NUR3056 EOC Questions Test 1

1

The nurse supports a patient’s decision to decline more cancer treatment and to be cared for by a hospice team, even though the nurse personally thinks the patient should seek more treatment. The nurse is practice which nursing role?

1. advocacy

2. change agent

3. leader

4. collaborator

1, 2, 3, 5

1. A profession has specific characteristics. In regard to how nursing meets these characteristics, Which criteria are consistent and standardized processes? (Select all that apply)

   1. Code of ethics

   2. Licensing

   3. Body of knowledge

   4. Educational preparation

   5. Altruism

2

1. What specific aspect of a profession does the development of theories provide?

   1. Altruism

   2. Body of knowledge

   3. Autonomy

   4. Accountability

3

Health care workers are discussing a diverse group of patients respectfully and are being responsive to the health beliefs and practices of these patients. What important aspect of nursing professional practice are they exhibiting?

1. Autonomy

2. Accountability

3. Cultural competence

4. Autocratic leadership

3

A nurse makes a medication error and reports it immediately. Which professional characteristic is demonstrated?

1. Autonomy

2. Collaboration

3. Accountability

4. Altruism

a, c

Included in ANA Standards of Professional Nursing Practice (Select all that apply)

a.        Standards of professional performance

b.        Code of ethics

c.        Standards of practice

d.        Legal scope of practice

e.     Licensure requirements

d

Which APRN core competency is exhibited when counseling a student nurse in therapeutic communication?

a.        Leadership

b.        Ethical decision-making

c.        Direct clinical practice

d.        Expert coaching

a, b, d

Components discussed in nursing theories (Select all that apply)

a.        Optimal functioning of the patient

b.        Interaction with components of the environment

c.        The conceptual makeup of the administration of the hospital

d.        The illness and health concept

e.     Safety aspect of medication administration

a, b, d

Factors affecting the nursing shortage (Select all that apply)

a.        Aging faculty

b.        Increasing elderly population

c.        Job satisfaction due to adequate number of nurses

d.        Aging nursing workforce

e.    Greater autonomy for nurses

b

A nurse performs a physical exam and reviews lab results. The nurse is performing which function?

a.        Diagnosis

b.        Assessment

c.        Education

d. Advocacy

c

What is the purpose of the nursing process?

a.        Providing patient-centered care

b.        Identifying members of the health care team

c.        Organizing the way nurses think about patient care

d.        Facilitating communication among health care team members

c

A hospitalized patient experiences a sharp, stabbing pain while visiting with his spouse. Both the patient and his wife become very concerned, and the patient’s call light is activated. What referent initiated the communication between the patient and the nurse?

a. Interaction between the patient and his wife

b. Concern on the part of the patient’s spouse

c. Pain experienced by the patient

d. Activation of the call light

a, b, c, d

Which factors influence whether a message is effectively communicated? (Select all that apply.)

a. Timing of the conversation

b. Educational level of participants

c. Mode of communication used

d. Physical environment of discussion

b

If a patient is grimacing, what assessment statement or question would be most beneficial in identifying the underlying cause of the nonverbal communication?

a. “Did you lose something?”

b. “You appear to be having pain.”

c. “I will turn off the lights and let you rest.”

d. “May I get you something to relieve your tension?”

a

What action by the nurse would most ensure accurate interpretation of patient communication?

a. Providing feedback regarding the conveyed message

b. Writing down the patient’s conversational highlights

c. Assuming significant cultural differences exist

d. Verifying the patient’s emotional state

b

If a patient’s verbal and nonverbal communications are inconsistent, which form of communication is most likely to convey the true feelings of the patient?

a. Written notes

b. Facial expressions

c. Implied inferences

d. Spoken words

a

What strategy would be most effective in communicating with a highly anxious adult immediately before surgery?

a. Providing specific, concise instructions

b. Detailing likely causes of the patient’s anxiety

c. Focusing on postoperative details

d. Using instructional multimedia DVDs

c

What is the first action the nurse should take if an alert and oriented patient asks the nurse for personal contact information?

a. Ask the patient why the personal information is needed.

b. Report the interaction to the nursing supervisor immediately.

c. State that it would not be appropriate to share that information.

d. Change the subject and hope that the patient does not ask again.

c

What would be the best therapeutic response to a patient who expresses indecision about recommended chemotherapy treatments?

a. “Can you tell me why you are undecided?”

b. “It’s always a good idea to have chemotherapy.”

c. “What are you thinking about the treatments at this point?”

d. “You should follow whatever your health care provider recommends.”

4

Which statement is most accurate regarding symbolic expression?

1. Skills confidence can be shared most effectively by nurses through wearing distinctive clothing.

2. Clothing choices by a hospitalized patient rarely reflects the patient’s economic resources.

3. Make-up use by a patient is unnecessary for any reason during hospitalization.

4. Nondramatic make-up use and minimal accessorizing by nurses demonstrates professionalism.

b

Which defense mechanism is being exhibited when a 27-year-old patient insists on having a parent present during routine care?

a. Denial

b. Regression

c. Repression

d. Displacement

a

The student nurse is preparing for the first clinical day of patient care. Which strategy of critical thinking would be an example of thinking ahead?

a. Researching evidence-based care strategies

b. Assessing the patient’s physical status

c. Identifying and preventing patient risk

d. Deciding what component of care could be improved

a, b, c, e

Which educational activities will promote the development of clinical judgment skills in nurses and student nurses? (Select all that apply.)

a. Unfolding case studies

b. Clinical assignments

c. Simulation of clinical scenarios

d. Answering true/false test questions

e. Concept mapping

f. Completing math calculations

c

The nurse is completing a patient assignment and will use information gathered to identify problems and work to prevent complications. In the National Council of State Boards of Nursing-Clinical Judgment Measurement Model (NCSBN-CJMM), this activity occurs in which step?

a. Take action

b. Outcome evaluation

c. Recognize cues

d. Analyze signs

a

The nurse recognizes that in Tanner’s Clinical Judgment Model, which statement best explains the step of interpreting?

a. The nurse engages in clinical reasoning to analyze what is occurring and to form a hypothesis.

b. After actions are considered for care, the nurse weighs the potential outcomes of those interventions.

c. The nurse gets the initial grasp of the patient’s situation.

d. The nurse “reads” the patient and adjusts interventions based on this assessment.

a, b, c

The nurse obtains a lower-than-normal (88% on room air) pulse oximetry reading on a patient. Which actions by the nurse result from accurately employing the clinical judgment attribute of early problem recognition? (Select all that apply.)

a. Assessing the patient for symptoms of hypoxia

b. Providing oxygen according to standing orders

c. Elevating the head of the bed, if not contraindicated

d. Allowing the patient to be alone to rest more comfortably

e. Discussing adaptations needed for daily activities with the patient

d

The nurse categorizes which nursing action as an example of professional autonomy?

a. The nurse working on a medical unit contacts the respiratory therapist to draw arterial blood gases (ABGs) for a patient with acute asthma.

b. The novice nurse seeks out an experienced colleague for guidance when preparing to administer blood.

c. The nurse contacts the PCP for clarification of a medication order.

d. The experienced nurse who works in the intensive care unit draws ABGs for an assigned ICU patient

a, c, d

The nurse identifies that confidence is one of the attributes of successful clinical judgment. Which statements by the nurse are accurate regarding this attribute? (Select all that apply.)

a. “Nurses who are confident are more assertive.”

b. “Overconfidence occurs with increased experience.”

c. “Legitimate confidence results from knowledge and willingness to seek guidance from expert practitioners.”

d. “Overconfidence may lead to negative patient outcomes.”

e. “Confidence in actions is simply reacting to problems.”

b

The nurse administers an IV pain medication that has an onset of 5 minutes to a patient who is reporting a pain level of 9/10. When the patient does not begin to get relief after the 5-minute time frame, the nurse immediately looks for interventions to help reduce the pain level. This response is an example of what aspect of Tanner’s Clinical Judgment Model?

a. Reflection-on-action

b. Reflection-in-action

c. Analysis of cues

d. Information seeking

a, d, e

The nurse recognizes which environmental factors that influence clinical judgment skills? (Select all that apply.)

a. Cultural values

b. Literature review

c. Cue analysis

d. Complexity of tasks

e. Interruptions

a, a, c, a, c, a, c

During the assessment of a patient admitted for a total hip replacement, the nurse asks the patient to explain prior hospital experiences and, more specifically, any operative experiences. These questions reflect the nurse’s use of which clinical judgment attributes? For each potential put an a if effective, b if ineffective, or c if unrelated:

Answer:

Clinical judgment attributes	effective	ineffective	unrelated
Early problem recognition
Strong knowledge base
Self-awareness
Intuition
Proficient technical skills
Effective communication
Courageous

d

A patient comes to the emergency department complaining of nausea and vomiting. What should the nurse ask the patient about first?

a. Family history of diabetes

b. Medications the patient is taking

c. Operations the patient has had in the past

d. Severity and duration of the nausea and vomiting

d

An alert, oriented patient is admitted to the hospital with chest pain. From whom should the nurse collect primary data on this patient?

a. Family member

b. Physician

c. Another nurse

d. Patient

b

What is the primary purpose of the nursing diagnosis?

a. Resolving patient confusion

b. Communicating patient needs

c. Meeting accreditation requirements

d. Articulating the nursing scope of practice

a, c

On what premise is a nursing diagnosis identified for a patient? (Select all that apply.)

a. Recognized cues

b. Nursing intuition

c. Clustered data

d. Medical diagnoses

a

Which statement is an appropriately written short-term goal?

a. Patient will walk to the bathroom independently without falling within 2 days after surgery.

b. Nurse will watch patient demonstrate proper insulin injection technique each morning.

c. Patient’s spouse will express satisfaction with patient’s progress before discharge.

d. Patient’s incision will be well approximated each time it is assessed by the nurse.

a

What should be the primary focus for nursing interventions?

a. Patient needs

b. Nurse concerns

c. Physician priorities

d. Patient’s family requests

c

Which nursing action is critical before delegating interventions to another member of the health care team?

a. Locate all members of the health care team.

b. Notify the physician of potential complications.

c. Know the scope of practice and competency of the other team member.

d. Call a meeting of the health care team to determine the needs of the patient

a

A patient reports feeling tired and complains of not sleeping at night. What action should the nurse perform first?

a. Consider possible reasons for the patient’s inability to sleep.

b. Request medication to help the patient sleep.

c. Tell the patient that sleep will come with relaxation.

d. Notify the physician that the patient is restless and anxious.

c

What action should the nurse take regarding a patient’s plan of care if the patient appears to have met the short-term goal of urinating within 1 hour after surgery?

a. Consult the surgeon to see whether the clinical pathway is being followed.

b. Discontinue the plan of care because the patient has met the established goal.

c. Monitor patient urine output to evaluate the need for the current plan of care.

d. Notify the patient that the goal has been attained and no further intervention is needed.

c

Which action by a patient marks the beginning of the physical assessment process?

a. Redressing after a physical examination

b. Breathing normally during auscultation

c. Greeting the nurse in the examination room

d. Sharing work environment information

a, b, c, d

Which factors should be taken into consideration by the nurse before and during a patient interview? (Select all that apply.)

a. Distance between the chairs in which the nurse and patient are sitting

b. Traditional treatments typically used by the patient to treat disease

c. Gender preference for primary care providers (PCPs)

d. Physical condition of the patient

e. Music preference of the patient

b

Which action by the nurse is most appropriate during the orientation phase of the patient interview?

a. Always position patients in a comfortable reclined position to ensure their comfort during questioning.

b. Ask which name a patient prefers to be called during care to show respect and build trust.

c. Quickly conduct a review of systems to determine the need for a complete or focused assessment

d. Begin with questions about intimacy and sexuality to address sensitive issues first.

b, d

Which activity by the nurse best demonstrates part of the working phase of a patient interview? (Select all that apply.)

a. Summarizing previously discussed key topics

b. Including selected family members in care planning

c. Transferring care responsibilities to the home health nurse

d. Discussing health promotion activities that could be beneficial

c

Which entry in a patient’s electronic health record best indicates the need for a nurse to gather secondary rather than primary subjective data?

a. Complaining of chest pain

b. Apical pulse 110

c. Comatose

d. Difficulty swallowing

d

Which line of questioning by the nurse best represents an appropriate approach to the review of systems aspect of the assessment process?

a. “What do you do for a living? Can you describe your work environment?”

b. “Is there a family history of heart disease, cancer, high blood pressure, or stroke?”

c. “When was your last annual physical? What immunizations did you receive at that time?”

d. “Do you have any chest tightness, shortness of breath, or difficulty breathing while exercising?”

a

Which cue by a patient can be validated by laboratory and diagnostic test results?

a. Deeply sighing with fatigue

b. Bilateral crackles in the lungs

c. Oxygen saturation of 98% on room air

d. 2+ pitting edema of the ankles and feet

d

A patient discusses his job stress and family relationships with the nurse during his health history interview. In which organizational framework is this type of data likely to be recorded most extensively?

a. Body systems model

b. Physical assessment model

c. Head-to-toe assessment model

d. Functional health patterns model

c

When initiating a physical examination, which action should the nurse take first?

a. Review of the patient’s prior medical records

b. Gather admission health history forms

c. Assess the patient’s vital signs

d. Perform light and deep palpation for fluid

d

If the nurse discovers that a patient’s right elbow is swollen and painful during a physical examination, which action should the nurse take next?

a. Apply ice to decrease swelling and reduce pain

b. Percuss the area to determine the presence of fluid

c. Perform passive range of motion to promote flexibility

d. Inspect the patient’s left elbow to compare its appearance