TEST BANK WILLIAMS DEWIT'S FUNDAMENTAL CONCEPTS AND SKILLS FOR NURSING 5TH EDITION

TEST BANK WILLIAMS DEWIT'S FUNDAMENTAL CONCEPTS AND SKILLS FOR NURSING 5TH EDITIONChapter1 MULTIPLE CHOICE 1. Florence Nightingale’s contributions to nursing practice and education: a. are historically important but have no validity for nursing today. b. were neither recognized nor appreciated in her own time. c. were a major factor in reducing the death rate in the Crimean War. d. were limited only to the care of severe traumatic wounds. ANS: C By improving sanitation, nutrition ventilation, and handwashing techniques, Florence Nightingale’s nurses dramatically reduced the death rate from injuries in the Crimean War. DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #1 TOP: Nursing History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 2. Early nursing education and care in the United States: a. were directed at community health. b. provided independence for women through education and employment. c. were an educational model based in institutions of higher learning. d. have continued to be entirely focused on hospital nursing. 1 | P a g eANS: B Because of the influence of early nursing leaders, nursing education became more formalized through apprenticeships in Nightingale schools that offered independence to women through education and employment. DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4 TOP: Nursing History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 3. In order to fulfill the common goals defined by nursing theorists (promote wellness, prevent illness, facilitate coping, and restore health), the LPN must take on the roles of: a. caregiver, educator, and collaborator. b. nursing assistant, delegator, and environmental specialist. c. medication dispenser, collaborator, and transporter. d. dietitian, manager, and housekeeper. ANS: A In order for the LPN to apply the common goals of nursing, he or she must assume the roles of caregiver, educator, collaborator, manager, and advocate. DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory #2 TOP: Art and Science of Nursing KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 4. Although nursing theories differ in their attempts to define nursing, all of them base their beliefs on common concepts concerning: a. self-actualization, fundamental needs, and belonging. 2 | P a g eb. stress reduction, self-care, and a systems model. c. curative care, restorative care, and terminal care. d. human relationships, the environment, and health. ANS: D Although nursing theories differ, they all base their beliefs on human relationships, the environment, and health. DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory #2 TOP: Nursing Theories KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 5. Standards of care for the nursing practice of the LPN are established by the: a. Boards of Nursing Examiners in each state. b. National Council of States Boards of Nursing (NCSBN). c. American Nurses Association (ANA). d. National Federation of Licensed Practical Nurses. ANS: D The National Federation of Licensed Practical Nurses modified the standards published by the ANA in 2004 to better fit the role of the LPN. DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: Theory #2 TOP: Standards of Care KEY: Nursing Process 3 | P a g eStep: N/A MSC: NCLEX: N/A 6. The LPN demonstrates an evidence-based practice by: a. using a drug manual to check compatibility of drugs. b. using scientific information to guide decision making. c. using medical history of a patient to direct nursing interventions. d. basing nursing care on advice from an experienced nurse. ANS: B The use of scientific information from high-quality research to guide nursing decisions is reflective of the application of evidence-based practice. DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: Theory #3 TOP: Evidence Based Practice KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 7. Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New York in 1893 in order to: a. offer a shelter to injured war veterans. b. found a nursing apprenticeship. c. provide health care to poor persons living in tenements. d. offer better housing to low-income families. 4 | P a g eANS: C Henry Street Settlement Service brought the provision of community health care to the poor people living in tenements. DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: Theory #4 TOP: Growth of Nursing KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 8. An educational pathway for an LPN refers to an LPN: a. learning on the job and being promoted to a higher level of responsibility. b. moving from a maternity unit to a more complicated surgical unit. c. obtaining additional education to move from one level of nursing to another. d. learning that advancement requires consistent work and commitment. ANS: C By broadening the educational base, an LPN may advance and build a nursing career. DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory #7 TOP: Nursing Education Pathways KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 9. When diagnosis-related groups (DRGs) were established by Medicare in 1983, the purpose was to: a. put patients with the same diagnosis on the same unit. 5 | P a g eb. attempt to contain the costs of health care. c. increase availability of medical care to the elderly. d. identify a patient’s condition more quickly. ANS: B The purpose of instituting DRGs was to contain skyrocketing costs of health care. DIF: Cognitive Level: Knowledge REF: p. 8 OBJ: Theory #10 TOP: Health Care Delivery KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 10. The advent of diagnosis-related groups (DRGs) required that nurses working in health care agencies: record supportive documentation to confirm a patient’s need for care in order to qualify for a. reimbursement. b. use the DRG rather than their own observations for patient assessment. c. be aware of the specific drugs related to the diagnosis. d. acquire cross-training to make staffing more flexible. ANS: A DRGs required that nurses provide more supportive documentation of their assessments and identified patient needs to qualify the facility for Medicare reimbursement. Observant assessment might also indicate another DRG classification and consequently more reimbursement for the facility. 6 | P a g eDIF: Cognitive Level: Comprehension REF: p. 8 OBJ: Theory #10 TOP: Managed Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 11. If a member of a health maintenance organization (HMO) is having respiratory problems such as fever, cough, and fatigue for several days and wants to see a specialist, the person is required to go: a. directly to an emergency room for treatment. b. to any general practitioner of choice. c. directly to a respiratory specialist. d. to a primary care physician for a referral. ANS: D Participants in an HMO must see their primary physician to receive a referral for a specialist in order for the HMO to pay for the care. DIF: Cognitive Level: Comprehension REF: p. 9 OBJ: Theory #11 TOP: Managed Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 12. An advantage of preferred provider organizations (PPOs) is that: a. they make insurance coverage of employees less expensive to employers. b. there are fewer physicians to choose from than in an HMO. c. long-term relationships with physicians are more likely. 7 | P a g ed. patients may go directly to a specialist for care. ANS: A The use of PPOs allows insurance companies to keep their premiums low and in turn makes insurance coverage less expensive for the employers. There are usually more physicians from which to choose than from a HMO, but long-term relationships between physician and patient cannot be established easily. Patients still must see their primary physician before being referred to other specialties. DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory #11 TOP: Preferred Provider Organizations KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 13. After passing the National Council Licensure Examination for Practical Nurses (NCLEX- PN), the nurse is qualified to take an additional certification in the field of: a. pharmacology. b. care of infants and children. c. operating room technology. d. community health. ANS: A After becoming an LPN, the nurse may apply for additional certification in pharmacology or long- term care. DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory #6 TOP: Educational Opportunities KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 8 | P a g e14. Nursing interventions are best defined as activities that: a. are taken to improve the patient’s health. b. involve researching methods to maintain asepsis. c. include the family in nursing care. d. review guidelines for handling infectious wastes. ANS: A Interventions are actions taken to improve, maintain, or restore health. DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory #2 TOP: Art and Science of Nursing KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 15. Nurse Practice Acts define the legal scope of an LPN’s practice, which are written and enforced by: a. the American Nurses Association. b. the National Council Licensure Examiners. c. each state. d. each health care agency. ANS: C Each state writes and enforces the Nurse Practice Act, which defines the legal scope of nursing practice. 9 | P a g eDIF: Cognitive Level: Comprehension REF: p. 5 OBJ: Theory #3 TOP: Nurse Practice Act KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 16. Women volunteers were organized to give nursing care to the wounded soldiers during the Civil War by: a. Florence Nightingale. b. Dorothea Dix. c. Clara Barton. d. Lillian Wald. ANS: B The Union government appointed Dorothea Dix, a social worker, to organize women volunteers to provide nursing care for the soldiers during the Civil War. DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4 TOP: Nursing History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 17. The nursing theory presented by Sister Calista Roy is based on: a. reduction of stress. 10 | P a g eb. achievement of maximum level of wellness. c. relief of self-care deficit. d. adaptation modes. ANS: D Adaptation modes (physiologic, psychological, sociologic, and independence) are the basis of the nursing theory of Sister Calista Roy. DIF: Cognitive Level: Knowledge REF: p. 4, Table 1-1 OBJ: Theory #2 TOP: Nursing Theories KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 18. The founding of the Red Cross is attributed to: a. Lillian Wald. b. Dorothea Dix. c. Florence Nightingale. d. Clara Barton. ANS: D Clara Barton founded the Red Cross. DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4 TOP: Nursing History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 19. The nursing theorist whose practice framework is based on 14 fundamental needs is: 11 | P a g ea. Dorothy Johnson. b. Jean Watson. c. Virginia Henderson. d. Martha Rogers. ANS: C Virginia Henderson’s nursing theory framework is based on 14 fundamental needs. DIF: Cognitive Level: Knowledge REF: p. 4, Table 1-1 OBJ: Theory #2 TOP: Nursing Theorists KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 20. The nursing theory that uses seven behavioral subsystems in an adaptation model is: a. Betty Neumann. b. Sister Calista Roy. c. Dorothy Johnson. d. Patricia Benner. ANS: C Dorothy Johnson’s practice framework is based on seven behavioral subsystems in an adaptation model. DIF: Cognitive Level: Knowledge REF: p. 4, Table 1-1 12 | P a g eOBJ: Theory #2 TOP: Nursing Theorists KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 21. The Standards of Clinical Nursing Practice are designed to direct LPNs to: a. advance their nursing career. b. seek a scientific basis for their interventions. c. deliver safe, knowledgeable care. d. a leadership role. ANS: C The Standards of Clinical Nursing Practice are designed to guide the LPN to deliver safe, knowledgeable care. DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: Theory #2 TOP: Nursing Standards KEY: Nursing Process Step: N/A MSC: NCLEX: Safe Effective Care Environment 22. A state’s Nurse Practice Act is designed to protect the: a. physician. b. nurse. 13 | P a g ec. public. d. hospital. ANS: C Nurse Practice Acts are designed to protect the public. DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory #5 TOP: Nurse Practice Act KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 23. It is appropriate for practical nurses to provide direct patient care to persons in a hospital under the supervision of a: a. physician’s assistant. b. registered nurse on the unit. c. supervising nurse who is responsible for care on several units. d. more experienced LPN on the unit. ANS: B Practical nurses provide direct patient care under the direct supervision of a registered nurse, physician, or dentist. DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory #9 TOP: Scope of Practice KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 24. An example of tertiary health care is care. 14 | P a g ea. hospice b. restorative c. emergency d. home health ANS: A Tertiary health care includes extended care, chronic disease management, medical homes, in- home personal care, and hospice care. DIF: Cognitive Level: Comprehension REF: p. 9, Box 1-2 OBJ: Theory #8 TOP: Health Care Services KEY: Nursing Process Step: N/A MSC: NCLEX: N/A COMPLETION 25. Preferred provider organizations (PPOs) use physical cost of the service. ANS: capitated cost The capitated cost is the set fee that is paid to the network for each patient enrolled to finance its services. DIF: Cognitive Level: Knowledge REF: p. 9 OBJ: Theory #8 TOP: Capitated Cost KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 26. In the United States, the Young Women’s Christian Association (YMCA) in New York opened The School, the first practical nursing school. 15 | P a g e to finance their services and pay theANS: Ballard In 1892, the YMCA opened The Ballard School, a 3-month course in practical nursing that was the first school of practical nursing. DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4 TOP: Ballard School KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 27. Such health services as surgical procedures, restorative care, and home health care would be classified as care. ANS: secondary Surgical procedures, restorative care, and home health are part of the many services classified as secondary care. DIF: Cognitive Level: Comprehension REF: p. 9, Box 1-2 OBJ: Theory #10 TOP: Health Care Services KEY: Nursing Process Step: N/A MSC: NCLEX: N/A MULTIPLE RESPONSE 28. Characteristics of primary nursing include which of the following? (Select all that apply.) a. Elimination of fragmentation of care between shifts b. Evolved in the mid-1950s c. Planning and direction performed by one nurse d. Ancillary workers used to increase productivity 16 | P a g ee. The care plan covering the entire day f. Associate nurses taking over care and planning when the primary nurse is off duty ANS: A, C, D, E, F Primary care reduces fragmentation of care between shifts. Care is planned by one nurse to cover a 24-hour period using ancillary workers to increase productivity. An associate nurse may take on direction of care in the absence of the primary nurse. DIF: Cognitive Level: Knowledge REF: p. 8 OBJ: Theory #8 TOP: Nursing Care Delivery KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 29. In 1991, the American Nurses Association (ANA) published the Standards of Clinical Nursing Practice. These standards are designed to: (Select all that apply.) a. set standards for safe nursing care delivery. b. define the legal scope of practice. c. establish state legal requirements for clinical practice. d. protect the nurse, patient, and health care agency. e. regulate the nursing profession. f. define activities in which nurses may engage. ANS: A, D, F 17 | P a g eThe Standards of Clinical Nursing Practice generally define activities in which nurses may engage, set standards for nursing care and delivery, and thereby protect the nurse, patient, and health care agency. DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: Theory #2 TOP: Nursing Practice KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 30. An example of the role of an LPN as a delegator is: (Select all that apply.) a. changing a patient’s wound dressing. b. assisting a patient to complete his or her bath. c. assigning patient care tasks to certified nursing assistants. d. requesting the housecleaning staff to mop the floor of a patient’s room. e. instructing the unit secretary to page a physician to the floor. ANS: C, D, E Delegation under the scope of the practice of an LPN is the assignment of a certified nursing assistant to certain nursing care or other non-medical staff to aspects of patient care. DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory #5 TOP: Art and Science of Nursing KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 31. During the Civil War, nursing schools offered education to women both in England and in the United States. The schools in the United States differed from those in Europe because in U.S. schools: (Select all that apply.) a. students worked without pay. 18 | P a g eb. the core curriculum was the same. c. instruction was presented by physicians at the bedside. d. the educational focus was on nursing care. e. classes were held separately from the clinical experience. ANS: A, C In the United States, the students staffed the hospital and worked without pay. There were no formal classes; education was achieved through work. There was no set curriculum, and content varied depending on the type of cases present in the hospital. Instruction was done at the bedside by the physician and therefore came from a medical viewpoint. Chapter 2 MULTIPLE CHOICE 1. The nurse is aware that any description of health would include the concept that: a. health is the absence of illness, and illness is the presence of chronic disease. b. culture, education, and socioeconomic status influence one’s definition of health or illness. c. illness is a biologic malfunction, and health is biologic soundness. d. lifestyle factors are the major determinant of health or illness. 19 | P a g eANS: B The concept of health is influenced by culture, education, and socioeconomic factors. DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: Theory #1 TOP: Views of Health and Illness KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 2. The nurse takes into consideration that the patient with an admitting diagnosis of type 2 diabetes mellitus and influenza is described as having: a. two chronic illnesses. b. two acute illnesses. c. one chronic and one acute illness. d. one acute and one infectious illness. ANS: C Chronic illnesses are those that develop slowly over a long period and last throughout a lifetime. Acute illnesses develop suddenly and resolve in a short time. Type 2 diabetes mellitus would be considered chronic, whereas influenza would be considered acute. DIF: Cognitive Level: Application REF: p. 15 OBJ: Theory #1 TOP: Classification of Illnesses KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 3. The nurse explains that an idiopathic disease is one that: a. is caused by inherited characteristics. b. develops suddenly, related to new viruses. 20 | P a g ec. results from injury during labor or delivery. d. has an unknown cause. ANS: D Idiopathic disease is defined as disease whose cause is unknown. DIF: Cognitive Level: Knowledge REF: p. 13 OBJ: Theory #1 TOP: Classification of Illnesses KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 4. The nurse assesses a terminal illness in a: 76 year old admitted to a nursing home with Alzheimer’s disease who is pacing and asking a. to go home. b. 43 year old with Lou Gehrig’s disease who is refusing food and fluid. 2 year old child who burned her esophagus by drinking drain cleaner and who is being fed c. by a tube. 52 year old diagnosed with lung cancer who had part of one lung removed and has a closed d. chest drainage device in place. ANS: B A terminal illness is defined as one in which a person will live only a few months, weeks, or days. A person who refuses food and hydration will generally not live more than a few days. DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: 21 | P a g eTheory #1 TOP: Stages of Illness KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: physiological adaptation 5. The nurse clarifies to a patient who now has an abscess following a ruptured appendix that the abscess is considered to be: a. a secondary illness. b. a life threatening complication. c. an expected event following any surgery. d. a disorder easily treated with antibiotics. ANS: A A secondary illness is an illness that arises from a primary disorder. DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: Theory #1 TOP: Views of Health and Illness KEY: Nursing Process Step: Intervention MSC: NCLEX: Physiological Integrity: physiological adaptation 6. The nurse uses a diagram to demonstrate how Dunn’s theory of health and illness can be compared with a: a. plant that grows from a seed, blossoms, wilts, and dies. continuum, with peak wellness and death at opposite ends; the person moves back and forth b. in a dynamic state of change. 22 | P a g eladder; from birth to death the individual moves progressively downward a ladder to c. eventual death. d. state of mind dependent on the individual perception of their own health or illness. ANS: B Dunn’s theory of a health continuum shows how an individual moves between peak wellness and death in a constant process. DIF: Cognitive Level: Knowledge REF: p. 14 OBJ: Theory #1 TOP: Views of Health and Illness KEY: Nursing Process Step: Intervention MSC: NCLEX: Physiological Integrity: physiological adaptation 7. A patient has been advised by the physician to take medication for high cholesterol and to change eating habits after discharge home. The home health nurse discovered that the patient refused to follow the medical and nutritional directions. The nurse’s best initial response to this situation is to: a. emphasize to the patient how important it is to follow the doctor’s advice. determine whether any cultural, socioeconomic, or religious values conflict, thus interfering b. with the patient’s compliance. explain that without diet and medication the condition will worsen and serious problems c. will develop. d. inform the physician that the patient is unable to understand the instructions. ANS: B The patient may have cultural, socioeconomic, or religious values that cause conflicts that prevent her from following the doctor’s instructions. 23 | P a g eDIF: Cognitive Level: Application REF: p. 15 OBJ: Theory #5 TOP: Concepts of Health and Illness | Cultural Influences KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychological Integrity: coping and adaptation 8. A nurse practicing a holistic approach to nursing care must: recognize that a change in one aspect of the person’s life can alter the whole of that person’s a. life. b. take responsibility for health care decisions. c. promote state of the art technology. d. discourage the use of more natural remedies and alternative methods of health care. ANS: A Holistic nursing requires that the nurse recognize that a change in one aspect of the patient’s life (biological, sociological, psychological, and spiritual) will bring about changes in that patient’s whole life. DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: Theory #6 TOP: Holistic Approach to Caring KEY: Nursing Process Step: Assessment MSC: NCLEX: N/A 9. According to Maslow’s hierarchy, physiological needs are those that: a. nurture intimacy. 24 | P a g eb. foster independence. c. encourage social interaction. d. are essential to human life. ANS: D Physiological needs are those that are essential to human life, such as oxygenation, nutrition, and elimination. DIF: Cognitive Level: Application REF: p. 17 OBJ: Theory #7 TOP: Maslow’s Hierarchy of Needs KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 10. The factors involved in assessing the importance the patient attaches to the relief of a particular deficit include: needs that the nurse must assess to prioritize care, because they may be different from a. person to person. ordering needs according to Maslow’s hierarchy, with lower level needs being least b. compelling. needs based on a hierarchy in which higher level needs are more prominent and demand c. attention before lower level needs. d. needs that are usually not known to the patient and that must be determined by the nurse. ANS: A 25 | P a g eA person’s concern relative to a needs deficit must be assessed by the nurse to meet the needs of each patient. Needs are viewed differently from one person to the next. DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: Theory #7 TOP: Maslow’s Hierarchy of Needs KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: physiological adaptation 11. The nurse believes that teaching a patient how to give insulin and monitor blood glucose levels will improve the level of the patient’s: a. physiological well being. b. security, by providing psychological comfort. c. self esteem, by promoting independence and learning. d. self actualization, by seeking knowledge and truth. ANS: C Teaching activities to a patient that are to be used after discharge enhances independence and promotes self esteem. DIF: Cognitive Level: Application REF: p. 19 OBJ: Theory #7 TOP: Maslow’s Hierarchy of Needs KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: psychosocial adaptation 12. Homeostasis can be described as: a. the unchanging steady condition of humans in a changing external environment. 26 | P a g ea tendency of biological systems toward stability of the internal environment by b. continuously adjusting to survive. c. biological wellness that comes from the ability of the body to change and respond to physical changes in the environment. a response to stress that results from a person’s choice of coping mechanisms to deal with d. the stress. ANS: B Homeostasis results from the constant adjustment of the internal environment in response to change; it is mental, emotional, and biological, as well as conscious and unconscious. DIF: Cognitive Level: Comprehension REF: p. 20 OBJ: Theory #8 TOP: Homeostasis KEY: Nursing Process Step: Assessment MSC: NCLEX: N/A 13. A patient admitted for diagnostic tests is frightened of hospital procedures and is nervous about the possible outcome of the tests. She states that her mouth is dry and her heart is pounding. Her blood pressure is 168/78 mm Hg (her usual blood pressure is 140/80 mm Hg), pulse is 112 beats/min, and respirations are 22 breaths/min. The nurse will recognize that these signs and symptoms are: indicative of serious, acute health problems and should be reported to the physician a. immediately. b. most likely related to the disease for which the patient is admitted to the hospital. c. the effects of the parasympathetic nervous system and can be ignored. d. the effects of the sympathetic nervous system that can negatively affect the patient’s health. ANS: D 27 | P a g eFear stimulates the sympathetic nervous system to produce the symptoms identified in the question. If prolonged, they negatively affect a person’s health. DIF: Cognitive Level: Analysis REF: p. 22, Table 2-2 OBJ: Theory #10 TOP: Stress KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity: coping and adaptation 14. According to Hans Selye’s general adaptation syndrome (GAS), a person who has experienced excessive and prolonged stress is likely to: a. develop an illness or disease such as allergy, arthritis, or asthma. b. become resistant to biological methods of treatment. c. seek treatment for imagined illnesses and nonexistent symptoms. d. be admitted to the hospital during the alarm stage. ANS: A Many diseases are known to be caused or exacerbated by prolonged stress. Seyle concluded that stress induced illnesses respond to biological methods of treatment. DIF: Cognitive Level: Comprehension REF: p. 22, Box 2-2 OBJ: Theory #10 TOP: Adaptation KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity: coping and adaptation 15. The nurse is aware that a stressor as experienced by an individual is usually perceived: a. as a negative event or stimulus that affects homeostasis in maladaptive ways. 28 | P a g eb. in different ways based on previous experience and personality traits. c. as an opportunity for growth and learning. d. in similar ways if age and education are similar. ANS: B Stressors are not perceived the same way by different people or even by the same person at different times. The experience of a stressor depends on previous experience and personality, as well as factors such as physical or emotional conditions, age, and education. DIF: Cognitive Level: Comprehension REF: p. 22 OBJ: Theory #9 TOP: General Adaptation Syndrome KEY: Nursing Process Step: Planning MSC: NCLEX: Psychological Integrity: psychosocial adaptation 16. In 1946, the World Health Organization redefined health as the: a. absence of disease or infirmity. b. state of complete physical, mental, and social well being. c. presence of disease or infirmity. d. state of incomplete physical, mental, and social well being. ANS: B In 1946, the World Health Organization redefined health as “the state of complete physical, mental, and social well being and not merely the absence of disease or infirmity.” DIF: Cognitive Level: Knowledge REF: p. 13 OBJ: Theory #1 29 | P a g eTOP: Views of Health and Illness KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 17. The nurse assesses that a person is in the acceptance stage of illness when the patient: a. looks to home remedies to become well. b. reassumes usual responsibilities and roles. c. assumes the “sick” role. d. rejects medical treatment. ANS: C When a person enters the acceptance stage of illness, he or she assumes the “sick role” and withdraws from usual responsibilities and will frequently seek medical treatment at this time. DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: Theory #1 TOP: Acceptance Stage KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: physiological adaptation 18. The nurse instructs a patient that according to Selye’s GAS theory, when stress is strong enough and occurs over a long enough period, the patient will enter the stage of: a. convalescence. b. alarm. c. transition. 30 | P a g ed. exhaustion. ANS: D The exhaustion stage in the GAS occurs when the stressor has been present for such a period that the patient will deplete the body’s resources for adaption. DIF: Cognitive Level: Comprehension REF: p. 18 OBJ: Theory #1 TOP: Exhaustion Stage of GAS KEY: Nursing Process Step: Intervention MSC: NCLEX: Psychosocial Integrity: coping and adaptation 19. The nurse explains defense mechanisms as a patient’s attempt to: a. justify the patient’s assumption of the “sick” role. b. reduce anxiety. c. problem solve. d. increase dependence. ANS: B Defense mechanisms are unconscious strategies to reduce anxiety. DIF: Cognitive Level: Knowledge REF: p. 22, Table 2-3 OBJ: Theory #9 TOP: Defense Mechanisms KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychological Integrity: coping and adaptation 20. In giving nursing care to persons of Asian origin, the nurse should: 31 | P a g ea. keep the room warm and free of drafts. b. look the patient directly in the eye. c. ask permission before touching the patient. d. warmly clasp the patient’s hand in greeting. ANS: C Seek permission before touching persons of Asian extraction because they may be sensitive to physical personal contact. DIF: Cognitive Level: Application REF: p. 16, Table 2-1 OBJ: Theory #4 TOP: Cultural Sensitivity KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychological Integrity: coping and adaptation 21. Sickle cell anemia is an example of a biological trait found primarily in populations. a. Asian b. African c. American Indian d. Hispanic ANS: B 32 | P a g eSickle cell anemia is a biological variation found predominantly in people of African descent. DIF: Cognitive Level: Knowledge REF: p. 16, Table 2-1 OBJ: Theory #5 TOP: Cultural Influences KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 22. When a young family man hospitalized after a breaking his leg confides to the nurse that he is concerned about the well being of his family and financial stress, the nurse can best support his sense of security by: a. reassuring him that his leg will heal quickly. b. actively listening to his concerns. c. encouraging family to make frequent visits. d. distracting him from his concerns by socialization. ANS: B A nurse’s ability to use active listening will enhance the sense of security when patients feel that their needs are perceived accurately. 23. The nurse assesses successful adaptation in a post stroke patient when the patient: a. learns to walk and maintain balance with the aid of a walker. b. consistently takes antihypertensive drugs. c. attempts to get out of bed unassisted. d. refuses assistance with feeding. 33 | P a g eANS: A Adaptation is a readjustment in habits to limitations and disabilities. Learning to walk and maintain balance with the aid of a walker is an example of this. DIF: Cognitive Level: Application REF: p. 20 OBJ: Theory #1 TOP: Adaptation KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: physiological adaptation 24. The nurse takes into consideration that in the stage of resistance in Selye’s GAS, the patient: a. regresses to a dependent state. b. continues to battle for equilibrium. c. becomes maladaptive. d. begins to develop stress related disorders. ANS: B The resistance stage is the second stage in the GAS when a patient is still attempting to find equilibrium. DIF: Cognitive Level: Comprehension REF: p. 22 OBJ: Theory #10 TOP: Selye’s GAS KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: physiological adaptation 25. A patient states, “I am not obese. My entire family is large.” The nurse assesses that the patient is using the defense mechanism of: 34 | P a g ea. sublimation. b. projection. c. denial. d. displacement. ANS: C Denial is a defense mechanism that allows a person to live as though an unwanted piece of information or reality does not exist. There is a persistent refusal to be swayed by the evidence. DIF: Cognitive Level: Application REF: p. 25, Table 2-3 OBJ: Theory #8 TOP: Defense Mechanisms KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity: coping and adaptation 26. A child who has just been scolded by her mother proceeds to hit her doll with a hairbrush. The nurse recognizes the child’s actions are characteristic of: a. denial. b. displacement. c. rationalization. d. repression. ANS: B Displacement is a defense mechanism that characterizes discharging intense feelings for one person onto an object or another person who is less threatening, thereby satisfying an impulse with a substitute object. 35 | P a g eDIF: Cognitive Level: Application REF: p. 25, Table 2-3 OBJ: Theory #8 TOP: Defense Mechanisms KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity: coping and adaptation 27. The nurse encourages a patient to participate in health maintenance by maintaining an ideal body weight as a method of prevention. a. primary b. secondary c. tertiary d. simple ANS: A Primary prevention avoids or delays occurrence of a specific disease or disorder. DIF: Cognitive Level: Comprehension REF: p. 26 OBJ: Theory #1 TOP: Primary Prevention KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 28. A nurse clarifies that methods of tertiary prevention are designed for: a. rehabilitation. 36 | P a g eb. delay of the development of a disorder. c. screening for early detection of disease. d. using an established protocol of therapy for a specific disease. ANS: A Tertiary prevention consists of rehabilitation measures after the disease or disorder has stabilized. Latent prevention does not exist. DIF: Cognitive Level: Comprehension REF: p. 26 OBJ: Theory #1 TOP: Tertiary Prevention KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: physiological adaptation 29. When a new admission to an extended care facility wanders about listlessly, eats only a small amount of each meal, and keeps himself isolated, the nurse can intervene by: a. assisting with feeding at each meal. b. reminding him that he is in a safe and secure area. c. socializing with him in the privacy of his room. d. supporting him to interact with an exercise group. ANS: D The membership and social interaction in a group may provide a means for a sense of belonging. DIF: Cognitive Level: Application REF: p. 19 OBJ: Theory #11 TOP: Love and Belonging KEY: Nursing Process Step: 37 | P a g eImplementation MSC: NCLEX: Psychosocial Integrity: psychosocial adaptation COMPLETION 30. Exercise can reduce stress and anxiety by the release of ANS: endorphins The release of endorphins induces a feeling of well being and tranquility. DIF: Cognitive Level: Knowledge REF: p. 24 OBJ: Theory #11 TOP: Views of Health and Illness KEY: Nursing Process Step: Assessment MSC: NCLEX: N/A 31. Adequate . is necessary in the communication between nurse and patient in order to meet the higher basic needs of security, love, belonging, and self esteem. ANS: feedback Adequate feedback and clarification are essential in assisting the patient meet the higher level needs. DIF: Cognitive Level: Comprehension REF: p. 20 OBJ: Theory #7 TOP: Communication KEY: Nursing Process Step: Assessment MSC: NCLEX: N/A MULTIPLE RESPONSE 32. When the brain perceives a situation as threatening, the sympathetic nervous system reacts by stimulating which of the following physiological functions? (Select all that apply.) a. Constriction of the pupils b. Dilation of the bronchial tubes c. Decreased heart rate 38 | P a g ed. Dilation of the pupils ANS: B, D Activation of the sympathetic nervous system causes the pupils and bronchial tubes to dilate. It also causes the heart rate to increase. DIF: Cognitive Level: Analysis REF: p. 22, Table 2-3 OBJ: Theory #11 TOP: Sympathetic Nervous System KEY: Nursing Process Step: Assessment MSC: NCLEX: N/A 33. The nurse describes behaviors of the transition stage of illness, which are: (Select all that apply.) a. awareness of vague symptoms. b. denial of feeling ill. c. resorts to self medication. d. withdrawal from roles and responsibilities. e. recovery from illness begins. ANS: A, B, C The transition stage (onset) of illness is demonstrated by the patient’s awareness of vague symptoms, denial of feeling ill, and initiation of self medication; however, he or she still fulfils the roles and responsibilities of life. DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: Theory #1 TOP: Stages of Illness KEY: Nursing Process 39 | P a g eStep: Assessment MSC: NCLEX: Physiological Integrity: physiological adaptation 34. Which defines the holistic approach to caring for the sick and promoting wellness? (Select all that apply.) a. The nurse’s focus is specific to the disease or injury. b. The nurse realizes that each person has a responsibility for his or her own health. Health care providers are required to intervene on behalf of all persons to ensure that health c. goals are met. Providers combine traditional methods of health care with relaxation techniques for pain d. management. e. A change in one aspect of a person’s life may or may not alter the person as a whole. ANS: B, C, D, E The holistic approach to medicine treats the patient as a whole and may use a mix of traditional medicine and alternative medicine. Any change in one aspect of the whole may change the entire whole. DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: Theory #6 TOP: Holistic Approach KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 35. The responses during the alarm stage of the general adaptation syndrome as defined by Hans Selye include: (Select all that apply.) a. slight increase in body temperature. 40 | P a g eb. substantial increase in energy. c. decreased appetite. d. hormones released for mobilization for defense. e. the body’s adaptation abilities temporarily overreacting. ANS: A, C, D The responses during the alarm stage according to the general adaptation syndrome include: a slight rise in temperature, a loss of energy, decreased appetite, and a release of hormones that mobilizes the body’s defenses. DIF: Cognitive Level: Comprehension REF: p. 21 OBJ: Theory #10 TOP: General Adaptation Syndrome KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 36. The nurse clarifies that a person who is self actualized would have the characteristics of: (Select all that apply.) a. having met all other need levels. b. being certain of their beliefs and values. c. not being swayed by new ideas. d. having little need for creative self expression. e. depending on significant others. 41 | P a g eANS: A, B Chapter3 MULTIPLE CHOICE 1. A student nurse who is not yet licensed: a. may not perform nursing actions until he or she has passed the licensing examination. b. is not responsible for his or her actions as a student under the state licensing law. c. may perform nursing actions only under the supervision of a licensed nurse. d. must apply for a temporary student nurse permit to practice as a student. ANS: C Students may perform nursing actions before they are licensed but only under the supervision of a licensed nurse. The student is responsible for his or her own actions; however, the supervising nurse may also be responsible, depending on the situation. No special permit is required to practice as a student in an approved school of nursing. DIF: Cognitive Level: Knowledge REF: p. 30 OBJ: Theory #1 TOP: Practice Regulations for the Student Nurse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 2. During an employment interview, the interviewer asks the nurse applicant about HIV status. The nurse applicant can legally respond: a. “No,” even though he or she has a positive HIV test. 42 | P a g eb. “I don’t know, but I would be willing to be tested.” c. “I don’t know, and I refuse to be tested.” d. “You do not have a right to ask me that question.” ANS: D In employment practice, it is illegal to discriminate against people with certain diseases or conditions. Asking a question about health status, especially HIV or AIDS infection, is illegal. DIF: Cognitive Level: Application REF: p. 31 OBJ: Clinical Practice #1 TOP: Discrimination KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 3. An example of a violation of criminal law by a nurse is: a. taking a controlled substance from agency supply for personal use. b. accidentally administering a drug to the wrong patient, who then has a serious reaction. c. advising a patient to sue the doctor for a supposed mistake the doctor made. d. writing a letter to the newspaper outlining questionable or unsafe hospital practices. ANS: A Theft of a controlled substance is a federal crime and consequently a crime against society. DIF: Cognitive Level: Application REF: p. 30 OBJ: 43 | P a g eTheory #2 TOP: Criminal Law KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 4. The LPN (LVN) assigns part of the care for her patients to a nursing assistant. The LPN is legally required to perform which of the following for the residents assigned to the assistant? a. Toilet the residents every 2 hours and as needed. b. Feed breakfast to one of the residents who needs assistance. c. Give medications to the residents at the prescribed times. d. Transport the residents to the physical therapy department. ANS: C Toileting, feeding, and transporting residents or patients are tasks that can be legally assigned to a nurse’s aide. Administering medications is a nursing act that can be performed only by a licensed nurse or by a student nurse under the supervision of a licensed nurse. DIF: Cognitive Level: Application REF: p. 31 OBJ: Theory #3 TOP: Delegation KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe Effective Care Environment: coordinated care 5. If a nurse is reported to a state board of nursing for repeatedly making medication errors, it is most likely that: a. the nurse will immediately have his or her license revoked. b. the nurse will have to take the licensing examination again. 44 | P a g ec. a course in legal aspects of nursing care will be required. d. there will be a hearing to determine whether the charges are true. ANS: D The nurse may have his or her license revoked or be required to take a refresher course, but this would be based on the evidence presented at a hearing. The licensing examination is not usually required as a correction of the situation as described. DIF: Cognitive Level: Knowledge REF: p. 31 OBJ: Theory #3 TOP: Professional Discipline KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 6. A nurse co-worker arrives at work 30 minutes late, smelling strongly of alcohol. The fellow nurses’ legal course of action is to: a. have the nurse lie down in the nurses’ lounge and sleep while others do the work. b. state that, if this happens again, it will be reported. c. report the condition of the nurse to the nursing supervisor. d. offer a breath mint and instruct the nurse co-worker to work. ANS: C Nurses must report the condition. It is a nurse’s legal and ethical duty to protect patients from impaired or incompetent workers. Allowing the impaired nurse to sleep enables the impaired nurse to avoid the consequences of his or her actions and to continue the risky behavior. Threatening to report “the next time” continues to place patients at risk, as does masking the signs of impairment with breath mints. DIF: Cognitive Level: Application REF: p. 31 OBJ: Theory #3 TOP: Professional Discipline KEY: Nursing 45 | P a g eProcess Step: N/A MSC: NCLEX: N/A 7. When a student nurse performs a nursing skill, it is expected that the student: a. perform the skill as quickly as the licensed nurse. b. achieve the same result as the licensed nurse. c. not be held to the same standard as the licensed nurse. d. always be directly supervised by an instructor. ANS: B Students are not expected to perform skills as quickly or as smoothly as experienced nurses, but students must achieve the same result in a safe manner. DIF: Cognitive Level: Comprehension REF: p. 30 OBJ: Theory #1 TOP: Practice Regulations for the Student Nurse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 8. If a nurse receives unwelcome sexual advances from a nursing supervisor, the first step the nurse should take is to: a. send an anonymous letter to the nursing administration to alert them to the situation. tell the nursing supervisor that she is uncomfortable with the sexual advances and ask the b. supervisor to refrain from this behavior