Fundamentals Final Exam Questions and Answers with Solutions 2024

A teen with an anxiety disorder is referred for biofeedback because parents do not want their child to take anxiolytics. Which statement from the teen indicates successful learning? - Biofeedback will help me with my thoughts and physiological responses to stress. A nurse is using the holistic approach to care. Which goal is the priority? - Incorporate the mind-body-spirit connection. A nurse is using caring-healing relationships to support whole person/whole system healing. Which type of nursing is the nurse using? - Integrative nursing. A nurse is teaching a patient about the use of biofeedback. Which goal should the nurse add to the care plan? - Controls autonomic physiological functions. A nurse is describing the effects of imagery. Which information should the nurse include in the teaching session? (select all that apply) - -Controls pain -Decreases nightmares -Helps with irritable bowel syndrome The nurse is caring for an older-adults patient. Which technique will the nurse use to enhance an older-adult patient's self-concept ? - Reviewing old photos with patient. A nurse is assessing a patient's self-concept. Which area will the nurse include? (select all that apply) - -Identity -Body image -Coping behaviors -Significant other's support A co-worker asks the nurse to explain spirituality. What is the nurse's best response? - It is awareness of one's inner self. The nurse is caring for a patient who is an agnostic. Which information should the nurse consider when planning care for this patient? - The patient believes there is no known reality Fundamentals Final Exam Questions and Answers with Solutions 2024 A cancer patient asks the nurse what criteria are for hospice care. Which information should the nurse share with the patient? - It is for those expected to live less than 6 months. A nursing assistive personnel (NAP) is caring for a dying patient. Which asction by the NAP will cause the nurse to intervene? - Making the patient eat. A nurse is documenting end-of-life care. Which information will the nurse include n th epatient's electronic medical record? - Time and date of death Location of body identification tags. Time of body transfer and destination A nurse us teaching guided imagery to a prenatal class. Which technique did the nurse describe? - Using sensory peaceful words. The nurse traches stress-reduction and relaxation training to a health education group after cardiac bypass surgery. Which level of intervention is the nurse using? - Tertiary A nurse is teaching a health promotion class about isotonic exercises. Which type of exercises will the nurse give as an example? - Swimming, jogging and bicycling. The patient reports being tired and weak and lacks energy. Upon assessment, the nurse finds that the patient has gained weight, and blood pressure and pulse are elevated after climbing stairs. Which nursing diagnosis will the nurse add to the care plan? - Activity intolerance The nurse prescribes strategies and alternatives to obtain expected outcome. Which standard nursing practice is the nurse following? - Planning An experienced medical-surgical nurse chooses to work in obstetrics. Which level of proficiency is the nurse upon initial transition to the obstetrical floor? - Novice A nurse has been working in the clinical setting for several years as an advanced practice nurse. However, the nurse has a strong desire to pursue research and theory development. To fulfill this desire, which program should the nurse attend? - Doctor of Philosophy degree (PhD) A nurse attends a workshop on current nursing issues provided by the American Nurses Association. Which type of education did the nurse receive? - Continuing education An nurse teaches a group of nursing students about nurse practice acts. Which information is most important to include in the teaching session about nurse practice acts? - Protects the public A nurse is using a guide that provides principles of right and wrong to provide care to patients. Which guide is the nurse using? - Code of ethics A nurse is teaching the staff about Benner's levels or proficiency. In which order should the nurse place the levels from beginning level to ending level? - -Novice -Advanced -Competent -Proficient -Expert The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should consider which information when planning for this patient? - Diagnosis- related groups (DRGs)provide a fixed reimbursement cost. A nurse is teaching the staff about managed care. Which information should the nurse include in the teaching session? - Managed care causes providers to focus on prevention. The nurse is applying for a position with a home care organization the specializes in spinal cord injury. In which type of health care facility does the nurse want to work? - Restorative A nurse working in a community hospital's emergency department provides care to patients having chest pain. Which level of care is the nurse providing? - Tertiary A nurse is working as a public health nurse. Which will be the nurse's primary focus? - Needs of the population A nurse wants to become a specialist in public health nursing. Which educational requirement will the nurse have to obtain? - A graduate level education with a focus in public health science/ A nurse is working as a community health nurse. Which action is a priority for this nurse? - Provide direct care to subpopulations A nurse focusing on acute and chronic care of individuals and families with a community while enhancing patient autonomy. Which type of nursing care is the nurse providing. - Community-based A nurse is using the Healthy People 2020 to establish goals for the community. Which goal is priority? - Increase life expectancy A nurse is working in community based nursing. Which competency is priority for this nurse? - Caregivef The nurse is caring for a patient who does not follow the prescribed regimen for diabetes management. As a prescriber to Orem's theory, the nurse interviews the patient in an attempt to identify the of the patient's noncompliance. What is the rationale for the nurse's behavior? - Orem's theory is useful in designing interventions to promote self-care. A nurse is testing meditation for migraine headaches and the expected outcome of care when performing this intervention. Which type of theory is type nurse using? - Prescriptive A nurse is using nursing theory and the nursing process simultaneously to plan nursing care. How will the nurse use nursing and the nursing process in practice? - Nursing theory can direct hoe a nurse uses the nursing process. A patient is admitted with possible methicillin-resistant Staphylococcus aureus (MSRA) and is placed in isolation until cultures can be obtained and declared noninfectious. During isolation process, the nurse encourages family visits. Which level of Maslow's hierarchy of needs is the nurse promoting when the family is encouraged to visit? - Third level Upon assessment, the nurse notices that the patient's respirations have increased, and the tip of the nose and earlobes are becoming cyanotic. The nurse finds the patient's pulse rate is over 100 beats per minute. According to Maslow's hierarchy of needs, which patient need should the nurse address first? - Physiological The home health nurse listens to the patient's concerns about having "open-heart" surgery. The nurse explains the different surgical procedures and other options, like cardiac rehabilitation. After several visits, the patient wants cardiac rehabilitation. The nurse notifies the healthcare provider and sets up a referral. Which theory is the nurse using? - Peplau's theory The patient is newly diagnosed with diabetes and will be discharged in the next day or so. The nurse is teaching the patient how to draw up and self--administer insulin. Which nursing theory is the nurse utilizing? - Orem's theory A nurse uses evidence-based practice (EBP) to provide nursing care. What is the best rationale for the nurse's behavior? - EBP is a guide for nurses in making clinical decisions In caring for patients, what must the nurse remember about evidence-based practice (EBP)? - EBP is dependent on patient values and expectations. A nurse has collected several research findings for evidence-based practice. Which article will be the best for the nurse to use? - An article that uses randomized controlled trials (RCT) The nurse uses PICOT question to develop an evidence-based change in protocol for a certain nursing procedure. However, to make these changes throughout the entire institution would require more evidence than is available at this time. What is the nurse's best option? - Conduct a pilot study to investigate findings. The nurse is preparing a smoking cessation class for family members of a patients with lung cancer. The nurse believes that the class will convert many smokers to nonsmokers once they realize the benefits of not smoking. Which health care model is the nurse using? - Health belief model The patient is reporting mild incisional pain that was not relieved by the last dose of pain medication. The patient is not due for another dose of medication for 2 1/2 hours. The nurse repositions the patient, asks what type of music the patient likes and sets the television to the channel playing that type of music. Which health care model is the nurse using? - Holistic health model A nurse is assessing internal variables that are affecting the patient's health status. Which area should the nurse asses? - Perception of functioning The nurse is working in a clinic that is designed to provide health education and immunizations. Which type of preventative care is the nurse providing? - Primary prevention A patient is admitted to a rehabilitation facility following a stroke The patient has right-side paralysis and is unable to speak. The patient will be receiving physical therapy and speech therapy. Which level of preventative care is the patient receiving? - Tertiary prevention Which area should the nurse assess to determine the effects of external variables on a patient's illness? (Select all that apply) - -Socioeconomic status -Cultural background -Social Support A nurse is preparing to provide hygiene care. Which principle should the nurse consider when planning hygiene care? - No two individuals perform hygiene in the same manner. The patient has been diagnosed with diabetes. When admitted, the patient is unkempt and is in need of a bath and foot care. When questioned about hygiene habits, the nurse learns the patient takes a bath once a week and sponge bath every other day. To provide ultimate care for this patient, which principle should the nurse keep in mind? - The patient's illness may require teaching of new hygiene practices. When providing hygiene for an older-adult patient, the nurse closely assesses the skin. What is the rationale for the nurse's action? - Less frequent bathing may be required. A nurse is assessing a patient's skin. Which patient is most at risk for impaired skin integrity? - A patient who is diaphoretic The nurse is caring for a patient who is immobile. The nurse frequently checks the patient for impaired skin integrity. What is the rationale for the nurse's action? - Pressure reduces circulation to affected tissue A nurse is teaching staff about the conduction of the heart. In which order will the nurse present the conduction cy7cle, starting with the first structure? - -Sinoatrial (SA) node -Intraatrial pathways -Atrioventricular (AV) node -Bundle of His -Purkinje network A nurse is teaching a patient with mitral valve problems about the valves in the hears. Starting on the right side of the heart, describe the sequence of the blood flow through these valves. - Tricuspid Pulmonic Mitral Aortic A nurse explains the function of the alveoli to a patient with respiratory. which information about the alveoli function will the nurse share with the patient? - Carries out gas exchange The nurse is teaching about the process of exchanging gases through the alveolar capillary membrane. Which term will the nu5se use to describe this process? - Diffusion A patient had dehydration. While planning care, the nurse considers that the majority of the patient's total water value exists in which compartment? - Intracellular The nurse is teaching about the process of passively moving water from an area of lower particle concentration to an area of higher particle concentration. Which process if the nurse describing? - Osmosis The nurse observes edema in a patient who has venous congestion from right heart failure. Which type of pressure facilitated the formation of the patient's edema? - Hydrostatic The nurse administers an intravenous (IV) hypertonic solution to a patient. In which direction will the fluid shift? - From Intracellular to extracellular The nurse is reviewing laboratory results. Which cation will the nurse observe is the MOST abundant in the blood? - Sodium The nurse receives the patients most recent blood work results. Which laboratory value is or greatest concern? - Calcium of 15.5 mg/dL The nurse observes that the patient's calcium is elevated. When checking the phosphate level, what does the nurse expect to see? - Decreased Four patients arrive at the emergency department at the same time. Which patient will the nurse see first? - An infant with temperature of 102.2° F and diarrhea for 3 days A chemotherapy patient has gained 5 pounds in 2 days. Which assessment question by the nurse is most appropriate? - "How many times a day do you urinate?" The healthcare provider asks the nurse to monitor the fluid volume status of a heart failure patient and a patient at risk for clinical dehydration. Which is the most effective nursing intervention for monitoring both of these patients? - Weigh the patients every morning before breakfast. A nurse is caring for a cancer patient who presents with anorexia, blood pressure 100/60, and elevated white blood cell count. Which primary purpose for starting total parenteral nutrition (TPN) will the nurse add to the care plan? - Replace fluid, electrolytes and nutrients A nurse is administering a diuretic to a patient and teaching the patient about foods to increase. Which foods by the patient will best indicate successful teaching - Potatoes and fresh fruit A nurse is assessing a patient. Which assessment finding should cause a nurse to further assess for extracellular fluid volume deficit? - Postural hypotension A nurse is caring for a patient who is receiving peripheral intravenous (IV) therapy. When the nurse is flushing the patient's peripheral IV, the patient reports pain. Upon assessment the nurse notices a red streak that is warm to the touch. What is the nurse's INITIAL action? - Discontinue the IV The nurse is caring for a patient with hyperkalemia. Which body system assessment is the PRIORITY? - Cardiac While the nurse is taking the patient history, the nurse discovers the patient has a type of diabetes that results from ahead injury and does not require insulin. Which dietary change should the nurse share with the patient? - Drink plenty of fluids throughout the day to stay hydrated. The nurse is caring for a young adult patient on the medical-surgical unit. When doing midnight checks, the nurse observes the patient awake, putting a puzzle together. Which information will the nurse consider to best explain this finding? - The patient's sleep-wake cycle preference is late evening. The nurse is caring for a patient who is having trouble sleeping. Which action will the nurse take? - Encourage deep breathing The nurse is providing an educational session on sleep regulation for new nurses in the Sleep Disorder Treatment Center. Which statement by the nurses will BEST indicate that the teaching is effective. - "If the patient has a disease process in the central nervous system, it can influence the functions of sleep" The nurse is teaching a new mother about the sleep requirements of a neonate. Which comment by the patient indicates a correct understanding of the teaching? - "I will ask my mom to come after the first week, when the baby is more alert. The nurse is beginning a sleep assessment on a patient. Which question will be MOST appropriate for the nurse to ask initially? - "How are you sleeping?" The nurse is caring for a postpartum patient. The patient's labor has lasted over 28 hours within the hospital; the patient has not slept and is disoriented to date and time. Which nursing diagnosis will the nurse document in the patient's care plan? - Sleep deprivation An oriented patient has recently had surgery. Which action is BEST for the nurse to take to assess this patient's pain? - Ask the patient to rate the level of pain A nurse is caring for a patient who recently had abdominal surgery and is experiencing severe pain. The patient's blood pressure is 110/60 mm Hg, and heart rate is 60 beats/min. Additionally, the patient does not appear to be in any distress. Which response by the nurse is MOST therapeutic? - What would you like to try to alleviate your pain? A nurse teaches the patient about the gate control theory. Which statement made by a patient reflects a correct understanding about the relationship between the gate control theory of pain and the use of meditation to relieve pain? - "Meditation controls pain by blocking pain impulses from coming through the gate." A nurse is caring for a patient who is experiencing pain following abdominal surgery. Which information is important for the nurse to share with the patient when providing patient education about effective pain management? - "We should work together to create a schedule to provide regular dosing of medication." The nurse had brought a patient the scheduled pain medication. The patient asks the nurse to wait to give the medication until the time for the dressing change, which is 2 hours away. Which response by the nurse is MOST therapeutic? - "Would you like medication to be given for dressing changes in addition to your regularly scheduled medication?" The nurse is caring for a group of patients. Which task may a nurse delegate to the nursing assistive personnel (NAP)? - Administer a back massage to a patient with pain. A nurse is teaching about energy needed at rest to maintain life-sustaining activities for a specific period of time. What is the nursed discussing? - Basal metabolism rate (BMR In teaching mothers-to-be about infant nutrition, which instruction should the nurse provide? - Provide breast milk or formula for the first 4 to 6 months. A nurse is teaching a patient about the urinary system. In which order will the nurse present the structures, following the flow of urine? - -kidney -urethra -bladder -ureters A nurse is reviewing urinary laboratory results. Which finding will cause the nurse to follow up? - Specific gravity of 1.036 A patient requests the nurse's help to the bedside commode and becomes frustrated when unable to void in front of the nurse. How should the nurse interpret the patient's inability to void? - The patient can be anxious, making it difficult for abdominal and perineal muscles to relax enough to void. The patient is having lower abdominal surgery and the nurse inserts an indwelling catheter. What is the rationale for the nurse's action? - Anesthetics can decrease bladder contractility and cause urinary retention. An 86 year old patient is experiencing uncontrollable leakage of urine with a strong desire to void and even leaks on way to the toilet. Which PRIORITY nursing diagnosis will the nurse include in the patient's plan of care? - Urge urinary incontinence A patient has fallen several times in the past week when attempting to get to the bathroom. The patient gets up 3 - 4 times a night to urinate. Which recommendation by the nurse is MOST appropriate in correcting this urinary problem? - Limit fluid and caffeine intake before bed. A nurse is caring for a male patient with urinary retention. Which action should the nurse take FIRST? - Assist to a standing position Upon palpation, the nurse notices that the bladder is firm and distended; the patient expresses an urge to urinate. Which question is MOST appropriate? - "When was the last time you voided?" A nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel (NAP)? - Obtaining a midstream urine specimen. While receiving a shift report on a patient, the nurse is informed that the patient has urinary incontinence. Upon assessment, which finding will the nurse expect? - Reddened irritated skin on buttocks. A nurse is inserting a catheter into a female patient When the nurse inserts the catheter , no urine is obtained. The nurse suspects the catheter is not in the urethra. What should the nurse do? - Leave the catheter in the vagina as a landmark for insertion of a new sterile catheter. A patient asks about treatment for stress urinary incontinence. Which is the nurse's BEST response? - Perform pelvic floor exercises. Which assessment question should the nurse ask if stress incontinence us suspected? - "Do you experience urine leakage when you cough or sneeze?" A nurse is reviewing results from a urine specimen. What will the nurse expect to see in a patient with a urinary tract infection? - Bacteria Which clinical manifestation will the nurse expect to observe in a patient with excessive white blood cells present in the urine? - Fever with chills. A female patient is having difficulty voiding in a bedpan but states that her ladder feels full. To stimulate micturition, which nursing intervention should the nurse try FIRST? - Utilizing the power of suggestion by turning on the faucet and letting the water run. A nurse is inserting an indwelling urinary catheter for a male patient. Which action will the nurse take? - Cleanse the meatus with circular strokes beginning at the meatus and working down. A nurse is evaluating a nursing assistive personnel's (NAP) care for a patient with an indwelling catheter. Which action by the NAP will cause the nurse to intervene? - Placing the drainage bag on the side rail of the patient's bed. A nurse is caring for a patient with a continent urinary reservoir. Which action will the nurse take? - Teach the patient how to self-cath the pouch A nurse is caring for a hospitalized patient with a urinary catheter. Which nursing action BEST prevents the patient from acquiring an infection? - Maintaining a closed urinary drainage system. A nurse is providing care to a patient with in indwelling catheter. Which practice indicates that the nurse is following guidelines for avoiding catheter-associated urinary tract infections (CAUTI)? - Drape the urinary drainage tubing with no dependent loops. A nurse is providing care to a group of patients Which patient will the nurse see FIRST? - A patient with reflex incontinence with elevated blood pressure and pulse rate. A nurse is teaching a health class about the gastrointestinal tract. The nurse will explain that which portion of the digestive tract absorbs most of the nutrients? - Duodenum A nurse is teaching a patient about the large intestine in elimination. In which order will the nurse list the structure, starting with the first portion? - -Cecum -Ascending -Transverse -Descending -Sigmoid -Rectum The nurse is planning care for a group of patients. Which task will b=the nurse assign to the nursing assistive personnel (NAP)? - Administering an enema A patient is using laxatives three times daily to lose weight. After stopping laxative use, the patient has difficulty with constipation and wonders if laxatives should be taken again. Which information will the nurse share with the patient? - Long term use of laxatives causes the bowel to become less responsive to stimuli, ad constipation may occur. A patient with a hip fracture is having difficulty defecating into a bedpan while lying in bed. Which action by the nurse will assist the patient in having a successful bowel movement? - Raising the head of the bed. Which patient is MOST as risk for increased peristalsis? - A 21 year old with three final examinations on the same day. a nurse is assisting s patient in making dietary choices that promote healthy bowel elimination. Which menu options should the nurse recommend - Grape and walnut chicken salad sandwich on whole wheat bread. A nurse is providing care to a group of patients. Which patient will the nurse see FIRST? - An older patient with glaucoma about to receive an enema. A patient had an ileostomy surgically placed 2 days ago. Which diet will the nurse recommend to the patient to ease the transition of the new ostomy? - Turkey meatloaf with white rice and apple juice. An older adult's perineal skin is dry and thin with mild excoriation When providing hygiene care after episodes of diarrhea, what should the nurse do? - Apply a skin protective ointment after perineal care. A nurse is providing discharge teaching for a patient who is going home with a guaiac test. Which statement by the patient indicates the need for further education? - "If I get s blue color that means the test is negative." The nurse is working on a medical-surgical unit that has been participating in a research project associated with pressure ulcers. Which risk factor will the nurse assess for that predisposes a patient to pressure ulcers? - Decreased level of consciousness. The nurse is caring for a patient who was involved in an automobile accident 2 weeks ago. The patient sustained a head injury and is unconscious. Which PRIORITY element will the nurse consider when planning care to decrease the development of a decubitus ulcer - Pressure Which nursing observation will indicate the patient is a risk for pressure ulcer formation? - The patient has fecal incontinence. The wound care nurse visit a patient in the long-term care unit. The nurse is monitoring a patient with Stage III pressure ulcer. The wound seems to be healing, and healthy tissue is observed. How should the nurse document this ulcer in the patient's medical record? - Healing Stage III pressure ulcer The nurse is admitting an older patient from a nursing home. During assessment, the nurse notes a shallow open reddish pink ulcer without slough on the right heel of the patient. How Will the nurse stage this pressure ulcer? - Stage II The nurse is caring for a patient with a Stage IV pressure ulcer. Which type of healing will the nurse consider when planning care for this patient? - Full-thickness wound repair The nurse is caring for a patient who is experiencing a full-thickness repair. Which type of tissue will the nurse expect to observe when the wound is healing? - Granulation The nurse is caring for a group of patients. Which patient will the nurse see FIRST? - A patient with appendicitis using a heating pad. The nurse is caring for a patient in the burn unit. Which type of wound healing will the nurse consider when planning care for this patient? - Secondary intention A nurse is assessing a patient's wound. Which nursing observation will indicate the wound healed by secondary intention? - Scarring that may be severe A nurse is caring for a patient with a wound. Which assessment data will be the MOST important for the nurse to gather with regard to wound healing? - Pulse Oximetry assessment The nurse is caring for a patient with a healing Stage III pressure ulcer. Upon entering the room the nurse notices an odor and observes purulent discharge, along with increased redness at the wound site. What is the next best step for the nurse? - Complete head-to toe assessment, including current treatment, vital signs, and laboratory results. The nurse is collaborating with the dietician about a patient with Stage III pressure ulcer. Which nutrient will the nurse most likely increase after collaboration with the dietician? - Protein The nurse is completing an assessment on a patient with a Stage IV pressure ulcer. The wound is odorous and a drain is currently in place. Which statement by the patient indicates issues with self-concept? - "I am ready for my bath and linen change right now since this is awful." The nurse is caring for a patient with a Stage IV pressure ulcer with grafted surgical sites. Which specialty bed will the nurse use for this patient? - Air fluidized the nurse is caring for patient with a pressure ulcer on the left hip. The ulcer is black. Which next step will the nurse anticipate? - Debride the wound The nurse is caring for a patient with a healing Stage III pressure ulcer. The wound is clean and granulating. Which health care provider's order will the nurse question? - Irrigate with Dakin's solution. The nurse is completing an assessment of the patient's skin's integrity. Which assessment is the PRORITY? - Pressure points The nurse is caring for a patient with a Stage IV pressure ulcer. Which nursing diagnosis does the nurse add to the care plan? - Impaired skin integrity The medical-surgical acute care patient has received a nursing diagnosis of Impaired skin integrity. Which health care team member will the nurse consult? - Registered dietician