Fundamental of Nursing (FON)

All Chapter MCQs

(Generic BSN 2nd Semester)

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UNIT # 01: NURSING PROCESS

Nursing Assessment
1. Which of the following behaviors is most representative of the nursing
diagnosis phase of the nursing process?
a) Identifying major problems or needs
b) Organizing data in the client’s family history
c) Establishing short-term and long-term goals
d) Administering an antibiotic
2. Which of the following behaviors would indicate that the nurse was
utilizing the assessment phase of the nursing process to provide nursing
care?
a) Proposes hypotheses.
b) Generates desired outcomes.
c) Reviews results of laboratory tests.
d) Documents care.
3. Which of the following elements is best categorized as secondary
subjective data?
a) The nurse measures a weight loss of 10 pounds since the last clinic visit.
b) Spouse states the client has lost all appetite.
c) The nurse palpates edema in lower extremities.
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d) Client states severe pain when walking up stairs.
4. The nurse wishes to determine the client’s feelings about a recent
diagnosis. Which interview question is most likely to elicit this
information?
a) “What did the doctor tell you about your diagnosis?”
b) “Are you worried about how the diagnosis will affect you in the future?”
c) “Tell me about your reactions to the diagnosis.”
d) “How is your family responding to the diagnosis?”
5. The use of a conceptual or theoretical framework for collecting and
organizing assessment data ensures which of the following?
a) Correlation of the data with other members of the health care team
b) Demonstration of cost-effective care
c) Utilization of creativity and intuition in creating a plan of care
d) Collection of all necessary information for a thorough appraisal
6. Which of the following is the purpose of assessing?
a) Establish a database of client responses to his or her health status.
b) Identify client strengths and problems.
c) Develop an individualized plan of care.
d) Implement care, prevent illness, and promote wellness.
7. In the validating activity of the assessing phase of the nursing process,
the nurse performs which of the following?
a) Collects subjective data.
b) Applies a framework to the collected data.
c) Confirms data are complete and accurate.
d) Records data in the client record.
8. A major characteristic of the nursing process is which of the
following?
a) A focus on client needs
b) Its static nature
c) An emphasis on physiology and illness
d) Its exclusive use by and with nurses

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 9. Which of the following would be true regarding use of the observing
method of data collection?
a) When observing, the nurse uses only the visual sense.
b) Observing is done only when no other nursing interventions are being
performed at the same time.
c) Data should be gathered as it occurs, rather than in any particular order.
d) Observed data should be interpreted in relation to other sources of
collected data.
10. Which of the following represent effective planning of the interview
setting? Select all that apply.
a) Keep the lighting dimmed so as not to stress the client’s eyes.
b) Ensure that no one can overhear the interview conversation.
c) Stand near the client’s head while he or she is in the bed or chair.
d) Keep approximately 3 feet from the client during the interview.
e) Use a standard form to be sure all relevant data are covered in the
interview
Answer : b, d, e

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 Nursing Diagnosis

1. The nurse is conducting the diagnosing phase (nursing diagnosis) of the

nursing process for a client with a seizure disorder. Which step exists
between data analysis and formulating the diagnostic statement?
a) Assess the client’s needs.
b) Delineate the client’s problems and strengths.
c) Determine which interventions are most likely to succeed.
d) Estimate the cost of several different approaches.
2. In the diagnostic statement “Excess Fluid Volume related to decreased
venous return as manifested by lower extremity edema (swelling),” the
etiology of the problem is which of the following?
a) Excess fluid volume
b) Decreased venous return
c) Edema
d) Unknown
3. Which of the following nursing diagnoses contains the proper
components?
a) Risk for Caregiver Role Strain related to unpredictable illness course
b) Risk for Falls related to tendency to collapse when having difficulty breathing
c) Impaired Communication related to stroke
d) Sleep Deprivation secondary to fatigue and a noisy environment
4. One of the primary advantages of using a three-part diagnostic statement
such as the problem–etiology signs/symptoms (PES) format includes
which of the following?
a) Decreases the cost of health care.
b) Improves communication between nurse and client.
c) Helps the nurse focus on health and wellness elements.
d) Standardizes organization of client data.

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 5. A collaborative (multidisciplinary) problem is indicated instead of a
nursing or medical diagnosis
a) If both medical and nursing interventions are required to treat the
problem.
b) When independent nursing actions can be utilized to treat the problem.
c) In cases where nursing interventions are the primary actions required to treat
the problem.
d) When no medical diagnosis (disease) can be determined.
6. In the case in which a client is vulnerable to developing a health
problem, the nurse chooses which type of nursing diagnosis status?
a) A risk nursing diagnosis
b) A syndrome nursing diagnosis
c) A health promotion nursing diagnosis
d) An actual nursing diagnosis
7. Which of the following is true regarding the state of the science in
regards to nursing diagnosis?
a) The original taxonomy has proven to be adequate in scope.
b) The organizing framework of the taxonomy is based on the work of Florence
Nightingale.
c) More research is needed to validate and refine the diagnostic labels.
d) New diagnostic labels are approved by means of a vote of registered nurses.
8. Which of the following would indicate a significant cue when comparing
data to standards? Select all that apply.
a) The client has moved partway toward a set goal (e.g., weight loss).
b) The client’s vision is within normal range only when wearing glasses.
c) A child is able to control bladder and bowels at age 18 months.
d) A recently widowed woman states she is “unable to cry.”
e) A 16-year-old high school student reports spending 6 hours doing homework
five nights per week.
Answer : a, d, e

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 Out Come Identification & Planning

1. After being admitted directly to the surgery unit, a 75-year-old client

who had elective surgery to replace an arthritic hip was discharged from
the post anesthesia recovery unit. The client has been on the orthopedic
floor for several hours. Which type of planning will be least useful during
the first shift on the orthopedic unit?
a) Initial
b) Ongoing
c) Discharge
d) Strategic
2. The client with a fractured pelvis requests that family members be
allowed to stay overnight in the hospital room. Before determining whether
or not this request can be honored, the nurse should consult which of the
following?
a) Hospital policies
b) Standardized care plans
c) Orthopedic protocols
d) Standards of care
3. The nurse assesses a postoperative client with an abdominal wound and
finds the client drowsy when not aroused. The client’s pain is ranked 2 on a
scale of 0 to 10, vital signs are within preoperative range, extremities are
warm with good pulses but skin is very dry. The client declines oral fluids
due to nausea, and reports no bowel movement in the past 2 days. Hip
dressing is dry with drains intact. Which element is most likely to be
considered of high priority for a change in the current care plan?
a) Pain
b) Nausea
c) Constipation
d) Potential for wound infection

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 4. The nurse selects the nursing diagnosis of Risk for Impaired Skin
Integrity related to immobility, dry skin, and surgical incision. Which of
the following represents a properly stated goal/outcome? The client will
a) Turn in bed q2h.
b) Report the importance of applying lotion to skin daily.
c) Have intact skin during hospitalization.
d) Use a pressure-reducing mattress.
5. The care plan includes a nursing intervention “4/2/15 Measure client’s
fluid intake and output. F. Jenkins, RN.” What element of a proper nursing
intervention has been omitted?
a) Action verb
b) Content
c) Time
d) None
6. Place the following activities of planning in the correct order of their
use.
a) Establish goals/outcomes.
b) Write the care plan.
c) Set priorities.
d) Choose interventions.
Answer : c, a, b, d
7. The nurse recognizes which of the following as a benefit of using a
standardized care plan?
a) No individualization is needed.
b) The nurse chooses from a list of interventions.
c) They are much shorter than nurse-authored care plans.
d) They have been approved by accrediting agencies.

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 8. Which of the following is likely to occur if a goal statement is poorly
written?
a) There is no standard against which to compare outcomes.
b) The nursing diagnoses cannot be prioritized.
c) Only dependent nursing interventions can be used.
d) It is difficult to determine which nursing interventions can be delegated.
9. When written properly, NOC outcomes and indicators
a) Do not require customization.
b) Address several nursing diagnoses.
c) Are broad statements of desired end points.
d) Reflect both the nurse’s and the client’s values.
10. Which of the following principles does the nurse use in selecting
interventions for the care plan?
a) Actions should address the etiology of the nursing diagnosis.
b) Always select independent interventions when possible.
c) There is one best intervention for each goal/outcome.
d) Interventions should be “doing,” not just “monitoring.”

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 Implementation & Evaluation

1. When initiating the implementation phase of the nursing process, the

nurse performs which of the following phases first?
a) Carrying out nursing interventions
b) Determining the need for assistance
c) Reassessing the client
d) Documenting interventions
2. Under what circumstances is it considered acceptable practice for the
nurse to document a nursing activity before it is carried out?
a) When the activity is routine (e.g., raising the bed rails)
b) When the activity occurs at regular intervals (e.g., turning the client in bed)
c) When the activity is to be carried out immediately (e.g., a stat medication)
d) It is never acceptable.
3. The primary purpose of the evaluation phase of the care planning
process is to determine whether
a) Desired outcomes have been met.
b) Nursing activities were carried out.
c) Nursing activities were effective.
d) Client’s condition has changed.
4. The client has a high-priority nursing diagnosis of Risk for Impaired
Skin Integrity related to the need for several weeks of imposed bed rest.
The nurse evaluates the client after 1 week and finds the skin integrity is
not impaired. When the care plan is reviewed, the nurse should perform
which of the following?
a) Delete the diagnosis since the problem has not occurred.
b) Keep the diagnosis since the risk factors are still present.
c) Modify the nursing diagnosis to Impaired Mobility.
d) Demote the nursing diagnosis to a lower priority.

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 5. If the nurse planned to evaluate the length of time clients must wait for a
nurse to respond to a client need reported over the intercom system on each
shift, which process does this reflect?
a) Structure evaluation
b) Process evaluation
c) Outcome evaluation
d) Audit
6. Which of the following is true regarding the relationship of
implementing to the other phases of the nursing process?
a) The findings from the assessing phase are reconfirmed in the
implementing phase.
b) After implementing, the nurse moves to the diagnosing phase.
c) The nurse’s need for involvement of other health care team members in
implementing occurs during the planning phase.
d) Once all interventions have been completed, evaluating can begin.
7. The care plan calls for administration of a medication plus client
education on diet and exercise for high blood pressure. The nurse finds the
blood pressure extremely elevated. The client is very distressed with this
finding. Which nursing skill of implementing would be needed most?
a) Cognitive
b) Intellectual
c) Interpersonal
d) Psychomotor
8. Which of the following demonstrates appropriate use of guidelines in
implementing nursing interventions? Select all that apply.
a) No interventions should be carried out without the nurse having clear
rationales.
b) Always follow the primary care provider’s orders exactly, without variation.
c) Encourage all clients to be as dependent as desired and allow the nurse to
perform care for them.
d) When possible, give the client options in how interventions will be
implemented.
e) Each intervention should be accompanied by client teaching.
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Answer : a, d, e
9. Which of the following represents application of the components of
evaluating?
a) Goal achievement must be written as either completely met or unmet.
b) Data related to expected outcomes must be collected.
c) If the outcome was achieved, conclude that the plan was effective.
d) After determining that the outcome was not met, start over with a new nursing
care plan.
10. An element of quality improvement, rather than quality assurance, is
which of the following?
a) Focus is on individual outcomes.
b) Evaluates organizational structures.
c) Aims to confirm that quality exists.
d) Plans corrective actions for problems.

Documenting & Reporting

1. Which action by a nurse ensures confidentiality of a client’s computer
record?
a) The nurse logs on to the client’s file and leaves the computer to answer the
client’s call light.
b) The nurse shares her computer password.
c) The nurse closes a client’s computer file and logs off.
d) The nurse leaves client computer worksheets at the computer workstation.
2. The case management model using critical pathways would be
appropriate for a client with which diagnosis?
a) Myocardial infarction (heart attack)
b) Diabetes, hypertension
c) Myocardial infarction, diabetes, hypertension
d) Diabetes, hypertension, an infected foot ulcer, senile dementia
3. After making a documentation error, which action should the nurse take?
a) Use correcting liquid to cover the mistake and make a new entry.
b) Draw a line through it and write error above the entry.
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c) Draw a line through it and write mistaken entry above it.
d) Draw a line through the mistake and write mistaken entry with initials
above it.
4. Which charting entry would be the most defensible in court?
a) Client fell out of bed
b) Client drunk on admission
c) Large bruise on left thigh
d) Notified Dr. Jones of BP of 90/40
5. The client’s VS are WNL. He has BRP and he receives his pain pill
PRN. His nutrition is DAT. Interpret the commonly used abbreviations.
a) NKA:
b) BRP:
c) PRN:
d) DAT:
6. During the first day a nurse is caring for a client who has been in the
hospital for 2 days, the nurse thinks that the client’s blood pressure (BP)
seems high. What is the next step?
a) Ask the client about past blood pressure ranges.
b) Review the graphic record on the client’s record.
c) Examine the medication record for antihypertensive medications.
d) Review the progress notes included in the client’s record.
7. A student nurse observes the change-of-shift report. Which behavior(s)
by the reporting nurse represents effective nursing practice? Select all that
apply.
a) Provides the medical diagnosis or reason for admission.
b) States the time the client last received pain medication.
c) Speaks loudly when giving report.
d) States priorities of care that are due shortly after the report.
e) Reports on number of visitors for each client.
Answer : a, b, d

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 8. Which charting entries are written correctly? Select all that apply.
a) MS 5 gr given IV for c/o abdominal pain
b) Lanoxin 0.25 mg given orally per Dr. Smith’s stat order
c) KCl 15 mL given orally for K+ level of 2.9
d) Regular insulin 10.0 u given SQ for capillary blood glucose of 180
e) Ambien 5 mg given orally at bedtime per request
Answer : b, c, e
9. A 74-year-old female is brought to the emergency department c/o right
hip pain. The right leg is shorter than the left and is externally rotated.
During inspection, the nurse observes what appears to be cigarette burns on
the client’s inner thighs. Which of the following is the most appropriate
documentation?
a) Six round skin lesions partially healed, on the inner thighs bilaterally
b) Several burned areas on both of the client’s inner thighs
c) Multiple lesions on inner thighs possibly related to elder abuse
d) Several lesions on inner thighs similar to cigarette burns
10. Which charting rule(s) will keep the nurse legally safe? Select all that
apply.
a) Use military time.
b) Document worries or concerns expressed by the client.
c) Perform most of the charting at the end of the shift.
d) Record only information that pertains to the client’s health problems
Answer : a, b, d

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 Critical Thinking

1. A client with diarrhea also has a primary care provider’s order for a bulk
laxative daily. The nurse, not realizing that bulk laxatives can help solidify
certain types of diarrhea, concludes, “The primary care provider does not
know the client has diarrhea.” What type of statement is this?
a) A fact
b) An inference
c) A judgment
d) An opinion
2. A client reports feeling hungry, but does not eat when food is served.
Using clinical reasoning skills, the nurse should perform which of the
following?
a) Assess why the client is not ingesting the food provided.
b) Continue to leave the food at the bedside until the client is hungry enough to
eat.
c) Notify the primary care provider that tube feeding may be indicated soon.
d) Believe the client is not really hungry.
3. A client complains of shortness of breath. During assessment the nurse
observes that the client has edema of the left leg only. The nurse reviews
evidence-based practice literature and reflects on a previous client with the
same clinical manifestations. What do these actions represent?
a) Clinical judgment
b) Clinical reasoning
c) Reflection
d) Intuition
4. The client who is short of breath benefits from the head of the bed being
elevated. Because this position can result in skin breakdown in the sacral
area, the nurse decides to study the amount of sacral pressure occurring in
other positions. What decision making is the nurse engaging in?
a) The research method
b) The trial-and-error method
c) Intuition
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d) The nursing process
5. In the clinical reasoning process, the nurse sets and weighs the criteria,
examines alternatives, and performs which of the following before
implementing a plan?
a) Reexamines the purpose for making the decision.
b) Consults the client and family members to determine their view of the criteria.
c) Identifies and considers various means for reaching the outcomes.
d) Determines the logical course of action should intervening problems
arise.
6. The nurse is concerned about a client who begins to breathe very
rapidly. Which action by the nurse reflects clinical reasoning?
a) Notify the primary care provider.
b) Obtain vital signs and oxygen saturation.
c) Request a chest x-ray.
d) Call the rapid response team.
7. The nurse is teaching a client about wound care during a follow up visit
in the client’s home. Which critical thinking attitude causes the nurse to
reconsider the plan and supports evidence based practice when the client
states, “I just don’t know how I can afford these dressings”?
a) Integrity
b) Intellectual humility
c) Confidence
d) Independence
8. When the nurse considers that a client is from a developing country and
may have a positive tuberculosis test due to a prior vaccination, which
critical thinking attitude and skill is the nurse practicing?
a) Creating environments that support critical thinking
b) Tolerating dissonance and ambiguity
c) Self-assessment
d) Seeking situations where good thinking is practiced

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 9. A client in a cardiac rehabilitation program says to the nurse, “I have to
eat a low-sodium diet for the rest of my life, and I hate it!” Which is the
most appropriate response by the nurse?
a) “I will get a dietary consult to talk to you before next week.”
b) “What do you think is so difficult about following a low-sodium diet?”
c) “At least you survived a heart attack and are able to return to work.”
d) “You may not need to follow a low-sodium diet for as long as you think.”
10. Which reasoning process describes the nurse’s actions when the nurse
evaluates possible solutions for care of an infected wound for optimal
client outcomes?
a) Intuition
b) Research process
c) Trial and error
d) Problem solving

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 UNIT # 02: CONCEPT OF VALUE BELIEF

1. When an ethical issue arises, one of the most important nursing

responsibilities in managing client care situations is which of the
following?
a) Be able to defend the morality of one’s own actions.
b) Remain neutral and detached when making ethical decisions.
c) Ensure that a team is responsible for deciding ethical questions.
d) Follow the client and family’s wishes exactly.
2. Which of the following situations is most clearly a violation of the
underlying principles associated with professional nursing ethics?
a) A hospital’s policy permits use of internal fetal monitoring during labor.
However, there is literature to both support and refute the value of this
practice.
b) When asked about the purpose of a medication, a nurse colleague
responds, “Oh, I never look them up. I just give what is prescribed.”
c) The nurses on the unit agree to sponsor a fund-raising event to support a labor
strike proposed by fellow nurses at another facility.
d) A client reports that he didn’t quite tell the doctor the truth when asked if he
was following his therapeutic diet at home.
3. Following a motor vehicle crash, the parents of a child with no apparent
brain function refuse to permit withdrawal of life support from the child.
Although the nurse believes the child should be allowed to die and organ
donation considered, the nurse supports their decision. Which moral
principle provides the basis for the nurse’s actions?
a) Respect for autonomy
b) Nonmaleficence
c) Beneficence
d) Justice
4. Which of the following statements would be most helpful when a nurse
is assisting clients in clarifying their values?
a) “That was not a good decision. Why did you think it would work?”

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b) “The most important thing is to follow the plan of care. Did you follow all
your doctor’s orders?”
c) “Some people might have made a different decision. What led you to
make your decision?”
d) “If you had asked me, I would have given you my opinion about what to do.
Now, how do you feel about your choice?”
5. After recovering from her hip replacement, an older adult client wants to
go home. The family wants the client to go to a nursing home. If the nurse
were acting as a client advocate, the nurse would perform which of the
following actions?
a) Inform the family that the client has a right to decide on her own.
b) Ask the primary care provider to discharge the client to home.
c) Suggest the client hire a lawyer to protect her rights.
d) Help the client and family communicate their views to each other.
6. Values, moral frameworks, and codes of ethics influence
the professional nurse’s moral decisions in which of the following ways?
a) The nurse will provide direct client care that is consistent with the nurse’s
personal values.
b) The nurse will seek to ensure that the client’s values and the nurse’s are the
same.
c) The choice of moral framework determines what the client outcome will be.
d) The nurse is bound to act according to the nurses’ code of ethics even if
the nurse’s values are different.

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 UNIT # 03: SELF CONCEPT & SELF PERCEPTION

1. Sally is 5′7″, weighs 105 lb., and believes that she is fat. Which of the
following most represents this perception?
a) Altered body image
b) Altered personal identity
c) Excessive self-expectation
d) Altered core self-concept
2. Students juggling the responsibilities of work, school, and family are
most likely to experience which of the following?
a) Role ambiguity
b) Role strain
c) Role conflict
d) Role enhancement
3. An appropriate desired outcome for clients with Situational Low Self-
Esteem includes which of the following?
a) Restored self-esteem
b) Consistently verbalizes self-acceptance
c) Teaches adaptive skills
d) Describes preoccupation with altered self
4. An 89-year-old client states, “I’m a lost cause. I can’t even stand long
enough to cook my own meals anymore.” Which is the most appropriate
response?
a) “That must be difficult. What things are you still able to do?”
b) “Well, that is to be expected at your age.”
c) “Do you have someone else who can cook for you?”
d) “Are you a good cook?”
5. An adult who has failed to satisfactorily resolve the develop-mental task
of adolescence—identity versus confusion—is most likely to show which
behavior?
a) Asserts independence
b) Is unable to express personal desires
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c) Has difficulty working as a member of a team
d) Goes along with the crowd in all activities
6. During an annual performance review, which statement by the nurse
indicates the area of self-awareness?
a) “I rarely make any medication errors.”
b) “I am willing to mentor new nurses.”
c) “My client satisfaction reports agree that I am friendly and helpful.”
d) “All of my clients have recovered quickly from their health problems.”
7. When asked to describe herself, a client newly diagnosed with a chronic
illness describes only those roles involving others (e.g., wife, mother,
medical assistant) and no personal hobbies or interests. What should the
nurse include when planning her care?
a) How her treatment will affect her ability to perform those roles
b) How to set goals for her to develop personal hobbies or interests
c) That the family must be present while the treatment plan is being developed
d) That she will need psychological counseling for role performance in addition
to her medical treatment
8. You are caring for a client who has a nursing diagnosis of Chronic Low
Self-Esteem. Which behaviors are consistent with this diagnosis? Select all
that apply.
a) Confronts authority
b) Verbalizes own weaknesses
c) Is unable to perform consistent with his/her family role (e.g., mother, father)
d) Sets unrealistically high goals
e) Has difficulty making positive observations about self
f) Has difficulty sleeping
Answer : b, e

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 9. Which interventions are appropriate for a client with low/poor self-
concept? Select all that apply.
a) Encourage the client to compare self with others.
b) Suggest the client not say negative things about self.
c) Suggest the client say positive things about self.
d) L f7s Recommend the client avoid situations of having to care for others.
e) Communicate very low-level expectations of the client’s behavior.
Answer : b, c

10. Self-concept may vary according to a variety of conditions affecting the

individual. The nurse recognizes that even appropriate nursing
interventions are least likely to alter which of the following?
a) Resources
b) Self-knowledge
c) Core self-concept
d) Social self

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 UNIT # 04: CONCEPT OF PAIN (Different Therapies)

1. During the transduction phase of nociception, which method of pain

control is most effective?
a) Tricyclic antidepressants
b) Opioids
c) Ibuprofen
d) Distraction
2. When a client has arrived at the nursing unit from surgery, the nurse is
most likely to give priority to which of the following assessments?
a) Pain tolerance
b) Pain intensity
c) Location of pain
d) Pain history
3. A client who describes his pain as 7 on a scale of 0 to 10 is classified as
having which of the following?
a) No pain
b) Mild pain
c) Moderate pain
d) Severe pain
4. A client who had abdominal surgery 4 hours ago is receiving a
continuous epidural infusion of an analgesic. Which of the following
observations indicates the nurse should monitor the client closely?
a) Drowsy; drifts off to sleep before completing a sentence
b) Respirations = 18/min
c) Drowsy; easily aroused
d) Pain rating 1–2/10
5. The client has an order of morphine 2.5 to 5.0 mg intravenous (IV) every
4 hours. He received 2.5 mg IV 4 hours ago for pain rated at 3 on a scale of
0 to 10. He is now watching television and visiting with family members.
When asked about his pain, he rates it as a 5. His vital signs are stable.
What nursing intervention is the most appropriate?

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a) Give morphine 3.5 mg IV and inform him to continue watching TV because it
is a distraction from the pain.
b) Give 2.5 mg of morphine IV to avoid the client becoming addicted.
c) Give nothing at this time because he is not exhibiting any signs of pain.
d) Give morphine 5.0 mg IV and reassess in 20 minutes.
6. During an admission nursing assessment, a client with diabetes describes
his leg pain as a “dull, burning sensation.” The nurse recognizes this
description to be characteristic of which type of pain?
a) Physiological
b) Somatic
c) Visceral
d) Neuropathic
7. Which interventions, when implemented by the nurse, would apply the
gate control theory of pain? Select all that apply.
a) Oral analgesics around the clock
b) Massage
c) Patient-controlled analgesia
d) Heat or cold application
e) Acupressure
Answer : a, b, d

8. Which statement best reflects the nurse’s assessment of the fifth vital
sign?
a) “Do you have any complaints?”
b) “Are you experiencing any discomfort right now?”
c) “Is there anything I can do for you now?”
d) “Do you have any complaints of pain?”

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 9. When planning care for pain control of older clients, which principles
should the nurse apply? Select all that apply.
a) Pain is a natural outcome of the aging process.
b) Pain perception increases with age.
c) The client may deny pain.
d) The nurse should avoid use of opioids.
e) The client may describe pain as an “ache” or “discomfort.”
Answer : a, b, d
10. A client recovering from abdominal surgery refuses analgesia, saying
that he is “fine, as long as he doesn’t move.” Which nursing diagnosis
should be a priority?
a) Deficient Knowledge (pain control measures)
b) Ineffective Health Maintenance
c) Risk for Ineffective Airway Clearance
d) Impaired Physical Mobility

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 UNIT # 05: Concept of Nutrition & Dietary

1. Which of the following nursing diagnoses is most appropriate for a

client with a body mass index (BMI) of 35?
a) Imbalanced Nutrition: Less Than Body Requirements
b) Obesity
c) Overweight
d) Deficient Knowledge
2. An adult reports usually eating the following each day: 3 cups dairy, 2
cups fruit, 2 cups vegetables, 5 ounces grains, and 5 ounces meat. The
nurse would counsel the client to:
a) Maintain the diet; the servings are adequate.
b) Increase the number of servings of dairy.
c) Decrease the number of servings of vegetables.
d) Increase the number of servings of grains.
3. Which of the following are allowed on a full liquid diet? Select all that
apply.
a) Scrambled eggs
b) Chocolate pudding
c) Tomato juice
d) Hard candy
e) Mashed potatoes
f) Cream of Wheat cereal
g) Oatmeal cereal
h) Fruit “smoothies”
Answer :b, c, d, f, h

4. What is the best indication of proper placement of a nasogastric tube in

the stomach?
a) Client is unable to speak.
b) Client gags during insertion.
c) pH of the aspirate is less than 5.
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d) Fluid is easily instilled into the tube.
5. What is the proper technique with gravity tube feeding?
a) Hang the feeding bag 1 foot higher than the tube’s insertion point into the
client.
b) Administer the next feeding only if there is less than 25 mL of residual
volume from the previous feeding.
c) Place client in the left lateral position.
d) Administer feeding directly from the refrigerator.
6. A 55-year-old female is about 9 kg (20 lb) over her desired weight. She
has been on a “low-calorie” diet with no improvement. Which statement
reflects a healthy approach to the desired weight loss? “I need to:
a) Increase my exercise to at least 30 minutes every day.”
b) Switch to a low-carbohydrate diet.”
c) Keep a list of my forbidden foods on hand at all times.”
d) Buy more organic and less processed foods.”
7. An older Asian client has mild dysphagia from a recent stroke. The
nurse plans the client’s meals based on the need to:
a) Have at least one serving of thick dairy (e.g., pudding, ice cream) per meal.
b) Eliminate the beer usually ingested every evening.
c) Include as many of the client’s favorite foods as possible.
d) Increase the calories from lipids to 40%.
8. Two months ago a client weighed 195 pounds. The current weight is 182
pounds. Calculate the client’s percentage of weight loss and determine its
significance.
a) % weight loss
b) Not significant
c) Significant weight loss
d) Severe weight loss

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 9. Which of the sites on the diagram below indicates the correct location
for the tip of a small-bore nasally placed feeding tube?

Answer : 02

10. Which of the following meals would the nurse recommend to the client
as highest in calcium, iron, and fiber?
a) 3 ounces cottage cheese with 1/3 cup raisins and 1 banana
b) 1/2 cup broccoli with 3 ounces chicken and 1/2 cup peanuts
c) 1/2 cup spaghetti with 2 ounces ground beef and 1/2 cup lima beans plus 1/2
cup ice cream
d) 3 ounces tuna plus 1 ounce cheese sandwich on whole-wheat bread plus a
pear

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 UNIT # 06: Concept of Elimination (urinary)

1. The nurse recognizes that urinary elimination changes may occur even in
healthy older adults because of which of the following?
a) The bladder distends and its capacity increases.
b) Older adults ignore the need to void.
c) Urine becomes more concentrated.
d) The amount of urine retained after voiding increases.
2. During assessment of the client with urinary incontinence, the nurse is
most likely to assess for which of the following? Select all that apply.
a) Perineal skin irritation
b) Fluid intake of less than 1,500 mL/day
c) History of antihistamine intake
d) History of frequent urinary tract infections
e) A fecal impaction
Answer : a, b, d, e

3. Which action represents the appropriate nursing management of a client

wearing a condom catheter?
a) Ensure that the tip of the penis fits snugly against the end of the condom.
b) Check the penis for adequate circulation 30 minutes after applying.
c) Change the condom every 8 hours.
d) Tape the collecting tubing to the lower abdomen.
4. The catheter slips into the vagina during a straight catheterization of a
female client. The nurse does which action?
a) Leaves the catheter in place and gets a new sterile catheter.
b) Leaves the catheter in place and asks another nurse to attempt the procedure.
c) Removes the catheter and redirects it to the urinary meatus.
d) Removes the catheter, wipes it with a sterile gauze, and redirects it to the
urinary meatus.

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 5. Which statement indicates a need for further teaching of the home care
client with a long-term indwelling catheter?
a) “I will keep the collecting bag below the level of the bladder at all times.”
b) “Intake of cranberry juice may help decrease the risk of infection.”
c) “Soaking in a warm tub bath may ease the irritation associated with the
catheter.”
d) “I should use clean technique when emptying the collecting bag.”
6. During shift report, the nurse learns that an older female client is unable
to maintain continence after she senses the urge to void and becomes
incontinent on the way to the bathroom. Which nursing diagnosis is most
appropriate?
a) Stress Urinary Incontinence
b) Reflex Urinary Incontinence
c) Functional Urinary Incontinence
d) Urge Urinary Incontinence
7. A female client has a urinary tract infection (UTI). Which teaching
points by the nurse would be helpful to the client? Select all that apply.
a) Limit fluids to avoid the burning sensation on urination.
b) Review symptoms of UTI with the client.
c) Wipe the perineal area from back to front.
d) Wear cotton underclothes.
e) Take baths rather than showers.
Answer : 2,4

8. The nurse will need to assess the client’s performance of clean

intermittent self-catheterization (CISC) for a client with which urinary
diversion?
a) Ileal conduit
b) Kock pouch
c) Neobladder
d) Vesicostomy

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 9. Which focus is the nurse most likely to teach for a client with a flaccid
bladder?
a) Habit training: Attempt voiding at specific time periods.
b) Bladder training: Delay voiding according to a preschedule timetable.
c) Credé’s maneuver: Apply gentle manual pressure to the lower abdomen.
d) Kegel exercises: Contract the pelvic muscles.
10. Which of the following behaviors indicates that the client on a bladder
training program has met the expected outcomes? Select all that apply.
a) Voids each time there is an urge.
b) Practices slow, deep breathing until the urge decreases.
c) Uses adult diapers, for “just in case.”
d) Drinks citrus juices and carbonated beverages.
e) Performs pelvic muscle exercises.
Answer : 2,4,5

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 Fecal

1. Clients should be taught that repeatedly ignoring the sensation of

needing to defecate could result in which of the following?
a) Constipation
b) Diarrhea
c) Incontinence
d) Hemorrhoids
2. Which statement provides evidence that an older adult who is prone to
constipation is in need of further teaching?
a) “I need to drink one and a half to two quarts of liquid each day.”
b) “I need to take a laxative such as Milk of Magnesia if I don’t have a BM
every day.”
c) “If my bowel pattern changes on its own, I should call you.”
d) “Eating my meals at regular times is likely to result in regular bowel
movements.”
3. A client is scheduled for a colonoscopy. The nurse will provide
information to the client about which type of enema?
a) Oil retention
b) Return flow
c) High, large volume
d) Low, small volume
4. The nurse is most likely to report which finding to the primary care
provider for a client who has an established colostomy?
a) The stoma extends 1/2 in. above the abdomen.
b) The skin under the appliance looks red briefly after removing the appliance.
c) The stoma color is a deep red-purple.
d) The ascending colostomy delivers liquid feces.
5. Which goal is the most appropriate for clients with diarrhea related to
ingestion of an antibiotic for an upper respiratory infection?
a) The client will wear a medical alert bracelet for antibiotic allergy.
b) The client will return to his or her previous fecal elimination pattern.
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c) The client will verbalize the need to take an antidiarrheal medication prn.
d) The client will increase intake of insoluble fiber such as grains, rice, and
cereals.
6. A client with a new stoma who has not had a bowel movement since
surgery last week reports feeling nauseous. What is the appropriate nursing
action?
a) Prepare to irrigate the colostomy.
b) After assessing the stoma and surrounding skin, notify the surgeon.
c) Assess bowel sounds and administer antiemetic.
d) Administer a bulk-forming laxative, and encourage increased fluids and
exercise.
7. The nurse assesses a client’s abdomen several days after abdominal
surgery. It is firm, distended, and painful to palpate. The client reports
feeling “bloated.” The nurse consults with the surgeon, who orders an
enema. The nurse prepares to give what kind of enema?
a) Soapsuds
b) Retention
c) Return flow
d) Oil retention
8. Which of the following is most likely to validate that a client is
experiencing intestinal bleeding?
a) Large quantities of fat mixed with pale yellow liquid stool
b) Brown, formed stools
c) Semisoft black-colored stools
d) Narrow, pencil-shaped stool
9. Which nursing diagnoses is/are most applicable to a client with fecal
incontinence? Select all that apply.
a) Bowel Incontinence
b) Risk for Deficient Fluid Volume
c) Disturbed Body Image
d) Social Isolation

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e) Risk for Impaired Skin Integrity
Answer : a, c, d, e

10. A student nurse is assigned to care for a

client with a sigmoid ostomy. The student will
assess which ostomy site?

Answer : 05

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 UNIT # 07: Concept of Sleep

1. A client is admitted for a sleep disorder. The nurse knows that the
reticular activating system (RAS) is involved in the sleep/wake cycle. In
the accompanying illustration, which letter indicates the location of the
RAS?

a) A
b) B
c) C
d) D

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2. A client has a history of sleep apnea. Which is the most appropriate question
for the nurse to ask?
a) Do you have a history of cardiac irregularities?
b) Do you have a history of any kind of nasal obstruction?
c) Have you had chest pain with or without activity?
d) Do you have difficulty with daytime sleepiness?
3. Because of significant concerns about financial problems, a middle-aged client
complains of difficulty sleeping. Which outcome would be the most appropriate
for the nursing care plan? “By day 5, the client will:
a) Sleep 8 to 10 hours per day.”
b) Report falling asleep within 20 to 30 minutes.”
c) Have a plan to pay all the bills.”
d) Decrease worrying about financial problems and will keep busy until
bedtime.”
4. A client reports to the nurse that she has been taking barbiturate sleeping pills
every night for several months and now wishes to stop taking them. Which
statement is the most appropriate advice for the nurse to provide the client?
a) Take the last pill on a Friday night so disrupted sleep can be compensated on
the weekend.
b) Continue to take the pills since sleeping without them after such a long time
will be difficult and perhaps impossible.
c) Discontinue taking the pills.
d) Continue taking the pills and discuss tapering the dose with the primary
care provider.
5. During a well-child visit, a mother tells the nurse that her 4-year-old daughter
typically goes to bed at 10:30 pm and awakens each morning at 7 am. She does
not take a nap in the afternoon. Which is the best response by the nurse?
a) Encourage the mother to consider putting her daughter to bed between 8
and 9 pm.
b) Reassure the mother that it is normal for 4-year-olds to resist napping, but
encourage her to insist that she rest quietly each afternoon.
c) Recommend that her daughter be allowed to sleep later in the morning.
d) Reassure her that her daughter’s sleep pattern is normal and that she has
outgrown her need for an afternoon nap.

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6. A college student was referred to the campus health service because of
difficulty staying awake in class. What should be included in the nurse’s
assessment? Select all that apply.
a) Amount of sleep he usually obtains during the week and on weekends
b) How much alcohol he usually consumes
c) Onset and duration of symptoms
d) Whether or not his classes are boring
e) What medications, including herbal remedies, he is taking
Answer : a, c, e
7. During a yearly physical, a 52-year-old male client mentions that his wife
frequently complains about his snoring. During the physical exam, the nurse
notes that his neck size is 18 inches, his soft palate and uvula are reddened and
swollen, and he is overweight. What is the most appropriate nursing intervention
for the nurse to recommend to this client?
a) Recommend that he and his wife sleep in separate bedrooms so that his
snoring does not disturb his wife.
b) Refer him to a dietitian for a weight loss program.
c) Caution him not to drink or take sleeping pills since they may make his
snoring worse.
d) Refer him to a sleep disorders center for evaluation and treatment of his
symptoms.
8. A new nursing graduate’s first job requires 12-hour night shifts. Which
strategy will make it easier for the graduate to sleep during the day and remain
awake at night?
a) Wear dark wrap-around sunglasses when driving home in the morning,
and sleep in a darkened bedroom.
b) Exercise on the way home to avoid having to stand around waiting for
equipment at the gym.
c) Drink several cups of strong coffee or 16 oz of caffeinated soda when
beginning the shift.
d) Try to stay in a brightly lit area when working at night.
9. The nurse is answering questions after a presentation on sleep at a local senior
citizens center. A woman in her late 70s asks for an opinion about the
advisability of allowing her husband to
nap for 15 to 20 minutes each afternoon. Which is the nurse’s best response?
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 a) “Taking an afternoon nap will interfere with his being able to sleep at night. If
he’s tired in the afternoon, see if you can interest him in some type of
stimulating activity to keep him awake.”
b) “He shouldn’t need to take an afternoon nap if he’s getting enough sleep at
night.”
c) “Unless your husband has trouble falling asleep at night, a brief
afternoon nap is fine.”
d) “Encourage him to consume coffee or some other caffeinated beverage at
lunch to prevent drowsiness in the afternoon.”
10. During admission to a hospital unit, the client tells the nurse that her sleep
tends to be very light and that it is difficult for her to get back to sleep if she’s
awakened at night. Which interventions should the nurse implement? Select all
that apply.
a) Remind colleagues to keep their conversation to a minimum at night.
b) Encourage the client’s family members to bring in a radio to play soft music
at night.
c) Deliver necessary medications and procedures at 1.5- or 3-hour intervals
between 11 pm and 6 am.
d) Encourage the client to ask family members to bring in a fan to provide
white noise.
e) Increase the temperature in the room.
Answer : a, c, d

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 UNIT # 08: Human responses to illness

1. Which one of the following is an example of the emotional component

of wellness?
a) The client chooses healthy foods.
b) A new father decides to take parenting classes.
c) A client expresses frustration with her partner’s substance abuse.
d) A widow with no family decides to join a bowling league.
2. Which individual appears to have “taken on” the sick role?
a) A client who is obese states, “I deserve to have a heart attack.”
b) A mother is ill and says, “I won’t be able to make your lunch today.”
c) A man with low back pain misses several physical therapy appointments.
d) An older adult states, “My horoscope says I will be well again.”
3. Because a client recently diagnosed with diabetes mellitus is confident
that blood sugar control can be improved with diet and exercise alone, and
recently checked out a video on the management of diabetes at the HMO
education center, the client’s actions are most representative of which
model?
a) Health belief model
b) Clinical model
c) Role performance model
d) Agent–host–environment model
4. Because a client with human immunodeficiency virus (HIV) is
scheduled to begin several medications to manage the infection, the nurse
will need to provide client education. Which client characteristics are most
likely to predict adherence with the treatment program? Select all that
apply.
a) Educational level
b) A trusting relationship with the health care provider
c) An expectation that the medications will be helpful
d) Being able to take the medications twice daily instead of four times daily
e) Sex

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 Answer : b, c, d

5. Which one of the following might be the BEST way to measure

adherence to a prescribed medication regime?
a) Direct observation of medication administration
b) Evidence of illness complications or exacerbations
c) Monitoring laboratory values of elements influenced by the medication
d) Questioning the client about his or her medication routine
6. Which of the following is least likely to influence a client’s personal
definition of health/wellness?
a) The client’s ability to perform his or her usual activities
b) The cultural traditions the client uses in everyday life
c) The availability and accessibility of health care services appropriate for the
client’s health condition
d) The medical diagnostic terminology used to describe the client’s signs
and symptoms
7. Which of the following is an internal variable affecting health status,
beliefs, or practices?
a) Living situation
b) Socioeconomic status
c) Family structure
d) Genetics
8. A client recently diagnosed with a chronic illness asks for help in
understanding the term chronic. It would be correct for the nurse to say
which of the following?
a) Symptoms are always less severe than with an acute illness.
b) Chronic illnesses are considered incurable.
c) Signs and symptoms of chronic illnesses tend to be stable for many years.
d) Chronic illnesses have no effective treatments.

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 9. Although not every client progresses in order through each stage, what is
the usual sequence in Suchman’s stages of illness?
a) The client makes contact with medical care.
b) The client goes into rehabilitation/recovery.
c) Signs and symptoms appear.
d) The client takes on the dependent role.
e) The client takes on the sick role.
Answer : c, e, a, d, b

10. A married mother of three small children has frequent immobilizing

headaches of unknown cause. The nurse anticipates that the woman may
have which of the following possible reactions? Select all that apply.
a) She feels guilty when unable to perform her usual activities.
b) She is angry and acting out.
c) She shifts some responsibilities to the spouse.
d) She takes on a job to help pay for the medical expenses.
e) She has fewer social interactions with her friends.
Answer : a, b, c, e

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 UNIT # 09: Concept of Sexuality

1. Clients may be unlikely to introduce the topic of sex with health care
providers for which reason?
a) They assume that health care providers know little about sexual
functioning.
b) Most clients have few questions or problems.
c) Female clients prefer to discuss problems with female health care providers.
d) They are too embarrassed to introduce the topic of sex.
2. A nurse receives information that a client is transgender. Appropriate
care is based on the knowledge that which of the following is most
representative of this client?
a) Gonadal gender, internal organs, and external genitals are contradictory.
b) Sexual anatomy contradicts gender identity.
c) Sexual attraction is to individuals of both genders.
d) Gender identity is altered by acute psychosis.
3. In conducting client teaching, the nurse bases content on knowing that
which of the following is true regarding masturbation?
a) People who masturbate are psychologically disturbed.
b) Teenage masturbation interferes with academic achievement.
c) Most people do not masturbate past the teenage years.
d) Masturbation is a way people learn about their sexual response.
4. A male client is beginning an antidepressant medication. Which of the
following should be included in the teaching?
a) “Your partner will be pleased because your sexual functioning is going to
improve.”
b) “You may find that your desire for sex will decrease while on this
medication.”
c) “Retrograde ejaculation is a common problem when taking antidepressants.”
d) “Your skin will probably become supersensitive to touch, so you may need to
change your activity during sex.”

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 5. A client who had a hysterectomy 3 days ago, says to the nurse, “I no
longer feel like a real woman.” What is the best response?
a) “Don’t worry about that. The feeling will probably go away.”
b) “You should talk to your doctor about how you feel.”
c) “I don’t blame you. I would feel like half a woman also.”
d) “I hear your concern. Tell me more about your feelings.”
6. Because a client reports having dyspareunia, it is most appropriate to ask
which question?
a) “Have you talked with your partner about this discomfort?”
b) “Have you had these spasms since you became sexually active?”
c) “Do you have pain before your period begins?”
d) “Do your breasts swell large enough to need a larger bra?”
7. Including at least some sexual health history questions would be most
relevant for clients taking which category of drugs?
a) Anti-inflammatories (such as aspirin or ibuprofen)
b) Hypnotics (sleeping pills)
c) Antihypertensives (blood pressure medications)
d) Antihistamines (cold medications)
8. A nurse informs a client who is 8 1/2 months pregnant that it is best to
abstain from intercourse until after the birth of the baby. This
communication is most representative of which component of the PLISSIT
model?
a) Permission giving (P)
b) Limited information (LI)
c) Specific suggestions (SS)
d) Intensive therapy (IT)

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 9. A 75-year-old male client reports decreased frequency of sexual
intercourse although he does not express dissatisfaction or difficulty. He
seems a little embarrassed by the discussion but is engaged and asks some
questions. An appropriate nursing diagnosis would be which of the
following?
a) Sexual Dysfunction
b) Disturbed Body Image
c) Sedentary Lifestyle
d) Readiness for Enhanced Knowledge
10. Which of the following outcomes may indicate the need for referral to a
more highly skilled therapist?
a) The client verbalizes methods of modifying sexual activity according to
physical limitations.
b) The client requests the phone number of a sex education support group.
c) Suggestions given by the nurse are ineffective in reaching the desired
goals.
d) The client reports experimenting with new sexual activities.

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 UNIT # 10: Concept of Loss grieving & death and dying

1. Which of the following may be considered normal or “healthy” types of

grief? Select all that apply.
a) Abbreviated grief
b) Anticipatory grief
c) Disenfranchised grief
d) Complicated grief
e) Unresolved grief
f) Inhibited grief
Answer : a, b, c

2. A client’s family tells the nurse that their culture does not permit a dead
person to be left alone before burial. Hospital policy states that after 6:00
pm when mortuaries are closed, bodies are to be stored in the hospital
morgue refrigerator until the next day. How would the nurse best manage
this situation?
a) Gently explain the policy to the family and then implement it.
b) Inquire of the nursing supervisor how an exception to the policy could be
made.
c) Call the client’s primary care provider for advice.
d) Move the deceased to an empty room and assign an aide to stay with the
body.
3. The shift changed while the nursing staff was waiting for the adult
children of a deceased client to arrive. The oncoming nurse has never met
the family. Which of the following initial greetings is most appropriate?
a) “I’m very sorry for your loss.”
b) “I’ll take you in to view the body.”
c) “I didn’t know your father but I am sure he was a wonderful person.”
d) “How long will you want to stay with your father?”

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 4. At which age does a child begin to accept that he or she will someday
die?
a) Less than 5 years old
b) 5–9 years old
c) 9–12 years old
d) 12–18 years old
5. An 82-year-old man has been told by his primary care provider that it is
no longer safe for him to drive a car. Which statement by the client would
indicate beginning positive adaptation to this loss?
a) “I told the doctor I would stop driving, but I am not going to yet.”
b) “I always knew this day would come, but I hoped it wouldn’t be now.”
c) “What does he know? I’m a better driver than he will ever be.”
d) “Well, at least I have friends and family who can take me places.”
6. When asked to sign the permission form for surgical removal of a large
but noncancerous lesion on her face, the client begins to cry. Which of the
following is the most appropriate response?
a) “Tell me what it means to you to have this surgery.”
b) “You must be very glad to be having this lesion removed.”
c) “I cry when I am happy or relieved sometimes, too.”
d) “Isn’t it wonderful that the lesion is not cancer?”
7. A nursing care plan includes the desired outcome of “quality of life” for
a client with a chronic degenerative illness who is likely to live for many
more years. Which of the following is one example that would indicate the
outcome has been met?
a) The client demonstrates having adequate financial resources to pay for health
care for many more years.
b) The client spends the majority of his or her time in spiritual reflection.
c) The client has no signs or symptoms of preventive complications of the
illness.
d) The client verbalizes satisfaction with current relationships with other
people.

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 8. The nurse is caring for a family in a shelter 2 days after the loss of their
home due to a fire. The fire caused minor burns to several members of the
family but no life-threatening conditions. Which of the following is the
most important assessment data for the nurse to gather at this time?
a) Availability of insurance coverage for rebuilding the house
b) Family members’ understanding of the extent of their physical injuries
c) Psychological support resources available from friends or other sources
d) Family members’ grief responses and coping behaviors
9. The client has been close to death for some time and the family asks how
the nurse will know when the client has actually died. Which of the
following would be the most accurate response from the nurse?
a) When the blood pressure can no longer be measured
b) When the gag reflex is no longer present
c) When there is no apical pulse
d) When the extremities are cool and dark in color
10. In working with a dying client, the nurse demonstrates assisting the
client to die with dignity when performing which action?
a) Allows the client to make as many decisions about care as is possible
b) Shares with the client the nurse’s own views about life after death
c) Avoids talking about dying and focuses on the present
d) Relieves the client of as much responsibility for self-care as is possible

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 UNIT # 11: Concept Stress & Coping

1. After the death of several long-term clients, which action indicates the
nurse is demonstrating ineffective coping?
a) The nurse talks at length to her partner about the deaths.
b) The nurse keeps busy with other actions and doesn’t think about the deaths for
several days.
c) The nurse offers to work extra shifts for several weeks.
d) Several nurses schedule a group session with the agency clergy to discuss the
deaths.
2. The nurse helps a 50-year-old client with diabetes who is to begin giving
insulin injections identify previously successful coping strategies that may
be useful in the current situation. Which stressor is closely related to the
new stressor?
a) Interviewing for a new job
b) Death of a pet while the person was a teenager
c) The person’s partner filing for a divorce
d) Starting to wear eyeglasses at age 30
3. Two people have been in a motor vehicle crash and have similar injuries.
According to the transaction based model, their degree of stress from the
crash would be
a) Based on previous experience and personal characteristics.
b) Extremely similar since they had the same stimulus.
c) The identical physiological alarm reaction.
d) Different depending on their external resources and support levels.
4. A client informed of a cancer diagnosis assures the nurse he is fine.
Which of the following is the most indicative physical evidence to the
nurse of the client’s stress?
a) Constricted pupils
b) Dilated peripheral blood vessels (flush)
c) Hyperventilation
d) Decreased heart rate

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 5. Immediately after the parents of a hospitalized child are informed that
the child has leukemia, the father responds by continuing his usual work
schedule, rarely visiting, and asking when the child can return to school. Of
the following, which is the least likely to be an appropriate nursing
diagnosis at this time?
a) Ineffective Denial
b) Caregiver Role Strain
c) Fear
d) Compromised Family Coping
6. The nurse has recently changed jobs to work with young adults and
recognizes that sources of stress common to that population include which
of the following? Select all that apply.
a) Marriage
b) Aging parents
c) Starting a new job
d) Leaving the parental home
e) Decreased physical abilities
f) Changing body structure
7. A middle-aged male client is experiencing job-related stress associated
with the fear of being laid off, resulting in his accepting projects that
require a great deal of travel. Which of the following would be the most
important health promotion strategy for this client?
a) Exercise
b) Sleep
c) Nutrition
d) Time management
8. The first time the nurse enters the client’s room, the client is on the
phone. Immediately, the client slams down the phone, sweeps everything
off the overbed table, and demands that the nurse perform several duties
“this very minute.” Which of the following would be the most appropriate
response for the nurse?
a) Tell the client “I will return” and then leave the room.
b) Tell the client no care will be given until the screaming ends.

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c) Begin providing needed care calmly and quietly.
d) Allow the client to complete venting, then respond calmly.
9. A client newly diagnosed with a chronic condition that will significantly
change the lifestyle must learn aspects of self-care. The client exhibits
severe anxiety: increased blood pressure and pulse, headache, and
nervousness. Based on this situation, how would the nurse appropriately
plan the teaching?
a) Recognize that the client’s ability to learn is severely impaired and teach
only the immediate, critical needs and plan to follow up and reinforce this
teaching later.
b) Recognize that the client’s learning will be adaptive and begin immediately to
implement the full teaching and learning plan.
c) Recognize that the client’s ability to learn will be slightly impaired and
modify the usual teaching strategies to accommodate for this impairment.
d) Recognize that the client cannot learn at this time, that the level of anxiety
must first be reduced, and then teaching can be based on this new level of
anxiety.
10. Which of the following defense mechanisms for coping with stress
could be effective and constructive? Select all that apply.
a) Compensation
b) Displacement
c) Minimization
d) Repression
e) Regression
Answer : a, b, d

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 UNIT # 12: Medication (oral + parental)

1. A client tells the nurse, “This pill is a different color than the one that I
usually take at home.” Which is the best response by the nurse?
a) “Go ahead and take your medicine.”
b) “I will recheck your medication orders.”
c) “Maybe the doctor ordered a different medication.”
d) “I’ll leave the pill here while I check with the doctor.”
2. The following medications are listed on a client’s medication
administration record (MAR). Which medication order should the nurse
question?
a) Lasix 40 mg, po, STAT
b) Ampicillin 500 mg, q6h, IVPB
c) Humulin L (Lente) insulin 36 units, subcutaneously, every morning before
breakfast
d) Codeine q4–6h, po, prn for pain
3. The primary care provider prescribed 5 mL of a medication to be given
deep intramuscular for a 40-year-old female who is 5′7″ tall and weighs
135 pounds. Which is the most appropriate equipment for the nurse to use?
Select all that apply.
a) Two 3-mL syringes
b) One 5-mL syringe
c) A #20–#23 gauge needle
d) A 1-inch needle
e) A 1 1/2-inch needle
Answer : a, c, e

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 4. The nurse is to administer 0.75 mL of medication subcutaneously in the
upper arm to a 300-pound adult client. The nurse can grasp approximately
2 inches of the client’s tissue at the upper arm. Which is the most
appropriate for the nurse to use?
a) A tuberculin syringe, #25–#27 gauge, 1/4- to 5/8-inch needle
b) Two 3-mL syringes, #20–#23 gauge, 1 1/2-inch needle
c) 2-mL syringe, #25 gauge, 5/8-inch needle
d) 2-mL syringe, #20–#23 gauge, 1-inch needle
5. The nurse is to administer a tuberculin test to a client who is 6 feet tall
and weighs 180 pounds. Which is the most appropriate for the nurse to
use?
a) A tuberculin syringe, #25–#27 gauge, 1/4- to 5/8-inch needle
b) Two 3-mL syringes, #20–#23 gauge, 1 1/2-inch needle
c) 2-mL syringe, #25 gauge, 5/8-inch needle
d) 2-mL syringe, #20–#23 gauge, 1-inch needle
6. The nurse is to administer 0.5 mL of a medication by intramuscular
injection to an older emaciated client. Which is the most appropriate for the
nurse to use?
a) A tuberculin syringe, #25–#27 gauge, 1/4- to 5/8-inch needle
b) Two 3-mL syringes, #20–#23 gauge, 1 1/2-inch needle
c) 2-mL syringe, #25 gauge, 5/8-inch needle
d) 2-mL syringe, #20–#23 gauge, 1-inch needle
7. An older client with renal insufficiency is to receive a cardiac
medication. Which is the nurse most likely to administer?
a) A decreased dosage
b) The standard dosage
c) An increased dosage
d) Divided dosages
8. Proper administration of an otic medication to a 2-year-old client
includes which of the following?
a) Pull the ear straight back.
b) Pull the ear down and back.

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c) Pull the ear up and back.
d) Pull the ear straight upward.
9. A primary care provider writes a prescription for 0.15
milligram of digoxin intravenously every day. The
medication is available in a concentration of 400
micrograms per mL. How many mL Will the nurse
administer?
After converting to
like numbers, the formula would be set up as follows:
400 micrograms = 1 mL
150 micrograms = X mL
Cross multiply (400 X = 150)
Divide by 400
X = 0.375
X=0.37
10. A nursing student is preparing to administer insulin to a client with
diabetes. Indicate the correct order for the administration of this
medication:
a) Cleanse the site with alcohol.
b) Insert the needle quickly into the subcutaneous tissue.
c) Mix the insulins.
d) Assess the skin for the injection.
e) Pinch the skin lightly.
f) Inject the medication.
g) Count to five.
h) Remove the syringe.
Correct sequence: c, a, d, e, b, f, g&h

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