lOMoARcPSD| 13728229
, lOMoARcPSD| 13728229
a. A h& “right h& time” problem h&
b. A h& “right h& dose” problem h&
c. A h& “right h& route” problem h&
d. A h& “right h& medication” problem h&
ANS: C h&
This is a “right route” problem: the nurse cannot assume the route and must
h& h& h& h& h& h& h& h& h& h& h& h& h&
the prescriber. This is not a “right time” problem because the ordered freque
h& h& h& h& h& h& h& h& h& h& h& h& h&
This is not a “right dose” problem because the dose is not related to an inabi
h& h& h& h& h& h& h& h& h& h& h& h& h& h& h& h&
not a “right medication” problem because the medication ordered will not chan
h& h& h& h& h& h& h& h& h& h& h& h&
DIF: Cognitive Level: Application h& h&
3. The nurse has been monitoring the patient’s progress on his new drug regimen s
h& h& h& h& h& h& h& h& h& h& h& h& h&
and has been documenting signs of possible adverse effects. What nursing proc
h& h& h& h& h& h& h& h& h& h& h& h&
nurse practising?
h& h&
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis h&
ANS: B h&
Monitoring the patient’s progress is part of the evaluation phase. Planning, imple
h& h& h& h& h& h& h& h& h& h& h&
nursing diagnosis are not illustrated by this example.
h& h& h& h& h& h& h& h&
DIF: Cognitive Level: Application h& h&
4. The nurse is caring for a patient who has been newly diagnosed with type 1 dia
h& h& h& h& h& h& h& h& h& h& h& h& h& h& h&
Which statement best illustrates an outcome criterion for this patient?
h& h& h& h& h& h& h& h& h& h&
a. The patient will follow instructions.
h& h& h& h&
b. The patient will not experience complications.
h& h& h& h& h&
c. The patient adheres to the new insulin treatment regimen.
h& h& h& h& h& h& h& h&
d. The patient demonstrates safe insulin self-administration technique.
h& h& h& h& h& h&
ANS: D h&
Having the patient demonstrate safe insulin self-administration technique is a spe
h& h& h& h& h& h& h& h& h& h&
outcome criterion. Following instructions and avoiding complications are not spe
h& h& h& h& h& h& h& h& h& h&
Adherence to the new insulin treatment regimen is not objective and would be
h& h& h& h& h& h& h& h& h& h& h& h& h&
DIF: Cognitive Level: Application h& h&
5. Which activity best reflects the implementation phase of the nursing process for
h& h& h& h& h& h& h& h& h& h& h& h
newly diagnosed with type 1 diabetes mellitus?
h& h& h& h& h& h& h&
a. Providing education regarding self-injection technique
h& h& h& h&
b. Setting goals and outcome criteria with the patient’s input
h& h& h& h& h& h& h& h&
c. Recording a history of over-the-counter medications used at home
h& h& h& h& h& h& h& h&
d. Formulating nursing diagnoses regarding knowledge deficits h& h& h& h& h&
related to the new treatment regimen
h& h& h& h& h& h&
ANS: A h&
Education is an intervention that occurs during the implementation phase. Setting
h& h& h& h& h& h& h& h& h& h&
criteria reflects the planning phase. Recording a drug history reflects the assessm
h& h& h& h& h& h& h& h& h& h& h& h&
, lOMoARcPSD| 13728229
6. The nurse is working during a very busy night shift, and the health care provider
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
nurse a medication order over the telephone, but the nurse does not recall the
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
best way for the nurse to avoid medication errors?
h& h& h& h& h& h& h& h& h&
a. Recopy the order neatly on the order sheet, with the most common route in
h& h& h& h& h& h& h& h& h& h& h& h& h&
b. Consult with the pharmacist for clarification about the most common route
h& h& h& h& h& h& h& h& h& h&
c. Call the health care provider to clarify the route of administration
h& h& h& h& h& h& h& h& h& h&
d. Withhold the drug until the health care provider visits the patient
h& h& h& h& h& h& h& h& h& h&
ANS: C h&
If a medication order does not include the route, the nurse must ask the health
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
it. Never assume the route of administration.
h& h& h& h& h& h& h&
DIF: Cognitive Level: Application | Cognitive Level: Analysis h& h& h& h& h& h&
7. Which constitutes the traditional Five Rights of medication administration?
h& h& h& h& h& h& h& h&
a. Right drug, right route, right dose, right time, and right patient
h& h& h& h& h& h& h& h& h& h&
b. Right drug, the right effect, the right route, the right time, and the right pat
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
c. Right patient, right strength, right diagnosis, right drug, and right route
h& h& h& h& h& h& h& h& h& h&
d. Right patient, right diagnosis, right drug, right route, and right time
h& h& h& h& h& h& h& h& h& h&
ANS: A h&
The traditional Five Rights of medication administration were considered to be Ri
h& h& h& h& h& h& h& h& h& h& h&
Right dose, Right time, and Right patient. Right effect, right strength, and right
h& h& h& h& h& h& h& h& h& h& h& h& h& h
the traditional Five Rights.
h& h& h& h&
DIF: Cognitive Level: Comprehension h& h&
8. What correctly describes the nursing process?
h& h& h& h& h&
a. Diagnosing, planning, assessing, implementing, and finally evaluating
h& h& h& h& h& h&
b. Assessing, then diagnosing, implementing, and ending with evaluating
h& h& h& h& h& h& h&
c. A linear direction that begins with assessing and continues
h& h& h& h& h& h& h& h&
through diagnosing, planning, and finally implementing
h& h& h& h& h& h&
d. An ongoing process that begins with assessing and continues
h& h& h& h& h& h& h& h&
with diagnosing, planning, implementing, and evaluating
h& h& h& h& h& h&
ANS: D h&
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step pr
h& h& h& h& h& h& h& h& h& h& h&
assessing and continues through diagnosing, planning, implementing, and finally
h& h& h& h& h& h& h& h& h& h
may then lead back to any of the other phases.
h& h& h& h& h& h& h& h& h& h&
DIF: Cognitive Level: Application h& h&
9. When the nurse is considering the timing of a drug dose, which is most importa
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
a. The patient’s identificationh& h&
b. The patient’s weight h& h&
c. The patient’s last meal h& h& h&
d. Any drug or food allergies h& h& h& h&
ANS: C h&
, lOMoARcPSD| 13728229
related to new drug therapy, as evidenced by statements such as ‘I’m upset ab
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
myself shots.’” The answer “Anxiety” is missing the “related to” and “as eviden
h& h& h& h& h& h& h& h& h& h& h& h& h&
answer “Anxiety related to new drug therapy” is missing the “as evidenced by”
h& h& h& h& h& h& h& h& h& h& h& h& h&
characteristics. The “related to” section in “Anxiety related to anxious feelings ab
h& h& h& h& h& h& h& h& h& h& h& h&
evidenced by statements such as ‘I’m upset about having to give myself shots’”
h& h& h& h& h& h& h& h& h& h& h& h& h&
restatement of the problem “anxiety,” not a separate factor related to the resp
h& h& h& h& h& h& h& h& h& h& h& h& h&
DIF: Cognitive Level: Analysis h& h&
OTHER
1. Place the phases of the nursing process in the correct order, starting with the fi
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
h& h& h& h&
DIF: Cognitive Level: Analysis h& h&
, lOMoARcPSD| 13728229
a. A h& “right h& time” problem h&
b. A h& “right h& dose” problem h&
c. A h& “right h& route” problem h&
d. A h& “right h& medication” problem h&
ANS: C h&
This is a “right route” problem: the nurse cannot assume the route and must
h& h& h& h& h& h& h& h& h& h& h& h& h&
the prescriber. This is not a “right time” problem because the ordered freque
h& h& h& h& h& h& h& h& h& h& h& h& h&
This is not a “right dose” problem because the dose is not related to an inabi
h& h& h& h& h& h& h& h& h& h& h& h& h& h& h& h&
not a “right medication” problem because the medication ordered will not chan
h& h& h& h& h& h& h& h& h& h& h& h&
DIF: Cognitive Level: Application h& h&
3. The nurse has been monitoring the patient’s progress on his new drug regimen s
h& h& h& h& h& h& h& h& h& h& h& h& h&
and has been documenting signs of possible adverse effects. What nursing proc
h& h& h& h& h& h& h& h& h& h& h& h&
nurse practising?
h& h&
a. Planning
b. Evaluation
c. Implementation
d. Nursing diagnosis h&
ANS: B h&
Monitoring the patient’s progress is part of the evaluation phase. Planning, imple
h& h& h& h& h& h& h& h& h& h& h&
nursing diagnosis are not illustrated by this example.
h& h& h& h& h& h& h& h&
DIF: Cognitive Level: Application h& h&
4. The nurse is caring for a patient who has been newly diagnosed with type 1 dia
h& h& h& h& h& h& h& h& h& h& h& h& h& h& h&
Which statement best illustrates an outcome criterion for this patient?
h& h& h& h& h& h& h& h& h& h&
a. The patient will follow instructions.
h& h& h& h&
b. The patient will not experience complications.
h& h& h& h& h&
c. The patient adheres to the new insulin treatment regimen.
h& h& h& h& h& h& h& h&
d. The patient demonstrates safe insulin self-administration technique.
h& h& h& h& h& h&
ANS: D h&
Having the patient demonstrate safe insulin self-administration technique is a spe
h& h& h& h& h& h& h& h& h& h&
outcome criterion. Following instructions and avoiding complications are not spe
h& h& h& h& h& h& h& h& h& h&
Adherence to the new insulin treatment regimen is not objective and would be
h& h& h& h& h& h& h& h& h& h& h& h& h&
DIF: Cognitive Level: Application h& h&
5. Which activity best reflects the implementation phase of the nursing process for
h& h& h& h& h& h& h& h& h& h& h& h
newly diagnosed with type 1 diabetes mellitus?
h& h& h& h& h& h& h&
a. Providing education regarding self-injection technique
h& h& h& h&
b. Setting goals and outcome criteria with the patient’s input
h& h& h& h& h& h& h& h&
c. Recording a history of over-the-counter medications used at home
h& h& h& h& h& h& h& h&
d. Formulating nursing diagnoses regarding knowledge deficits h& h& h& h& h&
related to the new treatment regimen
h& h& h& h& h& h&
ANS: A h&
Education is an intervention that occurs during the implementation phase. Setting
h& h& h& h& h& h& h& h& h& h&
criteria reflects the planning phase. Recording a drug history reflects the assessm
h& h& h& h& h& h& h& h& h& h& h& h&
, lOMoARcPSD| 13728229
6. The nurse is working during a very busy night shift, and the health care provider
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
nurse a medication order over the telephone, but the nurse does not recall the
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
best way for the nurse to avoid medication errors?
h& h& h& h& h& h& h& h& h&
a. Recopy the order neatly on the order sheet, with the most common route in
h& h& h& h& h& h& h& h& h& h& h& h& h&
b. Consult with the pharmacist for clarification about the most common route
h& h& h& h& h& h& h& h& h& h&
c. Call the health care provider to clarify the route of administration
h& h& h& h& h& h& h& h& h& h&
d. Withhold the drug until the health care provider visits the patient
h& h& h& h& h& h& h& h& h& h&
ANS: C h&
If a medication order does not include the route, the nurse must ask the health
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
it. Never assume the route of administration.
h& h& h& h& h& h& h&
DIF: Cognitive Level: Application | Cognitive Level: Analysis h& h& h& h& h& h&
7. Which constitutes the traditional Five Rights of medication administration?
h& h& h& h& h& h& h& h&
a. Right drug, right route, right dose, right time, and right patient
h& h& h& h& h& h& h& h& h& h&
b. Right drug, the right effect, the right route, the right time, and the right pat
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
c. Right patient, right strength, right diagnosis, right drug, and right route
h& h& h& h& h& h& h& h& h& h&
d. Right patient, right diagnosis, right drug, right route, and right time
h& h& h& h& h& h& h& h& h& h&
ANS: A h&
The traditional Five Rights of medication administration were considered to be Ri
h& h& h& h& h& h& h& h& h& h& h&
Right dose, Right time, and Right patient. Right effect, right strength, and right
h& h& h& h& h& h& h& h& h& h& h& h& h& h
the traditional Five Rights.
h& h& h& h&
DIF: Cognitive Level: Comprehension h& h&
8. What correctly describes the nursing process?
h& h& h& h& h&
a. Diagnosing, planning, assessing, implementing, and finally evaluating
h& h& h& h& h& h&
b. Assessing, then diagnosing, implementing, and ending with evaluating
h& h& h& h& h& h& h&
c. A linear direction that begins with assessing and continues
h& h& h& h& h& h& h& h&
through diagnosing, planning, and finally implementing
h& h& h& h& h& h&
d. An ongoing process that begins with assessing and continues
h& h& h& h& h& h& h& h&
with diagnosing, planning, implementing, and evaluating
h& h& h& h& h& h&
ANS: D h&
The nursing process is an ongoing, flexible, adaptable, and adjustable five-step pr
h& h& h& h& h& h& h& h& h& h& h&
assessing and continues through diagnosing, planning, implementing, and finally
h& h& h& h& h& h& h& h& h& h
may then lead back to any of the other phases.
h& h& h& h& h& h& h& h& h& h&
DIF: Cognitive Level: Application h& h&
9. When the nurse is considering the timing of a drug dose, which is most importa
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
a. The patient’s identificationh& h&
b. The patient’s weight h& h&
c. The patient’s last meal h& h& h&
d. Any drug or food allergies h& h& h& h&
ANS: C h&
, lOMoARcPSD| 13728229
related to new drug therapy, as evidenced by statements such as ‘I’m upset ab
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
myself shots.’” The answer “Anxiety” is missing the “related to” and “as eviden
h& h& h& h& h& h& h& h& h& h& h& h& h&
answer “Anxiety related to new drug therapy” is missing the “as evidenced by”
h& h& h& h& h& h& h& h& h& h& h& h& h&
characteristics. The “related to” section in “Anxiety related to anxious feelings ab
h& h& h& h& h& h& h& h& h& h& h& h&
evidenced by statements such as ‘I’m upset about having to give myself shots’”
h& h& h& h& h& h& h& h& h& h& h& h& h&
restatement of the problem “anxiety,” not a separate factor related to the resp
h& h& h& h& h& h& h& h& h& h& h& h& h&
DIF: Cognitive Level: Analysis h& h&
OTHER
1. Place the phases of the nursing process in the correct order, starting with the fi
h& h& h& h& h& h& h& h& h& h& h& h& h& h&
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Diagnosing
ANS:
C, E, A, D, B
h& h& h& h&
DIF: Cognitive Level: Analysis h& h&
