Fundamentals of Nursing Quiz | Practice MCQ #mcq.imBooz

• (A) Sitting upright
• (B) Lying flat on the back with knees flexed
• (C) Lying flat on the back with arms and legs fully extended
• (D) Side-lying with the knees flexed

Check AnswerSolution[A]:- If the patient is able, the nurse should have the patient sit upright to obtain vital signs in order to allow the nurse to easily access the anterior and posterior chest for auscultation of heart and breath sounds. It allows for full lung expansion and is the preferred position for measuring blood pressure. Additionally, patients might be more comfortable and feel less vulnerable when sitting upright (rather than lying down on the back) and can have direct eye contact with the examiner. However, other positions can be suitable when the patient’s physical condition restricts the comfort or ability of the patient to sit upright.

• (A) Ongoing assessment
• (B) Comprehensive physical assessment
• (C) Focused physical assessment
• (D) Psychosocial assessment

Check AnswerSolution[C]:- The nurse is performing a focused physical assessment, which is done to obtain data about an identified problem, in this case shortness of breath. An ongoing assessment is performed as needed, after the initial data are collected, preferably with each patient contact. A comprehensive physical assessment includes an interview and a complete examination of each body system. A psychosocial assessment examines both psychological and social factors affecting the patient. The nurse conducting a psychosocial assessment would gather information about stressors, lifestyle, emotional health, social influences, coping patterns, communication, and personal responses to health and illness, to name a few aspects.

• (A) Used a vague generality
• (B) Recorded an inference rather than a cue
• (C) Used a “waffle” word (e.g., appears)
• (D) All of the above

Check AnswerSolution[D]:- The nurse recorded a vague generality: “he has had a good night.” The nurse did not use the patient’s exact words, but she did not quote the patient at all, so that is not one of her errors. The nurse used the “waffle” word, “seems” worried instead of documenting what the patient said or did to lead her to that conclusion. The nurse recorded these inferences: worried and had a good night.

• (A) A body systems model
• (B) A head-to-toe framework
• (C) Maslow’s hierarchy of needs
• (D) Maslow’s hierarchy of needs and Gordon’s functional health patterns

Check AnswerSolution[D]:- Nursing models produce a holistic database that is useful in identifying nursing rather than medical diagnoses. Body systems and head-to-toe are not nursing models, and they are not holistic; they focus on identifying physiological needs or disease. Maslow’s hierarchy is not a nursing model, but it is holistic, so it is acceptable for identifying nursing diagnoses. Gordon’s functional health patterns are a nursing model.

• (A) Recording all the information on the agency-approved form during the interview
• (B) Asking the client, “Why did you think it was necessary to seek health care at this time?”
• (C) Using precise medical terminology when asking the client questions
• (D) Sitting, facing the client in a chair at the client’s bedside, using active listening

Check AnswerSolution[D]:- Active listening should be used during an interview. The nurse should face the patient, have relaxed posture, and keep eye contact. Asking “why” may make the client defensive. Note-taking interferes with eye contact. The client may not understand medical terminology or health care jargon.

• (A) The urinalysis report indicates there are white blood cells in the urine.
• (B) The client states she feels feverish; you measure the oral temperature at 98�F.
• (C) The client has clear breath sounds; you count a respiratory rate of 18.
• (D) The chest x-ray report indicates the client has pneumonia in the right lower lobe.

Check AnswerSolution[B]:- Validation should be done when subjective and objective data do not make sense. For instance, it is inconsistent data when the patient feels feverish and you obtain a normal temperature. The other distractors do not offer conflicting data. Validation is not usually necessary for laboratory test results.

• (A) American Nurses Association (ANA)
• (B) State nurse practice acts
• (C) National Council of State Boards of Nursing (NCSBN)
• (D) The Joint Commission

Check AnswerSolution[D]:- The Joint Commission has developed assessment standards, including that all clients be assessed for pain. The ANA has developed standards for clinical practice, including those for assessment, but not specifically for pain. State nurse practice acts regulate nursing practice in individual states. The NCSBN asserts that the scope of nursing includes a comprehensive assessment but does not specifically include pain.

• (A) Theoretical knowledge
• (B) Self-knowledge
• (C) Using reliable resources
• (D) Use of the nursing process

Check AnswerSolution[B]:- Personal knowledge (2) is self-understanding-awareness of one’s beliefs, values, biases, and so on. That best describes the nurse’s awareness that her bias can affect her patient care. Theoretical knowledge consists of information, facts, principles, and theories in nursing and related disciplines; it consists of research findings and rationally constructed explanations of phenomena. Using reliable resources is a critical thinking skill. The nursing process is a problem-solving process consisting of the steps of assessing, diagnosing, planning outcomes, planning interventions, implementing, and evaluating. The nurse has not yet met this patient, so she could not have begun the nursing process.

• (A) Influences on the nurse’s problem solving and decision making
• (B) Like feelings rather than cognitive activities
• (C) Cognitive activities rather than feelings
• (D) Applicable in all aspects of a person’s life

Check AnswerSolution[A]:- Cognitive skills are used in complex thinking processes, such as problem solving and decision making. Critical thinking attitudes determine how a person uses her cognitive skills. Critical thinking attitudes are traits of the mind, such as independent thinking, intellectual curiosity, intellectual humility, and fair-mindedness, to name a few. Critical thinking skills refer to the cognitive activities used in complex thinking processes. A few examples of these skills involve recognizing the need for more information, recognizing gaps in one’s own knowledge, and separating relevant from irrelevant data. Critical thinking, which consists of intellectual skills and attitudes, can be used in all aspects of life.

• (A) E, B, A, D, C
• (B) A, B, C, D, E
• (C) A, E, C, D, B
• (D) D, A, B, E, C

Check AnswerSolution[C]:- Logically, the steps are assessment, diagnosis, planning outcomes, planning interventions, and evaluation. Keep in mind that steps are not always performed in this order, depending on the patient’s needs, and that steps overlap.

• (A) Identify personal biases that may affect his thinking and actions
• (B) Identify the most effective interventions for a patient
• (C) Communicate more efficiently with colleagues, patients, and families
• (D) Learn and remember new procedures and techniques

Check AnswerSolution[A]:- The most basic reason is that self-knowledge directly affects the nurse’s thinking and the actions he chooses. Indirectly, thinking is involved in identifying effective interventions, communicating, and learning procedures. However, because identifying personal biases affects all the other nursing actions, it is the most basic reason.

• (A) Assessment
• (B) Diagnosis
• (C) Planning outcomes
• (D) Evaluation

Check AnswerSolution[D]:- In the assessment phase, the nurse gathers data from many sources for analysis in the diagnosis phase. In the diagnosis phase, the nurse identifies the client’s health status. In the planning outcomes phase, the nurse and client decide on goals they want to achieve. In the intervention planning phase, the nurse identifies specific interventions to help achieve the identified goal. During the implementation phase, the nurse carries out the interventions or delegates them to other health care team members. During the evaluation phase, the nurse judges whether her actions have been successful in treating or preventing the identified client health problem.

• (A) Assessment
• (B) Diagnosis
• (C) Planning outcomes
• (D) Evaluation

Check AnswerSolution[B]:- In the assessment phase, the nurse gathers data from many sources for analysis in the diagnosis phase. In the diagnosis phase, the nurse identifies the client’s health status. In the planning outcomes phase, the nurse formulates goals and outcomes. In the evaluation phase, which occurs after implementing interventions, the nurse gathers data about the client’s responses to nursing care to determine whether client outcomes were met.

• (A) Are important to use in nursing practice
• (B) Use an ordered series of steps
• (C) Are patient-specific processes
• (D) Were developed specifically for nursing

Check AnswerSolution[A]:- Nurses make many decisions: some require using the nursing process, whereas others are not client related but require critical thinking. The nursing process has specific steps; critical thinking does not. Neither is linear. Critical thinking applies to any discipline.

• (A) Antibiotics are ineffective in treating viral infections.
• (B) When you take a patient’s blood pressure, the patient’s arm should be at heart level.
• (C) In Maslow’s framework, physical needs are most basic.
• (D) When drawing medication out of a vial, inject air into the vial first and Antibiotics are ineffective in treating viral infections.

Check AnswerSolution[D]:- Theoretical knowledge consists of research findings, facts (e.g., “Antibiotics are ineffective . . .” is a fact), principles, and theories (e.g., “In Maslow’s framework . . .” is a statement from a theory). Instructions for taking a blood pressure and withdrawing medications are examples of practical knowledge-what to do and how to do it.

• (A) Respiratory therapist
• (B) Occupational therapist
• (C) Dentist
• (D) Speech therapist

Check AnswerSolution[D]:- Respiratory therapists provide care for patients with respiratory disorders. Occupational therapists help patients regain function and independence. Dentists diagnose and treat dental disorders. Speech and language therapists provide assistance to clients experiencing swallowing and speech disturbances. They assess the risk for aspiration and recommend a treatment plan to reduce the risk.

• (A) Team nursing
• (B) Case method nursing
• (C) Functional nursing
• (D) Primary nursing

Check AnswerSolution[C]:- With team nursing, an RN or LVN is paired with a NAP. The pair is then assigned to render care for a group of patients. In case method nursing, one nurse cares for one patient during her entire shift. Private duty nursing is an example of this care model. This medical surgical floor is following the functional nursing model of care, in which care is partitioned and assigned to a staff member with the appropriate skills. For example, the NAP is assigned vital signs, and the LVN is assigned medication administration. When the primary nursing model is utilized, one nurse manages care for a group of patients 24 hours a day, even though others provide care during part of the day.

• (A) Established standards of care
• (B) Professional organizations
• (C) Practice supported by scientific research
• (D) Activities determined by a scope of practice

Check AnswerSolution[C]:- The American Nurses Association (ANA) has developed standards of care, but they are unrelated to defining nursing as a profession or discipline. Having professional organizations is not included in accepted characteristics of either a profession or a discipline. A profession must have knowledge that is based on technical and scientific knowledge. The theoretical knowledge of a discipline must be based on research, so both are scientifically based. Having a scope of practice is not included in accepted characteristics of either a profession or a discipline.

• (A) Administering an antibiotic every day AND Assessing a client’s surgical incision
• (B) Teaching the importance of hand washing
• (C) Assessing a client’s surgical incision
• (D) Advising a woman to get an annual mammogram after age 50 years

Check AnswerSolution[A]:- Health restoration activities help an ill client return to health. This would include taking an antibiotic every day and assessing a client’s surgical incision. Hand washing and mammograms both involve healthy people who are trying to prevent illness.

• (A) The military
• (B) General hospitals
• (C) Civil service
• (D) Religious orders

Check AnswerSolution[D]:- When the Civil War broke out, the Army used nurses who had already been trained in religious orders. Although the Army did provide some training, it occurred later than in the religious orders. Although nurses were trained in hospitals, the training and the hospitals were affiliated with religious orders. Civil service was not mentioned in Chapter 1 and was not a factor in the early 1800s. Nursing started with religious orders. The Hindu faith was the first to write about nursing. In the United States, all training for nurses was affiliated with religious orders until after the Civil War.