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1. Skin changes with aging include: A. Thicker skin B. Increased elasticity C. Faster wound healing D. Thinner epidermis, decreased subcutaneous fat and slower healing Correct Answer: D. Thinner epidermis, decreased subcutaneous fat and slower healing Rationale: Skin tears and pressure injuries are common. Gentle handling is needed. 2. Respiratory changes with aging include: A. Increased vital capacity B. Stronger cough C. Reduced cough reflex, decreased elastic recoil and weaker respi...

1. A fracture liaison service: A. Identifies patients with fragility fractures and ensures osteoporosis evaluation and treatment B. Performs surgery C. Provides home cleaning D. Sells hip protectors Correct Answer: A. Identifies patients with fragility fractures and ensures osteoporosis evaluation and treatment Rationale: Many patients are never treated after a fracture. Liaison services close the gap. 2. Chronic subdural hematoma in older adults may present: A. Only immediately after t...

1. Normal age-related changes in the musculoskeletal system include: A. Increased muscle mass B. Increased height C. Loss of muscle mass and strength and decreased bone density D. Increased joint flexibility Correct Answer: C. Loss of muscle mass and strength and decreased bone density Rationale: These changes contribute to fall and fracture risk. Exercise can slow them. 2. Foot problems in older adults that increase fall risk include: A. Normal arches B. Flexible joints C. Bunions, to...

1. The concept of intrinsic capacity, used by the WHO, refers to: A. Income B. The combination of an individual's physical and mental capacities C. Housing D. Family size Correct Answer: B. The combination of an individual's physical and mental capacities Rationale: WHO's ICOPE approach monitors intrinsic capacity. Declines can be addressed early. 2. Normal aging of the nervous system includes: A. Loss of memory to the point of dementia B. Personality change C. Slower reaction...

1. Intrinsic fall risk factors are those related to: A. The environment, such as rugs B. The person, such as weakness, gait problems, vision loss and cognitive impairment C. Weather only D. Footwear only Correct Answer: B. The person, such as weakness, gait problems, vision loss and cognitive impairment Rationale: Extrinsic factors relate to the environment. Most falls involve both. 2. Depression increases fall risk through: A. Psychomotor slowing, poor concentration and antidepressant ...

1. Social determinants affecting older adults' fall risk include: A. Eye color B. Housing quality, income, transportation and social support C. Birth order D. Blood type Correct Answer: B. Housing quality, income, transportation and social support Rationale: Unsafe housing and isolation increase risk. Community resources can help. 2. Immobility in older adults leads quickly to: A. Improved strength B. Better sleep C. Muscle loss, deconditioning and increased fall risk D. Lower fall...

1. A person working outdoors in extreme heat develops heat stroke. Cellular injury occurs because: A. Cold causes ice crystals in cells B. High temperatures denature proteins and increase metabolic demand beyond oxygen supply C. Radiation breaks DNA strands D. Sodium is pumped out too quickly Correct Answer: B. High temperatures denature proteins and increase metabolic demand beyond oxygen supply Rationale: Hyperthermia increases metabolic rate, denatures enzymes and damages membranes, ...

1. A patient with chronic alcohol use disorder has damage to the liver, brain, and heart. Alcohol injures cells in part because its metabolism: A. Increases glutathione stores B. Improves fatty acid oxidation C. Produces acetaldehyde and free radicals and alters the NADH/NAD ratio D. Has no effect on the liver Correct Answer: C. Produces acetaldehyde and free radicals and alters the NADH/NAD ratio Rationale: Ethanol is metabolized to toxic acetaldehyde, generates free radicals, and increa...

1. An infection that spreads easily from one person to another is described as: A. Opportunistic B. Endogenous C. Latent D. Highly communicable Correct Answer: D. Highly communicable Rationale: Communicability reflects how easily a pathogen spreads, with measles being among the most communicable. Opportunistic infections affect weakened hosts, endogenous infections arise from a person's own flora, and latent infections are dormant. 2. Fever in an infected patient increases oxygen dem...

1. Oxygen and carbon dioxide cross the plasma membrane easily because the membrane is: A. Made mostly of carbohydrates B. Impermeable to all gases C. A single layer of protein D. A phospholipid bilayer that small, lipid-soluble molecules can diffuse through Correct Answer: D. A phospholipid bilayer that small, lipid-soluble molecules can diffuse through Rationale: The lipid bilayer lets small nonpolar molecules such as O2, CO2 and steroid hormones diffuse freely, while ions and large pol...

1. Asphyxial injury from strangulation causes cell injury by: A. Increasing oxygen delivery B. Causing hyperthermia C. Obstructing airflow and blood flow, leading to hypoxia D. Releasing lipases Correct Answer: C. Obstructing airflow and blood flow, leading to hypoxia Rationale: Strangulation compresses the airway and blood vessels, preventing oxygen delivery to the brain. Petechiae in the eyes and face are common findings. The other mechanisms do not apply. 2. Frostbite injures tissues ...

1. Hyperkalemia is often caused by which medication class? A. Loop diuretics B. Thiazide diuretics C. Beta-2 agonists D. ACE inhibitors and potassium-sparing diuretics Correct Answer: D. ACE inhibitors and potassium-sparing diuretics Rationale: ACE inhibitors, ARBs and spironolactone reduce aldosterone effects, causing potassium retention, especially in kidney disease. Loop and thiazide diuretics cause potassium loss, and beta-2 agonists shift potassium into cells. 2. Administering a hy...

1. In the Melnyk seven-step EBP process, the final step is to: A. Ask a PICOT question B. Search for evidence C. Cultivate inquiry D. Disseminate the outcomes of the EBP change Correct Answer: D. Disseminate the outcomes of the EBP change Rationale: Sharing results helps others learn. Evaluation of outcomes precedes dissemination. 2. The phrase "best available evidence" acknowledges that: A. Only RCTs count B. The highest-level evidence may not exist for every question, so the str...

1. A key organizational facilitator of EBP is: A. Discouraging questions B. Punishing errors C. Restricting library access D. Leadership support, EBP mentors and a culture that values inquiry Correct Answer: D. Leadership support, EBP mentors and a culture that values inquiry Rationale: Culture strongly predicts EBP use. Leaders model and resource it. 2. Practice based on tradition, such as routine vital signs every 4 hours for all patients, is an example of: A. A sacred cow that should...

1. Memoing in grounded theory involves: A. Sending emails to participants B. Writing analytic notes about codes, categories and emerging relationships C. Taking minutes D. Counting words Correct Answer: B. Writing analytic notes about codes, categories and emerging relationships Rationale: Memos trace theoretical development. They support the audit trail. 2. Ethical issues specific to qualitative research include: A. No ethical issues B. Only randomization ethics C. Protecting confiden...

1. Clinical reasoning and EBP are related because: A. They are unrelated B. EBP replaces reasoning C. Reasoning ignores evidence D. Clinical reasoning uses evidence along with assessment data to make patient decisions Correct Answer: D. Clinical reasoning uses evidence along with assessment data to make patient decisions Rationale: Good reasoning incorporates evidence. Both are essential nursing skills. 2. EBP is important for nurses because it: A. Reduces nurse involvement B. Replaces...

Evidence-Based Practice - 2026 Nursing Primer: Midterm Exam (Units 1-7) - Questions with Correct Answers

1. When searching for qualitative studies, useful terms include: A. Qualitative, interview, focus group, phenomenology and lived experience B. Randomized and placebo C. Odds ratio D. Double-blind Correct Answer: A. Qualitative, interview, focus group, phenomenology and lived experience Rationale: Design terms help find qualitative evidence. Filters exist in some databases. 2. Hand-searching reference lists of relevant articles (snowballing) helps: A. Remove duplicates B. Narrow the ques...

1. Evidence-based practice (EBP) in nursing is best defined as: A. Doing what has always been done on the unit B. Following physician orders without question C. A problem-solving approach that integrates the best available evidence with clinical expertise and patient preferences and values D. Conducting original research on every question Correct Answer: C. A problem-solving approach that integrates the best available evidence with clinical expertise and patient preferences and values Ra...

1. Moral agency means: A. The capacity to make moral judgments and act on them, being accountable for one's actions B. Following orders without thought C. Lack of responsibility D. Legal representation Correct Answer: A. The capacity to make moral judgments and act on them, being accountable for one's actions Rationale: Nurses are moral agents. Organizational constraints can limit agency. 2. The social contract between nursing and society means that: A. Nurses owe nothing to socie...