FUNDAMENTALS OF NURSING
12TH EDITION
• AUTHOR(S)PATRICIA A. POTTER;
ANNE G. PERRY; PATRICIA A.
STOCKERT; AMY HALL; WENDY
R. OSTENDORF
TEST BANK
,Question 1
A nurse enters a patient's room and finds the patient
attempting to get out of bed without assistance after receiving
an opioid pain medication. What is the nurse's priority action?
A. Remind the patient to wait for help before getting out of bed.
B. Assist the patient back to bed safely and assess for dizziness.
C. Apply wrist restraints to prevent another attempt.
D. Document the patient's behavior before intervening.
Correct Answer: B
Rationale:
Patient safety is the priority. The nurse should immediately
assist the patient to prevent a fall and assess for medication-
related effects such as dizziness or orthostatic hypotension.
After ensuring safety, the nurse can reinforce the use of the call
light and implement additional fall-prevention strategies.
Restraints are inappropriate unless all less restrictive measures
have failed and there is an immediate safety risk.
Documentation is important but follows intervention.
Question 2
,A nurse is preparing to administer oral medications. Which
action best demonstrates adherence to safe medication
administration principles?
A. Confirm the patient's identity using two approved identifiers
before administering the medication.
B. Ask another patient in the room to verify the patient's name.
C. Rely on the room number to identify the patient.
D. Prepare medications for multiple patients at the same time
to improve efficiency.
Correct Answer: A
Rationale:
Using two approved patient identifiers helps ensure
medications are administered to the correct patient and
reduces medication errors. Room numbers and other patients
are not acceptable identifiers. Preparing medications for
multiple patients simultaneously increases the risk of errors.
Question 3
A postoperative patient reports pain rated 8 on a 0-to-10 scale
despite receiving pain medication 30 minutes ago. Which
nursing action is most appropriate?
A. Explain that postoperative pain is expected.
B. Reassess the patient, evaluate the effectiveness of the
intervention, and notify the provider if needed.
, C. Delay reassessment until the next scheduled vital signs.
D. Encourage the patient to ignore the pain.
Correct Answer: B
Rationale:
Pain requires ongoing assessment and evaluation. The nurse
should reassess pain, evaluate medication effectiveness, assess
for complications, and determine whether additional
interventions or provider notification are needed. Simply
reassuring the patient or delaying reassessment does not
address the patient's needs.
Question 4
A nurse is caring for a patient with limited mobility. Which
intervention is most effective for reducing the risk of pressure
injuries?
A. Massage reddened bony prominences.
B. Reposition the patient at regular intervals and offload
pressure areas.
C. Keep the head of the bed elevated above 60 degrees
continuously.
D. Apply powder to all skin folds daily.
Correct Answer: B
Rationale:
Regular repositioning and pressure redistribution reduce
12TH EDITION
• AUTHOR(S)PATRICIA A. POTTER;
ANNE G. PERRY; PATRICIA A.
STOCKERT; AMY HALL; WENDY
R. OSTENDORF
TEST BANK
,Question 1
A nurse enters a patient's room and finds the patient
attempting to get out of bed without assistance after receiving
an opioid pain medication. What is the nurse's priority action?
A. Remind the patient to wait for help before getting out of bed.
B. Assist the patient back to bed safely and assess for dizziness.
C. Apply wrist restraints to prevent another attempt.
D. Document the patient's behavior before intervening.
Correct Answer: B
Rationale:
Patient safety is the priority. The nurse should immediately
assist the patient to prevent a fall and assess for medication-
related effects such as dizziness or orthostatic hypotension.
After ensuring safety, the nurse can reinforce the use of the call
light and implement additional fall-prevention strategies.
Restraints are inappropriate unless all less restrictive measures
have failed and there is an immediate safety risk.
Documentation is important but follows intervention.
Question 2
,A nurse is preparing to administer oral medications. Which
action best demonstrates adherence to safe medication
administration principles?
A. Confirm the patient's identity using two approved identifiers
before administering the medication.
B. Ask another patient in the room to verify the patient's name.
C. Rely on the room number to identify the patient.
D. Prepare medications for multiple patients at the same time
to improve efficiency.
Correct Answer: A
Rationale:
Using two approved patient identifiers helps ensure
medications are administered to the correct patient and
reduces medication errors. Room numbers and other patients
are not acceptable identifiers. Preparing medications for
multiple patients simultaneously increases the risk of errors.
Question 3
A postoperative patient reports pain rated 8 on a 0-to-10 scale
despite receiving pain medication 30 minutes ago. Which
nursing action is most appropriate?
A. Explain that postoperative pain is expected.
B. Reassess the patient, evaluate the effectiveness of the
intervention, and notify the provider if needed.
, C. Delay reassessment until the next scheduled vital signs.
D. Encourage the patient to ignore the pain.
Correct Answer: B
Rationale:
Pain requires ongoing assessment and evaluation. The nurse
should reassess pain, evaluate medication effectiveness, assess
for complications, and determine whether additional
interventions or provider notification are needed. Simply
reassuring the patient or delaying reassessment does not
address the patient's needs.
Question 4
A nurse is caring for a patient with limited mobility. Which
intervention is most effective for reducing the risk of pressure
injuries?
A. Massage reddened bony prominences.
B. Reposition the patient at regular intervals and offload
pressure areas.
C. Keep the head of the bed elevated above 60 degrees
continuously.
D. Apply powder to all skin folds daily.
Correct Answer: B
Rationale:
Regular repositioning and pressure redistribution reduce
