NURS 221 - Midterm Exam Questions and Answers Solved Correctly
A patient is preparing for discharge following hip surgery and the patient will likely require extensive
physiotherapy. What assessment question should the nurse prioritize? - Answers "Are you able to pay
for the costs of your physiotherapy treatments?"
A nurse is providing care for a patient who has undergone a partial foot amputation for the treatment of
osteomyelitis (bone infection). The nurse observes that the patient will not look at her foot when the
nurse changes the dressing. How should the nurse best follow up this observation? - Answers Gather
more data to better understand the patient's behaviour.
A nurse is interviewing a new client admitted to the hospital for surgery. Which action would the nurse
perform in the introductory phase of the interview? - Answers The nurse assesses the client's comfort
and ability to participate in the interview.
A client who gave birth yesterday refuses to eat the food provided by the hospital. She states that she
must eat special food brought from home by her family. How would the nurse most appropriately
address this situation? - Answers The nurse should plan no action because the client is not exhibiting a
health problem.
A client who is scheduled for coronary angioplasty is concerned if the surgery is safe and wonders
whether it would be beneficial to him. Which nursing diagnosis relates to this client's condition? -
Answers Fear related to potential risk and surgical outcomes
A client with a new colostomy often becomes short and sarcastic when nurses attempt to teach him
about the management of his new appliance. The nurse has consequently documented "Noncompliance
related hostility" on the client's chart. What mistake has the nurse made when choosing and
documenting this nursing diagnosis? - Answers presuming to know the factors contributing to the
problem
A nurse is reviewing the plan of care for a client and notes the following: "The client verbalizes three
signs of hypoglycemia to the staff accurately before discharge." The nurse interprets this statement as
a(n): - Answers outcome criteria
A client with multiple leg fractures following a motor vehicle accident tells the nurse, "I am going crazy
here. I have to wait 2 months before I can practice walking, again." What is the priority nursing
diagnosis? - Answers deficient diversional activity
A preceptor reviews the client outcomes written by a new nurse. Which outcome is the priority for the
client with paranoid delusions? - Answers Within 3 days, client will mingle in the day room without
violence.
The home health nurse caring for a client with limited eyesight notes that the client's route to the
bathroom is cluttered. What is the most effective way for the nurse to ensure the client's long-term
safety? - Answers Assist the client to identify strategies to promote safety in the home.
, The nurse is preparing to implement plans of care with several clients. Which action would be
inappropriate for the nurse to perform? - Answers Respond to the postoperative client's question that
baths are given only in the morning.
A nurse in the ICU (intensive care unit) has been assigned to care for a client who was seriously injured
during a gang rape. The nurse was raped 6 months ago and feels that she will be too upset to care for
the client properly. How should the nurse deal with the assignment? - Answers Recognize her limitations
and ask for another nurse to be assigned.
A client has a nursing diagnosis of Possible Spiritual Distress. What is the most appropriate nursing
intervention? - Answers Discuss spirituality with the client.
A nurse just reported to the oncoming shift that she had failed to do an ordered dressing change. She
reported to the nurse manager that this was the second time this week she had not had time to do the
dressing change. The nurse manager recognized that the nurse normally was very punctual and was
known to provide good care for her clients however the unit census had been very high on this
particular week. The nurse manager knows that quality care must be provided and reports this
occurrence as what type of quality approach? - Answers Quality by opportunity
The nurse is caring for Mr. H., a 35-year-old man who is hospitalized following a motorcycle accident. He
has a traumatic brain injury. The nurse is working with Mr. H. on self-care behaviors. The following
would help the nurse to assess the success of the nursing interventions except which of the following? -
Answers Model self-care behaviors for the client.
Which action should the nurse take when client data indicate that the stated goals have not been
achieved? - Answers Review each preceding step of the nursing process.
A health care facility plans to evaluate and revise the plan of care for a client based on the client's health
care records. The physician, dietitian, and nurse involved in the client's care are required to collate all of
the information for easy access. Which style would the nurse conclude that the facility is following in
order to record the client details? - Answers SOAP chartin
A nurse helps a client who has cystic fibrosis prepare a standalone personal health record. Which
statement by the nurse best explains this type of information? - Answers "You can fill in information
from your own records and store it on your computer or the Internet."
Which method of charting did the nurse used to document "Fluid Volume Overload. On assessment
client's lower limbs oedmatous ++. Affected leg elevated and furosemide 40 mg intramuscular given. No
signs of deep vein thrombosis noted. Limbs now oedema +"? - Answers focus charting
A client arrives at a crisis center in a state of bipolar mania. The client has a flight of ideas and it is
difficult for the nurse to obtain an adequate intake assessment. Which statement or question will elicit
the most specific information? - Answers are you allergic to any medications
A patient is preparing for discharge following hip surgery and the patient will likely require extensive
physiotherapy. What assessment question should the nurse prioritize? - Answers "Are you able to pay
for the costs of your physiotherapy treatments?"
A nurse is providing care for a patient who has undergone a partial foot amputation for the treatment of
osteomyelitis (bone infection). The nurse observes that the patient will not look at her foot when the
nurse changes the dressing. How should the nurse best follow up this observation? - Answers Gather
more data to better understand the patient's behaviour.
A nurse is interviewing a new client admitted to the hospital for surgery. Which action would the nurse
perform in the introductory phase of the interview? - Answers The nurse assesses the client's comfort
and ability to participate in the interview.
A client who gave birth yesterday refuses to eat the food provided by the hospital. She states that she
must eat special food brought from home by her family. How would the nurse most appropriately
address this situation? - Answers The nurse should plan no action because the client is not exhibiting a
health problem.
A client who is scheduled for coronary angioplasty is concerned if the surgery is safe and wonders
whether it would be beneficial to him. Which nursing diagnosis relates to this client's condition? -
Answers Fear related to potential risk and surgical outcomes
A client with a new colostomy often becomes short and sarcastic when nurses attempt to teach him
about the management of his new appliance. The nurse has consequently documented "Noncompliance
related hostility" on the client's chart. What mistake has the nurse made when choosing and
documenting this nursing diagnosis? - Answers presuming to know the factors contributing to the
problem
A nurse is reviewing the plan of care for a client and notes the following: "The client verbalizes three
signs of hypoglycemia to the staff accurately before discharge." The nurse interprets this statement as
a(n): - Answers outcome criteria
A client with multiple leg fractures following a motor vehicle accident tells the nurse, "I am going crazy
here. I have to wait 2 months before I can practice walking, again." What is the priority nursing
diagnosis? - Answers deficient diversional activity
A preceptor reviews the client outcomes written by a new nurse. Which outcome is the priority for the
client with paranoid delusions? - Answers Within 3 days, client will mingle in the day room without
violence.
The home health nurse caring for a client with limited eyesight notes that the client's route to the
bathroom is cluttered. What is the most effective way for the nurse to ensure the client's long-term
safety? - Answers Assist the client to identify strategies to promote safety in the home.
, The nurse is preparing to implement plans of care with several clients. Which action would be
inappropriate for the nurse to perform? - Answers Respond to the postoperative client's question that
baths are given only in the morning.
A nurse in the ICU (intensive care unit) has been assigned to care for a client who was seriously injured
during a gang rape. The nurse was raped 6 months ago and feels that she will be too upset to care for
the client properly. How should the nurse deal with the assignment? - Answers Recognize her limitations
and ask for another nurse to be assigned.
A client has a nursing diagnosis of Possible Spiritual Distress. What is the most appropriate nursing
intervention? - Answers Discuss spirituality with the client.
A nurse just reported to the oncoming shift that she had failed to do an ordered dressing change. She
reported to the nurse manager that this was the second time this week she had not had time to do the
dressing change. The nurse manager recognized that the nurse normally was very punctual and was
known to provide good care for her clients however the unit census had been very high on this
particular week. The nurse manager knows that quality care must be provided and reports this
occurrence as what type of quality approach? - Answers Quality by opportunity
The nurse is caring for Mr. H., a 35-year-old man who is hospitalized following a motorcycle accident. He
has a traumatic brain injury. The nurse is working with Mr. H. on self-care behaviors. The following
would help the nurse to assess the success of the nursing interventions except which of the following? -
Answers Model self-care behaviors for the client.
Which action should the nurse take when client data indicate that the stated goals have not been
achieved? - Answers Review each preceding step of the nursing process.
A health care facility plans to evaluate and revise the plan of care for a client based on the client's health
care records. The physician, dietitian, and nurse involved in the client's care are required to collate all of
the information for easy access. Which style would the nurse conclude that the facility is following in
order to record the client details? - Answers SOAP chartin
A nurse helps a client who has cystic fibrosis prepare a standalone personal health record. Which
statement by the nurse best explains this type of information? - Answers "You can fill in information
from your own records and store it on your computer or the Internet."
Which method of charting did the nurse used to document "Fluid Volume Overload. On assessment
client's lower limbs oedmatous ++. Affected leg elevated and furosemide 40 mg intramuscular given. No
signs of deep vein thrombosis noted. Limbs now oedema +"? - Answers focus charting
A client arrives at a crisis center in a state of bipolar mania. The client has a flight of ideas and it is
difficult for the nurse to obtain an adequate intake assessment. Which statement or question will elicit
the most specific information? - Answers are you allergic to any medications
