Test Bank for Fundamentals of Nursing
Care: Concepts, Connections & Skills 4th
Edition
, TABLE OF CONTENTS
Chapter 1 The Vista of Nursing
Chapter 2 Health-Care Delivery, Settings and Economics
Chapter 3 Ethics, Law, and Delegation in Nursing
Chapter 4 The Nursing Process: Critical Thinking, and Decision Making
Chapter 5 Documentation
Chapter 6 Communication and Relationships
Chapter 7 Promoting Health and Wellness
Chapter 8 Ethnic, Cultural, and Spiritual Aspects of Care
Chapter 9 Growth and Development throughout the Lifespan
Chapter 10 Loss, Grief, and Dying
Chapter 11 Complementary and Alternative Medicine
Chapter 12 Patient
Chapter 13 Safety
Chapter 14 Medical Asepsis and Infection Control
Chapter 15 Personal Care
Chapter 16 Moving and Positioning Patients
Chapter 17 Vital Signs
Chapter 18 Applying Heat and Cold
Chapter 19 Pain Management, Rest, and Restorative Sleep
Chapter 20 Admission, Transfer, and Discharge
Chapter 21 Physical Assessment
Chapter 22 Surgical Asepsis
Chapter 23 Nutrition
Chapter 24 Nutritional Care and Support
Chapter 25 Diagnostic Tests
Chapter 26 Wound Care
Chapter 27 Musculoskeletal Care
Chapter 28 Respiratory Care
Chapter 29 Fluids, Electrolytes, and Introduction to Acid-Base Balance
Chapter 30 Bowel Elimination and Care
Chapter 31 Urinary Elimination and Care
Chapter 32 Care of Elderly Patients
Chapter 33 Care of the Surgical Patient
Chapter 34 Phlebotomy and Blood Specimens
Chapter 35 Researching and Preparing Medications
Chapter 36 Administering Oral, Topical, and Mucosal Medications
Chapter 37 Administering Intradermal, Subcutaneous, and Intramuscular Injections
Chapter 38 Intravenous Therapy
,Chapter 1 The Vista of Nursing
1. The first practicing nurse epidemiologist was
a. Florence Nightingale.
b. Mildred Montag.
c. Clara Barton.
d. Mary Agnes Snively.
ANS: A
Nightingale was the first practicing nurse epidemiologist. Her statistical analyses connected poor
sanitation with cholera and dysentery. Mildred Montag, Clara Barton, and Mary Agnes Snively
came after Nightingale, each contributing to the nursing profession in her own way. Clara Barton
founded the American Red Cross. Dr. Mildred Montag established the first associate degree
nursing program in 1952. Mary Agnes Snively began forming the Canadian National Association
of Trained Nurses in 1883.
2. The American Red Cross was founded by
a. Florence Nightingale.
b. Harriet Tubman.
c. Clara Barton.
d. Mary Mahoney.
ANS: C
In 1882, the United States ratified the American Red Cross, founded by Clara Barton. Florence
Nightingale established the Training School for Nurses in London, England, in 1860. Harriet
Tubman was active in the Underground Railroad movement during the American Civil War.
Mary Mahoney was the first professionally trained African American nurse.
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3. Nurses working in the Henry Street Settlement in 1893 were among the first nurses to
demonstrate autonomy in practice. This was because those nurses
a. Had no ability to work in the hospital setting.
b. Were required to use critical thinking skills.
c. Focused solely on healing the very ill.
d. Planned their care around research findings.
ANS: B
In 1893, nurses working in the Henry Street Settlement were some of the first to demonstrate
autonomy in practice because they encountered situations that required quick and innovative
problem solving and critical thinking, and provided therapies aimed at maintaining wellness, as
well as curing the ill. Nursing hospitals expanded in the late nineteenth century and were major
providers of nursing care. Not until the early twentieth century was there a movement toward a
scientific, research-based body of nursing knowledge.
4. In 1923, the Goldmark Report was an important study that
a. Formed formal nurse midwifery programs.
b. Established the Center for Ethics and Human Rights.
c. Revised the ANA code of ethics.
d. Led to the development of the Yale School of Nursing.
ANS: D
In 1923, the Goldmark Report identified the need for increased financial support for university-
based schools of nursing. As a result, the Yale School of Nursing was developed. Graduate nurse
midwifery programs did not come into existence until the 1940s, and the Center for Ethics and
Human Rights was founded in 1990. The ANA code of ethics was published in 1985 and was
last updated in 2001.
5. The major difference between a baccalaureate degree nursing program and an associates
degree nursing program is that the baccalaureate program includes studies in
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a. Basic sciences and theoretical courses.
b. Social sciences and humanities.
c. Theoretical and clinical courses.
d. Basic sciences and clinical courses.
ANS: B
Both associates degree programs and baccalaureate programs focus on basic sciences and on
theoretical and clinical courses. Baccalaureate programs, however, also focus on courses in the
social sciences, arts, and humanities to support nursing theory.
6. The nurse has been working in the clinical setting for several years as an advanced practice
nurse and has earned her masters degree as a family nurse practitioner. However, she seems
unfulfilled and has a strong desire to do research. To fulfill her desire, the nurse most likely
would apply to attend a program that would lead to a
a. Doctor of Nursing Science degree (DNSc).
b. Doctor of Philosophy degree (PhD).
c. Doctor of Nursing Practice degree (DNP).
d. Doctor in the Science of Nursing degree (DSN).
ANS: B
PhD programs emphasize basic research and theory and are research oriented. Professional
doctoral programs in nursing (DSN or DNSc) prepare graduates to apply research findings to
clinical nursing. The DNP is a practice doctorate that prepares advanced practice nurses such as
nurse practitioners.
7. The nurse is caring for her patients and is focused on managing their care as opposed to
managing and performing skills. This nurse demonstrates which level of proficiency according to
Benner?
a. Novice
b. Competent
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c. Proficient
d. Expert
ANS: C
The proficient nurse focuses on managing care as opposed to managing and performing skills.
The novice nurse deals with a specific set of rules or procedures, which are usually stepwise and
linear. The competent nurse understands the organization and the specific care required by
specific types of patients and has experience with psychomotor skills. The expert nurse identifies
patient-centered problems, as well as problems related to the health care system.
8. Which of the following resources guides faculty on structure and evaluation of the nursing
curriculum?
a. ANAs Standards of Nursing Practice
b. Essentials of Baccalaureate Education
c. NLNAC Interpretive Guidelines
d. Standards of Professional Performance
ANS: B
The American Association of Colleges of Nursing (AACN) published Essentials of
Baccalaureate Education for Professional Nursing: A Final Report (1998), which guides faculty
on structure and evaluation of the curriculum and the performance of the graduate. The ANAs
Standards of Nursing Practice demonstrates the critical thinking model known as the nursing
process. Standards of Professional Performance describes a competent level of behavior in the
professional role. NLNAC Interpretive Guidelines identifies core competencies for the
professional nurse.
9. The nurse is caring for the patient who has had major abdominal surgery and also has a large
sacral pressure sore. The nurse implements coughing and deep breathing exercises and consults
the wound care specialist to evaluate and prescribe care for the pressure sore, even though no
physician order has provided instructions to do so. In doing this, the nurse is implementing the
element of
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a. Autonomy.
b. Accountability.
c. Advanced practice.
d. Nurse practitioner.
ANS: A
Autonomy is an essential element of professional nursing. Some independent nursing
interventions such as implementing coughing and deep breathing exercises and collaboration
with other health professionals can be initiated without medical orders. Accountability means
that the nurse is responsible, professionally and legally, for the type and quality of nursing care
provided. Advanced practice nurse is an umbrella term for advanced clinical nurses such as nurse
practitioners who provide care to a group of patients.
10. The physician is planning to take the patient to surgery in the morning and leaves an order
for the nurse to get the patient to sign the surgical permit. The physicians note indicates that the
patient has been educated on the procedure. However, the patient tells the nurse, I have no idea
what hes going to do. He rushed in and rushed out so fast, I couldnt ask any questions. The nurse
does not allow the patient to sign the permit and calls the physician to inform him of the patients
statement. This is an example of the nurse acting as
a. Patient advocate.
b. Patient educator.
c. Manager.
d. Clinical nurse specialist.
ANS: A
As a patient advocate, the nurse protects the patients human and legal rights, including the right
of the patient to understand procedures before signing permits. Although nurses can be
educators, it is the responsibility of the surgeon to provide education for the patient in
preparation for surgery, and it is the nurses responsibility to notify the physician if the patient is
not properly educated. Managers coordinate the activities of members of the nursing staff in
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delivering nursing care, and clinical nurse specialists are experts in a specialized area of nursing
practice in a variety of settings.
11. The patient requires routine gynecological services after giving birth to her son, and while
seeing the nurse midwife, she asks for a referral to a pediatrician for the newborn. The nurse
midwife should
a. Provide the referral as requested.
b. Offer to provide the newborn care.
c. Refer the patient to the supervising physician.
d. Tell the patient that she cannot make referrals.
ANS: B
The practice of nurse midwifery involves providing independent care for women during normal
pregnancy, labor, and delivery, as well as care for the newborn. As an independent practitioner,
supervising physicians are not required by the certified nurse midwife (CNM). However, a CNM
practices with a health care agency that provides medical consultation, collaborative
management, and referral. After being apprised of the CNM role, if the patient insists on seeing a
pediatrician, the nurse midwife should provide the referral.
12. The student nurse has a goal of becoming a certified registered nurse anesthetist (CRNA). It
is important for the student to understand that the CRNA
a. Works under the guidance of an anesthesiologist.
b. Manages acute medical conditions.
c. Manages gynecological services such as PAP smears.
d. Must have a PhD degree in anesthesiology.
ANS: A
Nurse anesthetists provide surgical anesthesia under the guidance and supervision of an
anesthesiologist, who is a physician with advanced knowledge of surgical anesthesia. Nurse
practitioners, not CRNAs, manage self-limiting acute and chronic stable medical conditions;
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certified nurse midwives provide gynecological services such as routine Papanicolaou (Pap)
smears. The CRNA is an RN with an advanced education in a nurse anesthesia accredited
program. A PhD is not a requirement.
13. The nurse is speaking in front of a group of ninth grade students about nursing as a
profession. One student states that she does not want to be a nurse because all nurses do is take
care of sick people and play politics. The most appropriate response that the nurse could give and
expand on is that
a. Nursing is ideal for the person who hates politics.
b. Nursing focuses on curing the persons disease.
c. Nursing is not political because it has its own knowledge base.
d. An area of nursing exists for every interest.
ANS: D
It is important to remember that opportunities are limitless for caring, compassionate, and
competent nursing care; an area of nursing exists for every interest. Current philosophies and
definitions of nursing demonstrate the holistic trend in nursingto address the whole person in all
dimensions, in health and illness, and in interaction with family and community. Political
activism and commitment are a part of professionalism and are an important aspect of the
delivery of health care. Nursing continues to draw on the social sciences and other fields as the
focus of nursing care expands.
14. A bill has been submitted to the State House of Representatives that is designed to reduce the
cost of health care by increasing the patient-to-nurse ratio from a maximum of 2:1 in intensive
care units to 3:1. The nurse realizes that
a. Legislation is politics beyond the nurses control.
b. National programs have no bearing on state politics.
c. The individual nurse can influence legislative decisions.
d. Focusing on nursing care provides the best patient benefit.
ANS: C
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Nurses can influence policy decisions at all governmental levels. One way is to get involved in
ANAs national efforts, such as Nursings Agenda for the Future: A Call to the Nation. This effort
is critical in exerting nurses influence early in the political process. Nurses need to become
serious students of social needs, activists in influencing policy to meet those needs, and generous
contributors of time and money to nursing organizations and candidates to help legislate
conditions that are likely to produce the best care possible.
15. During the American Civil War, which of the following women was active in the
Underground Railroad movement and assisted in leading more than 300 slaves to freedom?
a. Harriet Tubman
b. Clara Barton
c. Dorothea Dix
d. Mary Ann Ball (Mother Bickerdyke)
ANS: A
Harriet Tubman was active in the Underground Railroad movement and assisted in leading more
than 300 slaves to freedom. Clara Barton, founder of the American Red Cross, tended soldiers on
the battlefields, cleansing their wounds, meeting their basic needs, and comforting them in death.
As superintendent of the female nurses of the Union Army, Dorothea Lynde Dix organized
hospitals, appointed nurses, and oversaw and regulated supplies to the troops. Mother
Bickerdyke organized ambulance services and walked abandoned battlefields at night, looking
for wounded soldiers.
16. Graduates of baccalaureate degree or associates degree nursing programs are eligible to take
which of the following to become registered nurses in the state in which they will practice?
a. Continuing education credits
b. In-service education programs
c. National Council Licensure Examination
d. Graduate education
ANS: C
