NR 226: Adult Health I Midterm Exam Definitive Exam Preparation: Complete Study Guide, Targeted Practice Questions, and Final Test Bank Review

A nurse is asked to witness a patient’s signature on an informed-consent form before surgery. Which patient is currently unable to provide legally valid informed consent? A. A married 16-year-old scheduled for an appendectomy B. A 35-year-old with depression who understands the procedure C. A 50-year-old who communicates through a qualified interpreter D. A 65-year-old who recently received an opioid analgesic Correct Answer: D. A 65-year-old who recently received an opioid analgesic Rationale: Opioids may impair alertness, judgment, and decision-making capacity, making consent invalid until their cognitive effects have resolved. A married minor may be legally emancipated. Depression alone does not establish incompetence, and a language barrier does not prevent informed consent when a qualified interpreter provides accurate communication. Question 2 While preparing medications, a confused patient states, “This tablet looks different from the one I usually take.” What is the nurse’s priority action? A. Ask the patient to describe the usual tablet B. Explain why the prescribed medication is needed C. Compare the medication with the original prescription D. Reassure the patient that the pharmacy supplied the correct drug Correct Answer: C. Compare the medication with the original prescription Rationale: The nurse should stop and verify the medication against the original prescription and medication administration record. Even a confused patient’s concern may identify a medication error. Reassurance or further explanation does not resolve the discrepancy, and administering the medication before verification could be unsafe. Question 3 A nurse discovers that an incorrect medication dose was administered. What is the primary organizational purpose of completing an incident report? A. To establish evidence for possible litigation B. To identify the employee who should be disciplined C. To analyze risks and prevent similar occurrences D. To replace documentation in the patient’s medical record Correct Answer: C. To analyze risks and prevent similar occurrences Rationale: Incident reports support quality improvement and risk-management activities by identifying patterns, contributing factors, and system weaknesses. They are not primarily punitive or intended to establish legal liability. The nurse should still document the patient’s condition and interventions in the medical record without referring to the incident report itself. Question 4 A practitioner prescribes a medication dose that is substantially higher than the recommended range. Which action should the nurse take? A. Administer the prescribed dose because the practitioner is responsible B. Substitute the usual adult dose and document the change C. Withhold the medication and report the practitioner to a supervisor D. Clarify the prescription directly with the practitioner before administration Correct Answer: D. Clarify the prescription directly with the practitioner before administration Rationale: Nurses are responsible for determining whether medication prescriptions are complete, reasonable, and safe. A questionable dose should be clarified before administration. Administering the dose could harm the patient, while independently changing the prescription exceeds the nurse’s authority. If the concern remains unresolved, the nurse may escalate it through the appropriate chain of command. Question 5 A competent patient refuses a medication because it previously caused severe diarrhea. The nurse provides relevant education, but the patient continues to refuse. What should the nurse do first? A. Document the refusal and the education provided B. Ask a family member to persuade the patient C. Continue explaining until the patient agrees D. Conceal the medication in food to ensure treatment Correct Answer: A. Document the refusal and the education provided Rationale: A competent patient has the right to refuse treatment, even when the decision may not promote the best clinical outcome. The nurse should withhold the medication, document the refusal and education, and notify the prescriber as appropriate. Involving family without permission may violate confidentiality, while continued pressure may be coercive. Question 6 A family member asks a nurse to administer enough medication to hasten the death of a terminally ill patient who appears to be suffering. Which response is most consistent with professional nursing ethics? A. Participate if the family provides written authorization B. Decline participation in active euthanasia C. Administer the medication if two practitioners approve D. Participate if the nurse personally believes it is compassionate Correct Answer: B. Decline participation in active euthanasia Rationale: The nurse should not intentionally administer treatment for the purpose of causing death. Nursing care should focus on symptom management, comfort, dignity, and communication with the palliative-care team. Family authorization, practitioner approval, or personal beliefs do not eliminate the ethical and legal concerns associated with deliberately hastening death. Question 7 Which organization has the legal authority to determine whether a registered nurse meets the minimum requirements for licensure within a state? A. American Nurses Association B. State Board of Nursing C. National League for Nursing D. Sigma Theta Tau International Correct Answer: B. State Board of Nursing Rationale: State Boards of Nursing administer and enforce Nurse Practice Acts, issue licenses, and regulate nursing practice within their jurisdictions. The American Nurses Association establishes professional standards, while nursing education organizations support educational programs. Sigma Theta Tau International promotes scholarship and leadership but does not issue nursing licenses. Question 8 A nurse expert is called to testify in a malpractice lawsuit. Which subject is the nurse expert primarily qualified to address? A. Whether the defendant violated criminal law B. Whether the patient deserves financial compensation C. How professional nursing standards apply to the care provided D. Whether the prosecution or defense has the stronger legal argument Correct Answer: C. How professional nursing standards apply to the care provided Rationale: A nurse expert explains the applicable standard of nursing care and evaluates whether the defendant’s actions were consistent with what a reasonably prudent nurse would have done. The expert does not determine criminal liability, financial damages, or the overall legal outcome. Question 9 A hospitalized patient requests spiritual support. The nurse independently arranges a visit from the patient’s clergy member. How is the nurse functioning? A. Dependently B. Independently C. Interdependently D. Under delegated medical authority Correct Answer: B. Independently Rationale: Arranging spiritual support addresses a patient’s human and psychosocial needs and falls within the nurse’s independent scope of practice. A practitioner’s prescription is not required. Dependent interventions require an order, whereas interdependent interventions involve collaboration with other professionals. Question 10 A patient is considering participation in a clinical research study. Which protection ensures that the patient receives information about the study’s risks, benefits, alternatives, and right to withdraw? A. The state Nurse Practice Act B. The professional code of ethics C. The informed-consent process D. Hospital accreditation standards Correct Answer: C. The informed-consent process Rationale: Informed consent protects research participants’ autonomy by requiring understandable information about the study’s purpose, procedures, risks, potential benefits, alternatives, confidentiality, and voluntary nature. Nurse Practice Acts regulate nursing practice, ethical codes guide professional conduct, and accreditation standards evaluate organizations.