Davis Advantage Basic Nursing- Thinking Doing and Caring 3rd Edition Treas Wilkinson Test Bank (1)

www.mynursingtestprep.comDavis Advantage Basic Nursing: Thinking, Doing, and Caring 3rd Edition Treas Wilkinson Test Bank Chapter 1 Evolution of Nursing Thought & Action Multiple Choice Identify the choice that best completes the statement or answers the question. 1. What is the most influential factor that has shaped the nursing profession? 1) Physicians need for handmaidens 2) Societal need for healthcare outside the home 3) Military demand for nurses in the field 4) Germ theory influence on sanitation ANS: 3 Throughout the centuries, stability of the government has been related to the success of the military to protect or extend its domain. As the survival and well-being of soldiers is critical, nurses provided healthcare to the sick and injured at the battle site. The physicians handmaiden was/is a nursing stereotype rather than an influence on nursing. Although there has been need for healthcare outside the home throughout history, this has more influence on the development of hospitals than on nursing; this need provided one more setting for nursing work. Germ theory and sanitation helped to improve healthcare but did not shape nursing. PTS: 1 DIF: Moderate REF: dm 910 KEY: Nursing process: N/A Client need: N/A | Cognitive level: Recall 2. Which of the following is an example of an illness prevention activity? Select all that apply. 1) Encouraging the use of a food diary 2) Joining a cancer support group 3) Administering immunization for HPV 4) Teaching a diabetic patient about his diet ANS: 3 Administering immunization for HPV is an example of illness prevention. Although cancer is a disease, it is assumed that a person joining a support group would already have the disease; therefore, this is not disease prevention but treatment. Illness-prevention activities focus on avoiding a specific disease. A food diary is a health-promotion activity. Teaching a diabetic patient about diet is a treatment for diabetes; the patient already has diabetes, so it cannot prevent diabetes. PTS: 1 DIF: Moderate REF: p. 18; high-level question, not directly stated in text KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Application 3. Which of the following contributions of Florence Nightingale had an immediate impact on improving patients health? 1) Providing a clean environment 2)

www.mynursingtestprep.comImproving nursing education 3) Changing the delivery of care in hospitals 4) Establishing nursing as a distinct profession ANS: 1 Improved sanitation (a clean environment) greatly and immediately reduced the rate of infection and mortality in hospitals. The other responses are all activities of Florence Nightingale that improved healthcare or nursing, but the impact is long range, not immediate. PTS: 1 DIF: Easy REF: V1, p. 3; student must infer from content | V1, p. 10; student must infer from content KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application 4. All of the following are aspects of the full-spectrum nursing role. Which one is essential for the nurse to do in order to successfully carry out all the others? 1) Thinking and reasoning about the clients care 2) Providing hands-on client care 3) Carrying out physician orders 4) Delegating to assistive personnel ANS: 1 A substantial portion of the nursing role involves using clinical judgment, critical thinking, and problem solving, which directly affect the care the client will actually receive. Providing hands-on care is important; however, clinical judgment, critical thinking, and problem solving are essential to do it successfully. Carrying out physician orders is a small part of a nurses role; it, too, requires nursing assessment, planning, intervention, and evaluation. Many simple nursing tasks are being delegated to nursing assistive personnel; delegation requires careful analysis of patient status and the appropriateness of support personnel to deliver care. Another way to analyze this question is that none of the options of providing hands-on care, carrying out physician orders, and delegating to assistive personnel is required for the nurse to think and reason about a clients care; so the answer must be 1. PTS:1DIFifficultREF: p. 11 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Analysis 5. Which statement pertaining to Benners practice model for clinical competence is true? 1) Progression through the stages is constant, with most nurses reaching the proficient stage. 2) Progression through the stages involves continual development of thinking and technical skills. 3) The nurse must have experience in many areas before being considered an expert. 4) The nurses progress through the stages is determined by years of experience and skills. ANS: 2 Movement through the stages is not constant. Benners model is based on integration of

www.mynursingtestprep.comknowledge, technical skill, and intuition in the development of clinical wisdom. The model does not mention experience in many areas. The model does not mention years of experience. PTS:1DIF:ModerateREF:p. 15 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall 6. Which of the following best explains why it is difficult for the profession to develop a definition of nursing? 1) There are too many different and conflicting images of nurses. 2) There are constant changes in healthcare and the activities of nurses. 3) There is disagreement among the different nursing organizations. 4) There are different education pathways and levels of practice. ANS: 2 The conflicting images of nursing make it more important to develop a definition; they may also make it more difficult, but not to the extent that constant change does. Healthcare is constantly changing and with it come changes in where, how, and what nursing care is delivered. Constant changes make it difficult to develop a definition. Although different nursing organizations have different definitions, they are similar in most ways. The different education pathways affect entry into practice, not the definition of nursing. PTS: 1 DIF: Moderate REF: p. 11; How Is Nursing Defined? KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Analysis 7. Nurses have the potential to be very influential in shaping healthcare policy. Which of the following factors contributes most to nurses influence? 1) Nurses are the largest health professional group. 2) Nurses have a long history of serving the public. 3) Nurses have achieved some independence from physicians in recent years. 4) Political involvement has helped refute negative images portrayed in the media. ANS: 1 Nurses are trusted professionals and the largest health professional group. As such, they have political power to effect changes. If nursing were a small group, there would be little potential for power in shaping policies, even if all the other answers were true. Serving the public, while positive, does not necessarily help nurses to be influential in establishing health policy. Independence from physicians, although positive, does not necessarily make nurses influential in establishing healthcare policy. Refuting negative media, although positive, does not necessarily make nurses influential in establishing healthcare policy. PTS: 1 DIF: Moderate REF: p. 21 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Analysis 8. Nursing was described as a distinct occupation in the sacred books of which faith? 1)

www.mynursingtestprep.comBuddhism 2) Christianity 3) Hinduism 4) Judaism ANS: 3 The Vedas, the sacred books of the Hindu faith, described Indian healthcare practices and were the earliest writings of a distinct nursing occupation. PTS:1DIF:EasyREF:p. 7 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall 9. The American Red Cross was established by 1) Louisa May Alcott 2) Clara Barton 3) Dorothea Dix 4) Harriet Tubman ANS: 2 Clara Barton was an American teacher, nurse, and humanitarian who organized the American Red Cross after the Civil War. Louisa May Alcott was an American novelist who wrote Little Women in 1868. Dorothea Dix was an American activist who acted on behalf of the indigent population with mental illness. She was credited for establishing the first psychiatric institution. Harriet Tubman was an African American abolitionist and Union spy during the Civil War. After escaping captivity, she set up a network of antislavery activists, known as the Underground Railroad. PTS:1DIF:EasyREF:p. 10 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall 10. Which of the following is the most important reason to develop a definition of nursing? 1) Recruit more informed people into the nursing profession 2) Evaluate the degree of role satisfaction 3) Dispel the stereotypical images of nurses and nursing 4) Differentiate nursing activities from those of other health professionals ANS: 4 Nursing organization leaders think it is important to develop a definition of nursing to bring value and understanding to the profession, differentiate nursing activities from those of other health professionals, and help student nurses understand what is expected of them. A definition of nursing would not be likely to increase the number of informed people recruited into nursing. A definition of nursing would do little to improve the nurses role satisfaction. Although a definition of nursing might contribute to fighting stereotypes of nursing, other, more powerful influences (e.g., media portrayals) exist to counteract it. PTS:1DIF:EasyREF:V1, dm 1113; students must infer from content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall

www.mynursingtestprep.com11. Which of the following provides evidence-based support for the contribution that advanced practice nurses (APNs) make within healthcare? 1) Reduced usage of diagnostics using advanced technology 2) Decreased number of unnecessary visits to the emergency department 3) Improved patient compliance with prescribed treatments 4) Increased usage of complementary alternative therapies ANS: 3 Studies demonstrate that APNs have improved patient outcomes over those of physicians, including increased patient understanding and cooperation with treatments and decreased need for hospitalizations. No well-known, scientific studies support APNs effect on the use of advanced technology. No well-known, scientific studies support APNs effect on the frequency of emergency department visits. No well-known, scientific studies support APNs effect on the use of alternative therapies. PTS:1DIF:ModerateREF:p. 20 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall 12. Which of the following is an example of what traditional medicine and complementary and alternative medicine therapies have in common? 1) Both can produce adverse effects in some patients. 2) Both use prescription medications. 3) Both are usually reimbursed by insurance programs. 4) Both are regulated by the FDA. ANS: 1 Both traditional and complementary therapies can produce adverse effects in some patients. Many medications are derived from herbs, but the alternative treatments usually use the herbs, not prescription medication. Insurance programs do not necessarily reimburse alternative treatments, because many are not supported by sound scientific research methodology. Alternative medications are not regulated by the FDA. PTS:1DIF:ModerateREF:p. 20 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall 13. Of the following, the biggest disadvantage of having nursing assistive personnel (NAP) help nurses is that the nurse 1) Must know what aspects of care can legally and safely be delegated to the NAP 2) May rely too heavily on information gathered by the NAP when making patient care decisions 3) Is removed from many components of direct patient care that have been delegated to the NAP 4) Still maintains responsibility for the patient care given by the NAP ANS: 2

www.mynursingtestprep.comAll of the options may be disadvantages to using NAPs, but making decisions based on anothers information is the greatest drawback because of the potential for negatively affecting patient care. Treatment decisions based on incorrect information may cause harm to the patient. PTS:1DIFifficultREF:p. 2021; students must conclude from content KEY: Nursing process: N/A | Client need: N/A | Cognitive level:Analysis 14. An older adult has type 1 diabetes. He can perform self-care activities but needs help with shopping and meal preparation as well as with blood glucose monitoring and insulin administration. Which type of healthcare facility would be most appropriate for him? 1) Acute care facility 2) Ambulatory care facility 3) Extended care facility 4) Assisted living facility ANS: 4 Assisted living facilities are intended for those who are able to perform self-care activities but who require assistance with meals, housekeeping, or medications. Acute care facilities focus on preventing illnesses and treating acute problems. These facilities include physicians offices, clinics, and diagnostic centers. Ambulatory care facilities provide outpatient care. Clients live at home or in nonhospital settings and come to the site for care. Ambulatory care facilities include private health and medical offices, clinics, surgery centers, and outpatient therapy centers. Extended care facilities typically provide long-term care, rehabilitation, wound care, and ongoing monitoring of patient conditions. PTS:1DIF:EasyREF:p. 18; ESG, KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application 15. The nurse in the intensive care unit is providing care for only one patient, who was admitted in septic shock. Based on this information, which care delivery model can you infer that this nurse is following? 1) Functional 2) Primary 3) Case method 4) Team ANS: 3 The nurse is following the case method model of nursing care. In this model, one nurse cares for one patient during a single shift. When the functional nursing model is employed, care is compartmentalized, and each task is assigned to a staff member with the appropriate knowledge and skills. In primary nursing, one nurse plans the care for a group of patients round-the-clock. The primary nurse assesses the patient and develops the plan of care. When he or she is working, he or she provides care for those patients that he or she is responsible for. In his or her absence, the associate nurses deliver care. Although the nurse in this case could possibly be a primary nurse, there are not enough data to confidently infer that. If the team nursing approach is utilized, a licensed nurse (RN or LVN) is paired with a nursing assistant. The pair is then assigned to a group of patients.

www.mynursingtestprep.comPTS:1DIF:ModerateREF:ESG, KEY: Nursing process: Implementation | Client need: SECE | Cognitive level: Analysis 16. Which healthcare worker should the nurse consult to counsel a patient about financial and family stressors affecting healthcare? 1) Social worker 2) Occupational therapist 3) Physicians assistant 4) Technologist ANS: 1 The social worker coordinates services and counsels patients about financial, housing, marital, and family issues affecting healthcare. The occupational therapist helps patients regain function and independence for activities of daily living. Physicians assistants work under the physicians direction to diagnose certain diseases and injuries. Technologists provide a variety of specific functions in hospitals, diagnostic centers, and emergency care. For example, laboratory technologists aid in the diagnosis and treatment of patients by examining blood, urine, tissue, and body fluids. Radiology technologists perform x- rays and other diagnostic testing. PTS:1DIF:ModerateREF:ESG, KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Comprehension 17. Which type of managed care allows patients the greatest choice of providers, medications, and medical devices? 1) Health maintenance organization 2) Integrated delivery network 3) Preferred provider organization 4) Employment-based private insurance ANS: 3 Preferred provider organizations are a form of managed care that allows the patient a greater choice of providers, medications, and medical devices within the designated list. Health maintenance organizations allow the patient to choose a primary care provider within the organization to coordinate his care. This type of program will only reimburse medical care when the patient has first obtained a referral from the primary provider. Integrated delivery networks combine providers, healthcare facilities, pharmaceuticals, and services into one system, and the patient must remain within the system to receive care. Employment-based private insurance is not a managed care organization. PTS:1DIF:EasyREF:ESG, KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Analysis 18. A patient who underwent a total abdominal hysterectomy is assisted out of bed as soon as her vital signs are stable. This intervention is most likely being directed by a 1) Critical pathway 2) Nursing care plan 3) Case manager

www.mynursingtestprep.com4) Traditional care model ANS: 1 This patients care is most likely being directed by a critical pathway. A critical pathway is a multidisciplinary approach to care that sequences interventions over a length of stay for a given case type, such as total abdominal hysterectomy. Using this model, the patient can be assisted out of bed as soon as her vital signs are stable. Using the traditional model, the nurse would have to obtain a physicians order to assist the patient out of bed after surgery. The nursing care plan guides nursing care but cannot specify when the patient can get out of bed postoperatively without a physicians order. When case management is used, care is coordinated by the case manager across the healthcare setting, but the case manager does not direct each care intervention. PTS:1DIF:ModerateREF:ESG KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Application 19. Which member of the healthcare team typically serves as the case manager? 1) Occupational therapist 2) Physician 3) Physicians assistant 4) Registered nurse ANS: 4 Typically, registered nurses serve as case managers for patients with specific diagnoses. Their role is coordinator of care across the healthcare system. The occupational therapist, physician, and physicians assistant all serve on the healthcare team and take direction from the case manager. PTS: 1 DIF: Easy REF: ESG, KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Recall 20. Which of the following is considered a primary care service? 1) Providing wound care 2) Administering childhood immunizations 3) Providing drug rehabilitation 4) Outpatient hernia repair ANS: 2 Primary care services focus on health promotion and disease prevention; administering childhood immunizations is one such service. Providing wound care and drug rehabilitation are examples of tertiary care services. Outpatient hernia repair surgery is an example of a secondary care service. PTS:1DIF:ModerateREF:ESG, KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application 21. Which of the following nursing activities represent direct care? Choose all that apply. 1)

www.mynursingtestprep.comBathing a patient 2) Administering a medication 3) Documenting an assessment 4) Making work assignments for the shift ANS: 1 B Direct care involves personal interaction between the nurse and clients (e.g., giving medications, dressing a wound, or teaching a client about medicines or care). Nurses deliver indirect care when they work on behalf of an individual, group, family, or community to improve their health status (e.g., restocking the code blue cart [an emergency cart], ordering unit supplies, or arranging unit staffing). PTS:1DIF:EasyREF:p. 17 KEY: Nursing process: Implementation | Client need: SECE | Cognitive level: Comprehension 22. An 80-year-old patient fell and fractured her hip and is in the hospital. Before the fall, she lived at home with her husband and managed their activities of daily living very well. The goal is for the patient to recover from the injury and return to her home. The hospital is ready to discharge her because she has exceeded the recommended length of stay in a hospital. However, she cannot walk or care for herself yet, and she will require lengthy physical therapy and further monitoring of her medications and her physical and mental status. To which type of facility should she be transferred? 1) Nursing home 2) Rehabilitation center 3) Outpatient therapy center 4) None of these; she should receive home healthcare ANS: 2 A skilled nursing facility primarily provides skilled nursing care for patients who can be expected to improve with treatment. For example, a patient who no longer needs hospitalization may transfer to a skilled nursing facility to get skilled care until she is able to return home. A nursing home provides custodial care for people, like this patient, who cannot live on their own but who are not sick enough to require hospitalization. It provides a room, custodial care, and opportunity for recreation. This patient cannot ambulate or perform activities of daily living, so outpatient therapy and home care would not be appropriate. PTS:1DIF:ModerateREF:p. 18 KEY: Nursing process: Implementation | Client need: SECE | Cognitive level: Application Multiple Response Identify one or more choices that best complete the statement or answer the question. 1. Which of the following are examples of a health-promotion activity? Select all that apply. 1) Helping a client develop a plan for a low-fat, low-cholesterol diet

www.mynursingtestprep.com2) Disinfecting an abraded knee after a child falls off a bicycle 3) Administering a tetanus vaccination after an injury from a car accident 4) Distributing educational brochures about the benefits of exercise ANS: 1, 4 Health promotion includes strategies that promote positive lifestyle changes. Disinfecting an abraded knee is a treatment/intervention for an injury. Administering a vaccination is a disease-prevention and treatment activity. PTS: 1 DIF: Moderate REF: p. 18; high-level question, not directly stated in text KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Application Matching Match the nursing role listed on the left with the appropriate activity listed on the right. Each activity has only one correct answer. 1) Planning the units staffing schedule 2) Participating on a committee to develop a program to teach schoolchildren proper handwashing 3) Teaching the client about a scheduled test 4) Discussing new medication at a staff meeting 5) Discussing with the physician the clients reasons for not wanting the recommended surgery. 1. Direct care provider 2. Client advocate 3. Manager 4. Change agent 1.ANS:3PTS:1DIF:Moderate REF:p. 13; must recognize examples not provided in content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application 2.ANS:5PTS:1DIF:Moderate REF:p. 13; must recognize examples not provided in content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application 3.ANS:1PTS:1DIF:Moderate REF:p. 13; must recognize examples not provided in content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application 4.ANS:2PTS:1DIF:Moderate REF:p. 13; must recognize examples not provided in content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application Match the event with the appropriate year. Each item has only one correct answer. 1) Nursing programs become affiliated with religious groups 2) Start of public health nursing with the founding of the Henry Street Settlement 3) First formal nursing education in United States

www.mynursingtestprep.com4) First hospital 5) Establishment of the Army Nursing Service 6) Disassociation of nursing from religious orders 7) Florence Nightingale cared for the soldiers of the Crimean War 5. 1st-century AD 6. 15th to 19th century 7. 1854 8. 1861 9. 1873 10. 1893 • ANS:4PTS:1DIFifficult REF: dm 611; must recognize examples not provided in content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall • ANS:6PTS:1DIFifficult REF: dm 611; must recognize examples not provided in content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall • ANS:7PTS:1DIFifficult REF: dm 611; must recognize examples not provided in content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall • ANS:5PTS:1DIFifficult REF: dm 611; must recognize examples not provided in content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall • ANS:3PTS:1DIFifficult REF: dm 611; must recognize examples not provided in content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall • ANS:2PTS:1DIFifficult REF: dm 611; must recognize examples not provided in content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall Match the nursing organization with its function in the nursing profession. 1) Responsible for setting and maintaining nursing education standards 2) Developed Code for Nurses and the Standards of Clinical Nursing Practice 3) Responsible for publishing the journal, Image 4) Honor society for nursing 5) Represents nursing and promotes nursing leadership worldwide 11. American Nurses Association (ANA) 12. National Student Nurses Association (NSNA) 13. National League for Nursing (NLN) 14. International Council of Nursing (ICN) 15. Sigma Theta Tau International (STTI) • ANS: 2 PTS: 1 DIF: Moderate REF: p. 17 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall

www.mynursingtestprep.com• ANS: 3 PTS: 1 DIF: Moderate REF: p. 17 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall • ANS: 1 PTS: 1 DIF: Moderate REF: p. 17 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall • ANS: 5 PTS: 1 DIF: Moderate REF: p. 17 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall • ANS: 4 PTS: 1 DIF: Moderate REF: p. 17 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall True/False Indicate whether the statement is true or false. 1. The nurse caring for a patient undergoing minor surgery as an outpatient provides the same type of care as for a hospitalized patient undergoing the same procedure. ANS: T The nurse caring for a patient receiving care after outpatient surgery provides the same type of care as with the hospitalized patient. The only difference is that the outpatient spends fewer than 24 hours in the facility. PTS:1DIF:EasyREF:p. 18; students must draw conclusion from content KEY: Nursing process: Implementation | Client need: SECE | Cognitive level: Recall Completion Complete each statement. • is a health program, administered by the state and funded by federal and state governments to provide care for low-income people. ANS: Medicaid Medicaid is a health program run by the state and funded by the federal and state governments. It is intended to provide preventative and acute healthcare for individuals without ability to pay for services, particularly pregnant women and children. PTS:1DIF:ModerateREF:ESG KEY:Nursing process: N/A | Client need: SECE | Cognitive level: Recall • is a federal insurance-type program designed to fund healthcare for people age 65 years and older, the disabled, and those with end- stage renal disease from the high cost of healthcare. ANS: Medicare Medicare is a federal insurance program created by Title XVIII of Social Security Act of 1965. This Act was designed to protect people age 65 years and older from the high cost of healthcare. In 1972, the program was expanded to cover disabled workers as well as people with end-stage renal disease. Chapter 2 Clinical Judgement 1. Which of the following characteristics do the various definitions of critical thinking have in common? Critical thinking 1) Requires reasoned thought 2) Asks the questions why? or how? 3) Is a hierarchical process 4) Demands specialized thinking skills ANS: 1

www.mynursingtestprep.comThe definitions listed in the text as well as definitions in Box 2-1 state that critical thinking requires reasoning or reasoned thinking. Critical thinking is neither linear nor hierarchical. That means that the steps involved in critical thinking are not necessarily sequential, where mastery of one step is necessary to proceed to the next. Critical thinking is a purposeful, dynamic, analytic process that contributes to reasoned decisions and sound contextual judgments. PTS:1DIF:ModerateREF: p. 25; high-level question, answer not stated verbatim KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Analysis 2. A few nurses on a unit have proposed to the nurse manager that the process for documenting care on the unit be changed. They have described a completely new system. Why is it important for the nurse manager to have a critical attitude? It will help the manager to 1) Consider all the possible advantages and disadvantages 2) Maintain an open mind about the proposed change 3) Apply the nursing process to the situation 4) Make a decision based on past experience with documentation ANS: 2 A critical attitude enables the person to think fairly and keep an open mind. PTS:1DIF:ModerateREF:dm 26 KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Comprehension 3. The nurse has just been assigned to the clinical care of a newly admitted patient. To know how to best care for the patient, the nurse uses the nursing process. Which step would the nurse probably do first? 1) Assessment 2) Diagnosis 3) Plan outcomes 4) Plan interventions ANS: 1 Assessment is the first step of the nursing process. The nursing diagnosis is derived from the data gathered during assessment, outcomes from the diagnosis, and interventions from the outcomes. PTS:1DIF:EasyREF: p. 30-31 KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Application 4. Which of the following is an example of theoretical knowledge? 1) A nurse uses sterile technique to catheterize a patient. 2) Room air has an oxygen concentration of 21%. 3) Glucose monitoring machines should be calibrated daily. 4) An irregular apical heart rate should be compared with the radial pulse. ANS: 2

www.mynursingtestprep.comTheoretical knowledge consists of research findings, facts, principles, and theories. The oxygen concentration of room air is a scientific fact. The others are examples of practical knowledgewhat to do and how to do it. PTS:1DIF:ModerateREF:p. 30; high-level question, answer not stated verbatim KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application 5. Which of the following is an example of practical knowledge? (Assume all are true.) 1) The tricuspid valve is between the right atrium and ventricle of the heart. 2) The pancreas does not produce enough insulin in type 1 diabetes. 3) When assessing the abdomen, you should auscultate before palpating. 4) Research shows pain medication given intravenously acts faster than by other routes. ANS: 3 Practical knowledge is knowing what to do and how to do it, such as how to do an assessment. The others are examples of theoretical knowledge, anatomy (tricuspid valve), fact (type 1 diabetes), and research (IV pain medication). PTS:1DIF:ModerateREF:p. 30; high-level question, answer not stated verbatim KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application 6. Which of the following is an example of self-knowledge? The nurse thinks, I know that I 1) Should take the clients apical pulse for 1 minute before giving digoxin 2) Should follow the clients wishes even though it is not what I would want 3) Have religious beliefs that may make it difficult to take care of some clients 4) Need to honor the clients request not to discuss his health concern with the family ANS: 3 Self-knowledge is being aware of your religious and cultural beliefs and values. Taking the pulse is an example of practical knowledge. Following client wishes and honoring client requests are examples of ethical knowledge. PTS:1DIFifficultREF: p. 30; high-level question, answer not stated verbatim | V1, p. 32; high-level question, answer not stated verbatim KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application 7. Which of the following is the most important reason for nurses to be critical thinkers? 1) Nurses need to follow policies and procedures. 2) Nurses work with other healthcare team members. 3) Nurses care for clients who have multiple health problems. 4) Nurses have to be flexible and work variable schedules. ANS: 3 Critical thinking is essential for client care, particularly when the care is complex, involving numerous health issues. Following policies and procedures does not necessarily

www.mynursingtestprep.comrequire critical thinking, and working with others or being flexible and working different schedules do not necessarily require critical thinking. PTS:1DIF:ModerateREF: p. 26-27; high-level question, answer not stated verbatim KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application 8. The nurse administering pain medication every 4 hours is an example of which aspect of patient care? 1) Assessment data 2) Nursing diagnosis 3) Patient outcome 4) Nursing intervention ANS: 4 Interventions are activities that will help the patient achieve a goal, such as administering pain-relieving medication. An example of assessment data might be, Patient reports pain is a 5 on a 1 to 10 scale. The nursing diagnosis would be Pain. The nurse might define the patient outcome in this scenario as, The patient will state the level of pain is less than 4. PTS:1DIF:ModerateREF:p. 31; high-level question, answer not stated verbatim KEY: Nursing process: Interventions | Client need: SECE | Cognitive level: Application 9. How does nursing diagnosis differ from a medical diagnosis? A nursing diagnosis is 1) Terminology for the clients disease or injury 2) A part of the clients medical diagnosis 3) The clients presenting signs and symptoms 4) A clients response to a health problem ANS: 4 A nursing diagnosis is the clients response to actual or potential health problems. PTS:1DIF:ModerateREF: p. 31 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Recall 10. Which statement about the nursing process is correct? 1) It was developed from the ANA Standards of Care. 2) It is a problem-solving method to guide nursing activities. 3) It is a linear process with separate, distinct steps. 4) It involves care that only the nurse will give. ANS: 2 The nursing process is a problem-solving process that guides nursing actions. The ANA organizes its Standards of Care around the nursing process, but the process was not developed from the standards. The nursing process is cyclical and involves care the nurses give or delegate to other members of the healthcare team. PTS:1DIF:EasyREF: p. 31 KEY:Nursing process: N/A | Client need: SECE | Cognitive level: Recall

www.mynursingtestprep.com11. What do critical thinking and the nursing process have in common? 1) They are both linear processes used to guide ones thinking. 2) They are both thinking methods used to solve a problem. 3) They both use specific steps to solve a problem. 4) They both use similar steps to solve a problem. ANS: 2 Critical thinking and the nursing process are ways of thinking that can be used in problem solving (although critical thinking can be used beyond problem-solving applications). Neither method of thinking is linear. The nursing process has specific steps; critical thinking does not. PTS:1DIFifficultREF: p. 31 KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Analysis 12. A nurse admits a patient to the unit after completing a comprehensive interview and physical examination. To develop a nursing diagnosis, the nurse must now 1) Analyze the assessment data 2) Consult standards of care 3) Decide which interventions are appropriate 4) Ask the clients perceptions of her health problem ANS: 1 The basis of the nursing diagnosis is the assessment data. Standards of care are referred to when establishing nursing interventions. Customizing interventions personalizes nursing care. Asking the patient about her perceptions is a method to validate whether the nurse has chosen the correct nursing diagnosis and would probably have been done during the comprehensive assessment. PTS: 1 DIF: Moderate REF: p. 31 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Application 13. The nurse developed a care plan for a patient to help prevent Impaired Skin Integrity. She has made sure that nursing assistive personnel change the patients position every 2 hours. In the evaluation phase of the nursing process, which of the following would the nurse do first? 1) Determine whether she has gathered enough assessment data. 2) Judge whether the interventions achieved the stated outcomes. 3) Follow up to verify that care for the nursing diagnosis was given. 4) Decide whether the nursing diagnosis was accurate for the patients condition. ANS: 2 The evaluation phase judges whether the interventions were effective in achieving the desired outcomes and helped to alleviate the nursing diagnosis. This must be done before

www.mynursingtestprep.comexamining the nursing process steps and revising the care plan. PTS:1DIF:ModerateREF: p. 31 KEY: Nursing process: Evaluation | Client need: SECE | Cognitive level: Analysis 14. In caring for a patient with comorbidities, the nurse draws upon her knowledge of diabetes and skin integrity. In a spirit of inquiry, she looks up the latest guidelines for providing skin care and includes them in the plan of care. The nurse provides skin care according to the procedural guidelines and begins regular monitoring to evaluate the effectiveness of the interventions. These activities are best described as 1) Full-spectrum nursing 2) Critical thinking 3) Nursing process 4) Nursing knowledge ANS: 1 Full-spectrum nursing (1) involves the use of critical thinking, nursing knowledge, nursing process, and patient situation. Although the other answers are important for planning and delivering nursing care, they do not reflect all the nurse has demonstrated. PTS:1DIFifficultREF:dm 32-33; high-level question, answer not stated verbatim KEY: Nursing process: N/A | Client need: PHSI | Cognitive level: Analysis 15. The nurse is preparing to admit a patient from the emergency department. The transferring nurse reports that the patient is obese. The nurse has been overweight at one time and works very hard now to maintain a healthy weight. She immediately thinks, I know I tend to feel negatively about obese people; I figure if I can stop eating, they should be able to. I must remember how very difficult that is and be very careful not to be judgmental of this patient. This best illustrates 1) Theoretical knowledge 2) Self-knowledge 3) Using reliable resources 4) Use of the nursing process ANS: 2 Self-knowledge is self-understandingawareness of ones beliefs, values, biases, and so on. That best describes the nurses 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. PTS:1DIFifficultREF:dm 30; high-level question, answer not stated verbatim KEY: Nursing process: N/A | Client need: PHSI | Cognitive level: Comprehension Multiple Response Identify one or more choices that best complete the statement or answer the question. 1. Which aspects of healthcare are affected by a clients culture? Select all that apply. 1)

www.mynursingtestprep.comHow the clients views healthcare 2) How the client views illness 3) How the client will pay for healthcare services 4) The types of treatments the client will accept 5) When the client will seek healthcare services 6) The environment where the healthcare services are provided 7) The ease of accessibility of healthcare services ANS: 1, 2, 4, 5 Culture affects clients view of health and healthcare. It influences how they will define illness, when they will seek healthcare, and what treatments are acceptable in their culture. How services are paid for is related to economic status. Regardless of culture, anyone can be affected by previous healthcare experiences, the environment in which healthcare is provided, and accessibility of services. Chapter 3 Nursing Process Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Which of the following is an example of a problem that nurses can treat independently? 1) Hemorrhage 2) Nausea 3) Fracture 4) Infection ANS: 2 A nursing diagnosis (or nursing problem) is a human response to a disease, injury, or other stressor that nurses can identify, prevent, or treat independently. Nausea is the only problem that meets that criterion; all others are medical or collaborative problems. PTS:1DIF:ModerateREF: dm 57 KEY: Nursing process: Diagnosis | Client need: PHSI | Cognitive level: Application 2. Which of the following is an example of a cluster of related cues? 1) Complains of nausea and stomach pain after eating 2) Has a productive cough and states stools are loose 3) Has a daily bowel movement and eats a high-fiber diet 4) Respiratory rate 20 breaths/min, heart rate 85 beats/min, blood pressure 136/84

www.mynursingtestprep.comANS: 1 A cue is an unhealthy response; a cluster of cues consists of cues related to each other. Productive cough and loose stools are abnormal findings but are not obviously or usually related to each other. Daily bowel movement and high-fiber diet are related but normal responses. The vital signs are also within normal limits. PTS:1DIFifficultREF: dm 62 KEY: Nursing process: Diagnosis | Client need: PHSI | Cognitive level: Analysis 3. Which of the following explains why it is important to have the correct etiology for a nursing diagnosis? The etiology 1) Is the cause of the problem 2) Cannot always be observed 3) Directs nursing care 4) Is an inference ANS: 3 The etiology directs nursing interventions. If the incorrect etiology is given, the nursing care would not be appropriate for the client. The other statements are true but not a reason for the importance of the etiology being correct. PTS:1DIFifficultREF:dm 63 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Analysis 4. How does a risk nursing diagnosis differ from a possible nursing diagnosis? 1) A risk diagnosis is based on data about the patient. 2) A possible diagnosis is based on partial (or incomplete) data. 3) Nurses collect the data to support risk diagnoses. 4) A possible diagnosis becomes an actual diagnosis when symptoms develop. ANS: 2 A possible nursing diagnosis is based on nursing knowledge, intuition, and experience and does not have enough data to support it; it is based on incomplete data. A risk diagnosis describes a problem that may develop in a vulnerable client if nursing care is not initiated to prevent it; it is made when risk factors are present in the data. Nurses collect data to support both risk and possible diagnoses; therefore, this statement does not differentiate them. A risk diagnosis becomes an actual diagnosis when symptoms develop. PTS:1DIF:ModerateREF:p. 60 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Analysis 5. Which of the following describes the difference between a collaborative problem and a medical diagnosis? 1) A collaborative problem is treated by the nurse; a physician is responsible for the treatment of a medical problem. 2) A collaborative problem is a nursing diagnosis that requires specific orders from a physician; a medical diagnosis directs all nursing care.

www.mynursingtestprep.com3) A collaborative problem has the potential to become an actual nursing diagnosis; a medical diagnosis rarely changes. 4) A collaborative problem requires intervention by the nurse and physician or other professional; a medical diagnosis requires intervention by a physician. ANS: 4 Collaborative problems are physiological complications a client may be at risk for due to her medical diagnosis, medical treatment, or diagnostic studies. A collaborative problem requires monitoring by the nurse and intervention by a physician. A medical diagnosis requires interventions (medications, treatments) by the physician. Medical diagnoses do not direct all nursing care. Collaborative problems have the potential to become medical, not nursing, diagnoses. PTS:1DIF:ModerateREF: dm 5859 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Analysis 6. Which of the following is the best approach to validate a clinical inference? 1) Have another nurse evaluate it. 2) Have the physician evaluate it. 3) Have sufficient supportive data. 4) Have the clients family confirm it. ANS: 3 All clinical inferences should be well supported by data. The more reliable data you gather, the more certain you can be that your inference is accurate. Because inferences are nursing diagnoses, it would be inappropriate to have a physician evaluate them. Although another experienced nurse could evaluate the inference, it still needs to be supported by sound and sufficient data. Even clients can validate clinical inferences in some situations, but adequate supporting data are still needed. Keep in mind that the clients data might or might not be sufficient to prove the inference. PTS: 1 DIF: Easy REF: p. 63 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Recall 7. What is wrong with the following diagnostic statement? Impaired Physical Mobility related to laziness and not having appropriate shoes. The statement is 1) Judgmental 2) Too complex 3) Legally questionable 4) Without supportive data ANS: 1 Lazy implies criticism of the client and therefore is judgmental. There need to be several (certainly more than two) etiological factors for the statement to be complex. There is no blame implied or harm resulting, so the statement is not legally questionable. There is no minimum amount of supportive data for a diagnosis and the stated etiology related to the

www.mynursingtestprep.comnursing diagnosis. No supportive data are given in the stem of the question, so you could not choose lack of data as the best answer because all the options lack data as far as you can tell from the information given in the question. In addition, it is not necessary to include supportive data in the diagnostic statement (although some do prefer to use A.M.B. and include defining characteristics). PTS:1DIF:ModerateREF:p. 74 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Analysis 8. When making a diagnosis using NANDA-I, which of the following provides support for the diagnostic label you choose? 1) Etiology 2) Related factors 3) Diagnostic label 4) Defining characteristics ANS: 4 The defining characteristics are the signs and symptoms that must be present to support any given nursing diagnosis. The etiology and related factors are the causes or contributing factors to the problem. The diagnostic label is the name NANDA-I has given the problem; it is chosen based on the presence of defining characteristics. PTS:1DIF:EasyREF:p. 68 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Recall 9. Based only on Maslows hierarchy of needs, which nursing diagnosis should have the highest priority? 1) Self-care Deficit 2) Risk for Aspiration 3) Impaired Physical Mobility 4) Disturbed Sensory Perception ANS: 2 Highest priority is given to problems that are life threatening or that could be destructive to the client. Safety is most basic in Maslows hierarchy. Even though Risk for Aspiration is not an actual problem, it poses the most immediate life-threatening risk to the client, and nursing interventions must be performed to prevent it from becoming an actual problem. PTS:1DIF:ModerateREF:dm 6465 KEY: Nursing process: Diagnosis | Client need: PHSI | Cognitive level: Analysis 10. Which of the following describes the most important use of nursing diagnosis? (All statements are true.) 1) Differentiates the nurses role from that of the physician 2) Identifies a body of knowledge unique to nursing 3) Helps nursing develop a more professional image 4)

www.mynursingtestprep.comDescribes the clients needs for nursing care ANS: 4 Benefits to nurses and nursing are that nursing diagnoses differentiate the nurses role, they identify a unique body of nursing knowledge, and some think they help nursing to develop a more professional image. However, the primary goal of nursing is to serve the good of the patient. Therefore, the most important use of a diagnosis is to specifically identify the clients needs for quality nursing care. PTS: 1 DIF: Moderate REF: p. 56 KEY: Nursing process: Diagnosis | Client need: Safe-care environment | Cognitive level: Analysis 11. Which of the following is a criticism of standardized nursing diagnoses developed by NANDA-I? 1) There is little research to support nursing diagnoses labels. 2) A perfect nursing diagnosis must be written for it to be useful. 3) They are not included in all states nurse practice acts. 4) Other professions do not recognize nursing diagnoses. ANS: 1 Best practice is evidence-based practice; that is, it is developed through sound, scientific research. Research is currently being conducted, but many of the diagnoses are not research based. A perfect nursing diagnosis is impossible to write, so that is not an issue. Having standardized nursing diagnoses recognized in state practice acts or by other professions has nothing to do with the value of the NANDA-I taxonomy. PTS:1DIFifficultREF: p. 57 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Recall 12. Which of the following most accurately describes nursing diagnoses? A nursing diagnosis 1) Supports the nurses diagnostic reasoning 2) Supports the clients medical diagnosis 3) Identifies a clients response to a health problem 4) Identifies a clients health problem ANS: 3 Nursing diagnoses are statements that nurses use to describe a clients physical, mental, emotional, spiritual, and social response to disease, injury, or other stressor. Diagnostic reasoning is used to identify the appropriate nursing diagnosis; it is not meant to support the diagnosis. A health problem is a condition that requires intervention to promote wellness or prevent illness; it is sometimes, but not always, a nursing diagnosis. Nursing diagnoses are not medical diagnoses. PTS:1DIF:ModerateREF: p. 57 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Analysis 13. The diagnostic label, or patient problem, is used primarily to suggest 1) Client goals 2)

www.mynursingtestprep.comCue clusters 3) Interventions 4) Etiology ANS: 1 As a general rule, the problem suggests goals for client outcomes. The etiology suggests interventions. Cue clusters support whether the correct nursing diagnosis has been identified. PTS: 1 DIF: Moderate REF: p. 73 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Recall 14. Which nursing diagnosis is written in the correct format when using the NANDA-I taxonomy? 1) Bowel Obstruction related to recent abdominal surgery A.M.B. nausea, vomiting, and abdominal pain 2) Inability to Ingest Food related to imbalanced nutrition: less than body requirements A.M.B. inadequate food intake, weight less than 20% under ideal body weight 3) Impaired Skin Integrity related to physical immobility A.M.B. skin tear over sacral area 4) Caregiver Role Strain related to alienation from family and friends A.M.B 24-hour care responsibilities ANS: 3 The components of NANDA-I nursing diagnosis might include the following four parts: diagnostic label, defining characteristics, related factors, and risk factors. Impaired Skin Integrity . . . has the problem statement, etiology, and symptoms. For Bowel Obstruction . . . the problem is a medical diagnosis. The cause-and-effect order of Inability to Ingest Food . . . is incorrect; it starts with the etiology. The etiology and symptoms (A.M.B.) of Caregiver Role Strain . . . are reversed (alienation from family and friends are the symptoms that support the diagnosis). PTS: 1 DIF: Difficult REF: dm 7071 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Application 15. What is wrong with the format of this diagnostic statement: Possible Risk for Constipation related to irregular defecation habits A.M.B. statement that When Im busy, I cant always take the time to go to the bathroom. 1) Possible nursing diagnoses do not have signs and symptoms. 2) A nursing diagnosis is either a possible risk or a risk, not both. 3) Constipation is a medical diagnosis. 4) The etiology is actually a defining characteristic. ANS: 2 If there are risk factors, it is not a possible diagnosis, it is a risk diagnosis. It is possible to have a possible risk for diagnosis. The patient with possible diagnoses may have symptoms, just not enough to support the diagnosis. Constipation is a nursing diagnosis, and the etiology is a defining characteristic for a risk diagnosis because it contributes to the problem. In risk diagnoses, the etiology consists of the risk factors.

www.mynursingtestprep.comPTS: 1 DIF: Moderate REF: dm 60 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Analysis 16. Which nursing diagnosis is written in the correct format? 1) Imbalanced Nutrition: Less than Body Requirements related to body weight less than 20% under ideal weight 2) Ineffective Airway Clearance related to increased respiratory rate and irregular rhythm 3) Impaired Swallowing related to absent gag reflex 4) Excess Fluid Volume related to 3 lb weight gain in 24 hours ANS: 3 The etiology should describe what is causing or contributing to the problem. The etiologies for Ineffective Airway Clearance, Impaired Airway Swallowing, and Excess Fluid Volume describe signs or symptoms rather than causal factors. PTS: 1 DIF: Difficult REF: V1, p. 64 | dm 70-73 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Analysis 17. The patient shows the necessary defining characteristics, and the nurse has diagnosed Decisional Conflict related to unclear personal values and beliefs. What essential action should the nurse take to help ensure the accuracy of this diagnosis? 1) Ask a more experienced nurse to confirm it. 2) Have a social worker interview the patient. 3) Ask the patient to confirm the diagnosis. 4) Read about Decisional Conflict in the NANDA-I handbook. ANS: 3 After identifying problems and etiologies (which this nurse has done), the nurse should verify them with the patient to help ensure that her conclusions are accurate. If the patient does not agree that he has Decisional Conflict, the nurse might interview him more to clarify the meaning of the data. Certainly the nurse could ask another nurses opinion, but that is not essential. It would make no sense to have a social worker interview the patient unless the situation remains unclear even after confirming with the client. If the nurse did have adequate theoretical knowledge of Decisional Conflict for this patient, she should have been informed by reading the NANDA-I handbook before making the diagnosis. If the patient does not confirm the diagnosis, and the nurse concludes the diagnosis is in error, she might then reread the NANDA-I guide. PTS: 1 DIF: Moderate REF: V1, p. 56 | p. 63 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level:Application 18. The clients weight is appropriate for his height. His laboratory values and other assessments reflect normal nutritional status. However, he has told the nurse, I probably eat a little too much red meat. And what is this I hear about needing omega 3 oils in my diet? I dont like to take supplements, and I think I could really improve my nutrition. Which of the following nursing diagnoses should the nurse use? 1) Balanced Nutrition

www.mynursingtestprep.com2) Possible Imbalanced Nutrition: Less Than Body Requirements 3) Risk for Imbalanced Nutrition: Less Than Body Requirements 4) Readiness for Enhanced Nutrition ANS: 4 You will use a wellness diagnosis when a persons present level of wellness is effective and when the person wants to move to a higher level of wellnessin this case, a higher level of nutrition. The format for a wellness diagnosis is Readiness for Enhanced . . . Use a possible diagnosis when you have enough data to suspect a problem but need more data to support a diagnosis. Use a risk diagnosis when there are risk factors for a problem. PTS: 1 DIF: Moderate REF: p. 72 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Application 19. The patient verbalizes an overwhelming lack of energy. He says, I still feel exhausted even after I sleep. I feel guilty when I cant keep up with my usual daily activities or sleep during the day. Ive been a little depressed lately, too. The patient seems to have difficulty concentrating but has no apparent physical problems. Which of the following diagnoses best describes his health status? 1) Fatigue related to depression 2) Fatigue related to difficulty concentrating 3) Guilt related to lack of energy 4) Chronic confusion related to lack of energy ANS: 1 The diagnosis that best describes the overall health status is Fatigue. The only cue that might cause Fatigue is depression. You cannot use depression as the problem because it is a medical diagnosis, and it is not a NANDA-I label. The other cues (difficulty concentrating, inability to perform ADLs, and guilt) are symptoms of Fatigue, not etiologies. These diagnoses would lead the nurse to focus on dealing with guilt and confusion, so the source of the Fatigue would not be addressed. PTS: 1 DIF: Difficult REF: dm 70-73 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Application 20. Which of the following nursing diagnoses is written in correct format? Assume the facts are correct in all of them. 1) Readiness for Enhanced Nutrition 2) Pain related to stating, On a scale of 1 to 5, its a 5. 3) Impaired Mobility related to pain A.M.B. hip fracture 4) Risk for Infection related to compromised immunity A.M.B. fever ANS: 1 Wellness diagnoses (e.g., Readiness for Enhanced . . .) are usually one-part statements. A

www.mynursingtestprep.compain ranking of 5 is a symptom of pain, not an etiology, so it should be preceded by A.M.B. or as manifested by. Hip fracture is a medical diagnosis that is causing an etiology of pain; therefore, it should be preceded by secondary to. Risk diagnoses do not have symptoms, so it is not correct to put anything after A.M.B. PTS: 1 DIF: Moderate REF: dm 70-73 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Application Multiple Response Identify one or more choices that best complete the statement or answer the question. 1. Which of the following are cues? Select all that apply. 1) Taking a brisk walk five times a week 2) Using laxatives to have a bowel movement 3) Needing more sleep than usual 4) Decreasing the amount of fat in the diet 5) Weighing less than indicated by developmental norms ANS: 2, 3, 5 Cues are a deviation from norms, such as changes in usual health behavior, indications of delayed growth and development, changes in behaviors, or nonproductive or dysfunctional behavior. PTS:1DIF:ModerateREF:p. 61-62 KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Application 2. Using Maslows hierarchy of needs, rank the following nursing diagnoses in order of importance, beginning with the highest-priority diagnosis. 1) Anxiety 2) Risk for infection 3) Disturbed body image 4) Sleep deprivation ANS: 4, 2, 1, 3 In Maslows hierarchy, physiologic needs and safety are the highest priority. Sleep is a basic physiologic need. Infection can threaten physical health. In this question, infection is not present; therefore, there is just a risk for it. Sleep Deprivation is an immediate problem that affects general physical, mental, and emotional health. Neither Anxiety nor Disturbed Body image is a physiologic or safety need. Anxiety is a more immediate need than Disturbed Body Image, so it probably deserves a higher ranking. Remind students that the ranking would depend on the severity of each problem, which is not known by the labels alone. Chapter 4 Evidence-Based Practice: Theory & Research Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Which commonly accepted practice came out of the Framingham study? Use of 1)

www.mynursingtestprep.comMammography in breast cancer screening 2) Colonoscopy in colon cancer screening 3) Pap testing in cervical cancer screening 4) Digital rectal examination in prostate cancer screening ANS: 1 One commonly accepted practice that came out of the Framingham study is the link between mammography and breast cancer. Before the Framingham study, mammography was considered an unreliable tool in breast cancer screening. PTS:1DIF:EasyREF:p. 137 KEY:Nursing process: N/A | Client need: HPM | Cognitive level: Recall 2. Which theorist developed the nursing theory known as the science of human caring? 1) Florence Nightingale 2) Patricia Benner 3) Jean Watson 4) Nola Pender ANS: 3 Dr. Jean Watson developed the nursing theory known as the science of human caring. Her theory describes caring from a nursing perspective. Florence Nightingale developed the theory that stated that a clean environment would improve the health of patients. By changing the care environment, she dramatically reduced the death rate of soldiers. Dr. Patricia Benners theory described the progression of a beginning nurse who learns to be an expert nurse. Nola Penders theory on health promotion became the basis for most health-promotion teaching done by nurses. PTS: 1 DIF: Easy REF: p. 137 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall 3. A patient complains of pain after undergoing surgery. The nurse forms a mental image of pain based on her own experiences with pain. This mental image is known as a(n) 1) Phenomenon 2) Concept 3) Assumption 4) Definition ANS: 2 A concept is a mental image of a phenomenon, an aspect of reality that you can observe and experience. In the scenario above, the nurse forms a mental image of pain because of her past experiences with pain. Phenomena are the subject matter of a discipline. They mark the boundaries of a discipline. An assumption is an idea that is taken for granted. In a theory, the assumption is the idea that the researcher presumes to be true and does not intend to test with research. A definition is a statement of meaning of a term or concept that sets forth the concepts characteristics or indicators.

www.mynursingtestprep.comPTS: 1 DIF: Moderate REF: p. 138 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application 4. Hildegard Peplau was a nursing theorist whose major contribution to nursing was 1) Transcultural nursing 2) Health promotion 3) Nurse-patient relationship 4) Holistic comfort ANS: 3 Hildegard Peplau was a psychiatric nurse who showed that developing a relationship with psychiatric patients made their treatment more effective. From her work, she developed the theory of interpersonal relations, which focuses on the nurse-patient relationship. This theory is in use every day in nursing. PTS: 1 DIF: Easy REF: p. 142 KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Recall 5. The nurse and other hospital personnel strive to keep the patient care area clean. This most directly illustrates the ideas of which nursing theorist? 1) Virginia Henderson 2) Imogene Rigdon 3) Katherine Kolcaba 4) Florence Nightingale ANS: 4 Florence Nightingale was instrumental in identifying the importance of a clean patient care environment. During the Crimean War, Nightingale dramatically reduced the death rate of soldiers by changing the healthcare environment. Virginia Henderson identified 14 basic needs that are addressed by nursing care. Imogene Rigdon developed a theory about bereavement of older women after noticing that older women handle grief differently than do men and younger women. Katherine Kolcaba developed a theory of holistic comfort in nursing. PTS: 1 DIF: Moderate REF: p. 141 KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application 6. A patient who emigrated from India is admitted to the medical step-down unit with a bowel obstruction. A nasogastric (NG) tube is inserted to decompress her stomach. She asks the nurse if her daughter can bring in garlic to administer through her NG tube. The nurse tells the patient that she will ask the physician when she makes rounds. This nurse is utilizing the theory developed by which nurse theorist? 1) Betty Neuman 2) Dorothea Orem 3) Callista Roy 4) Madeline Leininger

www.mynursingtestprep.comANS: 4 The nurse is utilizing the theory developed by Madeline Leininger. Leiningers theory focuses on the values of cultural diversity. According to her theory, the nurse must make cultural accommodations for the health benefit of the patient. PTS:1DIF:ModerateREF:p. 142-143 KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Application 7. According to Maslows hierarchy of needs, which patient need should the nurse address first? 1) Protecting the patient against falls 2) Protecting the patient from an abusive spouse 3) Promoting rest in the critically ill patient 4) Promoting self-esteem after a body image change ANS: 3 According to Maslows hierarchy of needs, basic physiological needs should be met first. They include the need for rest, food, air, water, temperature regulation, elimination, sex, and physical activity. Therefore, the nurse should address the critically ill patients need for rest first. PTS:1DIF:ModerateREF: p. 144 KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Application 8. A nurse researcher is designing a research project. After identifying and stating the problem, the nurse researcher clarifies the purpose of the study. Which step in the research process should she complete next? 1) Perform a literature review. 2) Develop a conceptual framework. 3) Formulate the hypothesis. 4) Define the study variables. ANS: 1 After identifying and stating the problem, the nurse researcher should clarify the purpose of the study. Next, the researcher should perform a literature search to find out what is already known about the problem. After the literature search, the researcher should choose a conceptual framework to guide the research, formulate the hypothesis or research question, and define the study variables. PTS:1DIF:ModerateREF:p. 151-152 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Comprehension 9. The mother of a child participating in a research study that uses high-dose steroids wishes to withdraw her child from the study. Despite reassurance that adverse reactions to steroids in children are uncommon, the mother still wishes to withdraw. By withdrawing from the study, the mother is exercising which right? The right 1) Not to be harmed 2) To self-determination

www.mynursingtestprep.com3) To full disclosure 4) Of confidentiality ANS: 2 The mother is exercising the right to self-determination. This refers to the right of the participant (or parent in the case of a minor) to withdraw from a research study at any time and for any reason. The right to not be harmed outlines the safety protocols of the study. All research participants also have the right to full disclosure. This guarantees the participants answers to questions, such as the purpose of the research study, the risks and benefits, and what happens if the patient feels worse as a result of the study. Moreover, participants also have the right to confidentiality. Typically that right is preserved by giving participants an identification code rather than associating them by name. PTS:1DIF:ModerateREF:p. 151 KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application 10. After suffering an acute myocardial infarction, a patient attends cardiac rehabilitation. This will help to gradually build his exercise tolerance. According to Maslows hierarchy of needs, cardiac rehabilitation most directly addresses which need? 1) Safety and security 2) Physiological 3) Self-actualization 4) Self-esteem ANS: 2 Cardiac rehabilitation most directly addresses the patients physiological need for physical activity as well as for health and healing. Indirectly, of course, better physical condition might enable the patient to perform activities that would lead to higher self-esteem and even self-actualization. PTS:1DIF:ModerateREF: p. 144 KEY: Nursing process: N/A | Client need: PHSI | Cognitive level: Application 11. In his later work, Maslow identified growth needs that must be met before reaching self-actualization. These needs include 1) Cognitive and aesthetic needs 2) Love and belonging needs 3) Safety and security needs 4) Physiological and self-esteem needs ANS: 1 In his later work, Maslow identified two growth needs that must be met before reaching self-actualization. They include cognitive (to know, understand, and explore) and aesthetic (for symmetry, order, and beauty) needs. The needs Maslow identified in his earlier work were physiological, safety and security, love and belonging, esteem, and self-actualization. PTS:1DIF:EasyREF: p. 144-145

www.mynursingtestprep.comKEY: Nursing process: N/A | Client need: PSI | Cognitive level: Recall 12. The PICO question reads, Is TENS effective in the management of chronic low- back pain in adults? Which part of this question comes from the I in PICO? 1) Adults 2) Management 3) Pain 4) TENS ANS: 4 TENS is the intervention (I) in the PICO system. Adults comes from patient (P). Management comes from the outcome (O). There is no comparison intervention (C) in this PICO question. PTS:1DIFifficultREF:p. 152 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application 13. While reading a journal article, the nurse asks herself these questions: What is this about overall? Is it true in whole or in part? Does it matter to my practice? What is this nurse doing? 1) Reading the article analytically 2) Performing a literature review 3) Formulating a searchable question 4) Determining the soundness of the article ANS: 1 Analytical reading involves questioning the article to be sure you understand it and to determine whether it is applicable to your practice. Such reading asks these questions: What is this about as a whole? Is it true in whole or in part? Does it matter to my practice? A literature review is performed by searching indexes and databases and reading more than one article. Formulating a searchable question involves creating a PICO-type statement to guide a search of the literature. The nurse would determine whether the article is a research report by looking for the individual parts of the article to see if they were present in the form of research (e.g., title, problem, hypothesis, purpose, methods, data, data analysis, conclusions). PTS:1DIF:ModerateREF:p. 153 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application Completion Complete each statement. • 1. Nursing research is based on the method. ANS: scientific Nursing research is based on the scientific method. It is the process in which the researcher, through use of senses, systematically collects observable, verifiable data to describe, explain, or predict events. PTS:1DIF:EasyREF:p. 149 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall • The unit council in the intensive care unit is designing a

www.mynursingtestprep.comresearch study to see if they are meeting the spiritual needs of their patients. The study will involve patient interviews after discharge. After the interview process, the staff will examine patient statements for recurring themes. The unit council is conducting research. ANS: qualitative The unit council is conducting qualitative research, which focuses on the lived experiences of people. PTS:1DIF:ModerateREF:p. 149 KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Application • A 56-year-old patient diagnosed with an acute myocardial infarction (heart attack) makes inappropriate sexual comments to the licensed practical nurse (LPN). The LPN is visibly upset. The registered nurse (RN) assigned to the patient informs the patient that his behavior is unacceptable and will not be tolerated. Is the RN demonstrating holistic or mechanistic nursing? ANS: mechanistic The nurse is demonstrating the mechanistic nursing approach, which focuses on getting the task done. PTS:1DIF:ModerateREF:p. 136 KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Application • A 23-year-old athlete decides to donate bone marrow for a child who requires a bone marrow transplant to fight leukemia. According to Maslows later work, this athlete is fulfilling his need for . ANS: self-transcendence Self-transcendence is the drive to connect to something beyond oneself and to help others recognize their potential. Donating bone marrow to someone to improve his or her life fulfills the need for self-transcendence. PTS:1DIFifficultREF: p. 145 KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Application True/False Indicate whether the statement is true or false. 1. Institutional review boards were created to protect the rights of research participants. ANS: T Every healthcare facility and university that receives federal funding must have an institutional review board to protect the rights of research participants. Chapter 5 Life Span: Infancy Through Middle Adulthood Multiple Choice Identify the choice that best completes the statement or answers the question. 1. The nurse is providing prenatal counseling for a couple who is trying to become pregnant. The priority for the nurse is to include which of the following pieces of information? 1) Stages of growth and development of the fetus 2) Recommended schedule of visits to her healthcare provider 3)

www.mynursingtestprep.comRecommended average weight gain during pregnancy 4) Healthy eating habits before and during pregnancy ANS: 4 Maternal nutrition is vital to the healthy growth of the fetus. Poor maternal nutrition leads to an undergrown placenta. A small, poorly functioning placenta and smaller than normal umbilical cord are the causes for small-for-gestational age (otherwise known as small- for- dates) babies. The other options are all things the prospective mother needs to know, but they would not have an immediate impact on fetal health. PTS: 1 DIF: Moderate REF: p. 166 KEY: Nursing process: Planning | Client need: HPM | Cognitive level: Analysis 2. Which of the following would indicate a 4-year-old child has successfully gone through Eriksons Stage 3 (Initiative Versus Guilt)? The child 1) Refrains from hitting a friend 2) Plays cooperatively with friends 3) Is able to develop friendships 4) Is able to express his feelings ANS: 1 Stage 3 is Initiative Versus Guilt, in which the child becomes responsible for his behavior, develops self-discipline, and is able to manage his impulses. Cooperation and expressing feelings are tasks for Stage 2. Children develop friendships during the preschool age. PTS: 1 DIF: Moderate REF: dm 163-164 KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Application 3. The nurse is preparing to assess a toddler. To make the assessment go smoothly, before examining the child the nurse should first 1) Talk to the mother before talking to the child 2) Ask the child about his favorite toy 3) Get the childs height and weight 4) Ask the mother to undress the child ANS: 2 Toddlers have a fear of strangers, so it would be important to establish rapport before examining the child. Although talking to the mother before the child prior to a physical assessment does not lead to distrust, the action simply does not contribute to building a rapport with the child. Undressing the child before a trusting relationship is established often creates anxiety in the child, leading to uncooperativeness, fear, or withdrawal. Obtaining the childs height and weight would not help the child feel secure. PTS: 1 DIF: Moderate REF: p. 175 KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Application 4. According to Erikson, a behavior demonstrating an important psychosocial task for a toddler would be for the child to 1)

www.mynursingtestprep.comAct defiantly by refusing to hold her mothers hand while crossing the street 2) Recognize that it is wrong to take a toy away from someone else 3) Be able to understand the concept of time in hours 4) Express to his parents and playmates that he does not like something ANS: 1 The primary task during Eriksons stage 2, Autonomy Versus Shame and Doubt, is establishing an identity as separate from the parent/caregiver. A child between 18 months and 3 years typically tests the boundaries as part of exercising his will to control his environment. No is a declaration of independence and a bid for increased autonomy. Acts of independence and autonomy (e.g., refusing to hold her mothers hand) are normal during this developmental stage. The toddler should be able to tolerate time away from her parents, delay gratification, and have elimination control. The other tasks are accomplished during the preschool stage. PTS: 1 DIF: Moderate REF: p. 163 KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application 5. A mother comes to the clinic with her infant for a newborn checkup at 1 week of age. The mother tells the nurse, My baby looks yellow to me. The nurses best response is which of the following? 1) What type of detergent are you using to wash the baby clothes? 2) Is there a possibility you had hepatitis during your pregnancy? 3) The color is from the breakdown of maternal red blood cells. 4) There is a cream you can use to reduce the yellowing. ANS: 3 Jaundice results from the breakdown of the maternal red blood cells that are in the babys system after birth, which elevates the bilirubin in the serum. If detergent caused a reaction, the reaction would commonly present as a rash. Although hepatitis B virus may pass through the placenta to the fetus, the infant does not typically show signs at 1 week of life. If treatment becomes necessary, the infant would receive phototherapy; there is no cream to reduce the yellow appearance related to newborn jaundice. PTS: 1 DIF: Moderate REF: p. 170 KEY: Nursing process: Implementation | Client need: PHSI | Cognitive level: Application 6. A father brings his toddler to the clinic for well-child care. Which of the following would be most important for the nurse to assess? 1) How successful the child is with potty training 2) How the child acts when you enter the room 3) Whether the child is using eating utensils 4) Whether the home is child-proofed

www.mynursingtestprep.comANS: 4 Although all of these areas address important developmental tasks during the toddler period, safety is the highest priority at this age because the child has increased dexterity, mobility, and determination and is becoming more independent. Potty training is typically accomplished between 18 months and 3 years of age but is not a safety concern. It would be normal for a child at this age to be afraid of strangers. The child should be using utensils for most foods, but again it is not a safety concern. PTS: 1 DIF: Moderate REF: dm 174-175 KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Analysis 7. Which comment made by a woman in her early 50s would be a cue indicating the need for further assessment for a problem? 1) My skin is so dry I need to use lotion every day after I bathe. 2) I have episodes when I feel really hot even when others are not. 3) Its getting harder to lift those big bags of dog food. 4) I have to write myself notes because Im getting so forgetful. ANS: 4 Memory in middle adulthood should remain intact. There is a normal decrease in skin moisture and muscle tone in middle adulthood. The perimenopausal period occurs during this time, hallmarked by hot flashes and night sweats. PTS: 1 DIF: Moderate REF: dm 189-191 KEY: Nursing process: Diagnosis | Client need: PHSI | Cognitive level: Analysis 8. The nurse has instructed a group of parents on common adolescent behavior. Which comment by the parent would indicate the most urgent need for further discussion? 1) I guess my daughter wont be asking my opinion very much. 2) Im really going to watch my daughters eating habits. 3) We are really going to have to think about rules we want to enforce after he gets his drivers license. 4) We dont keep alcohol in the house, so thats at least one thing we dont need to worry about. ANS: 4 Concerns about alcohol intake during adolescence is highest priority, regardless of whether or not it is stored in the home. Alcohol-related injury and death are a risk that should be avoided in every circumstance. Not having alcohol in the house does not guarantee the teenager wont consume it with his friends. During the teen years, the relationships among peers strengthen and strongly influence adolescent behavior. Although the parents typically still maintain influence on the core values in the home, teens seek peers opinions for matters about social life or concerns of everyday living. As teens are developmentally concerned with appearance and social relationships, there can be an overemphasis on body image, leading to obesity, as well as eating disorders. Motor vehicle accidents are the leading cause of death for teenagers, typically due to

www.mynursingtestprep.comdistractibility, inattention, impulsiveness, and inexperience in various driving situations. PTS: 1 DIF: Moderate REF: p. 183 KEY: Nursing process: Evaluation | Client need: SECE | Cognitive level: Analysis 9. Which of the following would be the priority for most adolescents? Being 1) A good student 2) Sexually active 3) Picked to be on the soccer team 4) Able to function independently ANS: 3 The developmental task during adolescence is to establish personal identity. Socially, preteens and teens are driven by a need to belong to a group. School-age children need to receive positive reinforcement for accomplishments and desired behavior, such as being good students. Although a small number of preadolescents are sexually active, it is not the major focus for this age. Functioning independently is a task for the young adult. PTS: 1 DIF: Moderate REF: p. 182 KEY: Nursing process: Diagnosis | Client need: HPM | Cognitive level: Analysis 10. During adolescence, it would be most important to encourage the teen to eat plenty of 1) Grains 2) Dairy products 3) Vegetables 4) Fruit ANS: 2 Both males and females experience a growth spurt during adolescence. Although the childs diet should include adequate amounts of all the food groups, peak bone mass is attained during this stage, so the child needs to consume adequate calcium, vitamin D, iron, and protein. These nutrients are found in dairy products. PTS: 1 DIF: Easy REF: dm 181-182 KEY: Nursing process: Implementation | Client need: HPM | Cognitive level: Application 11. According to Erikson, which of the following must a middle-aged adult do to be prepared for the final stages of life? 1) Accept the fact that she is getting older. 2) Reconcile that death is a part of life. 3) Feel she has made a contribution to society. 4) Have had a meaningful and intimate relationship. ANS: 3 Generativity Versus Stagnation is the stage Erikson describes for the middle adult. During this stage, a mature adult either continues to gain skills, be productive, and pass on his or

www.mynursingtestprep.comher knowledge to the next generation or stagnates. During the middle years, many adults are realistic and insightful about age-related physical and emotional changes. Others experience difficulty coping with passing youth and advancing age. Accepting death as a part of the continuum of life is a task for the older adult. Developing meaningful relationships is a task most influential for the young adult. PTS: 1 DIF: Moderate REF: p. 190 KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Recall 12. The nurse teaches a mother of a preschool-age child about expected development. Which comment by the parent indicates that she understands the information? 1) She understands the monsters in books are not real. 2) When I mention that her birthday is in a week, she understands. 3) I am saving to buy her the roller skates shes been asking for. 4) I cant expect her to understand when a friend doesnt agree with her. ANS: 3 Preschoolers hand-eye coordination develops markedly during this period. They can hop on one foot, skip, and begin to learn to skate. The imagination of a preschool-age child is typically active, whereby they have fears of mythical figures, such as monsters. They have a limited ability to understand the concept of time or to tell time. A preschooler has the ability to consider simple viewpoints of other people. PTS: 1 DIF: Moderate REF: p. 176 KEY: Nursing process: Evaluation | Client need: HPM | Cognitive level: Application 13. A mother has brought her 8-month-old daughter to the healthcare clinic for a well-child appointment and any needed immunizations. To assess the childs physical development with age-appropriate norms, which of the following questions should the nurse ask? 1) Is your child able to walk while holding onto furniture? 2) Is your child able to crawl on her hands and knees? 3) Is your child able to pick up food with her fingers? 4) Is your child able to sit up without support? ANS: 4 At 7 months, most children can sit up by themselves. Cruising usually occurs around 8 to 12 months. At about 7 to 10 months, a child begins to crawl. Infants develop a pincer grasp around 10 months. PTS: 1 DIF: Moderate REF: p. 171 KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application 14. A mother comes to the healthcare clinic for a regular health examination for her 5-year-old son prior to kindergarten admission. Which comment by the mother would indicate the need for follow-up questions to the mother? 1) Hes not a good boy like my other son.

www.mynursingtestprep.com2) Ive had to treat him for lice a couple of times. 3) He has an imaginary friend he calls Buddy. 4) Hes so funny when he imitates his dad doing things. ANS: 1 Negative comments or comparisons with another child can be an indicator of or potential for child abuse. The nurse needs to determine whether this is an actual problem. Head lice are a common health problem for children of this age because of close physical contact with play. The mother seems to have a healthy attitude about the infestations and to be knowledgeable in the treatment. Imaginary play, magical thinking, and belief in mythical figures are normal at age 5. A child this age will normally imitate the same-sex parent. PTS: 1 DIF: Difficult REF: p. 177 p. 82 KEY: Nursing process: Diagnosis | Client need: HPM | Cognitive level: Analysis 15. Which behavior by the mother is most likely to help the infant to develop trust? 1) Talking to the infant 2) Breastfeeding instead of bottle-feeding 3) Promptly responding to the infants crying 4) Having the infant sleep in the same room with the parent ANS: 3 Because the infant is totally dependent on the parents, quickly responding to his cries promotes attachment and trust. Although all options may promote attachment, they are not absolutely necessary for bonding to occur. Mother-infant attachment is complex and involves all sensesnot simply hearing the mother talk to him. There are physical and emotional benefits to breastfeeding, but it is not necessary for mother-infant attachment. Sleeping in the same room may help the parent respond more quickly to the infants needs but is not the basis for attachment. PTS: 1 DIF: Moderate REF: p. 171 KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension 16. The nurse is talking to a class of children, ages 9 to 11 years. For this age group, it would be most important for the nurse to discuss 1) Safe sex practices 2) Healthy food choices 3) Use of seat belts and safety equipment 4) The importance of getting enough sleep ANS: 3 All are important topics to discuss with this age, but children of this age are very active, and injuries are common. Motor vehicle accidents are the most common cause of injury. They are just starting puberty, so sexual activity is still not usual. The discussion of appropriate food choices and getting enough sleep should be done throughout the childs developmental stages; it is not peculiar to ages 10 to 12 years. The preteen years are

www.mynursingtestprep.comparticularly important for adequate sleep and rest primarily because of the physical changes, active social lives, and increasingly complex demands on their lives. PTS: 1 DIF: Moderate REF: p. 181 KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Analysis 17. A 38-year-old client comes into the clinic for a health examination. Knowing the psychosocial development tasks and common health problems for this age group, it would be most important for the nurse to ask 1) If the client has episodes of feeling depressed 2) Whether the client practices safe sex 3) About the clients exercise habits 4) About the health history of the clients parents ANS: 1 Striving to be self-sufficient and successful and to establish a career and family are the tasks for this age. These tasks are demanding and can be emotionally difficult and potentially cause depression. Untreated depression is a leading cause of death among young adults. Sexually transmitted infections are a risk for this age group but are not as severe a threat as depression. Exercise is important to overall health but is not a source of stress. There are genetic health problems that can impact the client. Chapter 6 Life Span: Older Adults Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Which of the following is the most common major challenge for older adults? 1) Dealing with the needs of their children 2) Chronic health problems leading to the loss of independence 3) Loss of the ability to reminisce about the past 4) The decline of intellectual abilities ANS: 2 Older adults have many losses to deal with, including the development of chronic health concerns and loss of independence. During the older adult years, children often provide care for their aging parents. Loss of short-term memory is more common than recollection of events involving long-term memory. Older adults have vivid memories of past events. Intellectual abilities do not become impaired with age; short-term memory and reaction time decline. PTS: 1 DIF: Moderate REF: p.205 KEY: Nursing process: N/A | Client need: PHSI/PSI | Cognitive level: Comprehension 2. Which of the following would be the most important health assessment focus for older adulthood? 1) Cancer screening with the annual health examinations 2)

www.mynursingtestprep.comSeeking information about consistent use of seat belts 3) Screening for eating disorders 4) A bone scan (DEXA test) for osteoporosis ANS: 1 Chronic diseases, including cancer, are major health problems for older adults. In fact, cancer is the second leading cause of deaths for older adults. Older adults should also have an annual physical exam; they should receive cancer screening at that time. Habits for seat belt use should have already been established; although it may be important to reinforce seat belt use, the most important assessment is cancer screening. Eating disorders are more common in adolescence and young adulthood. Although loss of bone density is fairly common in older adults and can be pathological, it does not assume the status as cancer with regard to mortality for older adults. PTS: 1 DIF: Difficult REF: dm 211-212 KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Comprehension 3. To which age group do most hospitalized patients belong? 1) Infants 2) Young adults 3) Middle adults 4) Older adults ANS: 4 Half of all hospitalized patients are older adults. PTS: 1 DIF: Easy REF: p. 202 KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Recall 4. Which of the following reflects an understanding of the characteristics of older adults? 1) Fewer than 5% of all older adults live in nursing homes. 2) Average life expectancy at birth has declined slightly over the past 10 years. 3) In general, males tend to live longer than do females. 4) Black men have the lowest life expectancy, but the gap decreases as a person ages. ANS: 1 Only 3.3% of people 65 and over live in nursing homes; this rises to 15% for those over 85 years. In the United States, life expectancy at birth has risen dramatically in the past century: In 1900, average life expectancy was 49.2 years; in 2005, average life expectancy was 77.8 years. At age 65, white women led life expectancy with 20 years, followed closely by black women at 18.7 and white men at 17.2 years, whereas black men at age 65 had the lowest life expectancy at 15.2. The disparity in death rates for people of different races is less for older adults than younger ones. PTS: 1 DIF: Moderate REF: p. 206 KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension 5 A 75-year-old white female patient says, Ive heard that women live to an older

www.mynursingtestprep.comage than men do. My husband and I are the same age, so I am afraid I will have to spend some years without him. That really worries me. Which response is based on correct information? 1) That is a realistic concern, as women do have a longer life expectancy than men. But many things can happen to change that. 2) You need not worry, because both you and your husband are white. That statistic is true only for black men and women. 3) It is true that women have a longer life expectancy at birth. However, life expectancy measured at age 65 is almost the same for both sexes. You are both well past 65. 4) That is true only in certain geographical areas, such as those with a high population of newly retired persons. ANS: 3 For infants born in 2005, the average total life expectancy for females is 80.4 years. Life expectancy measured at age 65 was nearly the same for men and women in 1900; however, women had a lead of about 3 years over men in 2005, narrowing the gap as men age. So the longer men live, the longer they will live. The statistics are true for white people as well as black people. The answer saying, That is a realistic concern . . . is only partially true. Women do have a longer life expectancy at birth, but that tends to almost disappear after men reach age 65, and it continues to lessen as they continue to age. In- migration and out-migration have nothing to do with gender differences in life expectancy, although they do affect the population distribution within a state, for example. PTS: 1 DIF: Difficult REF: p. 202 KEY: Nursing process: Implementation | Client need: HPM | Cognitive level: Application 6 An 86-year-old patient had prostate surgery 2 days ago. Which nursing action best meets his developmental needs? 1) Perform a spiritual assessment and make referrals as needed. 2) Provide a complete bed bath and other hygiene needs. 3) Encourage the patient to perform self-care as much as possible. 4) Administer pain medications to keep the patient comfortable. ANS: 3 An important nursing goals for all older adults should be to maintain the persons ability to function independently for as long as possible. Encouraging self-care will help to achieve that goal. A spiritual assessment is appropriate but is not a need of older adults any more than of other age groups. Providing hygiene needs does not promote independence. Administering analgesics is appropriate but does not encourage functional independence. PTS: 1 DIF: Moderate REF: Cp. 212 KEY: Nursing process: Planning | Client need: HPM | Cognitive level: Application 7. A client tells the nurse, I cant see well enough to read anymore. I have new glasses, but its still hard. What should the nurse advise her to do first? 1)

www.mynursingtestprep.comGo back to the eye doctor and have him check your glasses. 2) Buy some audio books and listen to those. 3) Adapt to reading less and find a new leisure activity. 4) Install a bright but glare-free light near where you read. ANS: 4 With aging, there is decreased pupil accommodation, decreased tear production, and thickening of the lens of the eye. All of these contribute to impaired near vision (presbyopia). Decrease in pupil accommodation allows less light into the eye, so in order to read, the person needs a good light. However, there is also increased sensitivity to glare, so the light should have a glare-free bulb. The patient should try this first, since she already has new glasses. If this doesnt help, then perhaps she should have the glasses rechecked. If her vision cannot be improved, then she could think about buying audio books and other ways to adapt to her difficulty reading. PTS: 1 DIF: Moderate REF: Cp. 214 KEY: Nursing process: Implementation | Client need: HPM | Cognitive level: Application 8. A couple is planning to move to a housing development that has been built to provide elder-friendly dwellings and environments for independent living. The houses are smaller and on a single level. Their purchase includes home maintenance and repair, snow and trash removal, a pool, and a walking track. Only people 60 years and older qualify to buy a house in this community. Medical and nursing care are not a part of the purchase. How would their living situation be described? 1) Naturally occurring retirement community 2) Retirement community 3) Continuing care retirement community 4) Assisted living facilities ANS: 2 The scenario describes a retirement community. A naturally occurring retirement community is one in which the person ages in place, living in the same home as always and in a neighborhood where the neighbors have aged together and have provided support for each other through the years. A continuing care retirement community is residential living (e.g., cottages, cluster homes, apartments) into which a person must move. The person pays an entrance fee and monthly fees. In return, the contract provides for assistance with activities of daily living, coordinated social activities, health monitoring, and so on. There is usually a health clinic on site. Assisted living facilities (ALFs) are congregate residential settings that provide or coordinate personal services, 24-hour supervision and assistance (scheduled and unscheduled), activities, and health- related services. State regulations and level of services preclude residents from staying in an ALF when their needs become greater than the resources and services provided. PTS: 1 DIF: Moderate REF: p. 205 KEY: Nursing process: Implementation | Client need: HPM | Cognitive level: Application Multiple Response Identify one or more choices that best complete the statement or answer the question. 1. A client is concerned about the age-related changes of her mother, who is 80 years old. Which statement(s) made by the client would likely represent a normal change

www.mynursingtestprep.comof aging? 1) My mother seems to get cold very easily. 2) My mother complains of her mouth being dry. 3) Mother goes around the house turning on all the lights. 4) Mother complains of leaking urine when she coughs. ANS: 1, 2, 3 Incontinence is not a normal part of aging and should be explored further. The thinning of the layers of the skin causes older adults to feel colda normal part of aging. With aging, the brown fat layer, which contributes to generating and maintaining body temperature, becomes thinner as well. This is not the same type of fat as adipose, which is a white fat layer. Additionally, older adults who are sedentary often feel cooler. The elderly normally experience a decrease in saliva production, so although this is also a symptom of dehydration, dry mouth is a normal change of aging. Visual acuity decreases with age, but this, too, is a normal part of aging. PTS: 1 DIF: Moderate REF: dm 208-209, 214 KEY: Nursing process: Diagnosis | Client need: PHSI | Cognitive level: Analysis 2. A client lives alone. He is very weak, stays in bed most of the time, and becomes fatigued after taking only two or three steps with a walker. His personal hygiene is poor. He moves very slowly when doing even small tasks, such as eating a meal. Which of the following are appropriate interventions for this patient? Choose all that apply; assume all are possible. 1) Arrange for a home aide to assist with activities of daily living. 2) Refer the client to a senior center for an adapted physical activity (APA) program. 3) Assess the patient for symptoms of depression and memory loss. 4) Arrange for nutritious meals to be delivered to the patients home. ANS: 1, 3, 4 This client has the characteristics of frailty: low physical activity, muscle weakness, fatigue, and slowed performance. Clearly, the client is not able to perform ADLs adequately; therefore, a home aide is needed. Adapted physical activity programs are designed for adults in better physical health, not for frail elders. The client would be unlikely to benefit from an APA and probably could not even participate in such a group activity. Depression and impaired mental abilities tend to accompany frailty, so it is important to assess those for this client. Nutrition is essential to slow the progression of frailty, so having meals delivered is both appropriate and important. PTS: 1 DIF: Difficult REF: dm 214-216 KEY: Nursing process: Interventions | Client need: PHSI/PSI | Cognitive level: Application 3. When interpreting a population pyramid, which of the following do you need to know? 1) The youngest age group makes up the base of the pyramid.

www.mynursingtestprep.com2) Men are on the left side of the pyramid and women on the right. 3) The length of a bar indicates how many people are in that age category. 4) Adolescents are the youngest group on the pyramid. ANS: 1, 2 Age distribution of a population is often illustrated in a pyramid, with the youngest age group (04) at the base and the oldest age group (85+) at the peak, and men on the left of the figure and women on the right. The shape of a population pyramid changes to rectangle in developed countries with fewer births and increased life expectancy. The length of a bar does not indicate the absolute number of people in a category; it indicates the proportion of the total population represented by that category. PTS: 1 DIF: Difficult REF: dm 203-204 KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension 4. How can the nurse facilitate communication with an older adult? 1) Assess for hearing deficit at the beginning of the interaction. 2) Speak in a more loudly than normal, and at a slightly higher pitch. 3) Pay special attention to cues from body language. 4) Speak slowly, allowing time for the patient to word his answers. ANS: 1, 3, 4 The nurse should check for sensory deficits at the beginning of the interaction so he can allow for lip reading, as needed. Because older adults sometimes have difficulty expressing themselves, body language (e.g., wringing hands, fidgeting) is especially important. Because older adults process information slowly, the nurse should speak slowly, allowing them to formulate their answers. Speaking slowly does not mean the nurse should speak loudly or at a higher pitch. Many older adults have high-pitch hearing loss. PTS: 1 DIF: Moderate REF: p. 214 KEY: Nursing process: Implementation | Client need: HPM | Cognitive level: Comprehension 5. Which older adult is experiencing normal aging changes of the urinary system? 1) A man who has difficulty voiding, especially when starting his stream 2) A woman who wakes up to void once during the night 3) A man who has difficulty getting a hard erection 4) A man who says he has burning when he urinates ANS: 2, 3 Because of changes in bladder capacity and changes in blood flow to the kidneys, many older adults wake at least once during the night to void. Sexual response changes are also normal; it is common for older adult men to have less firm erections. A man who has difficulty starting his urine stream and voiding likely has an enlarged prostate, which is physiologically not normal. Burning on urination is indicative of a bladder infection and is

www.mynursingtestprep.comnot normal. Chapter 7 Experiencing Health and Illness Multiple Choice Identify the choice that best completes the statement or answers the question. 1. In an effort to promote health, the home health nurse opens the clients bedroom windows to let in fresh air and sunlight, washes her hands often, and teaches the patient and family about the importance of hygiene and cleanliness. This most closely illustrates the ideas of which of the following people? 1) Jean Watson 2) Jurgen Moltmann 3) Florence Nightingale 4) Robert Louis Stevenson ANS: 3 Florence Nightingale believed that health was prevention of disease through the use of fresh air, pure water, efficient drainage, cleanliness, and light. Jean Watson believes that health has three elements: a high level of overall physical, mental, and social functioning; a general adaptive-maintenance level of daily functioning; and the absence of illness (or the presence of efforts that lead to its absence). Jurgen Moltmann believes that true health is the strength to live, the strength to suffer, and the strength to die. He also stated that health is not a condition of the body; it is the power of the soul to cope with the varying condition of that body. Robert Louis Stevenson wrote that health is not a matter of holding good cards; it is playing a poor hand well. PTS: 1 DIF: Easy REF: p. 222 KEY:Nursing process: N/A | Client need: HPM | Cognitive level: Recall 2. Which of the following is known to be a healthy strategy for coping with stress? 1) Performing meaningful work 2) Consuming simple carbohydrates 3) Drinking three glasses of red wine each day 4) Weight training ANS: 1 Many individuals find that meaningful work is a healthy way to cope with stressors. Consuming simple carbohydrates is not a healthy way to cope with stress. Drinking more than one glass of red wine each day is considered unhealthy. Weight training has been shown to increase bone density and reduce the risk of osteoporosis and heart disease but not necessarily to reduce stress. PTS:1DIF:ModerateREF:p. 225 KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Application 3. Which family would most likely be helpful in encouraging the client to experience a high level of wellness? A family who 1) Controls feelings to avoid conflict 2)

www.mynursingtestprep.comTeaches negotiation skills and independence 3) Encourages risk taking and adventure 4) Views themselves as helpless victims ANS: 2 Families who promote independence and teach good negotiation skills enable family members to experience a high level of wellness by thinking for themselves. In contrast, families who tend to squelch personal feelings to avoid conflict may not allow a high level of wellness. Families who emphasize caution in new situations are more beneficial than those who encourage risk-taking. Families who view themselves as capable and successful are more advantageous than those who view themselves as helpless victims. PTS:1DIF:EasyREF:p. 225 KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Recall 4. The client is a 76-year-old man who is experiencing chronic illness. He has a genetic-linked anemia. He says he does not eat a balanced diet, as he prefers sweets to meat and vegetables. Which of the following dimensions of health can the nurse most likely influence by teaching and counseling him? 1) Age-related changes 2) Genetic anemia 3) Eating habits 4) Gender-related issues ANS: 3 The nurse is most likely to influence the patients eating habits because those are the dimension over which he has the most control and, therefore, has the most potential for changing. Although people consider biological factors when they describe themselves as well or ill, they are not entirely within our control. Biological factors include age and developmental stage, genetic makeup, and sex. PTS:1DIF:EasyREF:p. 224 KEY: Nursing process: Planning | Client need: HPM | Cognitive level: Application 5. What type of loss is most common among patients who are hospitalized for complex health conditions? 1) Privacy 2) Dignity 3) Functional 4) Identity ANS: 2 Hospitalized patients commonly experience the loss of dignity. Wearing a hospital gown, having their body exposed, invasive procedures, loss of control over body functionsall of these contribute to loss of dignity, and all are very common among hospitalized patients. Healthcare providers have a duty to protect privacy and confidentiality of patients, even though it is certainly threatened by some situations during hospitalization. Some patients

www.mynursingtestprep.comlose functioning and identity during hospitalization, but they are not common occurrences. PTS:1DIF:ModerateREF:p. 227 KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Comprehension 6. A 62-year-old patient is admitted to the hospital with hypertension. Which question by the nurse is most important when performing the initial assessment interview? 1) What medications do you take at home? 2) Do you have any environmental, food, or drug allergies? 3) Do you have an advance directive? 4) What is the greatest concern you are dealing with today? ANS: 4 It is most important for the nurse to ask the patient about his greatest concern. His concern can then be incorporated into the plan of care, making sure that his needs are met. Asking about medications, allergies, and an advance directive is also important but does not take priority over asking about the patients greatest concern. PTS:1DIF:ModerateREF:p. 231 KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Analysis 7. When developing goals, which guideline should the nurse keep in mind? Goals should be 1) Realistic so that progress is recognized by the patient 2) Developed solely by the healthcare team 3) Developed without family input, to maintain confidentiality 4) Valued by the multidisciplinary care providers ANS: 1 Goals should be realistic so that progress is recognized by the patient. They should be valued by both the patient and family. The nurse should develop goals with input from the patient and his family. PTS:1DIF:ModerateREF:p. 231 KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Comprehension 8. Which one of the following important nursing actions is a hospitalized patient likely to experience on an emotional level and remember long after this hospitalization has ended? 1) Administering her medications according to schedule 2) Allowing flexible visitation by her family and friends 3) Explaining treatment options in terms she can understand 4) Providing a healing presence by listening and being attentive ANS: 4 The nurse can contribute meaningfully to the patients hospitalization by providing a

www.mynursingtestprep.comhealing presence. The nurse can do this by listening to the patient and being attentive. Administering medications according to schedule, allowing flexible visitation, and explaining treatment options are important contributions that the nurse can make, but they will not be most meaningful to the patient. Patients may be impressed, even amazed, by the healthcare technology used to diagnose and treat their illnesses. However, often what they remember, perhaps through the rest of their lives, is the people who connected with them in a personal way. PTS:1DIF:ModerateREF:p. 232 KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Comprehension 9. Which statement best describes the health/illness continuum? 1) Health is the absence of disease; illness is the presence of disease. 2) Health and illness are along a continuum that cannot be divided. 3) Health is remission of disease; illness is exacerbation of disease. 4) Health is not having illness; illness is not having health. ANS: 2 The health/illness continuum is best described as a graduated spectrum that cannot be divided. PTS:1DIF:ModerateREF:p. 223 KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension 10. Which of the following helps the body release growth hormone (growth hormone assists in tissue regeneration, synthesis of bone, and formation of red blood cells)? 1) A healthy diet 2) Physical activity 3) Restful sleep 4) Comfortable room temperature ANS: 3 During sleep, our bodies release the majority of our growth hormone, which assists in tissue regeneration, synthesis of bone, and formation of red blood cells. Consuming healthy foods helps prevent disease. Physical activity reduces the risk of chronic disease and promotes longevity. Keeping the body at a comfortable temperature helps maintain health but not release of growth hormone. PTS:1DIF:ModerateREF:p. 224 KEY: Nursing process: N/A | Client need: PHSI | Cognitive level: Recall 11. A client has been hospitalized for 6 weeks. All of the following interventions are good ones, but which intervention is specifically focused on helping the patient cope with the emotional responses to prolonged hospitalization? 1) Providing skin care every shift to prevent skin breakdown 2) Encouraging the patient to get up in a chair to eat meals 3)

www.mynursingtestprep.comAssisting the patient to ambulate in the hallway for several minutes each day 4) Designating a corner of the patients room to display personal mementos ANS: 4 The patients environment can help nourish wellness. Helping the patient designate a corner of the room to display personal mementos can be healing and help the patient cope with the prolonged hospitalization. The other interventions might be helpful to the patient but are not as helpful in specifically dealing with hospitalization as is designating a portion of the room that is uniquely hers. PTS:1DIF:ModerateREF:p. 226 KEY: Nursing process: Implementation | Client need: PSI | Cognitive level: Application 12. Which of the following is particularly valuable in helping a patient with a terminal illness maintain a sense of self? 1) Family relationships 2) Spirituality 3) Nutrition 4) Sleep and rest ANS: 2 When a patient is faced with a terminal illness, spirituality can help the patient maintain his sense of self. Family relationships can provide a loving, supportive source of comfort and reassurance but can sometimes cause the patient pain and a feeling of loneliness when faced with a terminal illness. Nutrition, sleep, and rest are healing but usually not as helpful to a patient with terminal illness as is spirituality. PTS:1DIFifficultREF:p. 226 KEY:Nursing process: N/A | Client need: PSI | Cognitive level: Recall 13. A client with a history of schizophrenia is diagnosed with a urinary tract infection. What is probably the most significant barrier this patient faces? 1) Chronic urinary incontinence 2) Stigma associated with mental illness 3) Risk for recurring infections 4) Auditory hallucinations (hearing things) ANS: 2 Mental illness is associated with a stigma that is usually a barrier, and even considered a debilitating handicap. Chronic urinary incontinence is not commonly associated with urinary tract infection, and nothing in the scenario suggests that the patient is incontinent. The patient is at risk for recurring urinary tract infections, but this is not considered a debilitating handicap. Auditory hallucinations are associated with schizophrenia but have not been described as the most debilitating handicap. PTS:1DIF:ModerateREF:p. 226 KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Application 14. A 76-year-old patient is admitted with an acute myocardial infarction (heart attack). The doctor tells the patient that an angioplasty is necessary. The patient agrees and signs the informed consent. This patient is experiencing which stage of illness

www.mynursingtestprep.combehavior? 1) Sick-role behavior 2) Seeking professional care 3) Experiencing symptoms 4) Dependence on others ANS: 4 This patient is experiencing the dependence-on-others stage of illness behavior; he has accepted the diagnosis and treatment of the healthcare provider. The patient entered the experiencing illness stage when he began having chest pain at home. He entered the sick- role behavior phase when he admitted to family that he was experiencing chest pain. When he decided to go to the emergency department for healthcare intervention, he entered the seeking-professional-care stage of illness. PTS:1DIF:ModerateREF:dm 228-229 KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Analysis 15. Many health providers define illness as pathology; however, people experience, rather than define, illness. Which of the following is how most people experience illness? 1) Feeling lousy, a true sense of not being all right 2) A change in the way they feel or a disruption in their typical life 3) Something to be dreaded and avoided if at all possible 4) An experience that offers the potential for learning and spiritual growth ANS: 2 People typically describe their illness in terms of how it makes them feel or the effect it has on day-to-day life. Feeling lousy is inappropriate as many people do not feel lousy when they are ill. For example, hypertension is an illness that may have no symptoms. Similarly, patients may have chronic disease that is well managed and therefore does not make them feel ill. Something to be dreaded and avoided . . . is also not accurate. If a person has an external locus of control, he may view illness as a consequence of actions taken. From this viewpoint, he may have little control over whether he can avoid illness. Finally, although some people do grow and learn in the face of illness, most people do not hold such a positive view about illnessand the question asks how people experience illness. PTS:1DIF:ModerateREF:p. 222 KEY:Nursing process: N/A | Client need: PSI | Cognitive level: Recall 16. Dunn believes that an individuals state of health should be evaluated in the context of the persons environment. This approach illustrates that 1) An unhealthy physical environment, characterized by poor living conditions, always has a negative effect on an individuals health 2) Adequate income, food, and shelter create a healthful environment and always improve physical health status 3) Physical environment, family, and social support may help or hinder the health status of