Medical-Surgical Nursing:
Comprehensive
Final Exam Review questions and
answers 2025/2026 latest update
(passing score guaranteed)
Definition of Nursing -✔✔ answer Nursing is described as both an art and a science; a heart and a mind.
- Nursing is putting the patient in the best condition for nature to act (Florence Nightingale).
- The nurse's unique function is to aid patients, sick or well, in performing those activities contributing to
health or its recovery (or to peaceful death) that they would perform unaided if they had the necessary
strength, will, or knowledge--and to do this in such a way as to help them gain independence (Henderson).
- *Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and
injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the
care of individuals, families, communities, and populations (American Nursing Association).*
Nursing's View of Humanity (7 Dimensions of Wellness) -✔✔ answer 7 Dimensions of Wellness that
contribute to
health and quality of life:
1. Physical
2. Psychological
3. Social
4. Spiritual
,5. Intellectual
6. Career (Occupational)
7. Environmental
Scope of Nursing Practice -✔✔ answer The essential core of nursing is to deliver holistic patient-centered
care. *Describes the services that a qualified health professional is deemed competent to perform and
permitted to undertake.*
- More education and experience can prepare nurses for advanced practice. An *advanced practice
registered nurse (APRN)* is a nurse educated at the master's or doctoral level.
Standards of Professional Nursing Practice -✔✔ answer The American Nurses Association (ANA) defines
Standards of Professional Nursing Practice to guide nurses in how to perform professionally.
- 2 Parts:
- Standards of Practice: describes a competent level of nursing care based on the nursing process (ADPIE).
- Standards of Professional Performance: describes behavioral competencies expected of a nurse.
Quality and Safety Education for Nurses (QSEN) -✔✔ answer Addresses the challenge to prepare nurses
with the competencies needed to continuously improve the quality of care in their work environments.
- Defines specific competencies nurses need to possess to practice safely and effectively
Nurse Practice Act (NPA) -✔✔ answer Defines the scope and limitations of professional nursing practice;
vary from state to state
,- Defines the nursing scope of practice in addition to delegating patient care.
Clinical Judgement -✔✔ answer The ability to make decisions and solve problems by making sense of
information in a situation (the observed outcome of critical thinking and decision-making).
Nursing Process -✔✔ answer Assessment
Diagnosis
Planning
Implementation
Evaluation
Core Nursing Competencies (QSEN) -✔✔ answer *Patient-Centered Care*: Provide holistic,
compassionate, and coordinated care based on respect for patient's preferences.
*Interprofessional Partnerships*: Function effectively within nursing and interprofessional teams *Safety*:
Minimize risk of harm to patients and providers.
*Quality Improvement*: Use data to monitor the outcomes of care and to improve the quality and safety of
health care systems.
*Informatics and Health Care Technology*: Use information and technology to communicate, manage
knowledge, reduce errors, and support decision making.
*Evidence-Based Practice*: Integrate best current evidence with clinical expertise and the patient/caregiver
preferences and values for delivery of optimal health care.
,Nursing Care Plans -✔✔ answer The comprehensive nursing care plan is the central source of
information needed to guide holistic, goal-oriented care, and address each client's unique needs -
Guides for routine care
Coordinating Care -✔✔ answer Effective communication is key to fostering teamwork and coordinating
care. To provide safe, effective care, team members must exchange information clearly and accurately
among team members.
- *Situation-Background-Assessment-Recommendation (SBAR)*: Offers a structured way to discuss a
patient's condition between team members. It allows you to attention and action.
- *Patient Handoff Report*: The process of passing patient information to another team member during a
transition.
Clinical Pathways -✔✔ answer Interprofessional care plans outline the care and desired outcomes for a
specific time for patients with a specific diagnosis. If a patient's progress differs from the planned path, a
*variance* has occurred (These can be positive or negative)
Delegation and Assignment -✔✔ answer *Delegation* allows a care provider to perform a specific
nursing activity, skill, or procedure beyond their usual role. (Initial assessment, patient teaching, and
evaluation
CANNOT be delegated) (bathing, vital signs, ambulating, and feeding CAN be delegated)
*Assignment* is referred to when a RN directs an LPN/VN/ or AP to do an activity or procedure that is part of
their everyday job.
5 Rights of Delegation -✔✔ answer 1. Right task
,2. Right circumstance
3. Right person
4. Right direction/communication
5. Right supervision/evaluation
Evidence-Based Practice -✔✔ answer A problem solving approach to making clinical decisions using the
best evidence available.
- Steps of EBP Process:
1. Asking a clinical question
2. Searching for the best evidence
3. Critically appraise the evidence
4. Implement the evidence into practice
5. Evaluate the outcome
6. Share the results
National Patient Safety Goals (NPSGs) -✔✔ answer Goals issued by the Joint Commission to
improve patient safety in healthcare organizations nationwide -Improve accuracy of client identification.
-Improve effectiveness of communication among caregivers.
-Improve safety of using medications.
-Reduce risk of health-care-associated infections.
-Identify client safety risks inherent in its patient
population.
,PICOT format -✔✔ answer *P* - Identify the population or problem (age, gender, ethnicity,
disease/disorder)
*I* - Intervention, or range of interventions of interest (exposure to disease, risk behavior, education) *C* -
What will you compare the intervention against? (no disease, absence of risk factors, placebo or no
intervention)
*O* - Outcome of interest (risk of disease, rates of occurrence of adverse outcomes, accuracy of diagnosis)
*T* - Time it takes for intervention to achieve the outcome (selected to observe the population or
problem/condition)
Care and Performance Initiatives that influence payment for health care services -✔✔ answer - Clinical
outcomes
- Patient satisfaction
- Use of EBP
- Occurrence of serious reportable events
Accountable Care Organization (ACO) -✔✔ answer An organization of healthcare providers accountable
for the quality, cost, and overall care of Medicare beneficiaries who are assigned and enrolled in the
traditional feefor-service program
National Quality Forum (NQF) -✔✔ answer Reduces the occurrence of serious reportable events by
providing a list of effective Safe Practices to e used in health care settings.
,Preferred Provider Organization (PPO) and Health Maintenance Organizations -✔✔ answer Provide
health care services with charges established with predetermined reimbursement rates or capitation fees in
advance of the medical, hospital, and other care services delivered.
Social Determinants of Health *(Chapter 2: Harding Textbook)* -✔✔ answer Social and cultural factors
influence equity in health care. *Health disparities* are differences in the incidence, prevalence, mortality
rate, and burden of diseases that exist among specific population groups.
Social Determinants of Health: -✔✔ answer Are nonmedical factors that (1) influence the health of
persons and groups and (2) explain why some people have poorer health than others.
Health status -✔✔ answer A holistic concept that is more than the presence or absence of disease. It
encompasses life expectancy and self-assessment of health.
Examples of Social Health Determinants -✔✔ answer - Neighborhood
- Economic Stability
- Health Care
- Education
- Community
,Health Disparities and Health Equity -✔✔ answer Health disparities occur because of social, economic, or
environmental disadvantages. *Health equity* is achieved when every person has the opportunity to attain
their health potential, and no one is disadvantaged.
Stereotyping -✔✔ answer Refers to an overgeneralized viewpoint that members of a specific culture,
race, or ethnic group are alike and share the same values and beliefs.
Ethnocentrism -✔✔ answer Refers to the belief that one's own culture and worldview are superior to
those of others from different cultural, ethnic, and racial background.
Culture -✔✔ answer A way of life for a group of people. It includes the behaviors, beliefs, values,
traditions, and symbols that the group accepts, generally without thinking about them.
Values -✔✔ answer The set of rules by which persons, families, groups, and communities live. They are
the principles and standards that serve as the basis for beliefs, attitudes, and behaviors.
Acculturation -✔✔ answer The lifelong process of incorporating cultural aspects of contexts in which a
person grows, lives, works, and ages.
Cultural imposition -✔✔ answer Occurs when we impose our own cultural beliefs and practices on
another person or group of people.
,Cultural safety -✔✔ answer Describes care and advocacy for a person of another culture determined by
that person or family.
Cultural competence -✔✔ answer The ability to understand, appreciate, and work with people from
cultures other than your own.
- 4 components of cultural competence are: (1) cultural awareness (2) cultural knowledge (3) cultural
skill (4) cultural encounter
- Providing culturally competent care may increase patient satisfaction, promote health equity,
increase patient safety, and prevent misunderstandings.
Cultural Factors Affecting Health and Health Care -✔✔ answer *Folk Healers and Traditions*: *Folk
healers* speak the person's native language and cost less than conventional HCPs.
*Spirituality and Religion*: *Spirituality* refers to a person's effort to find purpose and meaning in life.
*Religion* is a more formal and organized system of beliefs, including belief in or worship of God or gods.
*Cross-Cultural Communication (verbal, nonverbal, and silence)*: *Communication* refers to an organized,
patterned system of behavior that may be verbal or nonverbal. *Verbal communication* includes not only
one's language or dialect but also voice tone, volume, timing, and ability to share thoughts and feelings.
*Nonverbal communication* may take the form of writing, gestures, body movements, posture, facial
expressions, and personal dress in some cultures. *Silence*: In some cultures, silence signifies understanding,
and it some circumstances people may become uncomfortable with silence.
Family Roles and Relationships -✔✔ answer Family roles differ from one culture to another. It is
important for you to determine who should be involved in communication and decision making related to
health care.
, Some cultural group emphasize interdependence while other prefer independence.
Touch -✔✔ answer Physical contact with patients convey various meanings depending on the culture.
Performing a physical assessment requires touching a patient.
Personal Space -✔✔ answer Personal space zones are the variable and subjective distance as which 1
person feels comfortable talking to another.
- *Intimate Zone*: Ranges from 0-18 inches (emotional)
- *Personal Zone*: Ranges from 18 inches-4 feet (friendly gathering)
- *Social Zone*: Ranges from 4-12 feet (unfamiliar people)
- *Public*: Ranges from 12 feet+ (addressing a group)
Nutrition -✔✔ answer An important part of cultural practices is food, including both the foods that one
eats, and ritual and practices associated with food.
Immigration and Immigration -✔✔ answer Several conditions drive migration, such as overcrowding,
natural disasters, geopolitical conflict, persecution, and economic forces.
Drugs -✔✔ answer Genetic differences among people diverse ethnic or racial groups may explain
differences in drug choice, dosage, or administration. For example, some drugs are more effective in certain
ethnic groups than others.
Comprehensive
Final Exam Review questions and
answers 2025/2026 latest update
(passing score guaranteed)
Definition of Nursing -✔✔ answer Nursing is described as both an art and a science; a heart and a mind.
- Nursing is putting the patient in the best condition for nature to act (Florence Nightingale).
- The nurse's unique function is to aid patients, sick or well, in performing those activities contributing to
health or its recovery (or to peaceful death) that they would perform unaided if they had the necessary
strength, will, or knowledge--and to do this in such a way as to help them gain independence (Henderson).
- *Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and
injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the
care of individuals, families, communities, and populations (American Nursing Association).*
Nursing's View of Humanity (7 Dimensions of Wellness) -✔✔ answer 7 Dimensions of Wellness that
contribute to
health and quality of life:
1. Physical
2. Psychological
3. Social
4. Spiritual
,5. Intellectual
6. Career (Occupational)
7. Environmental
Scope of Nursing Practice -✔✔ answer The essential core of nursing is to deliver holistic patient-centered
care. *Describes the services that a qualified health professional is deemed competent to perform and
permitted to undertake.*
- More education and experience can prepare nurses for advanced practice. An *advanced practice
registered nurse (APRN)* is a nurse educated at the master's or doctoral level.
Standards of Professional Nursing Practice -✔✔ answer The American Nurses Association (ANA) defines
Standards of Professional Nursing Practice to guide nurses in how to perform professionally.
- 2 Parts:
- Standards of Practice: describes a competent level of nursing care based on the nursing process (ADPIE).
- Standards of Professional Performance: describes behavioral competencies expected of a nurse.
Quality and Safety Education for Nurses (QSEN) -✔✔ answer Addresses the challenge to prepare nurses
with the competencies needed to continuously improve the quality of care in their work environments.
- Defines specific competencies nurses need to possess to practice safely and effectively
Nurse Practice Act (NPA) -✔✔ answer Defines the scope and limitations of professional nursing practice;
vary from state to state
,- Defines the nursing scope of practice in addition to delegating patient care.
Clinical Judgement -✔✔ answer The ability to make decisions and solve problems by making sense of
information in a situation (the observed outcome of critical thinking and decision-making).
Nursing Process -✔✔ answer Assessment
Diagnosis
Planning
Implementation
Evaluation
Core Nursing Competencies (QSEN) -✔✔ answer *Patient-Centered Care*: Provide holistic,
compassionate, and coordinated care based on respect for patient's preferences.
*Interprofessional Partnerships*: Function effectively within nursing and interprofessional teams *Safety*:
Minimize risk of harm to patients and providers.
*Quality Improvement*: Use data to monitor the outcomes of care and to improve the quality and safety of
health care systems.
*Informatics and Health Care Technology*: Use information and technology to communicate, manage
knowledge, reduce errors, and support decision making.
*Evidence-Based Practice*: Integrate best current evidence with clinical expertise and the patient/caregiver
preferences and values for delivery of optimal health care.
,Nursing Care Plans -✔✔ answer The comprehensive nursing care plan is the central source of
information needed to guide holistic, goal-oriented care, and address each client's unique needs -
Guides for routine care
Coordinating Care -✔✔ answer Effective communication is key to fostering teamwork and coordinating
care. To provide safe, effective care, team members must exchange information clearly and accurately
among team members.
- *Situation-Background-Assessment-Recommendation (SBAR)*: Offers a structured way to discuss a
patient's condition between team members. It allows you to attention and action.
- *Patient Handoff Report*: The process of passing patient information to another team member during a
transition.
Clinical Pathways -✔✔ answer Interprofessional care plans outline the care and desired outcomes for a
specific time for patients with a specific diagnosis. If a patient's progress differs from the planned path, a
*variance* has occurred (These can be positive or negative)
Delegation and Assignment -✔✔ answer *Delegation* allows a care provider to perform a specific
nursing activity, skill, or procedure beyond their usual role. (Initial assessment, patient teaching, and
evaluation
CANNOT be delegated) (bathing, vital signs, ambulating, and feeding CAN be delegated)
*Assignment* is referred to when a RN directs an LPN/VN/ or AP to do an activity or procedure that is part of
their everyday job.
5 Rights of Delegation -✔✔ answer 1. Right task
,2. Right circumstance
3. Right person
4. Right direction/communication
5. Right supervision/evaluation
Evidence-Based Practice -✔✔ answer A problem solving approach to making clinical decisions using the
best evidence available.
- Steps of EBP Process:
1. Asking a clinical question
2. Searching for the best evidence
3. Critically appraise the evidence
4. Implement the evidence into practice
5. Evaluate the outcome
6. Share the results
National Patient Safety Goals (NPSGs) -✔✔ answer Goals issued by the Joint Commission to
improve patient safety in healthcare organizations nationwide -Improve accuracy of client identification.
-Improve effectiveness of communication among caregivers.
-Improve safety of using medications.
-Reduce risk of health-care-associated infections.
-Identify client safety risks inherent in its patient
population.
,PICOT format -✔✔ answer *P* - Identify the population or problem (age, gender, ethnicity,
disease/disorder)
*I* - Intervention, or range of interventions of interest (exposure to disease, risk behavior, education) *C* -
What will you compare the intervention against? (no disease, absence of risk factors, placebo or no
intervention)
*O* - Outcome of interest (risk of disease, rates of occurrence of adverse outcomes, accuracy of diagnosis)
*T* - Time it takes for intervention to achieve the outcome (selected to observe the population or
problem/condition)
Care and Performance Initiatives that influence payment for health care services -✔✔ answer - Clinical
outcomes
- Patient satisfaction
- Use of EBP
- Occurrence of serious reportable events
Accountable Care Organization (ACO) -✔✔ answer An organization of healthcare providers accountable
for the quality, cost, and overall care of Medicare beneficiaries who are assigned and enrolled in the
traditional feefor-service program
National Quality Forum (NQF) -✔✔ answer Reduces the occurrence of serious reportable events by
providing a list of effective Safe Practices to e used in health care settings.
,Preferred Provider Organization (PPO) and Health Maintenance Organizations -✔✔ answer Provide
health care services with charges established with predetermined reimbursement rates or capitation fees in
advance of the medical, hospital, and other care services delivered.
Social Determinants of Health *(Chapter 2: Harding Textbook)* -✔✔ answer Social and cultural factors
influence equity in health care. *Health disparities* are differences in the incidence, prevalence, mortality
rate, and burden of diseases that exist among specific population groups.
Social Determinants of Health: -✔✔ answer Are nonmedical factors that (1) influence the health of
persons and groups and (2) explain why some people have poorer health than others.
Health status -✔✔ answer A holistic concept that is more than the presence or absence of disease. It
encompasses life expectancy and self-assessment of health.
Examples of Social Health Determinants -✔✔ answer - Neighborhood
- Economic Stability
- Health Care
- Education
- Community
,Health Disparities and Health Equity -✔✔ answer Health disparities occur because of social, economic, or
environmental disadvantages. *Health equity* is achieved when every person has the opportunity to attain
their health potential, and no one is disadvantaged.
Stereotyping -✔✔ answer Refers to an overgeneralized viewpoint that members of a specific culture,
race, or ethnic group are alike and share the same values and beliefs.
Ethnocentrism -✔✔ answer Refers to the belief that one's own culture and worldview are superior to
those of others from different cultural, ethnic, and racial background.
Culture -✔✔ answer A way of life for a group of people. It includes the behaviors, beliefs, values,
traditions, and symbols that the group accepts, generally without thinking about them.
Values -✔✔ answer The set of rules by which persons, families, groups, and communities live. They are
the principles and standards that serve as the basis for beliefs, attitudes, and behaviors.
Acculturation -✔✔ answer The lifelong process of incorporating cultural aspects of contexts in which a
person grows, lives, works, and ages.
Cultural imposition -✔✔ answer Occurs when we impose our own cultural beliefs and practices on
another person or group of people.
,Cultural safety -✔✔ answer Describes care and advocacy for a person of another culture determined by
that person or family.
Cultural competence -✔✔ answer The ability to understand, appreciate, and work with people from
cultures other than your own.
- 4 components of cultural competence are: (1) cultural awareness (2) cultural knowledge (3) cultural
skill (4) cultural encounter
- Providing culturally competent care may increase patient satisfaction, promote health equity,
increase patient safety, and prevent misunderstandings.
Cultural Factors Affecting Health and Health Care -✔✔ answer *Folk Healers and Traditions*: *Folk
healers* speak the person's native language and cost less than conventional HCPs.
*Spirituality and Religion*: *Spirituality* refers to a person's effort to find purpose and meaning in life.
*Religion* is a more formal and organized system of beliefs, including belief in or worship of God or gods.
*Cross-Cultural Communication (verbal, nonverbal, and silence)*: *Communication* refers to an organized,
patterned system of behavior that may be verbal or nonverbal. *Verbal communication* includes not only
one's language or dialect but also voice tone, volume, timing, and ability to share thoughts and feelings.
*Nonverbal communication* may take the form of writing, gestures, body movements, posture, facial
expressions, and personal dress in some cultures. *Silence*: In some cultures, silence signifies understanding,
and it some circumstances people may become uncomfortable with silence.
Family Roles and Relationships -✔✔ answer Family roles differ from one culture to another. It is
important for you to determine who should be involved in communication and decision making related to
health care.
, Some cultural group emphasize interdependence while other prefer independence.
Touch -✔✔ answer Physical contact with patients convey various meanings depending on the culture.
Performing a physical assessment requires touching a patient.
Personal Space -✔✔ answer Personal space zones are the variable and subjective distance as which 1
person feels comfortable talking to another.
- *Intimate Zone*: Ranges from 0-18 inches (emotional)
- *Personal Zone*: Ranges from 18 inches-4 feet (friendly gathering)
- *Social Zone*: Ranges from 4-12 feet (unfamiliar people)
- *Public*: Ranges from 12 feet+ (addressing a group)
Nutrition -✔✔ answer An important part of cultural practices is food, including both the foods that one
eats, and ritual and practices associated with food.
Immigration and Immigration -✔✔ answer Several conditions drive migration, such as overcrowding,
natural disasters, geopolitical conflict, persecution, and economic forces.
Drugs -✔✔ answer Genetic differences among people diverse ethnic or racial groups may explain
differences in drug choice, dosage, or administration. For example, some drugs are more effective in certain
ethnic groups than others.
