FUNDAMENTAL CONCEPTS AND SKILLS
FOR NURSING
7TH EDITION
• AUTHOR(S)PATRICIA A. WILLIAMS
TEST BANK
1
Reference: Ch. 1 — Nursing and the Health Care System —
Delivery of Nursing Care / Practice Settings
Clinical stem:
A 72-year-old male admitted to the long-term care facility
following hip fracture repair requires daily wound checks, pain
control with oral opioids PRN, morning range-of-motion
exercises, and twice-daily dressing changes. The charge RN asks
you (LPN) to perform the dressing change and report any
concerns. The resident’s vital signs are stable and pain is 4/10
on oral meds. You notice serosanguineous drainage at the
wound edge.
,Options:
A. Proceed with the dressing change and document the
serosanguineous drainage in the wound record.
B. Refuse and request that the RN perform the dressing change
because post-op wounds must be handled only by RNs.
C. Perform the dressing change and call the RN immediately to
report the drainage and reassess pain control.
D. Hold dressing change and schedule it for later when the RN is
available to supervise.
Correct Answer: C
Rationales:
Correct (C): Performing the dressing change is within the
LPN’s scope for routine wound care; immediately reporting the
drainage to the RN ensures timely assessment for possible
complication, supports collaboration, and maintains patient
safety.
A: Documenting alone without reporting could delay
necessary reassessment or provider notification for changing
wound status.
B: Refusing without clinical reason is inappropriate—routine
dressing changes may be delegated to LPNs depending on
facility policy.
D: Delaying care without clinical justification risks wound
deterioration and is unsafe.
,Teaching Point: Report unexpected findings promptly; do not
rely on documentation alone.
Citation: Williams, P. A. (7th ed.). Fundamental Concepts and
Skills for Nursing. Ch. 1.
2
Reference: Ch. 1 — Nursing and the Health Care System —
Nursing Education Pathways / Practical Nursing
Clinical stem:
A newly hired LPN with a diploma asks for guidance about
opportunities to advance to RN. You supervise orientation at a
community hospital. A patient’s care requires frequent
medication titration and IV infusion adjustments.
Options:
A. Explain LPN-to-RN bridge programs and advise focusing on
current competency during orientation.
B. Tell the LPN advancement is impossible while working full
time; discourage further schooling.
C. Advise the LPN to start independent IV titration tasks to gain
experience.
D. Recommend immediate enrollment in an RN program and
stop clinical practice.
Correct Answer: A
, Rationales:
Correct (A): Providing accurate info about bridge programs
while emphasizing present competency during orientation
aligns with professional development and ensures novice
nurses maintain safe practice.
B: Discouraging advancement is inaccurate and undermines
professional growth.
C: Encouraging independent IV titration without required
education and authorization is unsafe and out of LPN scope in
many settings.
D: Advising to stop practice is unnecessary; many LPNs work
while completing bridge programs.
Teaching Point: Support realistic career planning—prioritize
competence and authorized scope while pursuing education.
Citation: Williams, P. A. (7th ed.). Fundamental Concepts and
Skills for Nursing. Ch. 1.
3
Reference: Ch. 1 — Nursing and the Health Care System —
Historical Overview / Florence Nightingale
Clinical stem:
During a unit in-service about nursing history, a student asks
how Florence Nightingale’s work still affects modern nursing
practice in acute care settings.
FOR NURSING
7TH EDITION
• AUTHOR(S)PATRICIA A. WILLIAMS
TEST BANK
1
Reference: Ch. 1 — Nursing and the Health Care System —
Delivery of Nursing Care / Practice Settings
Clinical stem:
A 72-year-old male admitted to the long-term care facility
following hip fracture repair requires daily wound checks, pain
control with oral opioids PRN, morning range-of-motion
exercises, and twice-daily dressing changes. The charge RN asks
you (LPN) to perform the dressing change and report any
concerns. The resident’s vital signs are stable and pain is 4/10
on oral meds. You notice serosanguineous drainage at the
wound edge.
,Options:
A. Proceed with the dressing change and document the
serosanguineous drainage in the wound record.
B. Refuse and request that the RN perform the dressing change
because post-op wounds must be handled only by RNs.
C. Perform the dressing change and call the RN immediately to
report the drainage and reassess pain control.
D. Hold dressing change and schedule it for later when the RN is
available to supervise.
Correct Answer: C
Rationales:
Correct (C): Performing the dressing change is within the
LPN’s scope for routine wound care; immediately reporting the
drainage to the RN ensures timely assessment for possible
complication, supports collaboration, and maintains patient
safety.
A: Documenting alone without reporting could delay
necessary reassessment or provider notification for changing
wound status.
B: Refusing without clinical reason is inappropriate—routine
dressing changes may be delegated to LPNs depending on
facility policy.
D: Delaying care without clinical justification risks wound
deterioration and is unsafe.
,Teaching Point: Report unexpected findings promptly; do not
rely on documentation alone.
Citation: Williams, P. A. (7th ed.). Fundamental Concepts and
Skills for Nursing. Ch. 1.
2
Reference: Ch. 1 — Nursing and the Health Care System —
Nursing Education Pathways / Practical Nursing
Clinical stem:
A newly hired LPN with a diploma asks for guidance about
opportunities to advance to RN. You supervise orientation at a
community hospital. A patient’s care requires frequent
medication titration and IV infusion adjustments.
Options:
A. Explain LPN-to-RN bridge programs and advise focusing on
current competency during orientation.
B. Tell the LPN advancement is impossible while working full
time; discourage further schooling.
C. Advise the LPN to start independent IV titration tasks to gain
experience.
D. Recommend immediate enrollment in an RN program and
stop clinical practice.
Correct Answer: A
, Rationales:
Correct (A): Providing accurate info about bridge programs
while emphasizing present competency during orientation
aligns with professional development and ensures novice
nurses maintain safe practice.
B: Discouraging advancement is inaccurate and undermines
professional growth.
C: Encouraging independent IV titration without required
education and authorization is unsafe and out of LPN scope in
many settings.
D: Advising to stop practice is unnecessary; many LPNs work
while completing bridge programs.
Teaching Point: Support realistic career planning—prioritize
competence and authorized scope while pursuing education.
Citation: Williams, P. A. (7th ed.). Fundamental Concepts and
Skills for Nursing. Ch. 1.
3
Reference: Ch. 1 — Nursing and the Health Care System —
Historical Overview / Florence Nightingale
Clinical stem:
During a unit in-service about nursing history, a student asks
how Florence Nightingale’s work still affects modern nursing
practice in acute care settings.
