts a smoking-cessation program for patients of a neighborhood clinic. This is an example of which of the following aims of nursing? A) promoting health B) preventing illness C) restoring health D) facilitating coping with disability or death 19. Which of the following is a criteria that defines nursing as profession? A) an undefined body of knowledge B) a dependence on the medical profession C) an ability to diagnose medical problems D) a strong service orientation 20. Although all of the following are nursing responsibilities, which one would be expected of a nurse with a baccalaureate degree? A) providing direct physical care B) using research findings to improve practice C) administering medications as prescribed D) collaborating with other healthcare providers 21. Amy Jones, a high school senior, wants to become a geriatric nurse practitioner. What nursing degree will she need to attain this goal? A) licensed practical nurse B) associate degree C) baccalaureate degree D) masters degree 22. Why are nursing organizations important for the continued development and improvement of nursing as a whole? A) to provide socialization and networking for members B) to regulate work activities for members C) to set standards for nursing education and practice D) to provide information to nurses about legal requirements 23. Which of the following organizations has established standards for clinical nursing practice? A) American Nurses Association B) National League for Nursing C) International Council of Nurses D) State Board of Nursing 24. What is the primary purpose of standards of nursing practice? A) to provide a method by which nurses perform skills safely B) to ensure knowledgeable, safe, comprehensive nursing care C) to establish nursing as a profession and a discipline D) to enable nurses to have a voice in healthcare policy 25. After graduation from an accredited program in nursing and successfully passing the NCLEX, what gives the nurse a legal right to practice? A) enrolling in an advanced degree program B) filing NCLEX results in the county of residence C) being licensed by the State Board of Nursing D) having a signed letter confirming graduation 26. A nurse has been tried and found guilty of the felony crime of forgery. How might this affect the nurses license to practice nursing? A) It will have no effect on the ability to practice nursing. B) The nurse can practice nursing at a less-skilled level. C) The license may be revoked or suspended. D) The license will permanently carry the felony conviction. 27. Nurses use the nursing process to focus care on human responses to what? A) interactions with the environment B) physical effects of disease C) outcomes of medical or surgical treatment D) actual or potential health problems 28. Which age group in the population is expanding most rapidly, resulting in changes in the delivery of healthcare? A) older adults B) young adults C) school-aged children D) newborns 29. Which of the following is a current trend affecting nursing education and practice? A) over abundance of graduating nurses B) office-based care delivery systems C) increase in length of hospital stay D) increase in chronic health conditions Answer Key 1. C, E, F 2. B 3. A 4. D 5. C 6. B 7. A 8. B 9. B 10. B 11. C, E 12. B 13. A 14. C 15. D 16. A 17. B 18. B 19. D 20. B 21. D 22. C 23. A 24. B 25. C 26. C 27. D 28. A 29. D Chapter 2 Critical Thinking & Nursing Process 1. Which of the following is an essential feature of professional nursing? Select all that apply. A) provision of a caring relationship to facilitate health and healing B) attention to a range of human experiences and responses to health and illness C) use of objective data to negate the patients subjective experience D) use of judgment and critical thinking to form a medical diagnosis E) advancement of professional nursing knowledge through scholarly inquiry F) influence on social and public policy to promote social justice 2. What nursing organization first legitimized the use of the nursing process? A) National League for Nursing B) American Nurses Association C) International Council of Nursing D) State Board of Nursing 3. Which of the following group of terms best describes the nursing process? A) nursing goals, medical terminology, linear B) nurse-centered, single focus, blended skills C) patient-centered, systematic, outcomes-oriented D) family-centered, single point in time, intuitive 4. A patient comes to the emergency department complaining of severe chest pain. The nurse asks the patient questions and takes vital signs. Which step of the nursing process is the nurse demonstrating? A) assessing B) diagnosing C) planning D) implementing 5. A nurse is examining a 2-year-old. Based on her findings, she initiates a care plan for a potential problem with normal growth and development. Which step of the nursing process identifies actual and potential problems? A) assessing B) diagnosing C) planning D) implementing 6. A home health nurse reviews the nursing care with the patient and family and then mutually discusses the expected outcomes of the nursing care to be provided. Which step of the nursing process is the nurse illustrating? A) diagnosing B) planning C) implementing D) evaluating 7. Based on an established plan of care, a nurse turns a patient every 2 hours. What part of the nursing process is the nurse using? A) assessing B) planning C) implementing D) evaluating 8. Which of the following statements indicates that a plan to assist a patient in developing and following an exercise program has been effective? A) I have just been too busy to do my daily exercises. B) I guess I will begin the activity we discussed next week. C) I know I should exercise, but my health is not very good. D) I have lost 10 pounds because I walk 2 miles every day. 9. What name is given to standardized plans of care? A) critical pathways B) computer databases C) nursing problems D) care plan templates 10. Which of the following groups developed standard language to increase the visibility of nursings contribution to patient care by continuing to develop, refine, and classify phenomena of concern to nurses? A) NANDA B) NIC C) NOC D) HHCC 11. Legally speaking, how would the nurse ensure that care was not negligent? A) verbally reporting assessments to the patients physician B) keeping private notes about the care given to each assigned patient C) documenting the nursing actions in the patients record D) tape recording complete information for each oncoming shift 12. A nurse interviews a pregnant teenager and documents her answers on the patient record. At the same time, the nurse responds to the patients concerns and makes a referral for counseling and maternity care. This scenario is an example of which of the descriptors of the nursing process? A) systematic B) dynamic C) outcome oriented D) universally applicable 13. A nurse working in an outpatient surgery center is responsible for taking a health history and performing a physical assessment on each patient scheduled for surgery. Why is establishing this database so important for nursing care? A) to ensure good nursepatient relationships before surgery B) to ensure medical and surgical safety C) it is a routine part of any admission procedure D) to identify strengths and problems 14. An experienced ICU nurse is mentoring a student. The nurse tells the student, I think something is going wrong with your patient. What type of clinical decision making is the experienced nurse demonstrating? A) trial-and-error problem solving B) intuitive thinking C) scientific problem solving D) methodical reasoning 15. A nurse is caring for a patient in the ER who was injured in a snow mobile accident. The nurse documents the following patient data: uncontrollable shivering, weakness, pale and cold skin, and suspects the patient is experiencing hypothermia. Upon further assessment, the nurse notes a heart rate of 53 BPM and core internal temperature of 90F, which confirms the initial diagnosis. The nurse then devises a plan of care and continues to monitor the patient to evaluate the outcomes. This nurse is using which of the following types of problem solving in her care of this patient? A) trial-and-error B) scientific C) intuitive D) critical thinking 16. Nurses make decisions in their practice every day. Which of the following are potential errors in this decision-making process? Select all that apply. A) placing emphasis on the last data received B) avoiding information contrary to ones opinion C) selecting alternatives to maintain status quo D) being predisposed to multiple solutions E) prioritizing problems in order of importance F) failing to use appropriate resources 17. Which of the following is one example of a patient benefit of using the nursing process? A) greater personal satisfaction B) decreased reliance on the nursing staff C) continuity of care D) decreased incidence of medical errors 18. What is a systematic way to form and shape ones thinking? A) critical thinking B) intuitive thinking C) trial-and-error D) interpersonal values 19. What step in the nursing process is most closely associated with cognitively skilled nurses? A) assessing B) planning C) implementing D) evaluating 20. A nurse asks a multidisciplinary team to collaborate to develop the most appropriate plan of care to meet the needs of an adolescent with a severe head injury. Which of the blended skills essential to nursing practice is the nurse using? A) cognitive skills B) interpersonal skills C) technical skills D) ethical/legal skills 21. A student is asked to perform a skill for which he is not prepared. When using the method of critical thinking, what would be the first step to resolve the situation? A) purpose of thinking B) adequacy of knowledge C) potential problems D) helpful resources 22. Members of the staff on a hospital unit are critical of a patients family who has different cultural beliefs about health and illness. A student assigned to the patient does not agree, based on her care of the patient and family. What critical thinking attitude is the student demonstrating? A) being curious and persevering B) being creative C) demonstrating confidence D) thinking independently 23. Nurses apply critical thinking to clinical reasoning and judgment in their nursing practice every day. Which of the following are characteristics of this practice? Select all that apply. A) It is guided by standards, policies and procedures, ethics codes, and laws. B) It is based on principles of nursing process, problem solving, and the scientific method. C) It carefully identifies the key problems, issues, and risks involved. D) It is driven by the nurses need to document competent, efficient care. E) It calls for strategies that make the most of human potential. F) It is a skill that has been studied and evaluated to the point of perfection. 24. As a beginning student in nursing, what is essential to the mastery of technical skills, such as giving an injection? A) Read the steps of the procedure before clinical assignments. B) Even if you do not know how to give an injection, act as if you do. C) Practice giving injections in the learning laboratory until you feel comfortable. D) Tell your instructor that you dont think you can ever give a shot. 25. Which of the following interpersonal skills is essential to the practice of nursing? A) performing technical skills knowledgeably and safely B) maintaining emotional distance from patients and families C) keeping shared patient personal information confidential D) promoting the dignity and respect of patients as people 26. A nurse believes her employer has violated the law and reports this to the appropriate law enforcement agency. What is this type of action called? A) short stopping B) whistle-blowing C) mud smearing D) low balling Answer Key 1. A, B, E, F 2. B 3. C 4. A 5. B 6. B 7. C 8. D 9. A 10. A 11. C 12. B 13. D 14. B 15. B 16. B, C, F 17. C 18. A 19. B 20. B 21. A 22. D 23. A, B, C, E 24. C 25. D 26. B Chapter 3 Assessment 1. Which of the following group of terms best defines assessing in the nursing process? A) problem focused, time lapsed, emergency based B) design a plan of care, implement nursing interventions C) collection, validation, communication of patient data D) nurse focused, establishing nursing goals 2. A nurse performing triage in an emergency room makes assessments of patients using critical thinking skills. Which of the following are critical thinking activities linked to assessment? Select all that apply. A) carrying out a physicians order to intubate a patient B) teaching a novice nurse the principles of triage C) using the nursing process to diagnose a blocked airway D) interviewing a patient suspected of being a victim of abuse privately E) checking the data supplied by a patient with dementia with the family F) teaching a diabetic patient about the importance of proper foot care 3. On admission, a physician diagnoses a patient with rheumatoid arthritis. The nurse uses assessments to make the nursing diagnosis of Chronic Pain. What is the nurse diagnosing? A) the pathology of the illness B) the response of the patient to the illness C) information from a nursing textbook D) knowledge from more experienced nurses 4. The nurse completes a health history and physical assessment on a patient who has been admitted to the hospital for surgery. What is the purpose of this initial assessment? A) to gather data about a specific and current health problem B) to identify life-threatening problems that require immediate attention C) to compare and contrast current health status to baseline data D) to establish a database to identify problems and strengths 5. Mrs. James comes to her healthcare providers office because she is having abdominal pain. She has been seen for this problem before. What type of assessment would the nurse do? A) initial assessment B) focused assessment C) emergency assessment D) time-lapsed assessment 6. A nurse is assisting with lunch at a nursing home. Suddenly, one of the residents begins to choke and is unable to breathe. The nurse assesses the residents ability to breathe and then begins CPR. Why did the nurse assess respiratory status? A) to identify a life-threatening problem B) to establish a database for medical care C) to practice respiratory assessment skills D) to facilitate the residents ability to breathe 7. A nurse performs an assessment of a patient in a long-term care facility and records baseline data. The nurse reassesses the patient a month later and makes revisions in the plan of care. What type of assessment is the second assessment? A) comprehensive B) focused C) time-lapsed D) emergency 8. Which of the following statements best describes the relationship between nursing diagnosis and medical diagnosis? A) The nursing diagnosis confirms the medical diagnosis. B) The nursing diagnosis duplicates the medical diagnosis. C) There is no relationship between nursing and medical diagnoses. D) The nursing diagnosis is based on patient response to the medical diagnosis. 9. Of the following information collected during a nursing assessment, which are subjective data? A) vomiting, pulse 96 B) respirations 22, blood pressure 130/80 C) nausea, abdominal pain D) pale skin, thick toenails 10. A nurse in the emergency department is completing an emergency assessment for a teenager just admitted from a car crash. Which of the following is objective data? A) My leg hurts so bad. I cant stand it. B) Appears anxious and frightened. C) I am so sick; I am about to throw up. D) Unable to palpate femoral pulse in left leg. 11. Who or what is the primary source of information for a nursing history? A) previous medical records B) other healthcare personnel C) the patient D) family members 12. A nurse is collecting information from Mr. Koeppe, a patient with dementia. The patients daughter, Sarah, accompanies the patient. Which of the following statements by the nurse would recognize the patients value as an individual? A) Sarah, can you tell me how long your father has been this way? B) Sarah, I have to go and read your fathers old charts before we talk. C) Mr. Koeppe, tell me what you do to take care of yourself. D) Mr. Koeppe, I know you cant answer my questions, but its okay. 13. What type of patient record data would the nurse find in the medical history and progress notes? A) findings of the physicians assessment and treatment B) results of laboratory and diagnostic studies C) nursing documentation and plan of care D) information from other members of the healthcare team 14. A nurse is collecting data from a home care patient. In addition to information about the patients health status, what is another observation the nurse should make? A) number of rooms in the house B) safety of the immediate environment C) frequency of home visits to be made D) friendliness of the patient and family 15. Of the following data, what type would be collected during a physical assessment? A) color, moisture, and temperature of the skin B) type, amount, and duration of pain C) foods eaten that cause nausea D) specific allergies resulting in itching 16. A nurse is preparing to conduct a health history for a patient who is confined to bed. How should the nurse position herself? A) standing at the end of the bed B) standing at the side of the bed C) sitting at least 6 feet from the beside D) sitting at a 45-degree angle to the bed 17. Which of the following questions or statements would be appropriate in eliciting further information when conducting a health history interview? A) Why didnt you go to the doctor when you began to have this pain? B) Are you feeling better now than you did during the night? C) Tell me more about what caused your pain. D) If I were you, I would not wait to get medical help next time. 18. Which of the following questions or statements would be an appropriate termination of the health history interview? A) Well, I cant think of anything else to ask you right now. B) Can you think of anything else you would like to tell me? C) I wish you could have remembered more about your illness. D) Perhaps we can talk again sometime. Goodbye. 19. Which of the following are examples of common factors that may influence assessment priorities? Select all that apply. A) a patients diet and exercise program B) a patients standing in the community C) a patients ability to pay for services D) a patients developmental stage E) a patients need for nursing 20. After collecting data from a patient with respiratory distress, the nurse prioritizes the patient interventions to provide oxygen to the patient first. This is an example of which of the following models for organizing data? A) Hierarchy of Human Needs B) Functional Health Patterns C) Human Response Patterns D) Body Systems Model 21. A nurse is conducting a health history interview for a woman at an assisted-living facility. The woman says, I have been so constipated lately. How should the nurse respond? A) Do you have a family history of chest problems? B) Why dont you use a laxative every night? C) Do you take anything to help your constipation? D) Everyone who ages has bowel problems. 22. A nurse who collected and organized data during a patient history realizes that there is not enough information to plan interventions. Which of the following would be the best remedy to prevent this from happening in the future? A) The nurse should practice interviewing strategies. B) The nurse should modify data collection tool. C) The nurse should determine specific purpose of data collection. D) The nurse should review and practice communication techniques. 23. What is the primary purpose of validation as a part of assessment? A) to identify data to be validated B) to establish an effective nursepatient communication C) to maintain effective relationships with coworkers D) to plan appropriate nursing care 24. Which of the following examples of patient data needs to be validated? Select all that apply. A) A patient has trouble reading an informed consent, but states he does not need glasses. B) An elderly patient explains that the black and blue marks on his arms and legs are due to a fall. C) A nurse examining a patient with a respiratory infection documents fever and chills. D) A patient in a nursing home states that she is unable to eat the food being served. E) A pregnant patient is experiencing contractions that are 2 minutes apart. F) Following a MVA, the teenage driver with alcohol on his breath states that he was not drinking. 25. A student takes an adult patients pulse and counts 20 beats/min. Knowing this is not the normal range for an adult pulse, what should the student do next? A) Record the pulse rate on the appropriate vital signs sheet in the chart. B) Ask the instructor or a staff nurse to take the pulse. C) Discuss this finding during postconference with other students. D) Wait 4 hours and take the patients pulse again. 26. Which of the following entries would be an example of appropriate documentation? A) Patient appears depressed and tired. B) I am so down today, and I just dont have any energy. C) Patient had a good bowel movement. D) Complains of abdominal pain. Probably constipated. Answer Key 1. C 2. C, D, E 3. B 4. D 5. B 6. A 7. C 8. D 9. C 10. D 11. C 12. C 13. A 14. B 15. A 16. D 17. C 18. B 19. A, D, E 20. A 21. C 22. A 23. D 24. A, B, F 25. B 26. B Chapter 4 Analysis/Diagnosis 1. In addition to identifying responses to actual or potential health problems, what is another purpose of the diagnosing step in the nursing process? A) to collect information about subjective and objective data B) to correlate nursing and medical diagnostic criteria C) to identify etiologies of health problems D) to evaluate mutually developed expected outcomes 2. Which of the following patient care concerns is clearly a nursing responsibility? A) prescribing medications B) monitoring health status changes C) ordering diagnostic examinations D) performing surgical procedures 3. After completing assessments, a nurse uses the data collected to identify appropriate nursing diagnoses for a patient. What are the nursing diagnoses used for? A) selecting nursing interventions to meet expected outcomes B) establishing a database of information for future comparison C) mutually establishing desired outcomes of the plan of care D) evaluating the effectiveness of the established plan of care 4. Which of the following are examples of nursing responsibilities? Select all that apply. A) recognizing the signs and symptoms of pancreatitis when it presents in a patient B) making a diagnosis of uterine cancer following diagnostic testing C) referring a patient diagnosed with lung cancer to a smoke-cessation group D) researching and prescribing medication for an adolescent with uncontrolled asthma E) performing range-of-motion exercises on an elderly patient who is in a wheelchair F) teaching a group of high school students about the dangers of having unprotected sex 5. Which of the following statements accurately describe the legal responsibility of the nurse making a diagnosis for a patient? A) The nurse may make a diagnosis, but the physician is responsible for making sure it is appropriate for the patient. B) The nurse practitioner is responsible for making all nursing diagnoses and determining if they are appropriate for the patient. C) The nurse must decide if he or she is qualified to make a nursing diagnosis and will accept responsibility for treating it. D) The healthcare facility directs the nursing diagnosis in order to receive payment for services performed. 6. A student is reviewing a patients chart before giving care. She notes the following diagnoses in the contents of the chart: appendicitis and acute pain. Which of the diagnoses is a medical diagnosis? A) neither appendicitis nor acute pain B) both appendicitis and acute pain C) appendicitis D) acute pain 7. A nurse develops a plan of care to meet the needs of a patient who has had a large loss of blood after a snowmobile crash. The interventions include administering and monitoring the patients physiologic response to intravenous fluids and blood. What has the nurse focused care on? A) a medical diagnosis B) a nursing diagnosis C) a collaborative problem D) a goal for care 8. A nurse is reviewing the health history and physical assessment findings for a patient who is having respiratory problems. Of the following data collected, what data from the health history would be a cue to a nursing diagnosis for this problem? A) I often have diarrhea after I eat spicy foods. B) My skin is so dry I just cant keep from scratching. C) I get out of breath when I walk a few steps. D) I just feel so bad about myself these days. 9. What is the focus of a diagnostic statement for a collaborative problem? A) the patient problem B) the potential complication C) the nursing diagnosis D) the medical diagnosis 10. Successful implementation of each step of the nursing process requires high-level skills in critical thinking. Which of the following statements accurately describe a guideline for using this process? A) Trust clinical judgment and experience over asking for help. B) Respect clinical intuition, but never allow it to determine a diagnosis. C) Recognize personal biases as a strength in formulating diagnoses. D) Keep an open mind and trust your intuition when formulating diagnoses. 11. The nurse takes a patients vital signs and finds the pulse rate to be 120 beats/min. What would the nurse do next to interpret and analyze this pulse rate? A) Compare the patients pulse rate to the standard range. B) Notify the patients healthcare provider. C) Document the pulse in the appropriate chart page. D) Ask another nurse to verify the pulse rate. 12. A nurse observes a new mother tenderly holding and softly talking to her baby. What does this observation tell the nurse about the babys strengths? A) Nothing; this observation is not important. B) The mother is just behaving as all mothers do. C) A baby is not capable of having strengths. D) Nurturing is a strength for developing infants. 13. A nurse completes a health history and physical assessment for an adolescent before he begins football practice. Based on findings, the nurse recommends reinforcing health habits. What conclusion did the nurse reach after interpreting and analyzing the data? A) no problem B) possible problem C) actual problem D) clinical problem 14. A nurse caring for an elderly patient in a long-term care facility notices that the bedding is wet when the patient gets up in the morning. The nurse collects more data to form a conclusion. What type of problem is involved in this scenario? A) no problem B) possible problem C) actual problem D) clinical problem 15. A nurse is formulating a nursing diagnosis for a patient with a respiratory disease. Which of the following would be correct? A) needs nasal oxygen to improve breathing B) cough related to ineffective airway clearance C) ineffective airway clearance related to thick mucus D) refuses to cough and expectorate thick mucus 16. A nurse writes the following nursing diagnosis for a patient with Alzheimers: Disturbed Thought Processes related to Alzheimers disease as evidenced by incoherent language. Which part of this diagnosis is considered the problem statement? A) disturbed thought processes B) related to C) Alzheimers disease D) incoherent language 17. A nurse is formulating a diagnosis for a patient who is reliving a brutal mugging that took place several months ago. The patient is crying uncontrollably and states that he cant live with this fear. Which of the following diagnoses for this patient is correctly written? A) post-trauma syndrome related to being attacked B) psychological overreaction related to being attacked C) needs assistance coping with attack D) mental distress related to being attacked 18. Of the following types of nursing diagnoses, which one is validated by the presence of major defining characteristics? A) risk nursing diagnosis B) actual nursing diagnosis C) possible nursing diagnosis D) wellness diagnosis 19. Which of the following nursing diagnoses is an example of a wellness diagnosis? A) Acute Pain B) Risk for Infection C) Readiness for Enhanced Parenting D) Possible Chronic Low Self-Esteem 20. A nursing diagnosis is written as Disturbed Self-Esteem related to presence of large scar over left side of face. What does the phrase Disturbed Self-Esteem identify? A) the expected outcome of the plan of care B) a cue to determining a health problem C) the major defining characteristic of a health problem D) the health state or problem of the patient 21. In the nursing diagnosis Disturbed Self-Esteem related to presence of large scar over left side of face, what part of the nursing diagnosis is presence of large scar over left side of face? A) etiology B) problem C) defining characteristics D) patient need 22. A student identifies Fatigue as a health problem and nursing diagnosis for a patient receiving home care for treatment of metastatic cancer. What statement or question would be best to validate this patient problem? A) I have assessed you and find you are fatigued. B) I analyzed and interpreted your information as fatigue. C) Why are you so tired all the time? D) I think fatigue is a problem for you; do you agree? 23. Of all the benefits of using nursing diagnoses, which one is probably the most important to nurses? A) defining the domain of nursing practice B) informing patients of their care C) improving communication among nurses D) structuring curricular content Answer Key 1. C 2. B 3. A 4. A, C, E, F 5. C 6. C 7. C 8. C 9. B 10. D 11. A 12. D 13. A 14. B 15. C 16. A 17. A 18. B 19. C 20. D 21. A 22. D 23. C Chapter 5 Planning Outcomes 1. What is the primary purpose of the outcome identification and planning step of the nursing process? A) to collect and analyze data to establish a database B) to interpret and analyze data to identify health problems C) to write appropriate patient-centered nursing diagnoses D) to design a plan of care for and with the patient 2. Critical thinking is an essential component in all phases of the nursing process. What question might be used to facilitate critical thinking during outcome identification and planning? A) How do I best cluster these data and cues to identify problems? B) What problems require my immediate attention or that of the team? C) What major defining characteristics are present for a nursing diagnosis? D) How do I document care accurately and legally? 3. Nurses identifying outcomes and related nursing interventions must refer to the standards and agency policies for setting priorities, identifying and recording expected patient outcomes, selecting evidence-based nursing interventions, and recording the plan of care. Which of the following are recognized standards? Select all that apply. A) professional physicians organizations B) state Nurse Practice Acts C) The Joint Commission D) the Agency for Health Care Research and Quality E) the Patient Health Partnership F) the Patient Bill of Rights 4. A nurse admits a patient to the hospitals short-stay unit and completes a health history and physical assessment. Using these data, the nurse develops a(n) plan of care, based on planning? A) intermittent, focused B) comprehensive, initial C) single-use, ongoing D) standard, emergency 5. Although each care plan is individualized, there are certain risks and health problems that, for example, patients undergoing similar medical or surgical treatment have in common. What name is given to this type of care plan? A) initial B) ongoing C) discharge D) standardized 6. A nurse is discharging a patient from the hospital. When should discharge planning be initiated? A) at the time of discharge from an acute healthcare setting B) at the time of admission to an acute healthcare setting C) before admission to an acute healthcare setting D) when the patient is at home after acute care 7. A nurse assesses the vital signs of a patient who is one day postsurgery in which a colostomy was performed. The nurse then uses the data to update the patient plan of care. What are these actions considered? A) initial planning B) comprehensive planning C) on-going planning D) discharge planning 8. A father runs into the emergency room with his 18-month-old son in his arms. The father screams, Help, he is not breathing! The nursing diagnosis of Impaired Gas Exchange is what level of priority diagnosis? A) no priority B) low priority C) medium priority D) high priority 9. The nursing diagnosis Impaired Gas Exchange, prioritized by Maslows hierarchy of basic human needs, is appropriate for what level of needs? A) physiologic B) safety C) love and belonging D) self-actualization 10. A resident of a long-term care facility refuses to eat until she has had her hair combed and her make-up applied. In this case, what patient need should have priority? A) the need to have nutrition B) the need to feel good about oneself C) the need to live in a safe environment D) the need for love from others 11. In which of the following patients has the order of priorities for nursing diagnoses changed? Select all that apply. A) a patient in a long-term care facility who had a stroke B) a patient who is recovering from a broken leg C) a patient who insists on using the bathroom instead of a bedpan D) a patient who appears confused after taking pain medication E) a pregnant patient whose contractions are progressing as anticipated F) a patient who has wounds that require stitches as well as a concussion 12. From what part of the nursing diagnoses are outcomes derived during outcome identification and planning? A) the defining characteristics B) the related factors C) the problem statement D) the database 13. A nurse writes down the following outcome for a depressed patient: By 6/9/12, the patient will state three positive benefits of receiving counseling. This is an example of which of the following types of outcomes? A) psychomotor B) cognitive C) affective D) realistic 14. Which of the following is categorized as a psychomotor outcome? A) Within 2 days of teaching, the patients wife will demonstrate abdominal dressing change. B) Within 1 week of attending class, the patient will have cut smoking from 20 to 10 cigarettes per day. C) The patient will verbalize understanding of need to continue to take medications as prescribed. D) The patients skin will remain smooth, moist, and without breakdown or ulceration. 15. A nurse is developing outcomes for a specific problem statement. What is one of the most important considerations the nurse should have? A) that the written outcomes are designed to meet nursing goals B) to encourage the patient and family to be involved C) to discourage additions by other healthcare providers D) why the nurse believes the outcome is important 16. Which of the following outcomes is correctly written? A) Abdominal incision will show no signs of infection. B) On discharge, patient will be free of infection. C) On discharge, patient will be able to list five symptoms of infection. D) During home care, nurse will not observe symptoms of infection. 17. Which of the following are verbs that are helpful in writing measurable outcomes? Select all that apply. A) know B) define C) hear D) verbalize E) feel F) list 18. Which of the following illustrates a common error when writing patient outcomes? A) Patient will drink 100 mL of fluid every 2 hours from 6 a.m. to 9 dmm. B) Patient will demonstrate correct sequence of exercises by next office visit. C) Patient will be less anxious and fearful before and after surgery. D) On discharge, patient will list five symptoms of infection to report. Answer Key 1. D 2. B 3. B, C, D 4. B 5. D 6. B 7. C 8. D 9. A 10. B 11. A, C, D, F 12. C 13. C 14. A 15. B 16. C 17. B, D, F 18. C Chapter 6 Planning Interventions 1. Which of the following groups of terms best describes a nurse-initiated intervention? A) dependent, physician-ordered, recovery B) autonomous, clinical judgment, patient outcomes C) medical diagnosis, medication administration D) other healthcare providers, skill acquisition 2. What part of the nursing diagnosis statement suggests the nursing interventions to be included in the plan of care? A) problem statement B) defining characteristics C) etiology of the problem D) outcomes criteria 3. What is true of nursing responsibilities with regard to a physician-initiated intervention (physicians order)? A) Nurses do not carry out physician-initiated interventions. B) Nurses do carry out interventions in response to a physicians order. C) Nurses are responsible for reminding physicians to implement orders. D) Nurses are not legally responsible for these interventions. 4. A nurse is using a structured care methodology that follows a set of steps based on a clinicians decision process to help standardize nursing care plans. What is the term for this element of a structured care methodology? A) algorithm B) national guidelines C) standard of care D) clinical practice guideline 5. What name is given to tools that are used to communicate a standardized interdisciplinary plan of care for patients within a case management healthcare delivery system? A) Kardex care plans B) computerized plans of care C) clinical pathways D) student care plans 6. A nurse has developed a plan of care with nursing interventions designed to meet specific patient outcomes. The outcomes are not met by the time specified in the plan. What should the nurse do now in terms of evaluation? A) Continue to follow the written plan of care. B) Make recommendations for revising the plan of care. C) Ask another healthcare professional to design a plan of care. D) State goal will be met at a later date. 7. A nurse records patient data on a folded card and places it in a central file, where it is easily accessible to staff. Which system of care is this nurse using? A) critical pathways B) case management C) Kardex care plan D) concept map care plan 8. Which of the following types of care plans is most likely to enable the nurse to take a holistic view of the patients situation? A) Kardex B) case management C) critical pathways D) concept map care plan 9. Which of the following is an example of a well-stated nursing intervention? A) Patient will drink 100 mL of water every 2 hours while awake. B) Offer patient 100 mL of water every 2 hours while awake. C) Offer patient water when he complains of thirst. D) Patient will continue to increase oral intake when awake. 10. What common problem is related to outcome identification and planning? A) failing to involve the patient in the planning process B) collecting sufficient data to establish a database C) stating specific and measurable outcomes based on nursing diagnoses D) writing nursing orders that are clear and resolve the problem 11. Which of the following statements accurately describe the impact on nursing of using NIC/NOC standardized languages? Select all that apply. A) They demonstrate the impact that nurses have on the system of healthcare delivery. B) They standardize and define the knowledge base for nursing curricula and practice. C) They limit the number of appropriate nursing intervention to be selected. D) They hinder the teaching of clinical decision making to novice nurses. E) They enable researchers to examine the effectiveness and cost of nursing care. F) They slow the development and use of nursing information systems. 1. B 2. C 3. B 4. A 5. C 6. B 7. C 8. D 9. B 10. A 11. A, B, E Chapter 7 Implementation & Evaluation 1. What is the unique focus of nursing implementation? A) patient response to health and illness B) patient response to nursing diagnosis C) patient compliance with treatment regimen D) patient interview and physical assessment 2. What is one advantage of having a standard classification of nursing interventions? A) to standardize nomenclature (names or terms) B) to legitimize the use of the nursing process C) to classify indicators of patient outcomes D) to facilitate documentation of expected goals 3. The researchers developing classifications for interventions are also committed to developing a classification of which of the following? A) diagnoses B) outcomes C) goals D) data clusters 4. What activity is carried out during the implementing step of the nursing process? A) Assessments are made to identify human responses to health problems. B) Mutual goals are established and desired patient outcomes are determined. C) Planned nursing actions (interventions) are carried out. D) Desired outcomes are evaluated and, if necessary, the plan is modified. 5. What role of the nurse is crucial to the prevention of fragmentation of care? A) advocate B) teacher C) counselor D) coordinator 6. What phrase best describes nurse-initiated interventions? A) nurse-prescribed interventions B) physician-prescribed interventions C) healthcare team interventions D) interventions based on medical orders 7. Which of the following examples of nursing actions involve direct care of the patient? Select all that apply. A) A nurse counsels a young family who is interested in natural family planning. B) A nurse massages the back of a patient while performing a skin assessment. C) A nurse arranges for a consultation for a patient who has no health insurance. D) A nurse helps a patient in hospice fill out a living will form. E) A nurse arranges for physical therapy for a patient who had a stroke. F) A nurse comforts a distraught patient whose baby was stillborn. 8. A nurse documents the following diagnosis for a hospitalized patient: Risk for Imbalanced Nutrition: More Than Body Requirements. What is the major goal of interventions for a risk diagnosis? A) reduce or eliminate contributing factors B) prevent the problem C) collect additional data D) promote higher-level wellness 9. A nurse is changing a sterile pressure ulcer dressing based on an established protocol. What does this mean? A) The nurse is using critical thinking to implement the dressing change. B) The patient has specified how the dressing should be changed. C) Written plans are developed that specify nursing activities for this skill. D) The physician verbally requested specific steps of the dressing change. 10. What must occur before physician-initiated interventions can be carried out? A) They must be written on the nursing plan of care. B) The nurse relinquishes all responsibility for them. C) Any healthcare provider may order them. D) The physician gives a verbal or written order. 11. A patient who was previously awake and alert suddenly becomes unconscious. The nursing plan of care includes an order to increase oral intake. Why would the nurse review the plan of care? A) to implement evidence-based practice B) to ensure the order follows hospital policy C) to be sure interventions are individualized D) to be sure the intervention is safe 12. A nurse is preparing to insert an intravenous line and begin administering intravenous fluids. The patient has visitors in the room. What should the nurse do? A) Ask the visitors to leave the room. B) Ask the patient if visitors should remain in the room. C) Tell the patient to ask the visitors to leave the room. D) Wait until the visitors leave to begin the procedure. 13. A nurse is catheterizing a patient. What action illustrates respect for the patients privacy? A) explaining the procedure to the family B) leaving the patients pajamas on C) closing the door to the room D) asking another nurse if he wants to watch 14. A student is ambulating a patient for the first time after surgery. What would the student do to anticipate and plan for an unexpected outcome? A) Take the patients vital signs after ambulation. B) Ask the patients wife to assist with ambulation. C) Delay ambulation until the following shift. D) Ask another student to help with ambulation. 15. Each time a nurse administers an insulin injection to a patient with diabetes, she tells the patient what she is doing and demonstrates each step of preparing and giving the injection. What is the nurse promoting? A) self-care B) dependence C) coping with disability D) nursepatient relationship 16. Which of the following statements accurately describe a recommended guideline for implementation? Select all that apply. A) When implementing nursing care, remember to act independently, regardless of the wishes of the patient/family. B) Before implementing any nursing action, reassess the patient to determine whether the action is still needed. C) Assume that the nursing intervention selected is the best of all possible alternatives. D) Consult colleagues and the nursing and related literature to see if other approaches might be more successful. E) Reduce your repertoire of skilled nursing interventions to ensure a greater likelihood of success. F) Check to make sure that the nursing interventions selected are consistent with standards of care. 17. The staff in a long-term care facility often plays loud rock music on the radio and designs childrens games as exercise. What is the staff doing in this situation? A) considering the hearing level of older adults B) failing to consider visual deficits that occur with aging C) ignoring the developmental needs of older adults D) meeting needs for sensory input and exercise 18. A nurse administers a medication for pain but forgets to document it in the patients medical record. Legally, what does this mean? A) Nothing, the nurses honesty will not be questioned. B) The nurse can add the documentation after the patient goes home. C) The physician will verify that the nurse carried out the order. D) In the eyes of the law, if it is not documented, it was not done. 19. A nurse delegates a specific intervention to a UAP. What implications does this have for the nurse? A) The UAP is responsible and accountable for his or her own actions. B) Nurses do not have authority to delegate interventions. C) The nurse transfers responsibility but is accountable for the outcome. D) The UAP can function in an independent role for all interventions. 20. According to the American Nurses Association, who determines the scope of nursing practice? A) nurses B) lawyers C) physicians D) consumers 21. What characteristic of a competent nurse practitioner enables nurses to be role models for patients? A) sense of humor B) writing ability C) organizational skills D) good personal health 22. What core value of nursing care is missing when a nursing intervention is delegated to a UAP? A) communication B) patient teaching C) nurse/patient dynamic D) competent care Answer Key 1. A 2. A 3. B 4. C 5. C 6. A 7. A, B, D, E 8. B 9. C 10. D 11. D 12. B 13. C 14. D 15. A 16. B, D, F 17. C 18. D 19. C 20. A 21. D 22. C Chapter 8 Theory, Research, & Evidence-Based Practice 1. What phrase best describes the science of nursing? A) application of clinical skills B) body of nursing knowledge C) holistic patient care D) art of individualized nursing 2. The practice of changing patients bedclothes each day in acute care settings is an example of what type of knowledge? A) authoritative B) traditional C) scientific D) applied 3. A student nurse learns how to give injections from the nurse manager. This is an example of the acquisition of what type of knowledge? A) authoritative B) traditional C) scientific D) applied 4. Which of the following sources of knowledge is based on objective data? A) authoritative B) traditional C) scientific D) applied 5. A patient undergoing chemotherapy for a brain tumor believes that having a good attitude will help in the healing process. This is an example of what type of knowledge? A) science B) philosophy C) process D) virtue 6. Which of the following examples represents the type of knowledge known as process? Select all that apply. A) A nurse dispenses medications to patients. B) A nurse changes the linens on a patients bed. C) A nurse studies a nursing journal article on infection control. D) A nurse consults an ethics committee regarding an ethical dilemma. E) A nurse believes in providing culturally competent nursing care. F) A nurse monitors the vital signs of a postoperative patient. 7. Which of the following accurately describes Florence Nightingales influence on nursing knowledge? A) She defined nursing practice as the continuation of medical practice. B) She differentiated between health nursing and illness nursing. C) She established training for nurses under the direction of the medical profession. D) She established a theoretical base for nursing that originated outside the profession. 8. During the first half of the 20th century, a change in the structure of society resulted in changed roles for women and, in turn, for nursing. What was one of these changes? A) More women retired from the workforce to raise families. B) Women became more dependent and sought higher education. C) The focus of nursing changed to hands-on training. D) Nursing research was conducted and published. 9. Who was the first nurse to develop a nursing theory? A) Clara Barton B) Dorothea Dix C) Florence Nightingale D) Virginia Henderson 10. A nurse observes that certain patients have less pain after procedures than do others, and forms a theory of why this happens. What is a theory? A) a concept used to directly prove a fact or a group of facts B) an understanding borrowed from other disciplines C) a best guess based on intangible ideas D) a statement of an occurrence based on observed facts 11. A staff nurse asks a student, Why in the world are you studying nursing theory? How would the student best respond? A) Our school requires we take it before we can graduate. B) We do it so we know more than your generation did. C) I think it explains how we should collaborate with others. D) It helps explain how nursing is different from medicine. 12. Why are the developmental theories important to nursing practice? A) They describe how parts work together as a system. B) They outline the process of human growth and development. C) They define human adaptation to others and to the environment. D) They explain the importance of legal and ethical care. 13. Breaking the healthcare community into separate entities (such as the medical community, the nursing staff, management, support staff) and analyzing how they work as a whole together is an example of which nursing theory? A) general systems theory B) adaptation theory C) developmental theory D) compartment theory 14. There are four concepts common in all nursing theories. Which one of the four concepts is the focus of nursing? A) person B) environment C) health D) nursing 15. Which of the following are characteristics of nursing theories? Select all that apply. A) They provide rational reasons for nursing interventions. B) They are based on descriptions of what nursing should be. C) They provide a knowledge base for appropriate nursing responses. D) They provide a base for discussion of nursing issues. E) They help resolve current nursing issues and establish trends. F) They use complex terminology to resolve specific nursing issues. 16. What is the ultimate goal of expanding nursing knowledge through nursing research? A) learn improved ways to promote and maintain health B) develop technology to provide hands-on nursing care C) apply knowledge to become independent practitioners D) become full-fledged partners with other care providers 17. What was significant about the promotion of the National Center for Nursing Research to the current National Institute of Nursing Research (NINR)? A) Increased numbers of articles are published in research journals. B) NINR gained equal status with all other National Institutes of Health. C) NINR became the major research body of the International Council of Nurses. D) It decreased emphasis on clinical research as an important area for nursing. 18. Which of the following terms are part of quantitative research? A) process B) concept C) ethnography D) variable 19. A nurse uses the process of quantitative research to study the incidence and causes of hospital-acquired pneumonia in her hospital. The statement of what the researcher expects to find in these studies is called the: A) variable B) data C) hypothesis D) instrument 20. Information is collected for analysis in both quantitative and qualitative research. What is the information called? A) surveys B) answers C) interviews D) data 21. A patient in a clinical research study has given informed consent. This means that the patient has certain rights. These rights include which of the following? Select all that apply. A) confidentiality B) free medical care C) refusal to participate D) protection from harm E) guarantee of treatment F) consent knowledgeably 22. Which of the following represents the basic framework of the research process? A) Qualitative data B) Quantitative data C) Nursing Process D) Nursing Theory 23. Which of the following is a responsibility of an institutional review board (IRB)? A) secure informed consent for researchers B) review written accuracy of research proposals C) determine risk status of all studies D) secure funding for institutional research 24. Before developing a procedure, a nurse reviews all current research-based literature on insertion of a nasogastric tube. What type of nursing will be practiced based on this review? A) institutional practice B) authoritative nursing C) evidence-based nursing D) factual-based nursing 25. Which of the following are examples of characteristics of evidence-based practice? Select all that apply. A) It is a problem-solving approach. B) It uses the best evidence available. C) It is generally accepted in clinical practice. D) It is based on current institutional protocols. E) It blends the science and art of nursing. F) It is not concerned with patient preferences. 26. One step in implementing evidence-based practice is to ask a question about a clinical area of interest or an intervention. The most common method is the PICO format. Which of the following accurately defines the letters in the PICO acronym? A) P = population B) I = institution C) C = compromise D) O = output 27. A beginning student is reading a published research article. Where in the article would the student find the abstract? A) in the introduction B) in the methods section C) after the references D) at the beginning Answer Key 1. B 2. B 3. A 4. A 5. B 6. A, B, F 7. B 8. D 9. C 10. D 11. D 12. B 13. A 14. A 15. A, C, D, E 16. A 17. B 18. D 19. C 20. D 21. A, C, D, F 22. C 23. C 24. C 25. A, B, E 26. A 27. D Chapter 9 Life Span: Infancy Through Middle Adulthood 1. A nurse is teaching a 2-week pregnant woman what is occurring in the development of her baby. Which of the following occur in this preembryonic stage? Select all that apply. A) The zygote implants in the uterine wall. B) Rapid growth and differentiation of the cell layers occurs. C) All basic organs are established. D) Some human features are recognizable. E) Three distinct layers of cells exist. F) The heartbeat can be heard by doppler. 2. A pregnant woman is at the end of her first trimester. The nurse tells her that normally the following developments have occurred in her fetus. Select all that apply. A) some reflexes are present B) kidney secretion begins C) the sex of the infant is distinguishable D) sleepwake patterns are established E) lung surfactant is produced F) eyelids open 3. A nurse is teaching a young woman about healthy behaviors during the embryonic stage of pregnancy. Which of the following should the nurse emphasize to prevent congenital anomalies? A) adequate intake of food and fluids B) importance of rest and sleep C) avoidance of alcohol and nicotine D) progression of stages during delivery 4. A nurse is teaching a pregnant woman about nutritional needs. Which of the following nutritional deficiencies during pregnancy might result in neural tube defects in the developing fetus? A) vitamin D B) iodine C) calcium D) folic acid 5. At birth, the neonate must adapt to extrauterine life through several significant physiologic adjustments. Which of the following is the most important adjustment that occurs? A) body temperature responds to the environment B) reflexes develop C) stool and urine are eliminated D) breathing begins 6. A nurse documents the following data upon assessment of a neonate: heart rate 89 BPM, slow respiratory effort, flaccid muscle tone, weak cry, and pale skin tone. What would be the Apgar score for this neonate? A) 2 B) 3 C) 4 D) 5 7. A mother watches as a neonate cries, spreads his arms, and draws them in again in response to being pulled up and laid back down. She asks the nurse what is going on with her baby. What is the best explanation for this response? A) Your baby is experiencing gas, and this movement helps to expel it. B) Your baby is demonstrating a normal CNS response called the Moro reflex. C) Your baby is experiencing the signs and symptoms of an abnormal neural response to being startled. D) Your babys actions are normal automatic movements to help maintain core body temperature. 8. Of the following components of psychosocial development in the neonate and infant, which one facilitates emotional linkage between a baby and caregiver? A) bonding B) attachment C) play D) temperament 9. A nurse is teaching a group of parents about the dangers of Sudden Infant Death Syndrome (SIDS). The nurse recommends that parents place their children on a firm surface laying on their: A) left side B) right side C) abdomen D) back 10. A nurse is observing a group of toddlers at play. What behavior illustrates normal physiologic development in children of this age? A) attempting to feed self B) using fingers to pick up small objects C) throwing and catching a ball D) understanding the feelings of others 11. A nurse watches as a child continuously tells her mother no! to each comment the mother makes. The nurse knows that this behavior termed negativism is characteristic of which of the following developmental groups? A) toddler B) preschooler C) school-aged child D) adolescent 12. A preschooler is in Kohlbergs preconventional phase of moral reasoning. What is the focus of the phase? A) to learn sex differences and modesty B) a sexual desire for the opposite sex C) obeying rules to avoid punishment D) literal concept of God as a male human 13. Which of the following sets of terms best characterizes the school-aged child? A) reflexes, alert state, temperament B) negativism, regression, anal stage C) preoperational, asking why, fears D) doing, succeeding, accomplishing 14. What social group prepares the school-aged child to get along in the larger world and teaches appropriate sex role behavior? A) parents B) peers C) siblings D) grandparents 15. A student nurse reading a patients chart notes that the physician has documented an adolescent as