,Chapter 1: Concepts and Trends in Healthcare
30 Questions
SECTION A: MULTIPLE CHOICE (Questions 1-20)
Question 1
A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the
nurse that which is the priority when working as a professional nurse?
A) Attending to holistic client needs
B) Ensuring client safety
C) Not making medication errors
D) Providing client-focused care
Answer: B) Ensuring client safety
Rationale: All actions are appropriate for the professional nurse. However, ensuring client safety is the
priority. According to the 2000 Institute of Medicine report, up to 98,000 deaths result each year from
errors in hospital care, and many more clients have suffered injuries and less serious outcomes. Every
nurse has the responsibility to guard the client's safety.
Question 2
A nurse is orienting a new client and family to the inpatient unit. What information does the nurse
provide to help the client promote his or her own safety?
A) Encourage the client and family to be active partners
B) Have the client monitor hand hygiene in caregivers
C) Offer the family the opportunity to stay with the client
D) Tell the client to always wear his or her armband
Answer: A) Encourage the client and family to be active partners
Rationale: Each action could be important for the client or family to perform. However, encouraging the
client to be active in his or her health care as a partner is the most critical. The other actions are very
limited in scope and do not provide the broad protection that being active and involved does.
Question 3
A nurse is caring for a postoperative client on the surgical unit. The client's blood pressure was 142/76
mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is best?
A) Call the Rapid Response Team
B) Document and continue to monitor
,C) Notify the primary care provider
D) Repeat blood pressure measurement in 15 minutes
Answer: A) Call the Rapid Response Team
Rationale: The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating
before they suffer either respiratory or cardiac arrest. Since the client has manifested a significant
change, the nurse should call the RRT. Changes in blood pressure, mental status, heart rate, and pain are
particularly significant.
Question 4
A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best
demonstrates this concept?
A) Assesses for cultural influences affecting health care
B) Ensures that all the client's basic needs are met
C) Tells the client and family about all upcoming tests
D) Thoroughly orients the client and family to the room
Answer: A) Assesses for cultural influences affecting health care
Rationale: Client-centered care requires understanding the whole person, including cultural influences
that affect health beliefs, practices, and decision-making. While meeting basic needs, providing
information, and orienting to the room are important, assessing cultural influences is the most
comprehensive demonstration of client-centered care.
Question 5
Which trend in healthcare has most significantly shifted the focus of nursing practice in recent decades?
A) Increased emphasis on hospital-based acute care
B) Reduction in the number of licensed nurses
C) Movement toward community-based and preventive care
D) Elimination of the nurse's role in patient education
Answer: C) Movement toward community-based and preventive care
Rationale: Healthcare has increasingly shifted from hospital-based acute care toward community and
preventive care models, requiring nurses to expand their roles beyond inpatient settings to include
health promotion, disease prevention, and care coordination.
Question 6
A nurse is practicing in an outpatient clinic setting. This represents which level of healthcare?
A) Primary care
B) Secondary care
, C) Tertiary care
D) Restorative care
Answer: B) Secondary care
Rationale: Secondary care refers to specialized care provided by medical specialists and other health
professionals, often in outpatient or clinic settings. Primary care is the first point of contact, while
tertiary care involves specialized hospital-based services.
Question 7
Which organization is primarily responsible for accrediting hospitals in the United States?
A) American Nurses Association (ANA)
B) National League for Nursing (NLN)
C) The Joint Commission (TJC)
D) Centers for Medicare and Medicaid Services (CMS)
Answer: C) The Joint Commission (TJC)
Rationale: The Joint Commission is the primary accrediting body for hospitals and healthcare
organizations in the United States, setting standards for patient safety and quality of care.
Question 8
Which factor is considered a social determinant of health?
A) The patient's current medication regimen
B) The patient's blood pressure reading
C) The patient's socioeconomic status
D) The patient's most recent lab results
Answer: C) The patient's socioeconomic status
Rationale: Social determinants of health include non-medical factors such as socioeconomic status,
education, neighborhood, and social support, all of which significantly influence health outcomes.
Question 9
A nurse explains patient rights to a newly admitted client. This action reflects which ethical principle?
A) Beneficence
B) Non-maleficence
C) Autonomy
D) Justice
Answer: C) Autonomy
30 Questions
SECTION A: MULTIPLE CHOICE (Questions 1-20)
Question 1
A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the
nurse that which is the priority when working as a professional nurse?
A) Attending to holistic client needs
B) Ensuring client safety
C) Not making medication errors
D) Providing client-focused care
Answer: B) Ensuring client safety
Rationale: All actions are appropriate for the professional nurse. However, ensuring client safety is the
priority. According to the 2000 Institute of Medicine report, up to 98,000 deaths result each year from
errors in hospital care, and many more clients have suffered injuries and less serious outcomes. Every
nurse has the responsibility to guard the client's safety.
Question 2
A nurse is orienting a new client and family to the inpatient unit. What information does the nurse
provide to help the client promote his or her own safety?
A) Encourage the client and family to be active partners
B) Have the client monitor hand hygiene in caregivers
C) Offer the family the opportunity to stay with the client
D) Tell the client to always wear his or her armband
Answer: A) Encourage the client and family to be active partners
Rationale: Each action could be important for the client or family to perform. However, encouraging the
client to be active in his or her health care as a partner is the most critical. The other actions are very
limited in scope and do not provide the broad protection that being active and involved does.
Question 3
A nurse is caring for a postoperative client on the surgical unit. The client's blood pressure was 142/76
mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is best?
A) Call the Rapid Response Team
B) Document and continue to monitor
,C) Notify the primary care provider
D) Repeat blood pressure measurement in 15 minutes
Answer: A) Call the Rapid Response Team
Rationale: The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating
before they suffer either respiratory or cardiac arrest. Since the client has manifested a significant
change, the nurse should call the RRT. Changes in blood pressure, mental status, heart rate, and pain are
particularly significant.
Question 4
A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best
demonstrates this concept?
A) Assesses for cultural influences affecting health care
B) Ensures that all the client's basic needs are met
C) Tells the client and family about all upcoming tests
D) Thoroughly orients the client and family to the room
Answer: A) Assesses for cultural influences affecting health care
Rationale: Client-centered care requires understanding the whole person, including cultural influences
that affect health beliefs, practices, and decision-making. While meeting basic needs, providing
information, and orienting to the room are important, assessing cultural influences is the most
comprehensive demonstration of client-centered care.
Question 5
Which trend in healthcare has most significantly shifted the focus of nursing practice in recent decades?
A) Increased emphasis on hospital-based acute care
B) Reduction in the number of licensed nurses
C) Movement toward community-based and preventive care
D) Elimination of the nurse's role in patient education
Answer: C) Movement toward community-based and preventive care
Rationale: Healthcare has increasingly shifted from hospital-based acute care toward community and
preventive care models, requiring nurses to expand their roles beyond inpatient settings to include
health promotion, disease prevention, and care coordination.
Question 6
A nurse is practicing in an outpatient clinic setting. This represents which level of healthcare?
A) Primary care
B) Secondary care
, C) Tertiary care
D) Restorative care
Answer: B) Secondary care
Rationale: Secondary care refers to specialized care provided by medical specialists and other health
professionals, often in outpatient or clinic settings. Primary care is the first point of contact, while
tertiary care involves specialized hospital-based services.
Question 7
Which organization is primarily responsible for accrediting hospitals in the United States?
A) American Nurses Association (ANA)
B) National League for Nursing (NLN)
C) The Joint Commission (TJC)
D) Centers for Medicare and Medicaid Services (CMS)
Answer: C) The Joint Commission (TJC)
Rationale: The Joint Commission is the primary accrediting body for hospitals and healthcare
organizations in the United States, setting standards for patient safety and quality of care.
Question 8
Which factor is considered a social determinant of health?
A) The patient's current medication regimen
B) The patient's blood pressure reading
C) The patient's socioeconomic status
D) The patient's most recent lab results
Answer: C) The patient's socioeconomic status
Rationale: Social determinants of health include non-medical factors such as socioeconomic status,
education, neighborhood, and social support, all of which significantly influence health outcomes.
Question 9
A nurse explains patient rights to a newly admitted client. This action reflects which ethical principle?
A) Beneficence
B) Non-maleficence
C) Autonomy
D) Justice
Answer: C) Autonomy
