FUNDAMENTALS OF NURSING LECTURE
KOZIER & ERB’S FUNDAMENTALS
OF NURSING CONCEPTS, PROCESS, AND
PRACTICE TENTH EDITION
TRISHZA BADAJOS
UNIT 1 THE NATURE OF NURSING
CHAPTER 1 HISTORICAL AND
CONTEMPORARY NURSING PRACTICE
1. Which women made significant
contributions to the nursing care of
soldiers during the Civil War? Select all
that apply.
 Harriet Tubman
 Dorothea Dix
 Sojourner Truth
2. Curricula for nursing education are
strongly influenced by which of the
following? Select all that apply.
 Professional nursing organizations
 Individual state boards of nursing
 The National Council of State Boards of
Nursing
3. Which is an example of continuing
education for nurses?
 Completing a workshop on ethical
aspects of nursing
4. Health promotion is best represented by
which activity?
 Preventing accidents in the home
5. Who were America’s first two trained
nurses?
 Richards and Mahoney
6. A nurse with 2 to 3 years of experience
who has the ability to coordinate multiple
complex nursing care demands is at which
stage of Benner’s stages of nursing
expertise?
 Competent
7. Which professional organization
developed a code for nursing students?
 NSNA
8. Which social force is most likely to
significantly impact the future supply and
demand for nurses?
 Aging
9. A registered nurse is interested in
functioning as a health care advocate for
individuals whose lives are affected by
violence. This nurse will be investigating
which expanded career role?
 Forensic nurse
10. Fill in the blank: Instead of debating
academic requirements for RN
preparation, nursing is now focusing on
academic __________ for nursing
students and graduates.
 Progression
CHAPTER 2 EVIDENCE-BASED PRACTICE AND
RESEARCH IN NURSING
1. Which of the following is the lowest level
of “best evidence” for evidence-based
practice?
 Trial and error
2. A quantitative research approach is most
appropriate for which study?
 A study measuring the effects of sleep
deprivation on wound healing.
3. A qualitative research approach is most
appropriate for which study?
 A study examining client reactions to
stress after open heart surgery.
4. A key function of a study’s methodology is
to
 Exercise control over contaminating
factors in the study environment.
5. In the PICO format for phrasing research
questions and identifying key terms for a
literature search, what does the “P” stand
for?
 Population
6. Which of the following is a nursing
responsibility when reading published
nursing research?
 Evaluate whether the findings are
applicable to the nurse’s specific clients.
7. A research critique can best be defined as
a/an
 Appraisal of a study’s strengths and
weaknesses.
8. An 85-year-old client in a nursing home
tells a nurse, “Because the doctor was so
insistent, I signed the papers for that
research study. Also, I was afraid he
would not continue taking care of me.”
Which client right is being violated?
 Right to self-determination
FUNDAMENTALS OF NURSING LECTURE
KOZIER & ERB’S FUNDAMENTALS
OF NURSING CONCEPTS, PROCESS, AND
PRACTICE TENTH EDITION
TRISHZA BADAJOS
9. Place each of the following steps of
evidence-based practice change in their
usual sequence.
1. Assess the need for change.
2. Ask the clinical question.
3. Locate the best evidence.
4. Analyze the evidence.
5. Integrate the change with client
preferences.
6. Implement and evaluate the change.
10. A nurse proposes that the hospital apply
the findings from a recent research study
that shows that clients appreciate
classical orchestra music and playing it
frequently lowers clients’ blood pressure.
Which aspect of research suggests that it
may not be appropriate to implement this
as evidence-based practice?
 One study would not be sufficient to
show that all clients would find
orchestral music pleasing.
CHAPTER 3 NURSING THEORIES AND
CONCEPTUAL FRAMEWORKS
1. “A supposition or system of ideas that is
proposed to explain a given
phenomenon” best defines which of the
following?
 A theory
2. “A group of related ideas or statements”
best defines which of the following?
 A conceptual framework
3. “A set of shared understandings and
assumptions about reality and the world”
is a definition for which of the following?
 A paradigm
4. Which provides the best explanation for
describing nursing as a practice discipline?
 Nursing focuses on performing the
professional role.
5. Person, environment, health, and nursing
constitute the metaparadigm for nursing
because they do which of the following?
 Can be utilized in any setting when
caring for a client.
6. Which is an accurate statement about the
role of nursing theory?
 Practice theories assist nurses to reflect
on the effectiveness of what they do.
7. The purpose of theory in science is to
 Help scientists interpret phenomena.
CHAPTER 4 LEGAL ASPECTS OF NURSING
1. A primary care provider’s orders indicate
that a surgical consent form needs to be
signed. Because the nurse was not
present when the primary care provider
discussed the surgical procedure, which
statement best illustrates the nurse
fulfilling the client advocate role?
 “What were you told about the
procedure you are going to have?”
2. Although the client refused the
procedure, the nurse insisted and
inserted a nasogastric tube in the right
nostril. The administrator of the hospital
decides to settle the lawsuit because the
nurse is most likely to be found guilty of
which of the following?
 Battery
3. A nurse discovers that a primary care
provider has prescribed an unusually large
dosage of a medication. Which is the most
appropriate action?
 Notify the prescriber.
4. A primary care provider prescribes one
tablet, but the nurse accidently
administers two. After notifying the
primary care provider, the nurse monitors
the client carefully for untoward effects of
which there are none. Is the client likely
to be successful in suing the nurse for
professional negligence?
 No, the client was not harmed.
5. A nursing student is employed and
working as an unlicensed assistive
personnel (UAP) on a busy surgical unit.
The nurses know that the UAP is enrolled
in a nursing program and will be
graduating soon. A nurse asks the UAP if
he has performed a urinary
catheterization on clients while in the
nursing program. When the UAP says
“Yes,” the nurse asks him to help her out
by doing a urinary catheterization on a
postsurgical client. What is the best
response by the UAP?
 “I can’t do it. Is there something else I
can help you with?”
FUNDAMENTALS OF NURSING LECTURE
KOZIER & ERB’S FUNDAMENTALS
OF NURSING CONCEPTS, PROCESS, AND
PRACTICE TENTH EDITION
TRISHZA BADAJOS
6. The primary care provider wrote a do-notresuscitate (DNR) order. The nurse
recognizes that which applies in the
planning of nursing care for this client?
 The nurses will continue to implement all
treatments focused on comfort and
symptom management.
7. The nurse’s partner/spouse undergoes
exploratory surgery at the hospital where
the nurse is employed. Which practice is
most appropriate?
 Access to the chart requires a signed
release form.
8. Following a motor vehicle crash, a nurse
stops and offers assistance. Which of the
following actions is/are most
appropriate? Select all that apply.
 The nurse needs to know the Good
Samaritan Act for the state.
 The nurse is not held liable unless there
is gross negligence.
 The nurse offers to help but cannot insist
on helping.
9. The nurse notices that a colleague’s
behaviors have changed during the past
month. Which behaviors could indicate
signs of impairment? Select all that apply.
 Is increasingly absent from the nursing
unit during the shift.
 “Forgets” to sign out for administration
of controlled substances.
 Offers to administer prn opioids for
other nurses’ clients.
10. Which nursing actions could result in
professional negligence? Select all that
apply.
 Forgets to complete the assessment of a
client.
 Does not follow up on client’s
complaints.
CHAPTER 5 VALUES, ETHICS, AND ADVOCACY
1. When an ethical issue arises, one of the
most important nursing responsibilities in
managing client care situations is which of
the following?
 Be able to defend the morality of one’s
own actions.
2. Which of the following situations is most
clearly a violation of the underlying
principles associated with professional
nursing ethics?
 When asked about the purpose of a
medication, a nurse colleague responds,
“Oh, I never look them up. I just give
what is prescribed.”
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?
 Respect for autonomy
4. Which of the following statements would
be most helpful when a nurse is assisting
clients in clarifying their values?
 “Some people might have made a
different decision. What led you to
make your decision?”
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?
 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?
 The nurse is bound to act according to
the nurses’ code of ethics even if the
nurse’s values are different.
UNIT 2 CONTEMPORARY HEALTH CARE
CHAPTER 6 HEALTH CARE DELIVERY SYSTEMS
1. Which of the following is an example of a
primary prevention activity?
 Nutrition counseling for young adults
with a strong family history of high
cholesterol
FUNDAMENTALS OF NURSING LECTURE
KOZIER & ERB’S FUNDAMENTALS
OF NURSING CONCEPTS, PROCESS, AND
PRACTICE TENTH EDITION
TRISHZA BADAJOS
2. Which of the following statements is true
regarding types of health care agencies?
 Public health agencies are funded by
governments to investigate and provide
health programs.
3. In most cases, clients must have a primary
care provider in order to receive health
insurance benefits. If a client is in need of
a primary care provider, it is most
appropriate for the nurse to recommend
which of the following?
 Family practice physician
4. The most significant method for reducing
the ongoing increase in the cost of health
care in the United States includes
controlling which of the following?
 Numbers of uninsured and underinsured
persons
5. A client is seeking to control health care
costs for both preventive and illness care.
Although no system guarantees exact outof-pocket expenditures, the most prepaid
and predictable client contribution would
be seen with
 A health maintenance organization
(HMO).
CHAPTER 7 COMMUNITY NURSING AND
CARE CONTINUITY
1. The ANA’s Health System Reform Agenda
(2008) included which of the following?
 Case management should be focused on
clients with enduring health care needs.
2. The Pew Commission competencies for
future practitioners included the need for
providers to become skilled in which of
the following?
 Use of technology
3. Which of the following is characteristic of
nursing care provided in communitybased health?
 Clients are individuals in groups
according to their geographic
commonalities.
4. When performing collaborative health
care, the nurse must implement which of
the following?
 Rely on the expertise of other health
care team members.
5. The nurse concludes that effective
discharge planning (hospital to home) has
been conducted when the client states
which of the following?
 “I have the phone numbers of the home
care nurse and the therapist who will
visit me at home tomorrow.”
6. A large disaster in a community resulted
in the destruction of many family homes
and many individuals were injured. The
assistance of community health nurses
and home health nurses is needed. The
home health nurse is most likely to
perform which of the following?
 Assess and treat individual clients.
CHAPTER 8 HOME CARE
1. Care in the home is an alternative to
hospital placement. Which of the
following is one major difference
associated with in-home care?
 Facilitates extensive involvement of
significant others/family.
2. If a primary care provider prescribed the
following, which could be delegated to
the home health aide?
 Feeding and bathing the client
3. After the nurse instructed a client about
the rationale for sitting with feet elevated
to enhance venous return, the client
refuses to perform the activity. Which
statement by the nurse would be most
useful?
 “Tell me the reasons you won’t put your
feet up.”
4. A home health nurse is providing care for
a client who has paralysis on one side and
whose spouse provides most of the care.
Which of the following may be a sign of
caregiver role strain?
 The caregiver loses weight and has
insomnia.
5. A client is scheduled to be discharged
from the hospital. Which should the
discharge planner at the hospital acquire
first before home nursing care can be
initiated?
 A physician’s authorization
FUNDAMENTALS OF NURSING LECTURE
KOZIER & ERB’S FUNDAMENTALS
OF NURSING CONCEPTS, PROCESS, AND
PRACTICE TENTH EDITION
TRISHZA BADAJOS
6. The nurse doing home health care
recognizes that the practice includes
which of the following? Select all that
apply.
 Hospice care
 Care of both the client and the family
 Performing physical, psychosocial, and
emotional interventions
7. Which of the following indicates the client
and family require some added safety
teaching or teaching?
 Client puts on an emergency response
necklace whenever leaving home.
CHAPTER 9 ELECTRONIC HEALTH RECORDS
AND INFORMATION TECHNOLOGY
1. In nursing administration, technology
facilitates which activities? Select all that
apply.
 Institutional compliance with
accreditation health and safety
requirements
 Tracking the most expensive client
conditions
 Current budget expenditures
 Client satisfaction with care
2. What is the challenge most associated
with the utilization of an electronic client
record system?
 Privacy
3. What is one disadvantage associated with
electronic (e.g., Internet-based) courses?
 It is harder to establish a sense of
community.
4. What is the primary advantage of using
computers while conducting nursing
research?
 Analyzing the quantitative data
5. A client insists that the practitioner use a
treatment method discovered on an
Internet website. Which is the most
appropriate nursing response?
 “The treatment must be examined to see
if it is appropriate.”
UNIT 3 THE NURSING PROCESS
CHAPTER 10 CRITICAL THINKING AND
CLINICAL REASONING
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?
 An inference – conclude that is not avail
in the info.
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?
 Assess why the client is not ingesting the
food provided.
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?
 Clinical reasoning
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?
 The research method
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?
 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?
 Obtain vital signs and oxygen saturation.
FUNDAMENTALS OF NURSING LECTURE
KOZIER & ERB’S FUNDAMENTALS
OF NURSING CONCEPTS, PROCESS, AND
PRACTICE TENTH EDITION
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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”?
 Integrity
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?
 Creating environments that support
critical thinking.
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?
 “What do you think is so difficult about
following a low-sodium diet?”
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?
 Problem solving
CHAPTER 11 ASSESSING
1. Which of the following behaviors is most
representative of the nursing diagnosis
phase of the nursing process?
 Identifying major problems or needs
2. Which of the following behaviors would
indicate that the nurse was utilizing the
assessment phase of the nursing process
to provide nursing care?
 Reviews results of laboratory tests.
3. Which of the following elements is best
categorized as secondary subjective data?
 Spouse states the client has lost all
appetite.
4. The nurse wishes to determine the client’s
feelings about a recent diagnosis. Which
interview question is most likely to elicit
this information?
 “Tell me about your reactions to the
diagnosis.”
5. The use of a conceptual or theoretical
framework for collecting and organizing
assessment data ensures which of the
following?
 Collection of all necessary information for
a thorough appraisal
6. Which of the following is the purpose of
assessing?
 Establish a database of client responses to
his or her health status.
7. In the validating activity of the assessing
phase of the nursing process, the nurse
performs which of the following?
 Confirms data are complete and accurate.
8. A major characteristic of the nursing
process is which of the following?
 A focus on client needs
9. Which of the following would be true
regarding use of the observing method of
data collection?
 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.
 Ensure that no one can overhear the
interview conversation.
 Keep approximately 3 feet from the client
during the interview.
 Use a standard form to be sure all relevant
data are covered in the interview.
CHAPTER 12 DIAGNOSING
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?
 Delineate the client’s problems and
strengths.
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?
 Decreased venous return.
FUNDAMENTALS OF NURSING LECTURE
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3. Which of the following nursing diagnoses
contains the proper components?
 Risk for Caregiver Role Strain related to
unpredictable illness course
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?
 Standardizes organization of client data.
5. A collaborative (multidisciplinary) problem
is indicated instead of a nursing or
medical diagnosis.
 If both medical and nursing interventions
are required to treat the problem.
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 risk nursing diagnosis
7. Which of the following is true regarding
the state of the science in regards to
nursing diagnosis?
 More research is needed to validate and
refine the diagnostic labels.
8. Which of the following would indicate a
significant cue when comparing data to
standards? Select all that apply.
 The client has moved partway toward a set
goal (e.g., weight loss).
 A recently widowed woman states she is
“unable to cry.”
 A 16-year-old high school student reports
spending 6 hours doing homework five
nights per week.
CHAPTER 13 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 postanesthesia
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?
 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?
 Hospital policies
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?
 Nausea
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
 Have intact skin during hospitalization.
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?
 Time
6. Place the following activities of planning in
the correct order of their use.
1) Set priorities.
2) Establish goals/outcomes.
3) Choose interventions.
4) Write the care plan.
7. The nurse recognizes which of the
following as a benefit of using a
standardized care plan?
 The nurse chooses from a list of
interventions.
8. Which of the following is likely to occur if a
goal statement is poorly written?
 There is no standard against which to
compare outcomes.
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9. When written properly, NOC outcomes
and indicators
 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?
 Actions should address the etiology of
the nursing diagnosis.
CHAPTER 14 IMPLEMENTING AND
EVALUATING
1. When initiating the implementation phase
of the nursing process, the nurse
performs which of the following phases
first?
1) Reassessing the client
2) Determining the need for assistance
3) Carrying out nursing interventions
4) Documenting interventions
2. Under what circumstances is it considered
acceptable practice for the nurse to
document a nursing activity before it is
carried out?
 It is never acceptable.
3. The primary purpose of the evaluation
phase of the care planning process is to
determine whether.
 Desired outcomes have been met.
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?
 Delete the diagnosis since the problem has
not occurred.
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?
 Process evaluation
6. Which of the following is true regarding
the relationship of implementing to the
other phases of the nursing process?
 The findings from the assessing phase are
reconfirmed in the implementing phase.
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?
 Interpersonal
8. Which of the following demonstrates
appropriate use of guidelines in
implementing nursing interventions?
Select all that apply.
 No interventions should be carried out
without the nurse having clear
rationales.
 When possible, give the client options in
how interventions will be implemented.
 Each intervention should be accompanied
by client teaching.
9. Which of the following represents
application of the components of
evaluating?
 Data related to expected outcomes must
be collected.
10. An element of quality improvement,
rather than quality assurance, is which of
the following?
 Plans corrective actions for problems.
CHAPTER 15 DOCUMENTING AND
REPORTING
1. Which action by a nurse ensures
confidentiality of a client’s computer
record?
 The nurse closes a client’s computer file
and logs off.
2. The case management model using critical
pathways would be appropriate for a
client with which diagnosis?
 Myocardial infarction (heart attack)
3. After making a documentation error, which
action should the nurse take?
 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?
 Notified Dr. Jones of BP of 90/40
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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.
 NKA:
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?
 Review the graphic record on the client’s
record.
7. A student nurse observes the change-ofshift report. Which behavior(s) by the
reporting nurse represents effective
nursing practice? Select all that apply.
1) Provides the medical diagnosis or reason
for admission.
2) States the time the client last received
pain medication.
8. Which charting entries are written
correctly? Select all that apply.
1) Lanoxin 0.25 mg given orally per Dr.
Smith’s stat order
2) KCl 15 mL given orally for K+ level of 2.9
3) Regular insulin 10.0 u given SQ for
capillary blood glucose of 180
4) Ambien 5 mg given orally at bedtime per
request
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?
 Six round skin lesions partially healed, on
the inner thighs bilaterally.
10. Which charting rule(s) will keep the nurse
legally safe? Select all that apply.
1) Use military time.
2) Document worries or concerns expressed
by the client.
3) Record only information that pertains to
the client’s health problems.
UNIT 4 HEALTH BELIEFS AND PRACTICES
CHAPTER 16 HEALTH PROMOTION
1. A nurse and a primary care provider inform
a client that chemotherapy is
recommended for a diagnosis of cancer.
Which nursing action is most
representative of the concept of holism?
 Inquire how this will affect other aspects of
the client’s life.
2. A nurse is planning a workshop on health
promotion for older adults. Which topic
will be included?
 Adequate sleep
3. While hospitalized, a client is very worried
about business activities. The client
spends a great deal of time on the phone
and with colleagues instead of resting.
Which principle of need therapy applies
to this client?
 His lower level physiological needs are
being deferred while higher needs are
addressed.
4. Which statement by the client best
represents the contemplation stage of the
stages of behavior change?
 “I currently do not exercise 30 minutes
three times a week, but I am thinking
about starting to do so within the next
six months.”
5. A client who is 46 pounds overweight tells
you, “I was just born to be fat. I don’t
have the willpower.” Although weight loss
occurred while attending two previous
programs that “guaranteed” weight loss,
the weight returned along with extra
pounds after each program. According to
the Health Promotion Model, the nurse is
most likely to focus on which behavior
specific cognition and affect variable for
this client?
 Perceived self-efficacy
6. Which of the following are overarching
goals of Healthy People 2020? Select all
that apply.
 Increase quality and years of healthy life.
 Eliminate health disparities.
 Promote healthy behaviors.
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7. The nurse who is assisting a client in the
action stage of change would use which
strategy?
 Reinforce the importance of providing
rewards for positive behavior.
8. Which is the best response by the nurse if
a client fails to follow the information or
teaching provided?
 Reassess the client’s importance given to
the behavior and readiness to change it.
9. A client is admitted for heart failure. The
nurse assesses that the client’s blood
pressure is below normal range and the
apical pulse is 110 beats/min. The nurse
knows that the increase in the client’s
pulse illustrates which aspect of the
client’s homeostatic mechanism?
 Compensation
10. Using Maslow’s framework, which
statement characterizes the highest level
of need?
 “I’m very proud of receiving the Employee
of the Month award.”
CHAPTER 17 HEALTH, WELLNESS, AND
ILLNESS
1. Which one of the following is an example
of the emotional component of wellness?
 A client expresses frustration with her
partner’s substance abuse.
2. Which individual appears to have “taken
on” the sick role?
 A mother is ill and says, “I won’t be able to
make your lunch today.”
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?
 Health belief 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 trusting relationship with the health care
provider
 An expectation that the medications will
be helpful.
 Being able to take the medications twice
daily instead of four times daily.
5. Which one of the following might be the
BEST way to measure adherence to a
prescribed medication regime?
 Direct observation of medication
administration
6. Which of the following is least likely to
influence a client’s personal definition of
health/wellness?
 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?
 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?
 Chronic illnesses are considered incurable.
9. Although not every client progresses in
order through each stage, what is the
usual sequence in Suchman’s stages of
illness?
1. Signs and symptoms appear.
2. The client takes on the sick role.
3. The client makes contact with medical
care.
4. The client takes on the dependent role.
5. The client goes into
rehabilitation/recovery.
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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.
 She feels guilty when unable to perform
her usual activities.
 She is angry and acting out.
 She shifts some responsibilities to the
spouse.
 She has fewer social interactions with her
friends.
CHAPTER 18 CULTURALLY RESPONSIVE
NURSING CARE
1. The major factor contributing to the
increased emphasis on the need for
proficiency in cultural nursing practice in
the United States is which of the
following?
 Demographic changes
2. Which behavior is an initial step in
culturally responsive nursing practice?
 Discuss the meaning of the medical
regimen with the client.
3. In initiating care for a client from a
different culture than the nurse, which of
the following would be an appropriate
statement?
 “Please let me know if I do anything that is
not acceptable in your culture.”
4. Which behavior is most representative of a
culturally competent nurse?
 Interprets and validates beliefs of a client
with African American heritage.
5. An outcome of achieving national cultural
health goals would be which of the
following?
 All U.S. residents have access to the same
quality of health care.
6. Which nursing action primarily supports
restoring HEALTH using traditional
methods?
 Herbal teas
7. A client with strong preferences for folk
healing methods would prefer which of
the following to treat a sinus infection?
 Steam humidifier
8. Which of the following factors are most
likely to be influenced by culture as
opposed to personal characteristics?
Select all that apply.
 Value of older people in society
 Gender roles
 Nonverbal gestures
 Diet
9. What is the most productive method of
gathering assessment data regarding
heritage?
 Traditional beliefs and practices checklist
10. A client who speaks limited English
requires instructions for a test. No one at
your agency speaks the person’s
language. What is the nurse’s best
approach?
 Locate a professional interpreter.
CHAPTER 19 COMPLEMENTARY AND
ALTERNATIVE HEALING MODALITIES
1. A client asks the nurse the differences
between traditional therapies and
alternative therapies. What is the best
response?
 Alternative therapies can be as effective as
traditional therapies for some
conditions.
2. Before meeting with a client with a
terminal illness, a new graduate nurse
reviews information on spirituality. Which
is the best explanation of spirituality?
 That which gives people purpose and
meaning in their lives.
3. Which nursing action is most likely to
create a healing environment?
 Empower clients to make healthy decisions
for themselves.
4. A client asks the nurse to state one of the
primary principles associated with
naturopathy. Which of the following is the
best response?
 It is a way of life to maintain health and
prevent disease.
5. From the perspective of traditional Chinese
medicine, which is the best definition of
disease?
 Imbalance or interruption in the flow of qi
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6. A client asks how herbs are similar to
prescribed medications. What is the
nurse’s best answer?
 “Thirty percent of current prescription
drugs are derived from plants.”
7. What is a rationale for assessment of
clients’ use of herbs?
 There are potential adverse interactions
between some herbs and some
medications.
8. Which oils may be placed directly on the
skin?
 Lavender and tea tree
9. What are the effects of massage as a
manual healing method? Select all that
apply.
 Communication and caring
 Mental and physical relaxation
 Speeds the removal of waste products
 Lowers blood pressure and heart rate
10. Your friend is considering in vitro
fertilization in hopes of becoming
pregnant. Which one of the following is
an accurate statement?
 “There is some evidence that acupuncture
improves the chance of pregnancy in
this situation.”
UNIT 5 LIFE SPAN DEVELOPMENT
CHAPTER 20 CONCEPTS OF GROWTH AND
DEVELOPMENT
1. The parents of a 5-month-old infant and a
3-year-old child ask the nurse about the
sequence and timing of developmental
milestones for the infant. Which is the
most appropriate response?
 “The sequence of reaching each milestone
should follow the same pattern but may
be at a different rate.”
2. The nurse knows that the study of growth
and development is an exploration of
which of the following?
 Physical developments and the increasing
level and progression of function and
skill of the growing child
3. The nurse examines a 2-year-old child
recently hospitalized with pneumonia.
Which pattern of behavior is most likely
to be exhibited by the child?
 Fusses, cries, and pushes the nurse away
during assessment of the breath sounds.
4. A 14-year-old is scheduled to have surgical
repair of a spinal curvature (scoliosis). The
adolescent will be hospitalized for about 2
weeks. Which nursing intervention will be
most helpful during the hospital stay?
 Encourage her to arrange for her teachers
to provide her with homework.
5. A 65-year-old man who recently retired
from 40 years of work as an independent
contractor is scheduled for a physical
examination. The nurse should be
concerned about which comment?
 “Every day, when I wake up, it’s hard to
find a reason to get out of bed.”
6. An 11-year-old child is scheduled for a
yearly physical examination. The
accompanying parent expresses concern
because the child “seems all wrapped up
in the soccer teammates and other peers,
leaving very little time for the family.”
Using Havighurst’s developmental tasks,
what would be the nurse’s best response?
 “Although this is normal for 11-year-olds,
this transition can be difficult for
families.”
7. A nurse decides that a review of which
theorist would be helpful before teaching
4-and 5-year olds in a preschool class how
to brush their teeth?
 Erikson
8. A 5-year-old boy arrives for the
preadmission work-up for a surgical
procedure. When the nurse brings in the
intravenous (IV) control pump the child
states: “It’s going to bite me because I
have been bad.” Using knowledge of
Piaget, Erikson, and Fowler, which is the
best nursing action?
 Reassure him by providing opportunities to
touch and explore the machine, as well
as explaining how it works.
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9. A 15-month-old is admitted to the hospital
for hernia surgery. When his mother
leaves him, he cries inconsolably. Using
knowledge of attachment theory and
cognitive theory, which is the best nursing
action?
 Encourage his mother to stay with him as
much as possible.
10. Which behavior is of most concern to the
nurse caring for a 25-year-old client after
surgery for an appendectomy?
 The client states: “I have no problem living
at my parents’ house. They have lots of
room and money and it’s a very
comfortable and easy lifestyle for me.”
CHAPTER 21 PROMOTING HEALTH FROM
CONCEPTION THROUGH ADOLESCENCE
1. The parent of an 8-month-old girl who has
been admitted to the hospital with
pneumonia is worried about the infant
having sudden infant death syndrome
(SIDS). The parent stated that “My sister’s
baby died at the age of 2 months and all
he had was a little cold.” Which is the
nurse’s best response?
 “You must be very anxious; let’s talk about
SIDS and what you are thinking.”
2. Four-year-old Angie, whose grandmother
recently died, tells the nurse, “My
grandma has wings just like angels. She
flew to heaven yesterday and tomorrow
she’ll be back.” Which is the nurse’s best
response?
 “You must miss your grandma a lot.”
3. Because near-drowning is one of the
leading causes of vegetative state in
young children, which is the best
instruction for the nurse to teach
parents?
 Supervise children at all times when near
any source of water.
4. Which statement most accurately
describes physical development during
the school-age years?
 Child acquires stereognosis.
5. Females experience an increase in weight
and fat deposition during puberty. Which
nursing action is most appropriate to this
age group?
 Give reassurance that these changes are
normal.
6. A night shift nurse notices that a
postpartum (after delivery of a baby)
client is crying and rubbing her baby’s
head. The mother states, “Look how
lopsided my little Sam’s head is. It is all
my fault. My mom told me that I should
have laid down more instead of sitting.
Now, Sam’s head is all smashed and funny
looking.” Which is the best response by
the nurse?
 “The head is soft and changed shape as it
moved through the birth canal.”
7. During a physical examination a 24-monthold child clings to the parent and cries
every time the nurse attempts to touch
her. From knowledge of psychosocial
development, the nurse makes which
conclusion about the child?
 The child is displaying normal toddler
development.
8. After falling off playground equipment, a 5year-old is brought to the emergency
department with a broken arm. The
parents ask for ways to keep her occupied
while wearing the cast. Which is the best
response by the nurse?
 “Activities that do not involve the use of
the arm or risk damage to the cast are
okay.”
9. According to Piaget’s theory of cognitive
development, the movement from
intuitive reasoning to logical reasoning in
school-age children is called the concrete
operations phase. Which is an example of
this phase?
 A science-fair project comparing how fast
different objects fall from a set height.
10. Parents ask the nurse how they will know
that their daughter has reached puberty.
Which is the best response by the nurse?
 “The first noticeable sign of puberty in
females is appearance of the breast
bud.”
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CHAPTER 22 PROMOTING HEALTH IN YOUNG
AND MIDDLE-AGED ADULTS
1. Because a 45-year-old woman is worried
that she still has regular menstrual
periods, she asks about menopause.
Which answer by the nurse is most
appropriate?
 “It is common for women to experience
menopause in their late 40s.”
2. A nurse is planning a teaching session on a
wellness topic. Which adult generation
group would be most likely to be skeptical
about health teaching by the nurse?
 Generation X
3. A woman is seen at her primary care
provider’s office. She has been losing
weight and not feeling well. She is 44
years old. What is the leading cancer
death in female clients between the ages
of 25 and 64?
 Lung cancer
4. The nurse is planning an educational
program on sexually transmitted
infections (STIs) for young adults. Which
topic should be given priority?
 Chlamydia
5. Which statement about moral
development in adults is the most
correct?
 Moral development continues throughout
adulthood.
6. If the nurse were assessing the status of a
middle-aged client’s psychosocial
development, which activity should be
the focus?
 Balancing the needs of others
7. The nurse is developing a health
promotion teaching plan for a community
group of middle-aged adults. Information
about which immunizations should be
included?
 Influenza, pneumococcal
8. When planning a screening program for
cardiovascular disease in the middle-aged
adult, the nurse has limited funds and
decides to address which significant
elements? Select all that apply.
 Blood pressure measurement
 Electrocardiogram
 Cholesterol measurement
 Activity level
9. A woman comes into the emergency
department with multiple bruises about
the face and head. The nurse suspects
that IPV may be related to the injuries.
What is the most appropriate action for
the nurse to take at this time?
 Ask the person if she is afraid of someone
at home who is hurting her.
10. The nurse is completing a health history
on a 24-year-old male. Which activity is
the best indicator of appropriate
psychosocial development?
 Decorating his new apartment
CHAPTER 23 PROMOTING HEALTH IN OLDER
ADULTS
1. The nurse provides care for an older adult
whose husband died 8 months ago. Which
of the following behaviors indicates that
the client is experiencing effective
coping? Select all that apply.
 Shows the nurse photographs of her
family.
 Visits her husband’s grave every 2 weeks.
 Attends church on a regular basis.
2. A nurse in a long-term care facility is caring
for several older adults with noticeable
hearing losses. Which is the best way for
the nurse to communicate with these
clients?
 Speak in a low and distinct voice tone.
3. The nurse observes that an 85-year-old
man at an adult day care center fondly
shares stories about traveling on the
“orphan trains” and his subsequent
adoption. Following a behavioral
assessment, the nurse should perform
which interventions?
 Listen and ask him questions about his life.
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4. The home health nurse evaluates an older
adult for depression. The client’s daughter
is present and comments, “I don’t see the
need for this evaluation. Aren’t all older
people depressed?” Which is the nurse’s
best initial response?
 “Depression is not a normal part of aging.”
5. While being admitted to a rehabilitation
unit, an 82-year-old woman mentions to
the nurse that she “has trouble holding
her water,” adding “if I could have that
tube back in me like I had in the hospital, I
wouldn’t have so many accidents.” What
is the nurse’s best response?
 “Tell me more about your problem.”
6. The nurse notices that when an 80-yearold man rises from a seated position, the
client uses both arms to push himself up,
and also “rocks” back and forth before
finally standing. What is the most
appropriate nursing intervention for this
client?
 Suggest a referral to physical therapy for
strengthening exercises.
7. A healthy 78-year-old woman who is
considering marriage to a healthy 79year-old neighbor tells the nurse that she
wonders if they will be able to have sexual
intercourse. Which is the nurse’s most
appropriate response?
 “Both of you may have slower responses to
sexual stimulation.”
8. The client complains of having difficulty
clearly seeing the words in the newspaper
unless he holds the newspaper an arm’s
length away. The nurse uses which
terminology to document this
assessment?
 Presbyopia
9. The nursing student is planning care for an
older adult who had a total knee
replacement yesterday evening. Which
nursing intervention would be most
appropriate?
 Tell the client that he needs to rest and will
be given a complete bed bath.
10. A 76-year-old woman with dementia lives
in an assisted living facility and often asks,
“When will my sister come to visit me this
afternoon?” The sister passed away last
year. Which is the best response from the
nurse?
 “I understand you want her to visit you.
Where did you and your sister grow
up?”
CHAPTER 24 PROMOTING FAMILY HEALTH
1. Because a severely injured middle-aged
client informed the nurse that he did not
have any immediate family members, the
nurse contacted extended family
members. Which of the following is most
representative of extended family
members?
 Grandparents, aunts, and uncles
2. Examine Figures 24–3 and 24–4 on pages
390–391. Based on the information in
these two diagrams, which family
member is at greatest risk for developing
a health problem?
 Mary
3. What should a nurse instruct a client who
identifies “the family” as two college
roommates, a dog, and a cat when
completing a family health history form?
 Include all information about blood
relatives and the animals and
roommates that might influence his
health.
4. A visual representation of family members
by sex, age, health status, and lines of
relationships through the generations is
referred to as a _________.
 Genogram
5. To assess the impact of illness on the
family as a unit, it is essential for the
nurse to assess which factors? Select all
that apply.
 The duration of the illness
 The meaning of the illness to the family
and its significance to family systems
 The financial impact of the illness
(including factors such as insurance and
ability of the ill member to work)
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6. An adult child brings a parent to an agency
with signs and symptoms of potential
fluid retention (e.g., high blood pressure,
swollen feet) possibly related to excessive
sodium intake. Further nursing
assessment indicates inadequate food
storage and preparation techniques in the
home. Which would be the most
appropriate nursing diagnosis?
 Readiness for Enhanced Family Coping
7. Prior to finalizing a family-oriented nursing
care plan and implementing
interventions, it is essential for the nurse
to perform which of the following?
 Establish a trusting relationship with the
family as a group.
8. Nurses often utilize systems theory to
assess family units. Which example
illustrates a family unit that does NOT
meet the criteria of a well-functioning
system?
 The primary activities of each member
focus on personal purposes.
9. What is a primary function of a family?
 Provide an environment that supports
growth of individuals.
10. Which family risk factor for developing a
health problem is of highest priority for
the nurse to address?
 The primary wage earner for a family of
five has recently been let go from the
job and lost health insurance.
UNIT 6 INTEGRAL ASPECTS OF NURSING
CHAPTER 25 CARING
CHAPTER 26 COMMUNICATING
CHAPTER 27 TEACHING
CHAPTER 28 LEADING, MANAGING, AND
DELEGATING
UNIT 6 INTEGRAL ASPECTS OF NURSING
CHAPTER 25 CARING
CHAPTER 21 PROMOTING HEALTH FROM
CONCEPTION THROUGH ADOLESCENCE