TEST BANK
Timby's Fundamental Nursing Skills and Concepts
Loretta A. Donnelly-Moreno
12th Edition
,Table of Contents
Chapter 01 Nursing Foundations 1
Chapter 02 Nursing Process 10
Chapter 03 Laws and Ethics 20
Chapter 04 Health and Illness 34
Chapter 05 Homeostasis, Adaptation, and Stress 45
Chapter 06 Culture and Ethnicity 59
Chapter 07 The Nurse-Client Relationship 71
Chapter 08 Client Teaching 83
Chapter 09 Recording and Reporting 98
Chapter 10 Asepsis 111
Chapter 11 Admission, Discharge, Transfer, and Referrals 122
Chapter 12 Vital Signs 134
Chapter 13 Physical Assessment 146
Chapter 14 Special Examinations and Tests 158
Chapter 15 Nutrition 171
Chapter 16 Fluid and Chemical Balance 183
Chapter 17 Hygiene 196
Chapter 18 Comfort, Rest, and Sleep 208
Chapter 19 Safety 220
Chapter 20 Pain Management 233
Chapter 21 Oxygenation 245
Chapter 22 Infection Control 259
Chapter 23 Body Mechanics, Positioning, and Moving 273
Chapter 24 Fitness and Therapeutic Exercise 288
Chapter 25 Mechanical Immobilization 303
Chapter 26 Ambulatory Aids 318
Chapter 27 Perioperative Care 331
Chapter 28 Wound Care 346
Chapter 29 Gastrointestinal Intubation 358
Chapter 30 Urinary Elimination 370
Chapter 31 Bowel Elimination 382
Chapter 32 Oral Medications 394
Chapter 33 Topical and Inhalant Medications 407
Chapter 34 Parenteral Medications 419
Chapter 35 Intravenous Medications 433
Chapter 36 Airway Management 446
Chapter 37 Resuscitation 458
Chapter 38 End-of-Life Care 471
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Test Bank - Timby's Fundamental Nursing Skills and Concepts, 12th Edition (Donnelly-Moreno, 2021)
Chapter 1, Nursing Foundations
1. A client reports to the emergency department with ankle pain due to a minor road accident.
By asking the client to describe the accident, which type of nursing skill is the nurse using?
a. assessment skills
b. comforting skills
c. counseling skills
d. caring skills
ANS: A
Feedback: By asking the client to describe the accident, the nurse is using assessment skills
to collect more information about the client's condition. The nurse is interviewing the client
to collect related data. The nurse is not using comforting skills, as the nurse is not providing
any emotional support. The counseling skills of the nurse are also not used, as no health
education is provided. Caring skills include assistance provided with the activities of daily
living, which is not applicable in this scenario.
PTS: 1 REF: p. 15
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
2. One of the nursing achievements in the Crimean War was that the death rate of soldiers
dropped from 60% to 1%. What is the most appropriate reason for the fall in the death rate?
a. increased motivation among the soldiers
b. decreased rate of infection and gangrene
c. increased funds courtesy of donations from families
d. college-based education and training of nurses
ANS: B
Feedback: During the Crimean War, the death rate of British soldiers was 60%, which
dropped to 1% due to the nursing care provided. The nurses improved the ventilation,
nutritional, and sanitary conditions of the soldiers, leading to decreased rates of infection
and gangrene. As a result, the death rate dropped. The families and the soldiers donated
funds after the war, not during the war, through which an organized education and training
facility for nurses was started.
PTS: 1 REF: p. 3
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Remember NOT: Multiple Choice
3. A nurse at a health care facility provides information, assistance, and encouragement to
clients during the various phases of nursing care. In which activity does the nurse use
counseling skills?
a. educating a group of young girls about AIDS
b. telling a client to localize the pain in his abdomen
c. encouraging a client to walk without support
d. assisting a lactating mother in feeding her child
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Test Bank - Timby's Fundamental Nursing Skills and Concepts, 12th Edition (Donnelly-Moreno, 2021)
ANS: A
Feedback: The activity of educating a group of young girls about AIDS is based on the
nurse using counseling skills. Telling a client to localize his pain is an assessment skill.
Encouraging a client to walk without support can be both a comforting skill and a caring
skill. Assisting a lactating mother in feeding her baby is an example of a caring skill.
PTS: 1 REF: p. 15
NAT: Client Needs: Safe, Effective Care Environment: Management of Care | Health
Promotion and Maintenance
LOC: Client Needs Pn: Safe, Effective Care Environment: Coordinated Care | Health
Promotion and Maintenance TOP: Chapter 1: Nursing Foundations
KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Understand NOT: Multiple Choice
4. A nurse is conducting an interview of a 40-year-old client who is admitted with chest pain.
Which action by the nurse indicates active listening?
a. listening to the client silently
b. interrupting after each sentence
c. asking for clarifications and repetitions
d. talking about the nurse's own experience
ANS: C
Feedback: Active listening is an important component of counseling skills. It encourages the
client to open up and express their concerns. The nurse may ask the client to repeat and
clarify statements. Interrupting after every sentence may annoy the client. When the nurse
listens to the client silently, the client may feel that the nurse is not interested. On the other
hand, if the nurse talks about the nurse's own experience, the focus of the session shifts to
the nurse rather than to the client.
PTS: 1 REF: p. 15 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Caring
BLM: Cognitive Level: Apply NOT: Multiple Choice
5. A student wants to attend a nursing program that prepares its graduates for both staff and
managerial positions. Which type of nursing program should the nurse suggest for this
student?
a. hospital-based diploma
b. baccalaureate nursing program
c. associate degree program
d. continuing nursing program
ANS: B
Feedback: Baccalaureate-prepared nurses have the greatest potential for qualifying for
nursing positions at both staff and managerial levels. Hospital-based diploma programs are
3- year courses and provide maximum exposure to clinical nursing. Students becoming
nurses through the associate degree program would not be expected to work in a
management position. Continuing nursing programs are on-the-job educational programs.
PTS: 1 REF: p. 11
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
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Test Bank - Timby's Fundamental Nursing Skills and Concepts, 12th Edition (Donnelly-Moreno, 2021)
LOC: Client Needs Pn: Safe, Effective Care Environment: Coordinated Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
6. A client is brought to the emergency department with a head injury following an all-terrain
vehicle (ATV) accident. The nurse asks the family members to describe how the accident
occurred. The nurse is implementing which type of skill?
a. assessment skills
b. caring skills
c. counseling skills
d. comforting skills
ANS: A
Feedback: The immediate requirement when a client is brought to the emergency
department with a head injury is to assess the injury and the system affected, as well as a
description of how the accident occurred. This requires implementation of assessment skills.
Subsequently, the nurse can implement caring skills, counseling skills, and comforting
skills; however, assessment should be the priority.
PTS: 1 REF: p. 15
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
7. Training schools for nurses were established in the United States after the Civil War. The
standards of U.S. schools deviated from those of the Nightingale paradigm. Which
statement is true about U.S. training schools?
a. Training schools were affiliated with a few select hospitals.
b. Training of nurses provided no financial advantages to the hospital.
c. Training was formal, based on nursing care.
d. Training schools eliminated the need to pay employees.
ANS: D
Feedback: Training schools in the United States profited by eliminating the need to pay
employees because students worked without pay in return for training, which usually
consisted of chores. U.S. training schools were established by any hospital; there was no
formal training. Training was an outcome of work, which eliminated the need to pay
employees. Nightingale training schools were affiliated with a few select hospitals, training
of nurses provided no financial advantages to the hospital, and the training was formal,
based on nursing care.
PTS: 1 REF: p. 5
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
LOC: Client Needs Pn: Safe, Effective Care Environment: Coordinated Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
8. In a nursing unit, the RN delegates nursing tasks to the LPN. Keeping in mind the
delegation guidelines, which statement denotes the right task for the LPN?
a. Make beds with the help of unlicensed assistive personnel.
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Test Bank - Timby's Fundamental Nursing Skills and Concepts, 12th Edition (Donnelly-Moreno, 2021)
b. Assist clients with nasogastric tube feeds.
c. Take orders from an in-house physician.
d. Assess the client's needs and start an intravenous line.
ANS: B
Feedback: Assisting clients with nasogastric tube feeding is an appropriate task for an LPN,
as it does not require independent decisions and sophisticated techniques. According to the
delegation guidelines, "right task" means that the task should be assigned according to the
competency of the caregiver. LPNs may not be authorized to make independent decisions,
like starting an IV line, for the client. Bed making is a very basic task and may not be
appropriate for an LPN if the UAP is already present. When the RN and LPN are present,
the RN takes the physician's orders.
PTS: 1 REF: p. 8
NAT: Client Needs: Physiological Integrity: Basic Care and Comfort
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
9. A 50-year-old client reports to a primary care unit with an open wound due to a fall in the
bathroom. Which nursing actions represent caring skills?
a. The nurse cleans the wound and applies a dressing to it.
b. The nurse inspects and examines the wound for swelling.
c. The nurse tells the client to take care while on slippery surfaces.
d. The nurse informs the client that the wound is small and will heal easily.
ANS: A
Feedback: The nursing action of cleaning the wound and applying a dressing indicates
caring skills. Caring skills involve nursing interventions that restore or maintain a person's
health. The nurse implements assessment skills while inspecting and examining the wound.
The nurse counsels the client to take care when walking on slippery surfaces. By informing
the client about the wound's condition, the nurse uses comforting skills.
PTS: 1 REF: p. 15
NAT: Client Needs: Physiological Integrity: Basic Care and Comfort
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Caring
BLM: Cognitive Level: Understand NOT: Multiple Choice
10. The scope and character of nursing practice underwent significant changes in the years
following the Civil War. Which activity exemplifies nursing practice in the early years of
the 20th century?
a. providing basic health care to recent immigrants to the United States
b. contributing to the scientific knowledge base of nursing by conducting research
c. participating in collaborative practice with physicians
d. establishing school nursing as a recognized specialty in urban settings
ANS: A
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Test Bank - Timby's Fundamental Nursing Skills and Concepts, 12th Edition (Donnelly-Moreno, 2021)
Feedback: In the early 20th century, some nurses moved into communities and established
"settlement houses" where they lived and worked among poor immigrants. This period of
history was not characterized by collaboration between physicians and nurses due to the
subservient view of nursing that prevailed. Research and school nursing were not major
focuses at this time.
PTS: 1 REF: p. 4
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Understand NOT: Multiple Choice
11. A nursing student has begun a clinical placement at a large hospital that serves a diverse
population. The student has consequently acquired a new appreciation for the fact that
nursing combines art with science. What is the clearest manifestation of the scientific basis
for nursing?
a. mentoring students and junior nurses
b. providing evidence-based nursing care
c. maintaining an attitude of curiosity
d. participating in continuing educational activities
ANS: B
Feedback: By developing an accumulating body of unique scientific knowledge, it is now
possible to predict which nursing interventions are most likely to produce desired outcomes,
a process referred to as evidence-based practice (EBP). EBP is possible because of the
scientific basis that underlies nursing. Mentoring, maintaining curiosity, and participating in
continuing education are beneficial, but these are not direct manifestations of the scientific
basis for nursing.
PTS: 1 REF: p. 6
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Understand NOT: Multiple Choice
12. Beginning with Florence Nightingale, many definitions of nursing have been put forth by
individual nurses and by nursing organizations. Which statement best describes an aspect of
the changes in these definitions over time?
a. drawing a clear distinction between the art of nursing and science of nursing
b. definitions of nursing that have become narrower in scope over time
c. characterization of nursing as a discipline that is a distinct alternative to medical
treatment
d. definition of an independent health care practice that is not solely dependent on
physicians
ANS: D
Feedback: The most recent definitions of nursing specify that nursing has an independent
area of practice in addition to traditional dependent and interdependent functions involving
physicians. This does not mean, however, that nursing is an alternative to medical treatment.
Definitions have become broader over time and address the fact that nursing combines art
with science.
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Test Bank - Timby's Fundamental Nursing Skills and Concepts, 12th Edition (Donnelly-Moreno, 2021)
PTS: 1 REF: p. 6
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
13. A team of nurses who provide care in a community hospital have been encouraged to
participate in continuing educational activities. Why is continuing education needed in
nursing?
a. Continuing education helps to delineate the distinctions between nurses and
physicians.
b. Continuing education increases the public visibility of individual nurses and the
nursing profession.
c. Continuing education has the potential to partially alleviate the nursing shortage.
d. Continuing education allows for safer division of labor on hospital units and more
effective delegation of tasks.
ANS: C
Feedback: Health care officials hope that enrollment in all nursing programs and continuing
education will reduce the current and projected critical shortage of nurses. Continuing
education is not driven by a desire to increase the visibility of nursing, to draw distinctions
between nursing and medicine, or to facilitate the division of labor.
PTS: 1 REF: p. 11
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
14. A nurse has completed a hospital-based educational program that has allowed the nurse to
become cross-trained. A nurse who is cross-trained is able to:
a. perform certain nonnursing duties in addition to traditional nursing duties.
b. adopt a work schedule that deviates from the normal shift rotation at the hospital.
c. orientate new graduates and nursing students to the hospital.
d. retire with full benefits at an earlier date than a nurse who is not cross-trained.
ANS: A
Feedback: A nurse who is cross-trained is able to assume nonnursing jobs, depending on the
census or levels of client acuity on any given day. This does not necessarily guarantee
changes to work scheduling or earlier retirement. Cross-training does not address the
orientation of new employees or students.
PTS: 1 REF: p. 12
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Understand NOT: Multiple Choice
15. A medical-surgical unit manager intends to have licensed practical nurses (LPNs) in the unit
administer intravenous push (IVP) medications. What source would the manager contact to
include this procedure in the LPNs' practice?
a. American Nurses Association (ANA)
b. state nurse practice act (NPA)
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Test Bank - Timby's Fundamental Nursing Skills and Concepts, 12th Edition (Donnelly-Moreno, 2021)
c. facility policies and procedures committee
d. National League of Nursing (NLN)
ANS: B
Feedback: Each state has its own NPA, which determines what the nurse is allowed to do in
each particular state, providing constraints within which nurses practice. The NPA
delineates scope of practice. Therefore, the manager would contact the NPA in this scenario.
The other sources are not appropriate given the context of the scenario.
PTS: 1 REF: p. 8
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Nursing Foundations BLM: Cognitive Level: Analyze
NOT: Multiple Choice
16. The nurse is caring for a client who cannot meet health needs independently. Which action
made by the nurse depicts concern and attachment?
a. telling the client, "I will be back in 15 minutes to change your dressing."
b. asking the client, "How are you today? I am really worried about you."
c. talking about diabetes and teaching the client how to do foot care
d. organizing the work for the day and evaluating how the day went
ANS: B
Feedback: Concern and attachment are the result of a close relationship of one human being
with another. Thus, asking the client how the client is feeling and expressing concern
exemplifies caring. Stability and security, communication and teaching, and organization
and evaluation are physical care themes that are part of nursing care.
PTS: 1 REF: p. 15
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Caring
BLM: Cognitive Level: Apply NOT: Multiple Choice
17. A registered nurse (RN) is caring for four clients on a medical-surgical unit. Which task is
most appropriate for the nurse to delegate to the licensed practical nurse (LPN)?
a. administering bedside blood glucose testing
b. administering blood products
c. administering intravenous push medication
d. administering chemotherapy
ANS: A
Feedback: The LPN, under the nurse practice act (NPA), is permitted to administer testing
for bedside blood glucose. The nurse must recognize the scope of practice of the delegate,
and remember that client needs and activities delegated must be matched to skill level. The
RN would not delegate administration of blood products, intravenous push medication, or
chemotherapy to the LPN, as these tasks are not covered under the LPN's NPA.
PTS: 1 REF: p. 8
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
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Test Bank - Timby's Fundamental Nursing Skills and Concepts, 12th Edition (Donnelly-Moreno, 2021)
18. A middle-aged nurse is concerned about a potential shortage of nurses when the baby
boomer generation retires. What proactive intervention can the nurse take to address this
anticipated deficit of nurses?
a. develop a community program related to healthy nutrition and exercise
b. recruit more nurses to the acute care facility
c. encourage parents to immunize their children
d. lobby to increase the retirement age
ANS: A
Feedback: The promotion of wellness is important not only in community, but also in
nationwide health. Promotion of healthy habits and nutrition/exercise will be able to
decrease some of the risk factors leading to acute and chronic illnesses and will lead to a
decrease in hospital admissions. If effective, it would contribute to the management of
issues that require an increase in the number of nurses required. Nurses fill roles other than
in acute care facilities and the recruitment of more nurses to those facilities does not address
the issue of the shortage in other areas of nursing. Immunization of children does not affect
the nursing shortage directly because there is not a relationship between the lack of
immunization increasing the risk of illness to the present nurses employed in the field .
Increasing the retirement age can have a detrimental affect on those nurses being required to
work with age- related changes affecting health.
PTS: 1 REF: p. 8
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Apply NOT: Multiple Choice
19. The nurse is caring for a client at the end stage of life. The client is crying and states to the
nurse, "I just cannot believe I am going to be leaving my children without a parent. I am not
ready to go." What response by the nurse demonstrates the expression of empathy to the
client?
a. "This is so sad and I feel so bad that you are in this situation."
b. "It sounds as though you are most concerned about how your children will feel."
c. "I am so sorry that I am crying with you when you need my support the most."
d. "This just is not fair at all and I do not understand why this is happening to you."
ANS: B
Feedback: The nurse is demonstrating empathy when reiterating what the client is saying.
This helps the nurse become effective at providing for the client's emotional needs while
maintaining detachment. The other responses indicate that the nurse is feeling sympathy for
the client, which includes feeling as emotionally distraught as the client. While this may be
an unavoidable response, it may not help the client move through the grieving process as
effectively.
PTS: 1 REF: p. 15 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 1: Nursing Foundations KEY: Integrated Process: Caring
BLM: Cognitive Level: Apply NOT: Multiple Choice
20. The nurse is delegating tasks to the unlicensed assistive personnel (UAP) prior to beginning
the shift on the acute care unit. Which task would be appropriate to delegate to the UAP?
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