NR 226: Adult Health I Midterm Exam Practice Questions Intensive Study Guide: Full-Length Practice Exams, Detailed Test Bank, and Comprehensive Review Manual

A nurse is developing a home-management plan for a 12-year-old boy with primary nocturnal enuresis. Which interventions should the nurse recommend to the child and his parents? Select all that apply. A. Limit fluid intake after the evening meal. B. Encourage the child to void immediately before bedtime. C. Eliminate caffeinated beverages, particularly in the evening. D. Encourage the child to visualize waking up with a dry bed. E. Require the child to wash all soiled linens as punishment. Correct Answer: A, B, C, and D Rationale: Limiting evening fluids, voiding before bedtime, avoiding caffeine, and using positive imagery may help reduce nighttime urine production and support bladder control. Caffeine can increase urine production and stimulate the bladder. Positive imagery may also improve the child’s confidence. Punishing the child by requiring them to wash soiled linens can cause shame and negatively affect selfesteem because enuresis is not intentional behavior. Question 2 A confused hospitalized patient falls from bed and sustains an injury because the nurse failed to raise the side rails despite a documented order. Which legal concept most directly applies? A. Assault B. Battery C. Negligence D. Felony Correct Answer: C. Negligence Rationale: Negligence occurs when a person fails to provide the level of care that a reasonably prudent person would provide under similar circumstances, resulting in harm. In this situation, the nurse failed to implement an ordered safety intervention. Assault involves a threat, whereas battery involves unauthorized physical contact. A felony is a serious criminal offense and does not best describe this failure to provide routine safety precautions. Question 3 During an information session, a nursing faculty member explains that graduation from an approved nursing program does not automatically authorize a graduate to practice. Which statement about nursing licensure is accurate? A. Licensure is granted by the American Nurses Association. B. Licensure is automatically awarded at graduation. C. Licensure is approved by the National League for Nursing. D. Licensure is required under the laws of the state in which the nurse practices. Correct Answer: D. Licensure is required under the laws of the state in which the nurse practices. Rationale: Each state’s Nurse Practice Act establishes requirements for nursing licensure and defines the legal scope of nursing practice. Graduation demonstrates completion of an educational program but does not itself provide legal authority to practice. The American Nurses Association establishes professional standards, while nursing organizations may support or evaluate educational programs. Neither organization issues an individual nursing license. Question 4 Why do healthcare decisions frequently develop into ethical dilemmas? A. Legal rights always conflict with professional obligations. B. Decisions must always be made during emergencies. C. Healthcare professionals are prohibited from using personal values. D. Available choices may not be clearly right or clearly wrong. Correct Answer: D. Available choices may not be clearly right or clearly wrong. Rationale: An ethical dilemma occurs when competing moral principles, values, or professional duties support different courses of action and no option is clearly ideal. Time pressure may complicate decision-making but does not define an ethical dilemma. Ethical decisions require consideration of evidence, patient preferences, professional standards, and applicable ethical principles. Question 5 A nurse has provided privacy and completed hand hygiene before giving a patient a back massage. In which order should the nurse perform the remaining actions? 1. Warm lotion between the hands. 2. Position the patient on the side. 3. Assess the skin for redness, breakdown, and abnormal findings. 4. Arrange the gown and linens to expose only the back. 5. Massage the back and sacral muscles using appropriate strokes. A. 2, 4, 3, 1, 5 B. 4, 2, 1, 3, 5 C. 3, 2, 4, 5, 1 D. 2, 3, 1, 4, 5 Correct Answer: A. 2, 4, 3, 1, 5 Rationale: The patient should first be positioned safely and comfortably. The gown and linens are then adjusted while maintaining privacy. The nurse should inspect the skin before beginning the massage because redness, injury, or skin breakdown may contraindicate the procedure. The lotion is then warmed between the hands before the nurse performs the massage using appropriate strokes. Question 6 A nurse is called as an expert witness in a professional malpractice lawsuit. What is the nurse expert’s primary role? A. Interpret criminal statutes for the jury. B. Explain applicable nursing standards of care. C. Prove that the defendant intended to harm the patient. D. Testify only on behalf of the injured patient. Correct Answer: B. Explain applicable nursing standards of care. Rationale: A nurse expert explains the professional standards expected of a reasonably competent nurse and applies those standards to the facts of the case. The expert does not determine legal guilt or interpret statutes as an attorney would. Nurse experts may testify for either party. Intent to harm is generally not required in negligence or malpractice cases. Question 7 A nurse is assessing a patient with sudden postoperative pain. Which finding is more characteristic of acute pain than chronic pain? A. Social withdrawal B. Persistent sleep disturbance C. Significant changes in pulse and blood pressure D. Gradual reduction in activity over several months Correct Answer: C. Significant changes in pulse and blood pressure Rationale: Acute pain commonly activates the sympathetic nervous system, resulting in tachycardia, increased blood pressure, rapid respirations, diaphoresis, and dilated pupils. Chronic pain may produce fewer observable physiological changes because the body can adapt over time. Social withdrawal, persistent sleep disruption, and gradual activity limitation are more commonly associated with chronic pain. Question 8 Which characteristics are most strongly associated with chronic pain? Select all that apply. A. Gradual or progressive onset B. Persistence beyond the expected healing period C. A clearly predictable ending D. Depletion of physical and emotional resources E. Consistent relief from conventional short-term interventions Correct Answer: A, B, and D Rationale: Chronic pain may develop gradually, persist beyond the expected healing period, and continue for months or years. Its prolonged nature can deplete physical, psychological, and social resources. Chronic pain does not necessarily have a predictable endpoint and may respond incompletely to conventional short-term interventions. Management may require pharmacological, behavioral, rehabilitative, and psychosocial approaches. Question 9 A patient reports, “The pain occurs several times each evening, lasts about 20 minutes, and then disappears.” Which pain characteristic is the nurse documenting? A. Quality B. Intensity C. Pattern D. Location Correct Answer: C. Pattern Rationale: Pain pattern describes timing-related characteristics such as onset, frequency, duration, recurrence, and periods of remission. The patient’s description of repeated episodes and their duration reflects the pattern of the pain. Quality describes the sensation, intensity describes severity, and location identifies where the pain occurs. Question 10 A patient diagnosed with narcolepsy asks why strict safety measures are necessary. Which complication presents the greatest immediate risk? A. Progressive loss of intellectual ability B. Inability to complete all self-care activities C. Injury during an uncontrollable sleep episode D. Permanent paralysis after daytime sleepiness Correct Answer: C. Injury during an uncontrollable sleep episode Rationale: Narcolepsy can cause sudden, uncontrollable sleep episodes during activities such as driving, cooking, swimming, or operating machinery. These episodes create an immediate risk of injury to the patient and others. Fatigue and impaired functioning may occur, but maintaining physical safety is the priority. Narcolepsy does not ordinarily cause progressive intellectual decline or permanent paralysis.