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CONCEPTS FOR NURSING PRACTICE 4TH EDITION TEST
BANK | QUESTIONS 140 WITH NCLEX-STYLE ANSWERS &
RATIONALES | GIDDENS,100% CORRECT, ALREADY GRADED
A+
Concept 1: Development
Q1. A nurse is caring for a 6-month-old infant who has not yet begun to sit
without support. Which developmental principle best explains this finding?
A) Development occurs in a cephalocaudal pattern
B) Development occurs in a random sequence
C) Development is unpredictable and inconsistent
D) Development occurs in a lateral to medial direction
Answer: A) Development occurs in a cephalocaudal pattern
Rationale: Infants develop motor skills from head to toe (cephalocaudal).
Sitting without support typically occurs around 6–8 months. A slight delay
may be normal, but cephalocaudal progression explains the developmental
order.
Concept 2: Functional Ability
Q2. An 82-year-old patient with osteoarthritis struggles with dressing and
bathing. Which nursing intervention best supports functional ability?
A) Encourage strict bedrest
B) Provide adaptive devices like grab bars and dressing sticks
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C) Recommend complete dependence on caregivers
D) Limit activities to avoid pain
Answer: B) Provide adaptive devices like grab bars and dressing sticks
Rationale: Adaptive devices enhance independence and preserve dignity.
Limiting activity or enforcing dependence worsens functional decline.
Concept 3: Family Dynamics
Q3. A patient’s spouse insists on making all care decisions, but the patient
expresses a desire to decide independently. What is the nurse’s priority?
A) Support the spouse’s authority
B) Honor the patient’s autonomy in care decisions
C) Refer the case to social services immediately
D) Ask the family to leave during rounds
Answer: B) Honor the patient’s autonomy in care decisions
Rationale: Family dynamics can influence care, but patient autonomy is a
primary ethical principle. Nurses must advocate for the patient’s rights while
balancing family involvement.
Concept 4: Culture
Q4. A nurse provides care for a patient who refuses blood transfusions due
to religious beliefs. Which action is most appropriate?
A) Persuade the patient to accept transfusion for safety
B) Document refusal and explore culturally congruent alternatives
C) Administer blood products without informing the patient
D) Transfer the patient against their will
Answer: B) Document refusal and explore culturally congruent
alternatives
Rationale: Culturally competent care respects patient values. Nurses must
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document informed refusal and collaborate on acceptable alternatives such
as volume expanders.
Concept 5: Spirituality
Q5. During an admission assessment, a patient asks if the hospital has a
chaplain. What should the nurse do?
A) Ignore the request
B) Inform the patient of spiritual resources available in the hospital
C) Tell the patient spirituality is not a nursing concern
D) Ask family to provide all spiritual support
Answer: B) Inform the patient of spiritual resources available in the
hospital
Rationale: Spirituality influences healing and coping. Nurses should
facilitate access to spiritual resources, demonstrating holistic care.
Concept 6: Adherence
Q6. A patient with hypertension reports forgetting to take prescribed
medications three times per week. Which intervention best promotes
adherence?
A) Provide a pill organizer and medication schedule
B) Increase the medication dose
C) Tell the patient to rely on memory
D) Discontinue antihypertensive therapy
Answer: A) Provide a pill organizer and medication schedule
Rationale: Tools like pill organizers improve adherence by simplifying
routines. Nonadherence increases risks for complications such as stroke and
myocardial infarction.
Concept 7: Self-Management
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Q7. A diabetic patient states, “I don’t check my blood sugar because it’s too
much work.” What is the best nursing response?
A) “That’s your choice if you don’t want to manage your diabetes.”
B) “Monitoring blood sugar helps prevent serious complications. Let’s
discuss ways to make it easier.”
C) “You should be ashamed for not taking care of yourself.”
D) “Your provider will be upset if you don’t follow instructions.”
Answer: B) Monitoring blood sugar helps prevent serious
complications. Let’s discuss ways to make it easier
Rationale: Supporting self-management involves education, problem-
solving, and collaboration without judgment. Empowering the patient
increases motivation and health outcomes.
Concept 8: Fluid and Electrolytes
Q8. A patient presents with confusion, muscle weakness, and sodium level
of 120 mEq/L. Which action should the nurse anticipate?
A) Administer hypertonic saline as prescribed
B) Increase free water intake
C) Encourage low-sodium diet
D) Discontinue IV fluids
Answer: A) Administer hypertonic saline as prescribed
Rationale: Severe hyponatremia (<125 mEq/L) may cause neurological
changes. Hypertonic saline helps restore sodium balance and prevents
seizures or coma.
Concept 9: Acid-Base Balance
Q9. A patient with chronic obstructive pulmonary disease (COPD) has ABG
results: pH 7.30, PaCO₂ 60 mmHg, HCO₃ 26. How should the nurse
interpret this?
CONCEPTS FOR NURSING PRACTICE 4TH EDITION TEST
BANK | QUESTIONS 140 WITH NCLEX-STYLE ANSWERS &
RATIONALES | GIDDENS,100% CORRECT, ALREADY GRADED
A+
Concept 1: Development
Q1. A nurse is caring for a 6-month-old infant who has not yet begun to sit
without support. Which developmental principle best explains this finding?
A) Development occurs in a cephalocaudal pattern
B) Development occurs in a random sequence
C) Development is unpredictable and inconsistent
D) Development occurs in a lateral to medial direction
Answer: A) Development occurs in a cephalocaudal pattern
Rationale: Infants develop motor skills from head to toe (cephalocaudal).
Sitting without support typically occurs around 6–8 months. A slight delay
may be normal, but cephalocaudal progression explains the developmental
order.
Concept 2: Functional Ability
Q2. An 82-year-old patient with osteoarthritis struggles with dressing and
bathing. Which nursing intervention best supports functional ability?
A) Encourage strict bedrest
B) Provide adaptive devices like grab bars and dressing sticks
,2|Page
C) Recommend complete dependence on caregivers
D) Limit activities to avoid pain
Answer: B) Provide adaptive devices like grab bars and dressing sticks
Rationale: Adaptive devices enhance independence and preserve dignity.
Limiting activity or enforcing dependence worsens functional decline.
Concept 3: Family Dynamics
Q3. A patient’s spouse insists on making all care decisions, but the patient
expresses a desire to decide independently. What is the nurse’s priority?
A) Support the spouse’s authority
B) Honor the patient’s autonomy in care decisions
C) Refer the case to social services immediately
D) Ask the family to leave during rounds
Answer: B) Honor the patient’s autonomy in care decisions
Rationale: Family dynamics can influence care, but patient autonomy is a
primary ethical principle. Nurses must advocate for the patient’s rights while
balancing family involvement.
Concept 4: Culture
Q4. A nurse provides care for a patient who refuses blood transfusions due
to religious beliefs. Which action is most appropriate?
A) Persuade the patient to accept transfusion for safety
B) Document refusal and explore culturally congruent alternatives
C) Administer blood products without informing the patient
D) Transfer the patient against their will
Answer: B) Document refusal and explore culturally congruent
alternatives
Rationale: Culturally competent care respects patient values. Nurses must
,3|Page
document informed refusal and collaborate on acceptable alternatives such
as volume expanders.
Concept 5: Spirituality
Q5. During an admission assessment, a patient asks if the hospital has a
chaplain. What should the nurse do?
A) Ignore the request
B) Inform the patient of spiritual resources available in the hospital
C) Tell the patient spirituality is not a nursing concern
D) Ask family to provide all spiritual support
Answer: B) Inform the patient of spiritual resources available in the
hospital
Rationale: Spirituality influences healing and coping. Nurses should
facilitate access to spiritual resources, demonstrating holistic care.
Concept 6: Adherence
Q6. A patient with hypertension reports forgetting to take prescribed
medications three times per week. Which intervention best promotes
adherence?
A) Provide a pill organizer and medication schedule
B) Increase the medication dose
C) Tell the patient to rely on memory
D) Discontinue antihypertensive therapy
Answer: A) Provide a pill organizer and medication schedule
Rationale: Tools like pill organizers improve adherence by simplifying
routines. Nonadherence increases risks for complications such as stroke and
myocardial infarction.
Concept 7: Self-Management
, 4|Page
Q7. A diabetic patient states, “I don’t check my blood sugar because it’s too
much work.” What is the best nursing response?
A) “That’s your choice if you don’t want to manage your diabetes.”
B) “Monitoring blood sugar helps prevent serious complications. Let’s
discuss ways to make it easier.”
C) “You should be ashamed for not taking care of yourself.”
D) “Your provider will be upset if you don’t follow instructions.”
Answer: B) Monitoring blood sugar helps prevent serious
complications. Let’s discuss ways to make it easier
Rationale: Supporting self-management involves education, problem-
solving, and collaboration without judgment. Empowering the patient
increases motivation and health outcomes.
Concept 8: Fluid and Electrolytes
Q8. A patient presents with confusion, muscle weakness, and sodium level
of 120 mEq/L. Which action should the nurse anticipate?
A) Administer hypertonic saline as prescribed
B) Increase free water intake
C) Encourage low-sodium diet
D) Discontinue IV fluids
Answer: A) Administer hypertonic saline as prescribed
Rationale: Severe hyponatremia (<125 mEq/L) may cause neurological
changes. Hypertonic saline helps restore sodium balance and prevents
seizures or coma.
Concept 9: Acid-Base Balance
Q9. A patient with chronic obstructive pulmonary disease (COPD) has ABG
results: pH 7.30, PaCO₂ 60 mmHg, HCO₃ 26. How should the nurse
interpret this?
