FUNDAMENTALS OF NURSING
12TH EDITION
• AUTHOR(S)PATRICIA A. POTTER;
ANNE G. PERRY; PATRICIA A.
STOCKERT; AMY HALL; WENDY
R. OSTENDORF
TEST BANK
,Question 1
A nurse enters a patient's room and finds the patient lying on
the floor beside the bed. What is the nurse's priority action?
A. Complete an incident report immediately.
B. Assess the patient for responsiveness and injuries.
C. Notify the healthcare provider.
D. Return the patient to bed.
Correct Answer: B
Rationale:
The priority is to assess the patient's condition using the nursing
process and ABC principles before taking other actions. The
nurse should determine responsiveness, airway, breathing,
circulation, and the presence of injuries before moving the
patient. Incident reports and provider notification occur after
the patient's immediate needs have been addressed. Moving
the patient before assessment may worsen an injury.
Question 2
A nurse is preparing to administer oral medications. Which
action best promotes patient safety?
A. Ask the patient to state their full name and date of birth
before administration.
B. Confirm the patient's identity using the room number.
,C. Verify the medication only after it is administered.
D. Ask another patient to identify the patient.
Correct Answer: A
Rationale:
Using at least two patient identifiers, such as the patient's full
name and date of birth, helps ensure the correct patient
receives the medication. Room numbers are not reliable
identifiers. Medication verification should occur before
administration, and another patient should never identify a
patient.
Question 3
A nurse is teaching a patient how to use an incentive
spirometer following surgery. Which patient statement
indicates correct understanding?
A. "I should breathe into the device as quickly as possible."
B. "I should inhale slowly and hold my breath briefly."
C. "I only need to use the device when I feel short of breath."
D. "I should exhale forcefully into the device."
Correct Answer: B
Rationale:
The patient should inhale slowly and deeply through the
mouthpiece and hold the breath for several seconds to
maximize alveolar expansion. The device is intended to
, encourage deep inspiration, not forceful exhalation. Regular
use, even when feeling well, helps prevent postoperative
pulmonary complications.
Question 4
A nurse delegates the task of obtaining routine vital signs on a
stable patient to an unlicensed assistive personnel (UAP). Which
responsibility remains with the nurse?
A. Measuring the blood pressure
B. Reporting abnormal findings to the provider
C. Interpreting the vital signs and determining appropriate
interventions
D. Documenting the vital signs in the medical record
Correct Answer: C
Rationale:
Although certain tasks may be delegated, the nurse retains
responsibility for assessment, interpretation of findings, clinical
judgment, and development of the care plan. UAP may collect
data and report abnormal findings, but the nurse determines
the significance of those findings and appropriate interventions.
Question 5
A hospitalized patient tells the nurse, "I don't understand why I
need this treatment." What is the nurse's best response?
12TH EDITION
• AUTHOR(S)PATRICIA A. POTTER;
ANNE G. PERRY; PATRICIA A.
STOCKERT; AMY HALL; WENDY
R. OSTENDORF
TEST BANK
,Question 1
A nurse enters a patient's room and finds the patient lying on
the floor beside the bed. What is the nurse's priority action?
A. Complete an incident report immediately.
B. Assess the patient for responsiveness and injuries.
C. Notify the healthcare provider.
D. Return the patient to bed.
Correct Answer: B
Rationale:
The priority is to assess the patient's condition using the nursing
process and ABC principles before taking other actions. The
nurse should determine responsiveness, airway, breathing,
circulation, and the presence of injuries before moving the
patient. Incident reports and provider notification occur after
the patient's immediate needs have been addressed. Moving
the patient before assessment may worsen an injury.
Question 2
A nurse is preparing to administer oral medications. Which
action best promotes patient safety?
A. Ask the patient to state their full name and date of birth
before administration.
B. Confirm the patient's identity using the room number.
,C. Verify the medication only after it is administered.
D. Ask another patient to identify the patient.
Correct Answer: A
Rationale:
Using at least two patient identifiers, such as the patient's full
name and date of birth, helps ensure the correct patient
receives the medication. Room numbers are not reliable
identifiers. Medication verification should occur before
administration, and another patient should never identify a
patient.
Question 3
A nurse is teaching a patient how to use an incentive
spirometer following surgery. Which patient statement
indicates correct understanding?
A. "I should breathe into the device as quickly as possible."
B. "I should inhale slowly and hold my breath briefly."
C. "I only need to use the device when I feel short of breath."
D. "I should exhale forcefully into the device."
Correct Answer: B
Rationale:
The patient should inhale slowly and deeply through the
mouthpiece and hold the breath for several seconds to
maximize alveolar expansion. The device is intended to
, encourage deep inspiration, not forceful exhalation. Regular
use, even when feeling well, helps prevent postoperative
pulmonary complications.
Question 4
A nurse delegates the task of obtaining routine vital signs on a
stable patient to an unlicensed assistive personnel (UAP). Which
responsibility remains with the nurse?
A. Measuring the blood pressure
B. Reporting abnormal findings to the provider
C. Interpreting the vital signs and determining appropriate
interventions
D. Documenting the vital signs in the medical record
Correct Answer: C
Rationale:
Although certain tasks may be delegated, the nurse retains
responsibility for assessment, interpretation of findings, clinical
judgment, and development of the care plan. UAP may collect
data and report abnormal findings, but the nurse determines
the significance of those findings and appropriate interventions.
Question 5
A hospitalized patient tells the nurse, "I don't understand why I
need this treatment." What is the nurse's best response?
