Nursing 201 Exam 1
a patient is scheduled to receive metoprolol for blood pressure control at 09:00. The
order reads: "for SBP > 90, 25 mg PO daily." Prior to administration, the nurse rechecks
the blood pressure and finds it to be 90/50 with a heart rate of 68. This is an example of
using what type of nursing skill?
a) the nursing process
b) critical thinking
c) the nurse practice act
d) medical simulation - ✔️✔️b
a new nurse is caring for four patients for the first time. One patient is admitted with
respiratory distress, reports no shortness of breath, SpO2 is 95% on 2LNC, RR is 18.
The other patient is admitted for a laparoscopic prostatectomy, complains of 6/10 pain,
and has new onset of hematuria in the Foley catheter. The third is an IV drug user with
abscess and pain 3/10 and wants to go outside to smoke. The final patient is an elderly
confused patient admitted with a UTI and is determined to be a fall risk. Which patient
should be the nurse's priority?
a) patient 1
b) patient 2
c) patient 3
d) patient 4 - ✔️✔️b
a nurse is conducting a focus assessment of a hospitalized patient who is a fall risk.
which of the following would be most appropriate?
a) "do you have many stairs that you need to navigate at home"
b) "are you more unsteady on your feet when you are out of bed today"
c) "are you feeling any pain in your abdomen"
d) "what is your usual or baseline diet at home" - ✔️✔️b
a nurse is conducting an admission assessment on a confused patient brought in by his
son. which of the following would be included in primary sources for information?
choose all that apply
a) physical assessment
b) health history per the patient's son
c) clinical notes in the computer system from a past admission
d) patient's report of physical symptoms - ✔️✔️a, d
a nurse receives a patient at handoff who is experiencing acute changes in neurological
status. Which nursing action should be done first?
a) call the physician
b) perform an in-depth neurologic assessment
,c) administer an antihypertensive medication stat
d) move the patient back to bed - ✔️✔️b
a nurse is revising a plan of care for a patient with dysphagia (difficulty swallowing)
related to an esophageal mass. The patient's goal was to eat more than 50% of a
blenderized diet, but he is reporting 8/10 pain and shortness of breath when eating.
which phase of the nursing process is impacted when the nurse develops an
intermediate goal of pain less than 4/10 while eating?
a) assessment
b) outcome/planning
c) implementation
d) evaluation - ✔️✔️d
a nurse is admitting a patient with congestive heart failure. which of the following
describe appropriate aspects of assessment?
a) define patient goals for increasing ability for self-care
b) evaluate current therapeutic regimen at home
c) identify activities that exacerbate symptoms
d) apply oxygen therapy via nasal cannula - ✔️✔️c
in conducting an assessment of a patient with gastrointestinal bleeding, the nurse uses
which of the following pieces of subjective data? select all that apply
a) hematocrit 20%
b) appearance of stool
c) spouse's statement of symptoms
d) health record description of signs - ✔️✔️c
the nurse has admitted a single mother with nausea and vomiting for the last 3 days and
upper left quadrant abdominal pain. which of the statements below indicate that the
nurse is using the functional health patterns model of assessment? select all that apply
a) "please describe your appetite over the last week"
b) "what kind of help have you had from your family since this started"
c) "have you been able to sleep or rest lately as usual"
d) "have you had symptoms like this in the past"
e) "your blood pressure is 94/48; heart rate is 112" - ✔️✔️a, b, c
which of the following are true about the introductory phase of interviewing? select all
that apply
a) the introductory phase is the first phase of the interviewing process
b) introduce yourself by name and position
c) focus on goals and move to the next topic after data are collected
d) observe behavior and patient's self-perceptions - ✔️✔️b, d
outcome identification serves which of the following purposes? select all that apply
a) providing individualized care
, b) identifying potential health problems
c) planning care that is realistic and measurable
d) eliminating the need for the involvement of support people - ✔️✔️a, c
a day 1 postoperative patient has the following abnormal assessment findings: pain
7/10, diminished lung sounds, hypoactive bowel sounds, and a saturated bloody
abdominal dressing and bedsheets. which would be the nursing priority?
a) pain
b) lung sounds
c) bowel sounds
d) wound care - ✔️✔️d
a nurse is developing patient goals for a patient following abdominal surgery. which of
the following are appropriate goals? select all that apply
a) ambulates in the hall prior to discharge
b) demonstrates deep breathing and splinting of incision"
c) reports pain level at 4/10 with movement
d) incentive spirometry every 2 hours - ✔️✔️a, b, c
a nurse is developing outcome criteria for a patient following abdominal surgery. Which
of the following is most appropriate
a) patient ambulates by time of discharge
b) identify two techniques to safely rise out of bed
c) patient reports pain less than 6/10
d) patient ambulates safely in hall twice on post-op day 2 - ✔️✔️d
a patient is admitted to the unit following a left total hip repair. the nurse conducts a
focus health assessment. which of the following findings would be most appropriate?
select all that apply
a) sensation, movement, and temperature of left leg
b) effects on role as primary household provider
c) hip pain rated 8/10
d) wife's ability to provide care upon discharge - ✔️✔️a,c
a nurse is conducting a health history on a newly admitted patient. which of the
following should be included? select all that apply
a) reason for seeking healthcare
b) past surgical history
c) perception of health status
d) significant spiritual practices
e) auscultation of lung sounds - ✔️✔️a, b, c, d
the four basic techniques of physical examination includes - ✔️✔️inspection, palpation,
percussion, and auscultation
a patient is scheduled to receive metoprolol for blood pressure control at 09:00. The
order reads: "for SBP > 90, 25 mg PO daily." Prior to administration, the nurse rechecks
the blood pressure and finds it to be 90/50 with a heart rate of 68. This is an example of
using what type of nursing skill?
a) the nursing process
b) critical thinking
c) the nurse practice act
d) medical simulation - ✔️✔️b
a new nurse is caring for four patients for the first time. One patient is admitted with
respiratory distress, reports no shortness of breath, SpO2 is 95% on 2LNC, RR is 18.
The other patient is admitted for a laparoscopic prostatectomy, complains of 6/10 pain,
and has new onset of hematuria in the Foley catheter. The third is an IV drug user with
abscess and pain 3/10 and wants to go outside to smoke. The final patient is an elderly
confused patient admitted with a UTI and is determined to be a fall risk. Which patient
should be the nurse's priority?
a) patient 1
b) patient 2
c) patient 3
d) patient 4 - ✔️✔️b
a nurse is conducting a focus assessment of a hospitalized patient who is a fall risk.
which of the following would be most appropriate?
a) "do you have many stairs that you need to navigate at home"
b) "are you more unsteady on your feet when you are out of bed today"
c) "are you feeling any pain in your abdomen"
d) "what is your usual or baseline diet at home" - ✔️✔️b
a nurse is conducting an admission assessment on a confused patient brought in by his
son. which of the following would be included in primary sources for information?
choose all that apply
a) physical assessment
b) health history per the patient's son
c) clinical notes in the computer system from a past admission
d) patient's report of physical symptoms - ✔️✔️a, d
a nurse receives a patient at handoff who is experiencing acute changes in neurological
status. Which nursing action should be done first?
a) call the physician
b) perform an in-depth neurologic assessment
,c) administer an antihypertensive medication stat
d) move the patient back to bed - ✔️✔️b
a nurse is revising a plan of care for a patient with dysphagia (difficulty swallowing)
related to an esophageal mass. The patient's goal was to eat more than 50% of a
blenderized diet, but he is reporting 8/10 pain and shortness of breath when eating.
which phase of the nursing process is impacted when the nurse develops an
intermediate goal of pain less than 4/10 while eating?
a) assessment
b) outcome/planning
c) implementation
d) evaluation - ✔️✔️d
a nurse is admitting a patient with congestive heart failure. which of the following
describe appropriate aspects of assessment?
a) define patient goals for increasing ability for self-care
b) evaluate current therapeutic regimen at home
c) identify activities that exacerbate symptoms
d) apply oxygen therapy via nasal cannula - ✔️✔️c
in conducting an assessment of a patient with gastrointestinal bleeding, the nurse uses
which of the following pieces of subjective data? select all that apply
a) hematocrit 20%
b) appearance of stool
c) spouse's statement of symptoms
d) health record description of signs - ✔️✔️c
the nurse has admitted a single mother with nausea and vomiting for the last 3 days and
upper left quadrant abdominal pain. which of the statements below indicate that the
nurse is using the functional health patterns model of assessment? select all that apply
a) "please describe your appetite over the last week"
b) "what kind of help have you had from your family since this started"
c) "have you been able to sleep or rest lately as usual"
d) "have you had symptoms like this in the past"
e) "your blood pressure is 94/48; heart rate is 112" - ✔️✔️a, b, c
which of the following are true about the introductory phase of interviewing? select all
that apply
a) the introductory phase is the first phase of the interviewing process
b) introduce yourself by name and position
c) focus on goals and move to the next topic after data are collected
d) observe behavior and patient's self-perceptions - ✔️✔️b, d
outcome identification serves which of the following purposes? select all that apply
a) providing individualized care
, b) identifying potential health problems
c) planning care that is realistic and measurable
d) eliminating the need for the involvement of support people - ✔️✔️a, c
a day 1 postoperative patient has the following abnormal assessment findings: pain
7/10, diminished lung sounds, hypoactive bowel sounds, and a saturated bloody
abdominal dressing and bedsheets. which would be the nursing priority?
a) pain
b) lung sounds
c) bowel sounds
d) wound care - ✔️✔️d
a nurse is developing patient goals for a patient following abdominal surgery. which of
the following are appropriate goals? select all that apply
a) ambulates in the hall prior to discharge
b) demonstrates deep breathing and splinting of incision"
c) reports pain level at 4/10 with movement
d) incentive spirometry every 2 hours - ✔️✔️a, b, c
a nurse is developing outcome criteria for a patient following abdominal surgery. Which
of the following is most appropriate
a) patient ambulates by time of discharge
b) identify two techniques to safely rise out of bed
c) patient reports pain less than 6/10
d) patient ambulates safely in hall twice on post-op day 2 - ✔️✔️d
a patient is admitted to the unit following a left total hip repair. the nurse conducts a
focus health assessment. which of the following findings would be most appropriate?
select all that apply
a) sensation, movement, and temperature of left leg
b) effects on role as primary household provider
c) hip pain rated 8/10
d) wife's ability to provide care upon discharge - ✔️✔️a,c
a nurse is conducting a health history on a newly admitted patient. which of the
following should be included? select all that apply
a) reason for seeking healthcare
b) past surgical history
c) perception of health status
d) significant spiritual practices
e) auscultation of lung sounds - ✔️✔️a, b, c, d
the four basic techniques of physical examination includes - ✔️✔️inspection, palpation,
percussion, and auscultation
