Wilkinson’s Fundamentals of Nursing, 5th Edition –
Comprehensive Study Guide
Unit 1: Nursing Foundations & Professional Identity
1. Question: According to Wilkinson and the ANA, what is the primary focus of all nursing
practice?
ANSWER ✓ The primary focus is the human response to actual or potential health
problems. Nursing aims to promote health, prevent illness, facilitate coping, and restore
health across the lifespan.
2. Question: How does the concept of clinical judgment differ from simple critical thinking
in the nursing process?
ANSWER ✓ Clinical judgment is the observed outcome of critical thinking and decision-
making. It is an iterative process of noticing, interpreting, responding, and reflecting,
leading to nursing actions. It is the application of critical thinking to a clinical situation.
3. Question: What are the four overarching concepts, or metaparadigms, central to
nursing theory?
ANSWER ✓ The four metaparadigms are Person, Environment, Health, and Nursing. All
nursing theories define the relationship among these four core concepts.
4. Question: A nurse is adhering to the ethical principle of nonmaleficence. What is the
nurse committing to do?
ANSWER ✓ The nurse is committing to "do no harm," intentionally avoiding actions
that could cause injury or worsen a patient's condition.
5. Question: Explain the purpose of the Nurse Practice Act (NPA) in each state.
ANSWER ✓ The NPA is a state law that defines the scope of nursing practice,
establishes licensure requirements, and sets standards to protect public health, safety,
and welfare.
Unit 2: Health, Illness, & Health Disparities
6. Question: Using the Health Belief Model, what factor would influence a patient's
likelihood to pursue preventive screening?
ANSWER ✓ The patient's perceived susceptibility (belief about their personal risk of a
condition) and perceived benefits (belief that the screening will effectively reduce the
threat) are key influencing factors.
7. Question: What is the fundamental difference between health disparities and
health inequities?
ANSWER ✓ Health disparities are differences in health outcomes. Health inequities are a
, specific type of disparity that is systematic, avoidable, and unjust, often linked to social,
economic, or environmental disadvantage.
8. Question: A patient states, "My heart failure is under control; I can manage my
medications and diet." This reflects which stage of the Illness-Wellness Continuum?
ANSWER ✓ This reflects movement toward high-level wellness, where the individual is
actively engaged in behaviors that promote stability and improved health despite a
chronic condition.
9. Question: Why is cultural humility considered more important than just cultural
knowledge?
ANSWER ✓ Cultural humility involves self-reflection, recognizing one's own biases, and
committing to a lifelong learning partnership with patients, rather than assuming
mastery over a static set of cultural facts.
10. Question: What is the primary goal of health promotion nursing activities?
ANSWER ✓ The primary goal is to empower individuals and communities to increase
control over their health and improve it, focusing on behaviors and environments that
support well-being before illness occurs.
Unit 3: The Nursing Process & Clinical Judgment
11. Question: During the assessment phase, what is the critical difference between
subjective and objective data?
ANSWER ✓ Subjective data (symptoms) are reported or described by the patient (e.g., "I
feel nauseous"). Objective data (signs) are observable and measurable by the nurse (e.g.,
vomiting, pale skin).
12. Question: Write a correctly structured, three-part nursing diagnosis (PES statement) for
a patient with COPD who is exhibiting shortness of breath and anxiety about
suffocating.
ANSWER ✓ Anxiety (Problem) related to perceived threat to physiological integrity
(shortness of breath) (Etiology) as evidenced by verbal reports of fear of suffocating,
restlessness, and increased respiratory rate (Defining Characteristics).
13. Question: How does a patient-centered goal differ from a nursing intervention?
ANSWER ✓ A patient-centered goal is a measurable outcome the patient is expected to
achieve (e.g., "Patient will ambulate 50 feet with a walker by post-op day 2"). A nursing
intervention is an action the nurse performs to help achieve that goal (e.g., "Assist
patient with ambulation BID").
14. Question: When evaluating patient outcomes, what must the nurse do if the goal
was not met?
ANSWER ✓ The nurse must reassess the patient, re-examine the nursing diagnoses and
interventions, and revise the plan of care. This involves determining if the goal was
unrealistic, the interventions inadequate, or if the patient's condition has changed.
Comprehensive Study Guide
Unit 1: Nursing Foundations & Professional Identity
1. Question: According to Wilkinson and the ANA, what is the primary focus of all nursing
practice?
ANSWER ✓ The primary focus is the human response to actual or potential health
problems. Nursing aims to promote health, prevent illness, facilitate coping, and restore
health across the lifespan.
2. Question: How does the concept of clinical judgment differ from simple critical thinking
in the nursing process?
ANSWER ✓ Clinical judgment is the observed outcome of critical thinking and decision-
making. It is an iterative process of noticing, interpreting, responding, and reflecting,
leading to nursing actions. It is the application of critical thinking to a clinical situation.
3. Question: What are the four overarching concepts, or metaparadigms, central to
nursing theory?
ANSWER ✓ The four metaparadigms are Person, Environment, Health, and Nursing. All
nursing theories define the relationship among these four core concepts.
4. Question: A nurse is adhering to the ethical principle of nonmaleficence. What is the
nurse committing to do?
ANSWER ✓ The nurse is committing to "do no harm," intentionally avoiding actions
that could cause injury or worsen a patient's condition.
5. Question: Explain the purpose of the Nurse Practice Act (NPA) in each state.
ANSWER ✓ The NPA is a state law that defines the scope of nursing practice,
establishes licensure requirements, and sets standards to protect public health, safety,
and welfare.
Unit 2: Health, Illness, & Health Disparities
6. Question: Using the Health Belief Model, what factor would influence a patient's
likelihood to pursue preventive screening?
ANSWER ✓ The patient's perceived susceptibility (belief about their personal risk of a
condition) and perceived benefits (belief that the screening will effectively reduce the
threat) are key influencing factors.
7. Question: What is the fundamental difference between health disparities and
health inequities?
ANSWER ✓ Health disparities are differences in health outcomes. Health inequities are a
, specific type of disparity that is systematic, avoidable, and unjust, often linked to social,
economic, or environmental disadvantage.
8. Question: A patient states, "My heart failure is under control; I can manage my
medications and diet." This reflects which stage of the Illness-Wellness Continuum?
ANSWER ✓ This reflects movement toward high-level wellness, where the individual is
actively engaged in behaviors that promote stability and improved health despite a
chronic condition.
9. Question: Why is cultural humility considered more important than just cultural
knowledge?
ANSWER ✓ Cultural humility involves self-reflection, recognizing one's own biases, and
committing to a lifelong learning partnership with patients, rather than assuming
mastery over a static set of cultural facts.
10. Question: What is the primary goal of health promotion nursing activities?
ANSWER ✓ The primary goal is to empower individuals and communities to increase
control over their health and improve it, focusing on behaviors and environments that
support well-being before illness occurs.
Unit 3: The Nursing Process & Clinical Judgment
11. Question: During the assessment phase, what is the critical difference between
subjective and objective data?
ANSWER ✓ Subjective data (symptoms) are reported or described by the patient (e.g., "I
feel nauseous"). Objective data (signs) are observable and measurable by the nurse (e.g.,
vomiting, pale skin).
12. Question: Write a correctly structured, three-part nursing diagnosis (PES statement) for
a patient with COPD who is exhibiting shortness of breath and anxiety about
suffocating.
ANSWER ✓ Anxiety (Problem) related to perceived threat to physiological integrity
(shortness of breath) (Etiology) as evidenced by verbal reports of fear of suffocating,
restlessness, and increased respiratory rate (Defining Characteristics).
13. Question: How does a patient-centered goal differ from a nursing intervention?
ANSWER ✓ A patient-centered goal is a measurable outcome the patient is expected to
achieve (e.g., "Patient will ambulate 50 feet with a walker by post-op day 2"). A nursing
intervention is an action the nurse performs to help achieve that goal (e.g., "Assist
patient with ambulation BID").
14. Question: When evaluating patient outcomes, what must the nurse do if the goal
was not met?
ANSWER ✓ The nurse must reassess the patient, re-examine the nursing diagnoses and
interventions, and revise the plan of care. This involves determining if the goal was
unrealistic, the interventions inadequate, or if the patient's condition has changed.
