Nursing Fundamentals Exam 1 Questions &
Answers Latest Updated Version
A female patient who is receiving chemotherapy for breast cancer tells the nurse, "The treatment for
this cancer is worse than the disease itself. I'm not going to come for my therapy anymore." The nurse
responds by using critical thinking skills to address this patient problem. Which action is the first
step the nurse would take in this process?
A. The nurse judges whether the patient database is adequate to address the problem.
B. The nurse considers whether or not to suggest a counseling session for the patient.
C. The nurse reassesses the patient and decides how best to intervene in her care.
D. The nurse identifies several options for intervening in the patient's care and critiques the merit of
each option. - ✔✔✔ - c. The first step when thinking critically about a situation is to identify the
purpose or goal of your thinking. Reassessing the patient helps to discipline thinking by directing all
thoughts toward the goal. Once the problem is addressed, it is important for the nurse to judge the
adequacy of the knowledge, identify potential problems, use helpful resources, and critique the
decision.
The nursing process ensures that nurses are person centered rather than task centered. Rather than
simply approaching a patient to take vital signs, the nurse thinks, "How is Mrs. Barclay today? Are
our nursing actions helping her to achieve her goals? How can we better help her?" This
demonstrates which characteristic of the nursing process?
A. Systematic
B. Interpersonal
C. Dynamic
D. Universally applicable in nursing situations - ✔✔✔ - b. Interpersonal. All of the other options are
characteristics of the nursing process, but the conversation and thinking quoted best illustrates the
interpersonal dimension of the nursing process
An experienced nurse tells a beginning nurse not to bother studying too hard, since most clinical
reasoning becomes "second nature" and "intuitive" once you start practicing. What thinking below
should underlie the beginning nurse's response?
A. Intuitive problem solving comes with years of practice and observation, and novice nurses should
base their care on scientific problem solving.
B. For nursing to remain a science, nurses must continue to be vigilant about stamping out intuitive
reasoning.
C. The emphasis on logical, scientific, evidence-based reasoning has held nursing back for years; it is
time to champion intuitive, creative thinking!
,D. It is simply a matter of preference; some nurses are logical, scientific thinkers, and some are
intuitive, creative thinkers. - ✔✔✔ - a. Beginning nurses must use nursing knowledge and scientific
problem solving as the basis of care they give; intuitive problem solving comes with years of practice
and observation
The nurse uses blended competencies when caring for patients in a rehabilitation facility. Which
examples of interventions involve cognitive skills? Select all that apply.
A. The nurse uses critical thinking skills to plan care for a patient.
B. The nurse correctly administers IV saline to a patient who is dehydrated.
C. The nurse assists a patient to fill out an informed consent form.
D. The nurse learns the correct dosages for patient pain medications.
E. The nurse comforts a mother whose baby was born with Down syndrome.
F. The nurse uses the proper procedure to catheterize a female patient. - ✔✔✔ - a, d. Using critical
thinking and learning medication dosages are cognitive competencies. Performing procedures
correctly is a technical skill, helping a patient with an informed consent form is a legal/ethical issue,
and comforting a patient is an interpersonal skill.
A nurse uses critical thinking skills to focus on the care plan of an older adult who has dementia and
needs placement in a long-term care facility. Which statements describe characteristics of this type
of critical thinking applied to clinical reasoning? Select all that apply.
A. It functions independently of nursing standards, ethics, and state practice acts.
B. It is based on the principles of the nursing process, problem solving, and the scientific method.
C. It is driven by patient, family, and community needs as well as nurses' needs to give competent,
efficient care.
D. It is not designed to compensate for problems created by human nature, such as medication errors.
E. It is constantly re-evaluating, self-correcting, and striving for improvement.
F. It focuses on the big picture rather than identifying the key problems, issues, and risks involved
with patient care - ✔✔✔ - b, c, e. Critical thinking applied to clinical reasoning and judgment in
nursing practice is guided by standards, policies and procedures, and ethics codes.
A nurse is caring for a patient who has complications related to type 2 diabetes mellitus. The nurse
researches new procedures to care for foot ulcers when developing a care plan for this patient. Which
QSEN competency does this action represent?
A. Patient-centered care
B. Evidence-based practice
C. Quality improvement
,D. Informatics - ✔✔✔ - c. Quality improvement involves routinely updating nursing policies and
procedures. Providing patient-centered care involves listening to the patient and demonstrating
respect and compassion. Evidence-based practice is used when adhering to internal policies and
standardized skills. The nurse is employing informatics by using information and technology to
communicate, manage knowledge, and support decision making.
A nurse is assessing a patient who is diagnosed with anorexia. Following the assessment, the nurse
recommends that the patient meet with a nutritionist. This action best exemplifies the use of:
A. Clinical judgment
B. Clinical reasoning
C. Critical thinking
D. Blended competencies - ✔✔✔ - a. Although all the options refer to the skills used by nurses in
practice, the best choice is clinical judgment as it refers to the result or outcome of critical thinking
or clinical reasoning—in this case, the recommendation to meet with a nutritionist.
A nurse working in a long-term care facility bases patient care on five caring processes: knowing,
being with, doing for, enabling, and maintaining belief. This approach to patient care best describes
whose theory?
A. Travelbee's
B. Watson's
C. Benner's
D. Swanson's - ✔✔✔ - d. Swanson (1991) identifies five caring processes and defines caring as "a
nurturing way of relating to a valued other toward whom one feels a personal sense of commitment
and responsibility."
The nurse practices using critical thinking indicators (ctis) when caring for patients in the hospital
setting. The best description of ctis is:
A. Evidence-based descriptions of behaviors that demonstrate the knowledge that promotes critical
thinking in clinical practice
B. Evidence-based descriptions of behaviors that demonstrate the knowledge and skills that promote
critical thinking in clinical practice
C. Evidence-based descriptions of behaviors that demonstrate the knowledge, characteristics, and
skills that promote critical thinking in clinical practice
D. Evidence-based descriptions of behaviors that demonstrate the knowledge, characteristics,
standards, and skills that promote critical thinking in clinical practice - ✔✔✔ - c. Evidence-based
descriptions of behaviors that demonstrate the knowledge, characteristics, and skills that promote
critical thinking in clinical practice.
, During rounds, a charge nurse hears the patient care technician yelling loudly to a patient regarding
a transfer from the bed to chair. Upon entering the room, what is the nurse's BEST response?
A. "You need to speak to the patient quietly so you don't disturb the other patients."
B. "Let me help you with your transfer technique."
C. "When you are finished, be sure to apologize for your rough demeanor."
D. "When your patient is safe and comfortable, meet me at the desk." - ✔✔✔ - d. The charge nurse
should direct the patient care technician to determine the patient's safety. Then the nurse should
address any concerns regarding the patient care technician's communication techniques privately.
The nurse should direct the patient care technician on aspects of therapeutic communication
A public health nurse is leaving the home of a young mother who has a special needs baby. The
neighbor states, "How is she doing, since the baby's father is no help?" What is the nurse's BEST
response to the neighbor?
A. "New mothers need support."
B. The lack of a father is difficult."
C. "How are you today?"
D. "It is a very sad situation." - ✔✔✔ - a. The nurse must maintain confidentiality when providing
care. The statement "New mothers need support" is a general statement that all new parents need
help. The statement is not judgmental of the family's roles.
A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and dehydration.
During the admission interview, the nurse should implement which communication techniques to
elicit the most information from the parents?
A. The use of reflective questions
B. The use of closed questions
C. The use of assertive questions
D. The use of clarifying questions - ✔✔✔ - d. The use of the clarifying question or comment allows
the nurse to gain an understanding of a patient's comment. When used properly, this technique can
avert possible misconceptions that could lead to an inappropriate nursing diagnosis. The reflective
question technique involves repeating what the person has said or describing the person's feelings.
Open-ended questions encourage free verbalization and expression of what the parents believe to be
true. Assertive behavior is the ability to stand up for yourself and others using open, honest, and
direct communication
A nurse enters a patient's room and examines the patient's IV fluids and cardiac monitor. The patient
states, "Well, I haven't seen you before. Who are you?" What is the nurse's BEST response?
Answers Latest Updated Version
A female patient who is receiving chemotherapy for breast cancer tells the nurse, "The treatment for
this cancer is worse than the disease itself. I'm not going to come for my therapy anymore." The nurse
responds by using critical thinking skills to address this patient problem. Which action is the first
step the nurse would take in this process?
A. The nurse judges whether the patient database is adequate to address the problem.
B. The nurse considers whether or not to suggest a counseling session for the patient.
C. The nurse reassesses the patient and decides how best to intervene in her care.
D. The nurse identifies several options for intervening in the patient's care and critiques the merit of
each option. - ✔✔✔ - c. The first step when thinking critically about a situation is to identify the
purpose or goal of your thinking. Reassessing the patient helps to discipline thinking by directing all
thoughts toward the goal. Once the problem is addressed, it is important for the nurse to judge the
adequacy of the knowledge, identify potential problems, use helpful resources, and critique the
decision.
The nursing process ensures that nurses are person centered rather than task centered. Rather than
simply approaching a patient to take vital signs, the nurse thinks, "How is Mrs. Barclay today? Are
our nursing actions helping her to achieve her goals? How can we better help her?" This
demonstrates which characteristic of the nursing process?
A. Systematic
B. Interpersonal
C. Dynamic
D. Universally applicable in nursing situations - ✔✔✔ - b. Interpersonal. All of the other options are
characteristics of the nursing process, but the conversation and thinking quoted best illustrates the
interpersonal dimension of the nursing process
An experienced nurse tells a beginning nurse not to bother studying too hard, since most clinical
reasoning becomes "second nature" and "intuitive" once you start practicing. What thinking below
should underlie the beginning nurse's response?
A. Intuitive problem solving comes with years of practice and observation, and novice nurses should
base their care on scientific problem solving.
B. For nursing to remain a science, nurses must continue to be vigilant about stamping out intuitive
reasoning.
C. The emphasis on logical, scientific, evidence-based reasoning has held nursing back for years; it is
time to champion intuitive, creative thinking!
,D. It is simply a matter of preference; some nurses are logical, scientific thinkers, and some are
intuitive, creative thinkers. - ✔✔✔ - a. Beginning nurses must use nursing knowledge and scientific
problem solving as the basis of care they give; intuitive problem solving comes with years of practice
and observation
The nurse uses blended competencies when caring for patients in a rehabilitation facility. Which
examples of interventions involve cognitive skills? Select all that apply.
A. The nurse uses critical thinking skills to plan care for a patient.
B. The nurse correctly administers IV saline to a patient who is dehydrated.
C. The nurse assists a patient to fill out an informed consent form.
D. The nurse learns the correct dosages for patient pain medications.
E. The nurse comforts a mother whose baby was born with Down syndrome.
F. The nurse uses the proper procedure to catheterize a female patient. - ✔✔✔ - a, d. Using critical
thinking and learning medication dosages are cognitive competencies. Performing procedures
correctly is a technical skill, helping a patient with an informed consent form is a legal/ethical issue,
and comforting a patient is an interpersonal skill.
A nurse uses critical thinking skills to focus on the care plan of an older adult who has dementia and
needs placement in a long-term care facility. Which statements describe characteristics of this type
of critical thinking applied to clinical reasoning? Select all that apply.
A. It functions independently of nursing standards, ethics, and state practice acts.
B. It is based on the principles of the nursing process, problem solving, and the scientific method.
C. It is driven by patient, family, and community needs as well as nurses' needs to give competent,
efficient care.
D. It is not designed to compensate for problems created by human nature, such as medication errors.
E. It is constantly re-evaluating, self-correcting, and striving for improvement.
F. It focuses on the big picture rather than identifying the key problems, issues, and risks involved
with patient care - ✔✔✔ - b, c, e. Critical thinking applied to clinical reasoning and judgment in
nursing practice is guided by standards, policies and procedures, and ethics codes.
A nurse is caring for a patient who has complications related to type 2 diabetes mellitus. The nurse
researches new procedures to care for foot ulcers when developing a care plan for this patient. Which
QSEN competency does this action represent?
A. Patient-centered care
B. Evidence-based practice
C. Quality improvement
,D. Informatics - ✔✔✔ - c. Quality improvement involves routinely updating nursing policies and
procedures. Providing patient-centered care involves listening to the patient and demonstrating
respect and compassion. Evidence-based practice is used when adhering to internal policies and
standardized skills. The nurse is employing informatics by using information and technology to
communicate, manage knowledge, and support decision making.
A nurse is assessing a patient who is diagnosed with anorexia. Following the assessment, the nurse
recommends that the patient meet with a nutritionist. This action best exemplifies the use of:
A. Clinical judgment
B. Clinical reasoning
C. Critical thinking
D. Blended competencies - ✔✔✔ - a. Although all the options refer to the skills used by nurses in
practice, the best choice is clinical judgment as it refers to the result or outcome of critical thinking
or clinical reasoning—in this case, the recommendation to meet with a nutritionist.
A nurse working in a long-term care facility bases patient care on five caring processes: knowing,
being with, doing for, enabling, and maintaining belief. This approach to patient care best describes
whose theory?
A. Travelbee's
B. Watson's
C. Benner's
D. Swanson's - ✔✔✔ - d. Swanson (1991) identifies five caring processes and defines caring as "a
nurturing way of relating to a valued other toward whom one feels a personal sense of commitment
and responsibility."
The nurse practices using critical thinking indicators (ctis) when caring for patients in the hospital
setting. The best description of ctis is:
A. Evidence-based descriptions of behaviors that demonstrate the knowledge that promotes critical
thinking in clinical practice
B. Evidence-based descriptions of behaviors that demonstrate the knowledge and skills that promote
critical thinking in clinical practice
C. Evidence-based descriptions of behaviors that demonstrate the knowledge, characteristics, and
skills that promote critical thinking in clinical practice
D. Evidence-based descriptions of behaviors that demonstrate the knowledge, characteristics,
standards, and skills that promote critical thinking in clinical practice - ✔✔✔ - c. Evidence-based
descriptions of behaviors that demonstrate the knowledge, characteristics, and skills that promote
critical thinking in clinical practice.
, During rounds, a charge nurse hears the patient care technician yelling loudly to a patient regarding
a transfer from the bed to chair. Upon entering the room, what is the nurse's BEST response?
A. "You need to speak to the patient quietly so you don't disturb the other patients."
B. "Let me help you with your transfer technique."
C. "When you are finished, be sure to apologize for your rough demeanor."
D. "When your patient is safe and comfortable, meet me at the desk." - ✔✔✔ - d. The charge nurse
should direct the patient care technician to determine the patient's safety. Then the nurse should
address any concerns regarding the patient care technician's communication techniques privately.
The nurse should direct the patient care technician on aspects of therapeutic communication
A public health nurse is leaving the home of a young mother who has a special needs baby. The
neighbor states, "How is she doing, since the baby's father is no help?" What is the nurse's BEST
response to the neighbor?
A. "New mothers need support."
B. The lack of a father is difficult."
C. "How are you today?"
D. "It is a very sad situation." - ✔✔✔ - a. The nurse must maintain confidentiality when providing
care. The statement "New mothers need support" is a general statement that all new parents need
help. The statement is not judgmental of the family's roles.
A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and dehydration.
During the admission interview, the nurse should implement which communication techniques to
elicit the most information from the parents?
A. The use of reflective questions
B. The use of closed questions
C. The use of assertive questions
D. The use of clarifying questions - ✔✔✔ - d. The use of the clarifying question or comment allows
the nurse to gain an understanding of a patient's comment. When used properly, this technique can
avert possible misconceptions that could lead to an inappropriate nursing diagnosis. The reflective
question technique involves repeating what the person has said or describing the person's feelings.
Open-ended questions encourage free verbalization and expression of what the parents believe to be
true. Assertive behavior is the ability to stand up for yourself and others using open, honest, and
direct communication
A nurse enters a patient's room and examines the patient's IV fluids and cardiac monitor. The patient
states, "Well, I haven't seen you before. Who are you?" What is the nurse's BEST response?
