Week 1

1. A client asks the nurse “Can you explain Medicare, an amendment to the Social
Security Act?” The nurse responds that Medicare:

A. Led to many hospital closings

B. Provided medical insurance to those younger adults or children who were not eligible
for private insurance because of catastrophic illnesses such as cancer
C. Provided preventative care for women, infants, and children
D. Ensured that individuals ages 65 and older and those with end-stage renal disease
or permanent disabilities had health care insurance

2. A comparison of nursing in the 1980s to nursing in the 1990s reveals that:

A. in the 1990s nursing experienced a significant reduction occurred in preventable

diseases caused by unsafe/unhealthy lifestyles
B. Tuberculosis was the primary concern for nursing in the 1980s, whereas the AIDS
epidemic emerged and was its focus during the 1990s
C. a decrease in ambulatory services in the 1980s prompted an increase in public
health nurses in the 1990s
D. the demand for advanced practice nursing increased in the 1980s and the 1990s as
a result of the economy and concern about the health of the nation.

3. World War I contributed to the advancement of health care by:

a.increasing the number of private care hospitals and decreasing the role of public
health services.
b. employing a large number of civilians to provide care to returning soldiers through
the Red Cross.
C. introducing specialists in nursing such as nurse anesthetists.
d. increasing the number of community health nurses.

4. What historical event first led to the recognition of the contribution of blacks to
nursing?

a. Florence Nightingale's acceptance of black nurses into the first nursing school
b. The contributions of black nurses at the Pennsylvania Hospital, the first hospital in
America
c. Mary Seacole's efforts to care for soldiers during the Crimean War
d. The work done by wives of wealthy black nobles who carried food and medicine from
house to house during the Middle Ages
5. The requirements for early nursing school applicants asked that applicants are
submissive to authority, sensitive, and display "ladylike behavior".
Group of answer choices

True
False
Answer: True

6. Goals of nursing education include which of the following? (Choose all that
apply)

To develop concepts of professionalism

To identify values and ethical standards for practice
To think like a nursing assistant because that is all you will be responsible for
To see the healthcare world through the practice of nursing
To acquire new knowledge and skills

7. Which statement is true regarding the image of nursing?

A. The most effective way to protect the image of nursing is for nurses to
demonstrate professional behavior.
B. Nurses must ignore the negative images portrayed in the public regarding the
profession.
C. Nurses must protect the image of the profession by avoiding conversations
specific to issues of image.
D. The American Nurses Association does not have services related to professional
standards.

8) Which of Florence Nightingale's nursing principles is still practiced today?

A) The nurse's role is defined by the physician's orders.

B) The nurse's primary role is to spend time caring for others.
C) The nurse is viewed as an independent healthcare provider
D) The nurse is tasked with the responsibility of keeping the environment clean

9. In 1851 Mary Seacole went to Panama to visit her brother who had gone there
to open up a hotel in Cruces. Shortly after she arrived the town, cholera struck.
Which of these did Seacole NOT use in her treatment of cholera?

A. Mustard
B. Mercury chloride
C. Cinnamon
D. Opium
10. Florence stood up for what two things.
A. fair wages for nurses
B. education and women's rights
C. cleaning up after oneself
D. not fighting wars

11) The nurse manager has four different generations represented in the nursing
staff on the unit. What statements indicate the manager is wise about how to deal
with this generational mix?
Select all that apply.

1. "I don't see why everyone can't just get along."

2. "Generation X nurses are just lazy."
3. "Our Generation Y nurses help keep us all up on new technology."
4. "The most loyal of all my nurses are the traditionalists."
5. "I expect that our next manager will come from my group of baby boomers."

12. Florence earned what nickname for checking on people during the night?
A. The lady of the dark.
B. The midnight princess.
C. The late night nurse.
D. The lady with the lamp

13. What day is National Nurses Day celebrated in the US?

A. May 2nd
B. May 10th
C. May 6th
D. May 12th

14. How did Florence help many people?

A. She sang them songs.
B. She taught them to read
C. She trained many nurses.
D. She fought in the war.

15.To be effective in today's healthcare system, the nurse manager must be

aware of which trends? Select all that apply.

1. An environment that does not change

2. Decreasing resources
3. Adequate staffing
4. Increasing numbers of retirees
5. Complicated technology
16) The nurse executive is reviewing statistics about the nursing staff. Which
statistic shows that the staff reflects national trends?

1. The average age of the nursing staff is 40.

2. The number of nurses under age 30 has increased in the last two years.
3. There are no nurses older than age 55.
4. All nurses older than age 45 are managers.

17) A client who was discharged yesterday is very upset about the quality of care
received during hospitalization for gastric surgery. What options for reporting
concerns does this client have? Select all that apply.

1. There is no mechanism for complaint because the client is no longer hospitalized.

2. The client can indicate dissatisfaction on the survey often sent to clients after
discharge.
3. The client can call the hospital administration.
4. The client can make a formal complaint through the American Nursing Association
(ANA).
5. The client can make a public report through the Agency for Healthcare Research and
Quality (AHRQ).

18) Which organization would the hospital management team contact to pursue
certification as a Magnet hospital?

1. Magnet Recognition Program

2. American National Magnet Commission
3. The Joint Commission
4. American Medical Association (AMA)

19) A graduating nurse is deciding which nursing specialty would be a good

place to begin a nursing career and ensure long-term stability. Which specialty is
most likely to have the greatest growth in need?

1. Pediatric nursing
2. Psychiatric nursing
3. Geriatric nursing
4. Maternity nursing

20) A beginning nursing student asks about the principles taught by the
Nightingale Nursing School. What should the nurse's answer include? Select all
that apply.

A) Cleanliness is vital to recovery.

B) Cure is better than prevention.
C) The nurse must work as a member of a team.
D) The nurse should be healthy in both mind and in body
E) The nurse must use discretion, but must follow the physician's orders.

Week 2

21. A nurse delegates a LNP to provide one on one observation for a client
who requires suicide precautions. Which of the following actions by the LPN
should indicate to the nurse that she requires further teaching?

a. Accompanying the client to physical and occupational therapy

b. Ambulating the clients roommate while the client sleeps
c. Asking the nurse at lunchtime to assign another LPN to perform this
task until her return
d. Remaining with the client while family members are visiting

22. A charge nurse on a medical surgical unit is assigning client care to the
upcoming shift. Which of the following tasks should the nurse delegate to an
assistive personnel? SATA

a. Performing colostomy care

b. Measuring a clients intake and output
c. Interpreting a clients laboratory values following surgery
d. Providing postmortem care to a client
e. Checking nasogastric tube patency

23. A nurse delegated the task of emptying a indwelling urinary catheter

drainage bag to an assistive personnel. The nurse later observes the AP
emptying the bag without wearing gloves. Which of the following action should
the nurse take?

a. Notify the charge nurse about the incident

b. Insist that the AP attend an in service training about standard
precautions
c. Talk with the AP about the technique used and educate proper
technique
d. Observe the AP a second time and intervene if the technique is the
same

24. A nurse is caring for a client who is scheduled to have his chest tube
removed. Which of the following actions should the nurse take?

a. Delegate the removal of the chest tube to a LNP

b. Provide pain medication immediately after removal
 c. Delage the AP to dress the patients wound with a hydrocolloid
dressing after removal
d. Instruct client to perform the Valsalva maneuver during
removal

25. A nurse delegates the collection of a client’s temperature to an AP. The

nurse notes the documentation that the AP obtained the clients axillary temp
however the nurse wanted an oral temp. The nurse should identify that which of
the following rights of delegation should have prevented this situation from
occurring?

a. Right task
b. Right circumstance
c. Right person
d. Right communication

26. A nonprofit organization that distributes to governmental agencies, the public,

business, and health care professional’s knowledge related to health care for the
purpose of improving health is the:

a. Institute for Safe Medication Practices.

b. Institute of Medicine.
c. National Committee for Quality Assurance.
d. The Joint Commission.
 
27. A nurse is removing a saturated dressing from an abdominal incision and must cut
the tape to remove the dressing. The nurse accidentally cuts the sutures holding the
incision, and evisceration occurs. In quality improvement, this incident is best identified
as a:
a. root cause.
b. sentinel event.
c. variation in performance.
d. causal factor.

28. A nurse is assisting with the delivery of twins. The first infant is placed on the scale
to be weighed. The physician requests an instrument stat. The nurse turns to hand the
instrument to the physician, and the infant falls off the scale. When evaluating the
incident, the nurse and her manager list contributory factors such as the need for two
nurses when multiple births are known, and the location of the scale so far from the
delivery field. These nurses are performing a(n):

a. standardization of care.
b. root cause analysis.
c. process variation.
d. analysis of a deployment flowchart.

29. An organization's emergency preparedness task force meets to discuss how it

should react in case of a terrorist attack and develops a disaster evacuation plan that
details how each department will assist individuals in reaching safety. This type of
diagram is referred to as a:
a. Pareto chart.
b. control chart.
c. top-down flowchart.
d. deployment chart.
 
30. A group of nurses is presenting the importance of high-quality care during a system-
wide meeting of medical-surgical nurses. They point out a finding of the Quality Chasm
that:

a. being insured has little effect on a person's longevity and the quality of care received.
b. lobbyists for the drug companies are able to gain permission for the use of new drugs
within 1 year of their discovery.
c. although a greater number of lawsuits stem from medication errors, more people
actually die from human immunodeficiency virus (HIV) and acquired immunodeficiency
disease syndrome (AIDS).
d. medication-related errors place a tremendous financial burden on the U.S. health
care system.

31. A nurse on a medical unit is caring for a client who has been coughing intermittently
during meals, attempting to clear her throat repeatedly, and eating only a small portion
of each meal. The nurse should recommend a referral to which of the following
members of the interprofessional team to evaluate the client for dysphagia?

a. Speed-language pathologist
b. Social worker
c. Physical therapist
d. Occupational therapist 
32. A nurse is caring for a client who had a stroke and has difficulty using adaptive
devices for eating. The nurse should initiate a referral to which of the following members
of the interprofessional healthcare team?
a. Occupational therapist
b. Social worker
c. Registered dietitian
d. Physician assistant 
 33. A nurse is assisting with planning the discharge of a client who requires bilevel
positive airway pressure (BiPAP) at night to treat obstructive sleep apnea. The nurse
should arrange a consultation with which of the following members of the
interdisciplinary team?

e. Occupational therapist
f. Physical therapist
g. Respiratory therapist 
h. Paramedical technologist 
34. A nurse is coordinating an interprofessional team to review proposed standards
to reduce the transmission of methicillin-resistant Staphylococcus aureus (MRSA).
which of the following members of the interprofessional team should the nurse
consult?

a. Risk management coordinator

b. Clinical pharmacist
c. Nursing supervisor
d. Infection control nurse
35. A nurse is caring for a client who has anorexia nervosa. Which of the following
interdisciplinary team members should be consulted in regard to this client's care?
(select all that apply)

e. Nutritional therapist
f. Case manager 
g. Mental health counselor
h. Occupational therapist
i. Physical therapist

Week 3

36. Holding a medication for a patient who has an absolute contraindication to the
drug is an example of which of the following ethical principles:

a. Veracity
b. Autonomy
c. Negligence
d. Correct: Non-Maleficence

37. What is the ethical principle describing being honest and truthful to clients?

a. Correct: Veracity
b. Autonomy
c. Non-Maleficence
d. Goodness

38. Supporting a client’s choice to not have a surgical operation and informing
the provider of their decision is an example of which ethical principle?

a. Veracity
b. Non-Maleficence
c. Correct: Autonomy
d. Tort

39. Threatening to administer medications to a client against their will is an

example of:

a. Battery
b. Correct: Assault
c. False Imprisonment
d. Manslaughter

40. A nurse is caring for a client who decides not to have surgery despite
significant blockages in his coronary arteries. The nurse understands that this
client's choice is an example of which of the following ethical principles?

A. Fidelity
B. Correct: Autonomy
C. Justice
D. Nonmaleficence

41. A nurse offers pain medication to a client who is postoperative prior to

ambulation. The nurse understands that this aspect of care delivery is an
example of which of the following ethical principles?

A. Fidelity
B. Autonomy
C. Justice
D. Correct: Beneficence

42. A nurse is instructing a group of nursing students about how to know and
what to expect when ethical dilemmas arise. Which of the following situations
should the students identify as an ethical dilemma?

A. A nurse on a medical-surgical unit demonstrates signs of chemical impairment.

B. A nurse overhears another nurse telling an older adult client that if he doesn't stay in
bed, she will have to apply restraints.
C. Correct: A family has conflicting feelings about the initiation of enteral tube feedings
for their father, who is terminally ill.
D. A client who is terminally ill hesitates to name her spouse on her durable power of
attorney form.

43. A nurse manager is teaching the purpose of the nurse's Code of Ethics to a
group of high school students. Which statement by one of the students indicates
that the teaching has been effective? The purpose of the nurse's Code of Ethics
is:

a. "to assist in clarifying the individual nurse's personal values and goals."
b. "to differentiate between moral and immoral acts."
c. Correct: "to guide the behavior of the professional nurse."
d. "to identify acts that are legal for the nurse to perform."

44. A nurse is instructing a group of nursing students about the responsibilities

involved with organ donation and procurement. When the nurse explains that all
clients waiting for a kidney transplant have to meet the same qualifications, the
students should understand that this aspect of care delivery is an example of
which of the following ethical principles?

A. Fidelity
B. Autonomy
C. Correct: Justice
D. Nonmaleficence

45. A nurse is assisting a client with an advance directive. Which of the following
nursing responsibilities should be included regarding advance directives? Select
all that apply.

a. Inform all members of the client's family of the client's wishes.

b. Ensure that each family member receives a copy of the advance directive.
c. Correct: Provide written information to the client about advance directives.
d. Correct: Document the client's advance directive in the medical chart.
e. Correct: Confirm that the advance directive is current.

46. A nurse is aware that the human genome project has numerous ethical
implications. This project examined:

a. Correct: The relationship between nursing and genetics

b. The arrangement of all the human genes
c. The future of disease treatment
d. The effects of drugs on human DNA
47. A nurse manager confronts a nurse with the smell of alcohol on her breath.
Which action should the nurse manager take?

a. Provide a series of counseling sessions with the nurse.

b. Talk with the nurse’s coworkers to determine a potential cause for the
impairment.
c. Correct: Set up a formal meeting with the nurse within 24hr.
d. Report the nurse’s chemical impairment to the risk manager.

48. A nurse is caring for a patient who states, “I just want to die.” What would be
the most appropriate topic to discuss in order to comply with this request?

a. Passive euthanasia
b. Living wills
c. Correct: Advanced directives
d. Assisted suicide

49. A nurse manager is providing information to the nurse on the unit about
ensuring client rights. Which of the following regulations outlines the rights of
individuals in health care settings?

a. American Nurses Association Code of Ethics

b. HIPAA
c. Correct: Patient Self-Determination Act
d. Patient Care Partnership

50. A nurse is reviewing a client’s health record and discovers that the client’s
do-no-resuscitate (DNR) prescription has expired. The client’s condition is stable.
Which of the following actions should the nurse take?
a. Assume that the client does not want to be resuscitated and take no action if they
experience cardiac arrest.
b. Write a note on the front of the provider prescription sheet asking that the DNR be re-
prescribed
c. Anticipate that CPR will be instituted if the client goes into cardiac arrest.
d. Correct: Call the provider to determine whether the prescription should be
immediately reinstated.

Week 4

51. The nurse manager is trying to determine whether the nursing staff is functioning
as a team or a group. Which characteristic would lead the manager to decide that
the nurses are functioning as a team?
a. They have clear goals and purpose.
b. They are not very well organized.
c. No one emerges as a leader.
 d. There is no evaluation of the work done.

52. A nurse is teaching a newly licensed nurse about methods to reduce cost of client
care. Which of the following statements by the newly licensed nurse indicates
understanding of teaching?

a. “I should wait to empty my client’s drainable colostomy until it is three-

fourths full”
b. “I should delegate providing closed irrigation to the assistive personnel
(AP).”
c. “I should encourage clients to receive an annual flu immunization.”
d. “I should recommend that my clients who have an established
tracheostomy use sterile technique at home to provide ostomy care.”

53. A nurse manager establishes staff nurse committees to address unit issues,
institutes an open-door policy for speaking about concerns, and supports professional
staff development. Which of the following leadership styles is this nurse manager
displaying?
a) Laissez-faire
b) Democratic
c) Autocratic
d) Transactional

54. Managing clinical outcomes, studying variance trends, and evaluating actions taken
to correct deviations from critical pathways are components of:

a) Performance improvement
b) Risk management
c) The nursing process
d) Utilization review

55. An experienced nurse is serving as a mentor to a newly licensed nurse. Which of

the following actions should the mentor take?

a) Establish a set of goals for the newly licensed nurse to achieve.

b) Establish a set timeframe with the newly licensed nurse for the mentorship
process.
c) Serve as a guide and teacher for the newly licensed nurse in an
established relationship.
d) Develop a program of study for the newly licensed nurse to follow.

56. As an advocate for the client, the nurse must make sure that “safe, effective care” is
given in conformity with the 

a) American Nursing Association (ANA)

b) Nurse Practice Act
 c) National council for licensure examinations
d) State board of licensure

57. A nurse manager believes that a nurse is taking breaks that are too frequent and
lengthy. Which assertive statement should the charge nurse use to initiate a discussion
of the issue?

a) “I understand you are allowed to take scheduled breaks during each shift,
but you are taking more than the number allocated. Let’s set a time when
we can discuss this behavior.”
b) “You are taking more breaks during each shift than hospital policy allows.
You will need to take only the number of breaks specified and ensure you
are back on time.”
c) “You have been taking too many breaks during each shift and do not
return on time after your break. I will have to make a formal note about this
issue that will be reflected on your next performance appraisal.”
d) “Why do you take so many breaks? Are you aware there is a policy that
designates how many breaks you can take?”

58. A nurse manager needs to address an increased rate of client medication errors.
Which of the following strategies represents an authoritarian approach to managing the
issue?
a) Inform the staff of the penalties that can results from medication errors
b) Encourage the staff to have 2 nurses verify medication orders to prevent
errors
c) Provide a suggestion box for the staff to submit ideas for error prevention
d) Ask 3 experienced nurses to help investigate common causes of the
errors

59. A mother and her three children often seek medical services at the emergency
room. The nurse realizes that they have no insurance and are unable to pay for
services. The action the nurse should take that would provide the greatest assistance to
the family would be to

a) Advise them to use urgent care centers where fees are lower
b) Leave the newspaper classified ads in a visible place
c) Advise the mother to seek work at the hospital personnel office
d) Contact a social worker to discuss medicaid with the mother

60. There have been several patient complaints that the staff members of the unit are
disorganized and that “no one seems to know what to do or when to do it.” The staff
members concur that they don’t have a real sense of direction and guidance from their
leader. Which type of leadership is this unit experiencing?
 
a) Autocratic
b) Bureaucratic
 c) Laissez-faire
d) Authoritarian

61. What is a disadvantage of using the team approach for care delivery? 
a) The team leader might not have the necessary leadership skills required
to successfully lead the team. 
b) There is a risk that care will be fragmented
c) This approach often leads to greeted staff dissatisfaction, with staff
members feeling like they are just grinding out tasks
d) This approach may lead to decreased collaboration and redundancy in
patient care
Week 5

62. The staff nurse is planning an educational session about computer systems and
infection control. Which item is the most appropriate for the nurse to include in the
educational session?
a. Disinfect computer keyboards and mice daily.
b. Avoid using sealed computer keyboards with built-in covers.
c. Wear gloves when using a computer keyboard or mouse.
d. Use a diluted bleach solution to clean computer keyboards.

63. A nurse on a medical-surgical unit is caring for a group of clients. For which of the
following situations should the nurse complete a variance report? 
a. A clarification of a medication dosage prescribed by a provider.
b. CORRECT! The discovery that a preoperative client has received and eaten
breakfast.
c. The identification of a safety concern with a piece of equipment.
d. A dispute with a coworker about client assignments.  

64. A charge nurse is performing a quality-assurance audit on the documentation of

several clients’ charts. Which of the following documentation items should the charge
nurse identify as a correct entry in the client’s medical record?
a. “The client appeared angry when family members were visiting.”
b. CORRECT! “The client ambulated for 10 min three times during the shift.”
c. “The client seemed to be upset about the diagnosis.”
d. “An incident report was completed when the client fell at 1000.”

65. A nurse is preparing to transfer an older adult client to a long-term care facility. To
promote   continuity of care, which of the following actions should the nurse plan to
take?
a. Discuss the client’s long-term goals with him 
b. Discuss the client’s nursing care needs with his provider
c. Transfer a summary of the client’s nursing plan of care to the facility via a
secure portal 
 d. Review the client’s plan of care with a family member who is approved to
receive confidential health information 

66. Telehealth is beneficial for clients and healthcare providers in that (select all that
apply)
a. Reduces healthcare cost
b. Available to clients in rural areas
c. Fosters a closer provider-client relationship
d. Beneficial for clients with mobility issues 
e. Beneficial for clients with hearing impairment 

67. The clinical nurse educator is designing an online course about the use of patient
portals for consumer and client e-health. Which item should be included when designing
the online course?
a. To use the portal, the client must first register in person at the healthcare
facility.
b. Prescription refill requests are not permitted when using a portal.
c.  Clients must provide a user identification and password for each
portal visit.
d.  Protected health information is encrypted and securely transmitted via the
portal.

68. During the unit tour, the new nurse notes which ergonomic measure to prevent
injuries to the staff that use nursing informatics?
a. Notebook computers
b. Wrist supports on the keyboard
c. Lumbar supports on the chairs
d. Computer monitors above eye level

69. A nurse is delegating to the newly hired nursing unlicensed assistive personnel
(UAP) the task of assisting with oral hygiene, knowing that this assignment “does not
require decisions based on the nursing process.” The nurse is correctly using which of
the five rights of delegation?
a. Supervision
b. Communication
c. Person
d. Circumstance
i. ANS: D Right circumstance involves the delegation of tasks that do
not require independent nursing judgments.
70. A nurse realizes that much time is wasted during shift report when coworkers
discuss personal items such as recent movies or department store sales. Which
statement would help with time management during this critical interaction?
a. “Let’s talk only about one movie you recently watched.”
b. “I like to know about department store sales, but we need to get through
this report, so let’s talk about sales as we walk between patient rooms.”
c.  “I know your shift has been busy. What went wrong?”
d.  “I have the list of patients; let’s start with revisions to the plan of care and
scheduled activities for the next shift.”
i. ANS:    D The statement “I have the list of patients; let’s start with
revisions to the plan of care and scheduled activities for the next
shift” focuses the conversation during report, keeping personal
conversations to a minimum.

71. A nurse is having difficulty managing assignments at work, which results in a feeling
of “failure” and tasks that are not completed or that are not completed satisfactorily. The
mentor suggests some tips for time management. These include: (select all that apply)
a. focusing on activities to be completed, rather than on objectives.
b. planning for tomorrow today.
c. making certain that the last hours are the most productive in tying up loose
ends.
d. maintaining a log of how the nurse spends time (no need to worry about
using complete sentences).
e. picking five major objectives for the day and not stopping until they are
achieved.
i. ANS:    B, D Planning for the future is an effective time
management strategy. Maintaining a log of how you spend your
time is an effective time management strategy.

72. A nurse is delegating to the newly hired nursing unlicensed assistive personnel
(UAP) the task of assisting with oral hygiene, knowing that this assignment “does not
require decisions based on the nursing process.” The nurse is correctly using which of
the five rights of delegation?
a. Supervision
b. Communication
c. Person
d. Circumstance
i. ANS:    D Right circumstance involves the delegation of tasks that
do not require independent nursing judgments.
73. The RN instructs the LPN to “Give an enema to the patient in room 327 who is being
discharged but is complaining of being constipated. Then be sure to document on the
medication administration record when given.” Which of the five rights was missing in
this situation? The right of:
a. direction and communication.
b. Task.
c. Person.
d. Circumstances.

74. When paper-and-pencil medical records are compared with computer-based

records:
a. paper-and-pencil records provide controls to determine who has viewed
the health information.
b. information contained in a paper-and-pencil record has the capability of
being more in-depth than that found in computer-based records.
c. patients have the right to know that the confidentiality of their records is
strictly maintained, regardless of the type of medical record used.
d. patients must sign for each item of information released on the computer
record.
i.

75. A nurse in a provider’s office observes a newly licensed nurse taking a client’s
health history while in the waiting area. Which of the following actions should the nurse
take? 
a. Continue to observe the nurse.
b. CORRECT! Speak to the nurse immediately in private. 
c. Consider using the same practice to make efficient use of time and office space. 
d. Report the nurse’s actions to the provider. 

76. A nurse is caring for a client who is a local public official. A newspaper reporter
repeatedly phones the unit seeking information and states, “The public has a right to
know the health status of the elected officials.” Which of the following actions should the
nurse take?
a.  Acknowledge that the person is a client on the unit but give no specific details of
the client’s condition.
b. Refer any calls directly to the client’s room so that the client and her family can
decide what to tell the press. 
c. CORRECT! Refer all media inquiries to the nursing supervisor. 
d. Hang up on media callers because nursing staff members are not required to
speak to them. 

77. A charge nurse is observing a group of newly licensed nurses. Which of the
following actions should the charge nurse report to the nurse manager as a violation of
HIPAA?
a. Assigning a client who requested a private room to a semi-private room due to
unavailability. 
b. Placing a client who is confused in restraints. 
c. CORRECT! Talking about clients with other nurses in the cafeteria. 
 d. Wheeling a client who is wearing a sheet down the hall into the shower room. 

78. A nurse is documenting data about a client at a computer terminal in the nurses’
station when he has to leave the area to assist another client. Which of the following
actions should the nurse take?
a. Turn the computer monitor away from the view of others. 
b. Ask the unit clerk to make sure no one else uses that computer. 
c. Turn off the monitor so that the computer will log off automatically. 
d. CORRECT! Log off the computer before leaving the nurses’ station.

Week 6

 
79. A nurse is planning to perform a negotiation to manage a conflict between
himself and another staff member. Which of the following actions should the
nurse plan to take?
a) Create a solution in which all parties are satisfied
b) Make as many concessions as needed to make everyone happy
c) Ensure there is equality in the concessions that each party makes
d) Continue the negotiation until all parties agree on a settlement

80. A nurse manager is meeting to address a conflict between staff members and
a client family.  In the meeting staff and family members will identify common
goals and express their concerns.  Which of the following conflict resolution
strategies is the nurse manager implementing?
a. Competition
b. Collaboration
c. Accommodation
d. Smoothing

81. In an emergent situation what type of conflict resolution style should the
charge nurse use?
a. Autocratic
b. Democratic
c. Coaching
d. Collaborative

82. Upon recommendations from a regulatory body to make changes the unit’s
policy/procedure, one of the staff nurses persistent in using the old protocol.  The
nurse manager observes that the nurse does not deliver care according to the
new policy.  What action should the nurse manager take?
 a. Ignore the resistance and allow peer pressure to facilitate the change over
time?
b. Reinforce the new policy with the nurse, emphasizing the importance of
the new changes
c. Encourage the nurse to verbalize their reasons for resisting the new
changes
d. Remind the nurse of the disciplinary actions that will be forthcoming if the
new changes are not adhered to

83. A charge nurse if facilitating conflict resolution between two nurses.  Which of
the following conflict resolution styles is an example of one nurse putting aside
her own goals to satisfy the other nurse?
a. Avoidance
b. Accommodation
c. Compromise
d. Collaboration
e.
84. What resolution style establishes a win-win outcome?
a. Negotiation
b. Collaboration
c. Compromise
d. Smoothing

85. The nurse practice act that establishes standards of care in nursing are legal
guidelines that are established by?
           A. The Center for Disease Control
           B. Each state
           C. The World Health Organization
           D. The American Nurses Association
 
86. Where can a nurse find the nurse practice act for the state of California?
           A. Department of Health website
           B. Health and Human Services website
           C. California Board of Registered Nursing website
           D. Office of Disease Prevention Website

87. If a nurse practices according to their institutional policy, and the established
standard of care but an injury occurs to their client, the nurse will be?

           A. Terminated immediately

           B. Given remediation training
           C. Legally protected for their actions
           D. Receive a letter of reprimand

88. What incidents would need to be reported to the Joint Commission?

           A. Sentinel events
           B. Ineffective time management
           C. Interpersonal conflict
           D. Understaffing while a nurse is on vacation

89. Guidelines for tasks, such as changing of IV tubing, that correspond with the nurse
practice act can be found locally for a nurse in?
           A. An information card placed behind their badge
           B. A senior assistive personnel
           C. The facility’s policy and procedure manual
           D. The bulletin board in the nurse’s lounge

90. A nurse is delegating a task to an assistive personnel (AP). The AP is to transfer a

client who has a below-the-knee amputation from a bed to a wheelchair. The AP has
never transferred a client with an amputation before. Which of the following actions
should the nurse take?
           A. Provide the AP with a manual on how the transfer should be done.
           B. Assist the AP after he has practiced the transfer.
           C. Transfer the client while the AP observes.
           D. Ask another AP to transfer the client.

91. A nurse is looking to renew her RN license online, what official website should she
visit to complete this task? 
a) California Nurse Association 
b) National Board of Registered Nursing
c) Nurse Care Practice Act
d) DCA BreEZe Online Services

92. True or False: An RN registered in California cannot maintain their license if they
are no longer practicing in the state of California? 
o False: they do not have to reside within, or work, within the state to keep
their active CA license. 

93. How soon can you renew your California RN license before the listed expiration
date?
a) 30 days
b) 60 days
c) 90 days
d) 120 days

94. What types of positions can a registered nurse move into with additional nursing
advanced degrees or certifications (select all that apply)?
a) Nursing Physician’s Assistant 
b) Forensic Nurse
c) Nurse Anesthetist
d) Nurse Cardiologist
 e) Nurse Midwife
f) Nursing Informaticist 
g)
95. True or False: A Nurse Practitioner (NP) must work under a doctor’s supervision in
the state of California?
a) True
96. The roles/responsibilities of a registered RN include (select all that apply)?
a) Advocate
b) Obtaining consent 
c) Assessments
d) Maintaining patient safety
e) Teacher
f) Diagnosing 

97. A nurse is prioritizing care for a group of clients. The nurse should plan to attend to
which of the following clients first?
a. A client who requires a sterile dressing change
b. A client who requires a gastrostomy tube feeding
c. A client who requires urinary catheter care
d. A client who requires endotracheal suctioning

98. A nurse is caring for a client who was recently raped. The client states, "I never
should have
been out on the street alone at night." Which of the following responses should
the nurse make?

A. "Your actions had nothing to do with what happened."

B. "You should focus on recovery rather than blaming yourself for what
happened."
C."You believe this wouldn't have happened if you hadn't been out alone?"
D."Why do feel that you should not have been alone on
the street at night?
99. A hospice nurse is caring for a client who has terminal cancer and takes PO
morphine for pain relief. The client reports that he had to increase the dose of morphine
this week to obtain pain relief. Which of the following scenarios should the nurse
document as the explanation for this situation?

A. "I want to talk to you about the importance of considering the donation of your
child’s organs for transplantation."
B. "I want to give you some information about an option that you have regarding
donating your child's organs to others who are in need."
 C. "I am legally required to inform you that you can donate your child’s organs for
transplantation."
D. "Have you ever considered donating your organs for transplantation?"
100. After a disaster plan is put into effect, a nurse in a pediatric unit is asked to prepare
a list of clients who can be discharged to home due to a local incident involving many
child victims. Which of the following clients should the nurse place on the potential
discharge list?

A. A preschooler with asthma who has scattered wheezes that resolve with PRN
albuterol
B. A school-age child with a femur fracture in an external fixation device whose
pain is controlled with PRN oral codeine
C. An adolescent client who is developmentally delayed, has a PICC line, and
needs 6 more weeks of antibiotics
D. A toddler with a ventricular septal defect and bronchiolitis who is on 28%
oxygen by oxyhood
E. An adolescent client who is 1 day postoperative following scoliosis repair and
is on a PCA pump
101. A nurse is providing teaching about a living will for a client who has end-stage
breast cancer. Which of the following pieces of information should the nurse include in
the teaching?

A. The client has the right to change the living will at any time.
B. The client should be certain of the decision because the document establishes
guidelines for refusing resuscitation.
C. A durable power of attorney is required with a living will.
D. The handwritten living will is not a legal document and cannot be included in
the client’s medical record.
102. A nurse in an emergency department is caring for a female client who has
ecchymosis of the trunk and face. The client reports that her partner hit her, causing
these injuries. When offered information about shelters for intimate partner violence, the
client declines, stating, "I could never leave my husband because of my kids." Which of
the following responses should the nurse make?
A. "Aren’t you worried about the safety of your children?"
B. "Can you identify which of your behaviors provoke your partner?"
C. "The next time this occurs, what could you do to ensure your safety?"
D. "You need to remove yourself and your children from an abusive situation."

103. A nurse in a mental health clinic is assessing an older adult client who is tearful
and reports sleep disturbances. The client tells the nurse, "All of my friends have died,
and my children are too busy for me." Which of the following actions should the nurse
take first?
A. Contact the client's family for support
B. Administer the Geriatric Depression Scale
C. Refer the client to his provider for an antidepressant medication
D. Encourage the client to join a senior support group
104. A nurse is preparing to care for a group of clients after receiving a change-of-shift
report. Which of the following clients should the nurse assess first?

a) A client who has benign prostatic hyperplasia (BPH) and reports dysuria
b) A client who has ulcerative colitis and reports diarrhea
c) A client who has emphysema and reports dyspnea
d) A client who has esophageal cancer and reports painful swallowing

105. A charge nurse finds an increased incidence of healthcare-associated infections

(HAIs) on a long-term care unit. Which priority action should the charge nurse take to
address the problem?

a) Monitor the staff’s hand hygiene techniques

b) Hold a mandatory in-service training session about hand hygiene and
infection rates
c) Require nurses to take an online course on HAIs
d) Conduct a chart review to gather data about clients who developed HAIs

106. A nurse is caring for a client who is dying and unable to make decisions for
himself. The client’s adult children disagree about his code status. Which of the
following sources should the nurse depend on for decisions regarding the clients end-of-
life care?

a) The clients oldest child

b) The attending provider
c) The clients health care proxy
d) The facilities ethics committee

107. A nurse is preparing a client for discharge. The client states, “My partner hurts me.
I don’t want to go home.” Which of the following actions should the nurse take?

a) Refer the client to social services for assistance in seeking safe housing
b) Delay the discharge until the client’s partner can be interviewed
 c) Ask the client to document and further violence for the authorities
d) Contact the facility security officer to escort the client to the vehicle

108. A school nurse is assessing a child who has multiple bruises on his trunk and
extremities. The child reports falling out of a tree 2 days ago. The nurse’s assessment
findings show patterns of bruising that are not typically sustained during a fall from a
tree. Which of the following actions should the nurse take?

a) Report the findings to the local police and social service agencies
b) Report the findings to the school district superintendent
c) Call the parents of the child and further assess the causative event
d) Reassess the child on a weekly basis for injuries

109. A charge nurse in an emergency department is making assignments for an

assistive personnel (AP) during a shift with unexpected staff absences. Which of the
following assignments should the charge give to a float AP from the medical surgical
unit?

a) Escorting clients from the emergency department to other areas of the

facility for tests
b) Sitting at the reception desk answering telephones and directing clients
c) Restocking the examination rooms after each client is discharged
d) Shadowing an AP who is regularly assigned to the emergency department

110. An emergency room nurse is assessing a client who has a new traumatic brain
injury. The nurse observes extension of the client’s arms and legs, pronation of the
arms, and plantar flexion of the feet. Which of the following actions is the nurse’s
priority?

a. Monitor urinary output

b. Administer an osmotic diuretic
c. Provide supplemental oxygen
d. Initiate seizure precautions

111. A nurse in an emergency department is caring for 4 clients. Which of the following
findings requires the nurse to act as a mandatory reporter?

a) A child who was left unsupervised for several hours at home and is being
treated for a fractured leg
 b) A client who was admitted for pneumonia and reports having no heat or
running water at home
c) A client who has depression and a self-inflicted wrist laceration
d) A public official who is admitted with alcohol withdrawal and delirium
tremens

112. A nurse is preparing to provide discharge teaching to an older adult client. Which
of the following teaching considerations should the nurse include?

a) Allow frequent rest periods during teaching

b) Use colored paper with a glossy finish
c) Present the information at a tenth-grade reading level
d) Use 12-point font size

113. A nurse enters the room of an older adult client and finds him attempting to crawl
over the side rail of his bed. Which of the following actions should the nurse take?

a) Tell the client that he will be put in restraints if he attempts to get out of
bed again
b) Ask an assistive personnel to sit with the client
c) Remind the client to stay in bed
d) Restrain the client immediately to prevent self-harm

114. A nurse is an emergency department is teaching a newly licensed nurse about

planning interventions for clients who experience sexual assault. Which of the following
actions should be included in the teaching?
a. Determine if the client is experiencing thoughts of self-harm
b. Postpone collection of forensic evidence if a sexual assault nurse
examiner is not available
c. Encourage the client to shower before undergoing a physical examination
d. Assess the client for the presence of a maturational crisis

115. What is the name of the federal law that requires anyone coming to an ED to be
stabilized and treated regardless of their insurance status or ability to pay?

a) Good Samaritan laws

b) Emergency Medical Treatment and Active Labor Act (EMTALA)
c) Health Insurance Portability and Accountability ACT (HIPAA)
d) Patient Safety and Quality Improvement Act (PSQIA)
116. A nurse manager is orienting newly licensed nurses to a facility and is emphasizing
the importance of practicing within standards of care. To which of the following legal
concepts is the nurse manager referring?

a) Punitive damages
b) Intentional torts
c) Good Samaritan laws
d) Professional negligence

117. While admitting a client to the medical unit, the nurse asks him if he had advanced
directives. The client states, “I have a document with me that names someone who can
make healthcare decisions for me if I am not able.” The nurse should identify that the
client is referring to which of the following documents?

a) Informed consent form

b) Living will document
c) Do-not-resuscitate (DNR) directive
d) Durable power of attorney document

118. A community health nurse is visiting the home of an older adult client and her
caregiver. The client has excoriations to her wrists and ankles. Which of the following
actions should the nurse take first?

a) Refer the caregiver to a support group

b) Interview the client in private
c) Document the client’s wounds
d) Contact adult protective services

119. A home health nurse is prioritizing visits for four clients. Which of the following
clients should the nurse plan to visit first?

a) A client who has heart failure and reports a weight loss of 2.2 kg (1 lb)
over the past week
b) A client who has osteoarthritis of the knees and reports joint pain when
ambulating
c) A client who has Alzheimer’s disease and is not able to remember the
current year
d) A client who has type 2 diabetes mellitus and reports a new fissure
between her toes
120. The nurse is discussing end-of-life care procedures with an elderly patient who is
Buddhist. The nurse knows that the patient will most likely want to incorporate:

a) No autopsy and cremation

b) Time for meditation
c) No blood transfusions
d) Prayers to provide support and comfort

121. The nurse cares for an 82-year-old woman with frequent constipation. Which of the
following statements by the nurse would be inappropriate?

a) “You can try light exercise for at least 30 minutes every day.”
b) “You should eat dark green vegetables and whole grains.”
c) “Make sure you are well hydrated. 6-8 glasses of water a day would be good.”
d) “It could help to remove dairy products like milk and cheese from your diet.”
e) “You can take a laxative whenever you want to have a bowel movement.”

122. The nurse is performing an assessment on an older client who is having difficulty
sleeping at night. Which statement by the client indicates the need for further teaching
regarding measures to improve sleep?
a) "I swim three times a week."
b) "I have stopped smoking cigars."
c) "I drink hot chocolate before bedtime."
d) "I read for 40 minutes before bedtime.”

123. A visiting nurse who observes that the older male client is confined by his
daughter-in-law to his room. When the nurse suggests that he walk to the den and join
the family, he says, "I'm in everyone's way; my daughter-in-law needs me to stay here."
Which is the most important action for the nurse to take?
a) Say to the daughter-in-law, "Confining your father-in-law to his room is
inhumane."
b) Suggest to the client and daughter-in-law that they consider a nursing home
for the client”
c) Say nothing, because it is best for the nurse to remain neutral and wait to be
asked for help.
d) Suggest appropriate resources to the client and daughter-in-law, such as
respite care and a senior citizens' center.

124. A nurse is preparing an elderly patient for discharge. The patient states, “my
caretaker hurts me. I don’t want to go home.” Which of the following actions should the
nurse take?

a) refer the patient to the case manager  for assistance in seeking safe housing
b) delay the discharge until the patient’s partner can be interviewed
c) ask the patient to document any further violence for the authorities 
d) contact the facility security officer to escort the patient to the vehicle
125. The 50-year-old son of an elderly widow brings his mother to the clinic for an
examination. He states that she is becoming confused and is falling in the home. When
left to be examined by the nurse, the female widow appears fearful, lucid, and says that
she has never fallen down in her own home. What type of situation might this elderly
widow be experiencing?

a. Psychological abuse.
b. Financial abuse.
c. Social abuse.
d. Physical abuse.

126. The nurse is performing an assessment on an older adult client. Which

assessment data would indicate a potential complication associated with the skin?

a) Crusting
b) Wrinkling
c) Deepening of expression lines
d) Thinning and loss of elasticity in the skin

127. The home health nurse is visiting a client for the first time. While assessing the
client's medication history, it is noted that there are 19 prescriptions and several over-
the-counter medications that the client has been taking. Which intervention should the
nurse take first?

a) Check for medication interactions.

b) Determine whether there are medication duplications.
c) Call the prescribing health care provider (HCP) and report polypharmacy.
d) Determine whether a family member supervises medication administration

128. The long-term care nurse is performing assessments on several of the residents.
Which are normal age-related physiological change(s) the nurse expects to note?
Select all that apply.

a) Increased heart rate

b) Decline in visual acuity
c) Decreased respiratory rate
d) Decline in long-term memory
e) Increased susceptibility to urinary tract infections
f) Increased incidence of awakening after sleep onset

129. The healthcare provider is performing an assessment on a patient who is taking

propranolol (Inderal) for supraventricular tachycardia. Which assessment finding is an
indication the patient is experiencing an adverse effect of this drug?

a) Dry mouth
b) Bradycardia
c) Urinary retention
d) Paresthesia

130. A patient who has experienced atrial fibrillation for the past 3 days is admitted to
the cardiac care unit. In addition to administering an antidysrhythmic medication, the
healthcare provider should anticipate which of these orders?

a) Initiate a heparin infusion

b) Give atropine IV push
c) Prepare for immediate cardioversion
d) Prepare the pt for AV node ablation

131. A nurse is reviewing the records of a group of older adult patients. Which of the
following findings should the nurse identify as an unexpected manifestation of the aging
process?

a) decreased absorption of nutrients

b) impaired excretion of medications
c) high-pitched frequency hearing loss
d) obesity 

132. Explain special situations including the culture of care with older adults and end-
of-life care.
Select the term which is not used interchangeably with Durable Power of Attorney
(DPOA)

a) Durable power of attorney (DPOA)

b) Informed consent (IC)
c) Health care proxy (HCP)
d) Healthcare surrogate (HCC)

133. The gerontological nurse is monitoring signs of suspected abuse in an 89-year-old

patient who was admitted from home. When planning for the patient's discharge, the
nurse's first action is to:

a)  delay discharge by informing the provider of the suspected abuse.

b)  enlist the help of family members with transitioning the patient home.
c)  notify Adult Protective Services of the patient's discharge.
d)  restrict the family members' access to the patient prior to discharge

134. Mr. Lee, a Chinese gentleman, has a large family that has gathered at the bedside.
The staff should:

a) Explain that visitors are not allowed in the room

b) Only allow one family member to see the client
 c) Explain to family members that they can all be together for a short while
and then take "shifts" or turns visiting
d) Ask the family to only allow immediate family members

135. Describe the role of the various members of the interdisciplinary team in providing
care for the older high-acuity patient.

What member of the interdisciplinary team should be consulted when addressing an

older adult client’s trouble swallowing while eating. 

a) Case manger
b) Physical therapy
c) Occupational therapy
d) Speech therapy