A1 PASSERS TRAINING, RESEARCH REVIEW AND DEVELOPMENT COMPANY

COMPETENCY APPRAISAL
NURSING PRACTICE III Care of Clients with Physiologic and Psychosocial Alterations (Part A)
GENERAL INSTRUCTIONS:
1. This test booklet contains 100 test questions
2. Read INSTRUCTIONS TO EXAMINESS printed on your answer sheet.
3. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your
answer.
4. AVOID ERASURES.
INSTRUCTIONS:
1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set.
2. Write the subject title Nursing Practice III on the box provided.
3. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box B if your test booklet is Set B.
Situation: Pain is the fifth vital signs. It is one of the priorities of the nurse when confronted with situations that
call for immediate nursing response. The utilization of Nursing process is essential for safe and effective
management of clients with pain.
1. Pain assessment is best accomplished when
a. The nurse validates, with the family, whether or not the client is experiencing pain.
b. The nurse considers past experiences with clients who have reported similar pain.
c. The client is calm and emotional during the assessment.
d. The nurse acknowledges that pain is a subjective experience.
2. Comprehensive documentation of a clients pain requires that the nurse record:
a. The nurses ideas about the level of pain.
c. Verbal and non verbal expressions of pain.
b. Doctors orders and client diagnosis.
d. All of the above
3. Which one of the following precautions should be included for the client who is receiving amitriptyline?
a. Administer the medication in the morning instead of at night to avoid sleep disturbances.
b. Have an artificial airway and suction equipment readily available.
c. Have the client rest in a sitting position before shifting from a reclining position to a standing position.
d. Have the client take the medication with food to avoid gastrointestinal upset.
4. Which one of the following statements best describes the nurses responsibility when giving an analgesic?
a. Calculate and administer the amount of medication the client should receive.
b. Evaluate and document the effectiveness of the medication.
c. Give the medication as ordered by the physician.
d. Change the dosage of the medication if there are adverse reactions.
5. A client who had an above-the-knee amputation of the right leg 5 hours ago is to receive Demerol 50 mg to 75 mg
every 3 to 4 hours. To evaluate the effectiveness of the pain-management regimen, the nurse must:
a. Anticipate the clients level of pain.
c. Questions family members about usual pain
b. Observe the client and ask questions.
relief measures.
d. Offer the medication as scheduled.
6. The nurse would be correct to question the use of Transcutaneous Electrical Stimulation (TENS) for pain
management if the client:
a. Has a pacemaker.
c. Is in active labor.
b. Is receiving an analgesic.
d. Reports a tingling sensation.
7. Which one of the following medications should be on hand when a client is receiving a narcotic analgesic?
a. Acetylsalicylic acid
c. Indomenthacin
b. Dexamethasone
d. Naloxone
8. A client is recovering from anesthesia immediately following an appendectomy. To best minimize pain, the nurse
should:
a. Administer prescribed pain medication every 3 to 4 hours if the client verbalizes the presence of pain.
b. Validate the presence of pain with objective data before administering pain medication.
c. Collaborate with the physician to prescribe an opioid around the clock instead of prn for the first 36 hours.
d. Attempt to control pain with nonpharmacologic measures before using narcotic analgesics.
9. A client who has breast cancer with metastasis to the long bones has intractable pain. Which pain-management
regimen is most likely to provide a measure of comfort?
a. Oral administration of large doses of analgesics and relaxation techniques
b. Frequent intramuscular injections of small doses of an analgesic and distraction techniques
c. Good hygiene, frequent back rubs, and massage of the long bones
d. Alcohol injection via transnasal approach of the pituitary gland and good hygiene
10. Destruction of interruption of a nerve root or pain pathway is most likely to be used for which of the following
conditions?
a. Peptic or duodenal ulcers
c. Tic douloureux (trigeminal neuralgia)
b. Menstrual cramps
d. Labor pains
e.
f. Situation: PERI-OPERATIVE Nursing is an essential field of nursing wherein nurses take care of patients
throughout the entire surgical experience. The nurse should be well- versed with all aspects of surgery
in order to render safe and quality care to clients undergoing surgery.
11. Emergency clients who are candidates for a surgical procedure whoso NPO status is unknown usually receive:
a. Bowel preperation
c. Nasogastric tube
b. Laxative
d. Rectal tube.

12. Mary Rodriquez has arrived in OR suite 8 for an exploratory laparotomy. The circulating nurse has a primary duty to:
a. Evaluate tubes for patency
b. Locate laboratory studies.
c. Review the clients chart for history of the illness.
d. Protect the clients health and safety needs.
13. Regional anesthetics have the advantage of minimizing the complications that sometimes occur with general
anesthesia, in particular, what two ________ complications?.
a. Pulmonary and gastrointestinal
c. Endocrine and genitourinary
b. Metabolic and musculoskeletal
d. Cardiac and endocrine
14. Miss Waters developed a transient hypothermia secondary to changes in environmental temperature while in surgery.
The nurse in the immediate postoperative period will evaluate her skin for:
a. Abrasions and bruises.
c. Raised rash on the trunk.
b. Color and temperature.
d. Turgor and elasticity.
15. Janet Diverticula is scheduled for an endoscopy at 9:00am. This type of surgery is classified as:
a. Curative.
c. Diagnostic.
b. Exploratory.
d. Palliative.
16. The amnesia stage of anesthesia/analgesia occurs when?
a. First
c. Second
b. Fourth
d. Third
17. Malignant hyperthermia manifest as a sudden, rapid increase in body temperature, possibly as rapid as_________
per five minutes.
a. 0.1oF
c. 1OF
O
b. 1 C
d. O.1OC
18. Mr. Alexander has returned from an uncomplicated rhinoplasty. He does not have a urinary catheter. You expect him
to void within ________ Hour (s) of his return from surgery.
a. 1
c. 6
b. 3
d. 8
19. Kathy Enriquez, 3 months old, is transferred to the OR for emergency surgery. As the nurse caring for her, you realize
the importance of monitoring, particularly ______ and ______loss.
a. Heat; urine
c. Heat; sleep
b. Blood; heat
d. Blood; urine
20. Preoperative medications should be given approximately ____ hour (s) before surgery in order to result in optimal
blood levels.
a. 1
c. 3
b. 2
d. 4
21. Dr. Benjamin prefers to use absorbable skin-closure methods. The scrub nurse plans to have available which of the
following?
a. Staples
c. Clips
b. 3-0 Chromic
d. 4-0 Silk
22. When Joy Billings is admitted to the RR after a cholecystectomy, you expect her initial vital signs to be monitored
every ________ minutes.
a. 10
c. 20
b. 15
d. 30
23. As a general rule, normal bowel tones should be present before:
a. Ambulation is begun.
c. Deep breathing is encouraged.
b. Intravenous fluids are discontinued.
d. Pain medication is administered.
e.
f. Situation: Assessment of vital signs after surgery is necessary to monitor post- operative status.
24. Irregularities in the heart rhythm may be related to which of the following?
a. An overstimulation of the parasympathetic nervous system
b. Heart disease, medications, and electrolyte imbalances
c. Oxygen administration by mask or cannula
d. Inadequate reflex compensation to position change
25. False high blood pressure measurements may the result of all the following except:
a. The arm positioned below the level of the heart.
b. A blood pressure cuff that is too small.
c. The client in the supine position.
d. A client whose arm is not supported during assessment while sitting or standing.
26. The amount of blood ejected from each ventricle with each heartbeat is referred to as:
a. Stroke volume.
c. Perfusion volume.
b. Cardiac output.
d. Effective circulating volume.
27. Mr. Beasley is admitted to your unit with a diagnosis of congestive heart failure. When assessing his pulse, you note
that it is thready, weak, and easily obliterated with pressure. You would classify the quality of this pulse as which of the
following?
a. 1+
c. 3+
b. 2+
d. 4+
e. Situation: Medication administration is an essential dependent nursing functions. The nurse
should observe the different principles in administration of drugs to promote safe and effective
nursing care.
28. A system of medication distribution in which the medication is pre-labelled and pre-packaged in individual doses by
the pharmacy is referred to as:
a. Self-administered medication
b. Stock supply

c. Unit dose
d. Safe-T-Dose.
29. Which of the following dangers is associated with the use of over-the-counter medications?
a. Considered unsafe when used as
c. Serious drug interactions
directed
d. Should be used under the supervision of
b. Illegal use of the drug
a nurse
30. In the hospital setting, narcotics are kept where as a safety measure?
a. Nursing service
c.
c. Medication drawer at the
b.
b. Hospital pharmacy
clients bedside
d.
d. Locked drawer or box
31. A second nurse is required to witness and countersign the narcotic sheet when:
a. Any narcotic is given.
c. All or part of a narcotic is to be discarded.
b. The primary nurse is suspected of drug
d. A non-prescription pain medication is
abuse.
administered.
32. The primary site of medication metabolism is the:
a. Intestines.
c. Lungs.
b. Liver.
d. Kidneys.
33. The primary site of drug excretion is the:
a. Intestines
c. Lungs.
b. Liver
d. Kidneys.
34. When pouring s liquid medication, you should measure from which of the following?
a. From the top of the medication cup
c. From the bottom of the meniscus
b. From the top of the meniscus
d. From the middle of the medication cup
35. After administering an injection, the nurse should:
a. Dispose of the syringe and needle in a needle disposal box.
b. Recap the needle before disposal.
c. Break the needle before disposal.
d. A and B only
36. Ms. Lucky has an IV of 0.9% NaCI ordered to infuse at 125 mL/h. The nurse, during the initial assessment, discovers
that Ms. Luckys IV is 125mL behind. The most appropriate intervention would be:
a. To regulate the IV rate to 250 mL/h for 1 hour then adjust the rate to 125 mL/h and notify the Doctor.
b. To regulate the IV to 140 mL/h for the next 8 hours and notify the doctor.
c. To regulate the IV to 125 mL/h and refer to hospital policy for further actions.
d. Not to alter the IV in any way.
37. Situation: Disturbances in oxygenation is a priority physiologic needs among others. It may include problems
with the heart, lungs, blood vessels and respiratory system.
38. Epinephrine increases blood pressure because it does which of the following?
a. Increases water resorption by the kidneys
b. Causes vasodilation in the skin and viscera
c. Decreases heart rate and force of contraction
d. Increases heart rate and force of cardiac contraction
39. When blood pressure decreases, the kidneys help raise it by secreting which of the following?
a. Rennin
c. Aldosterone
b. Epinephrine
d. Erythropoietin
40. Which of the following prevents the backflow of blood in veins?
a. Pre-capillary sphincters
c. Smooth muscle layer
b. Middle layer
d. Valves
41. The nurse is checking a patients blood pressure for orthostatic hypotension. The nurse understands that normally
when the patient stands, the blood pressure drops by which of the following amounts?
a. Up to 15 mm Hg
c. Up to 25 mm Hg
b. Up to 20 mm Hg
d. Up to 30 mm Hg
42. A patient visits the doctor for a severe sore throat and fever. As the nurse plans the patients care, the nurse
understands that it is important that which of the following diagnostic tests is obtained to help prevent cardiac
complications?
a. Chest x-ray examination
c. White blood cell count
b. Throat culture
d. Erythrocyte sedimentation rate
43. Which of the following does the nurse understand usually precedes rheumatic fever?
a. A viral infection
c. A staphylococcal infection
b. A fungal infection
d. A beta-hemolytic streptococcal infection
44. A patient has a positive Homans sign. Which of the following does the nurse understand explains why ambulation and
performing the Homans sign is now contraindicated?
a. They can cause calf swelling.
c. They can cause an emboli.
b. They can cause patient pain.
d. They may cause a clot to form.
45. A patient develops a postoperative deep vein thrombosis and is started on intravenous heparin. Which of the following
laboratory tests is monitored during the heparin therapy?
a. Plasma fibrinogen
c. Partial thromboplastin time (PTT)
b. Prothrombin time (PT)
d. International normalized ratio (INR)
46. The nurse is caring for a patient on warfarin (Coumadin) with an elevated INR level. Which of the following would be
ordered as the antidote for warfarin?
a. Vitamin K
c. Calcium chloride
b. Vitamin B12
d. Protamine sulfate
47. Before a cardiac catheterization and coronary arteriogram, it is essential that the nurse ask a patient if he or she is
allergic to which of the following?

a. Eggs
c. Iodine
b. Codeine
d. Penicillin
48. Which of the following statements by a patient demonstrates to the nurse that the patient understands when to
replace nitroglycerin tablets?
a. Pills no longer tingle when used
c. Pills smell like vinegar.
b. Pills disintegrate when touched
d. Pills become discolored.
49. A patient, hospitalized with an MI, suddenly begins to have severe respiratory distress with frothy sputum. These
signs indicate that the patient probably has developed which of the following?
a. Pneumonia
c. Pulmonary edema
b. Cardiac tamponade
d. Pheumothorax
50. Which of the following diagnostic tests does the nurse understand measures the pressures in the cardiac chambers?
a. ECG
c. Echocardiogram
b. Exercise stress test
d. Cardiac catheterization
e.
50. Which of the following indicates pressure in the left chambers of the heart?
f.
a. CVP measurements
g.
b. Blood pressure measurements
h.
c. Pulmonary artery and pulmonary capillary wedge pressure
i.
d. Echocardiography and electrocardiography
j. 51. A patient with a cardiac disorder is having increased PVCs and feels anxious. After assessment and vital
signs, what is the next action for the nurse to take?
a. Order an ECG and cardiac enzymes.
c. Elevate the head of the bed and start
b. Call the physician.
oxygen at 2 L/min.
d. Put the bed in Trendelenburgs position.
e.52. A patient is being given digozin (Lanoxin) to treat heart failure. Which of the following is a usual adult daily
dosage of digoxin (Lanoxin)?
a. 0.005 mg
c. 0.25 mg
b. 0.025 mg
d. 2.5 mg
e.53.When the nurse is reviewing a patients daily laboratory test results, which of the following electrolyte
imbalances should the nurse recognize as predisposing the patient to digoxin toxicity?
f.
a. Hypokalemia
g.
b. Hyperkalemia
h.
c. Hyponatremia
i.
d. Hypernatremia

j.
54. Which of the following adventitious lung sounds is a violin-like sound?
a. Crackles
c. Friction rub
b. Wheezes
d. Crepitus
e.55. The purpose of pursed-lip breathing is to promote which of the following?
a. Carbon dioxide excretion
c. Oxygen excretion
b. Carbon dioxide retention
d. Oxygen retention
e.56. Which position will help increase oxygen saturation in the patient with lung disease?
a. Prone
c. Trendelenburg
b. Supine with head on pillow
d. Side lying with good lung dependent
e.57. What is the purpose of chest physiotherapy?

e.59. A 72-year-old chemist has left lower lobe pneumonia. His nurse checks his oxygen saturation and the result is
86%. Which of the following actions by the nurse is best?
a. Call the physician for an order for oxygen.
b. No action necessary, this is a normal SaO2.
c. Call the respiratory therapist stat for assistance.
d. Walk the patient in the hall and recheck his 02 saturation.
f. 60. How many liters per minute of oxygen should be administered to the patient with emphysema?
a. 2 L/min
c. 10L/min
b. 6L/min
d. 95L/min
e.
61. Which of the following positions is best for a chest-drainage system when the patient is being
transported
f.
by wheelchair?
a. Hang it on the top of the wheelchair backrest.
b. Place it on the patients feet and ask the patient to hold it.
c. Hang it on the same pole as the patients IV.
d. Place it in the patients lap.
g.62. How can the nurse help monitor effectiveness of therapy for the patient with a pneumothorax and a chestdrainage system?
a. Palpate for crepitus.
c. Document color and amount of sputum.
b. Auscultate lung sounds.
d. Monitor suction level.
e. Situation: Disturbances in nutrition, metabolism and elimination are challenging aspects of
nursing care as they involve privacy and safety of the patient. It requires careful assessment and
thorough nursing intervention.
f.
63. Which of the following structures are connected by the ileocecal valve?
a. Duodenum to the stomach
c. Stomach to the esophagus
b. Colon to the small intestine
d. Ileum to the jejunum
e.
f.
64. Bowel sounds heard as soft clicks and gurgles at a rate of four per minute would be documented
by the
g.
nurse as which of the following types of findings?
a. Absent
c. Hypoactive
b. Hyperactive
d. Normal
e.
65. Which of the following diagnostic procedures on stool specimens must the nurse collect using
sterile
f.
technique?
a. Stool for ova and parasites
c. Stool culture
b. Stool for occult blood
d. Stool for lipids
e.
66. Which of the following diagnostic procedures does the nurse understand does not require the
patient to be
f.
nil per orem (NPO)?
a. Upper GI series (barium swallow)
c. Magnetic resonance imaging (MRI)
b. Flat plate of the abdomen
d. ERCP
e.
67. Which of the following colors would the nurse recognize as an expected finding for the patients
stools
f.
immediately after a barium swallow?
a. Brown
c. White
b. Black
d. Green
e.
68. A patient visits his physician with complaints of chronic diarrhea that is sometimes bloody.
Ulcerative
f.
colitis is diagnosed. How should the nurse explain the patients diagnosis to him?
a. you have inflamed sacs throughout your colon
b. Your colon and rectum are inflamed and ulcerated
c. You have ulcerations and fistulas in your small bowel.
d. Your colon is spastic and hypertonic.

g.
h.
a.
b.
c.
d.
i.
j.
a.
b.
c.
d.
k.
l.
a.
b.
c.
d.
m.
n.
a.
b.
e.
a.
b.
e.
f.
a.
b.
e.
f.
a.
b.
e.
a.
b.
c.
d.
f.
a.
b.
e.
f.
a.
b.
c.
d.
i.
j.
a.
b.
c.
d.
k.
l.
a.
b.
e.
a.
b.

69. Which of the following diet instructions should be included in the plan of care to help a patient
control
ulcerative colitis symptoms?
Drink milk or eat a milk product at least six times daily.
Include four servings daily of whole grain breads or cereals.
Limit coffee to six cups daily.
Avoid fresh fruits and vegetables.
70. Which of the following explanations by the nurse to reinforce the patients preoperative
education for a
loop ostomy would be correct?
You will have a stoma in the middle of your abdomen that will constantly drain liquid stool.
You will have a looped bag system to collect stool from your stoma.
You will have a loop of bowel on your abdomen, but it will not drain stool.
You will have a loop of bowel on your abdomen that can be put back in after your bowel has healed.
71. A patient is concerned about ileostomy odor. Which of the following responses by the nurse
would be
best?
a teaspoon of baking soda in your pouch will absorb all the odor.
The plastic your pouch is made of is odorproof. You shouldnt have to worry about odor as long as you
dont have a leak.
Effluent from an ieostomy has no odor. Its colostomies that can smell bad from time to time.
Changing your pouch and face plate daily will help prevent odor.
72. Which of the following nursing interventions related to esophageal tamponade with a SenstakenBlakemore tube is inappropriate?
Keeping a pair of scissors at the bedside
c. Maintaining traction on the tube, if ordered
Having oral suction available
d. Deflating the gastric balloon periodically
73. Which of the following instructions should be given to the patient with portal hypertension?
Cough and deep breathe every 2 hours.
c. Increase fluid intake.
Avoid straining to have a bowel movement.
d. Expect urine to be tea colored.
74. A patient with chronic liver failure has asterixis and fetor hepaticus and is confused. The nurse
recognizes these as symptoms of which complication?
Hepatic encephalopathy
c. Portal hypertension
Hepatorenal syndrome
d. Ascites
75. The nurse can expect which of the following pain medications to be ordered for the patient with
biliary
colic?
Codeine
c. Apomorphine
Morphine
d. Meperidine
76. Patients with acute pancreatitis frequently describe their pain as
Dull, boring, beginning in the mid epigastrium and radiating to the back
Knifelike, centered in the left lower quadrant
Burning, focused over the left flank and radiating to the shoulder
Sharp, severe pain that begins in the right upper quadrant
77. Which two hormones help regulate the blood calcium level?
Insulin and glucagon
c. Thyroxine and epinephrine
Calcitonin and PTH
d. Cortisol and aldosterone
78. A patient with hypothyroidism is started on levothyroxine (Synthroid), a synthetic thyroid
hormone. You
know that she understands the side effects of this medication when she makes the following
statement:
I know I should call my doctor if my heart races
I understand that I may develop a moon-shaped face.
The sleepiness I experience when I start this medication with subside within 2 weeks.
Ill have to watch my diet to avoid further weight gain while on this medication.
g.
h.
79. A 26-year-old female patient is hospitalized for radioactive iodine treatment for
hyperthyroidism.which of
the following precautions by the nurse is appropriate?
Talk with the patient only over the intercom system.
Wear gloves when emptying her bedside commode.
Maintain reverse isolation for 3 months.
No precautions are necessary because the dose is so small.
80. Following surgery for thyroidectomy, the nurse watches carefully for which of the following signs
and
symptoms of tetany?
Numb fingers, muscle cramps
c. Hallucinations, delusions
Weakness, muscle fatigue
d. Dyspnea and tachycardia
81. What assessment findings should the nurse monitor to detect the onset of thyrotoxicosis?
Peripheral pulses
c. Vital signs
Serum sodium
d. Incision site

e.
f.
a.
b.
e.
a.
b.
e.
f.
a.
b.
e.
1.
2.
a.
b.
e.

82. A patient enters a clinic with possible Cushings syndrome. Which of the following assessment
findings
support this diagnosis?
Weight loss, pale skin
c. Nausea, vomiting
Buffalo hump, easy bruising
d. Polyuria, polydipsia
83. Which assessment activity by the nurse is most important for the patient with a
pheochromocytoma?
Vital signs
c. Peripheral pulses
Daily weights
d. Bowel sounds
84. A 56-year-old gentleman is admitted to the hospital with a blood glucose of 680 mg/dL, and
ketones in
his blood and urine. Which type of diabetes does he have?
Type 1
c. Pre-diabetes
Type 2
d. Gestational
85. By which routes can insulin be administered? Choose all correct answers.
Oral
3. Intravenous
Inhaled
4. Subcutaneous
1,3
c. 1,4
3,4
d. 2,3,4
86. A patient takes NPH insulin every morning. At which of the following times should the patient
observe for
signs and symptoms of low blood sugar level?
1 hour after administration of insulin
6 to 12 hours after administration of insulin
24 t o36 hours after administration of insulin
NPH insulin does not cause low blood sugar level
87. At what point after injection does the peak action of regular insulin occur?
30 to 60 minutes
c. 2 to 5 hours
1 to 2 hours
d. 8 t0 12 hours
88. For emergency episodes of hypoglycaemia which of the following is given as emergency drugs?
a. Insulin
c. Glucagon
b. Cola
d. Steroids

f.
a.
b.
c.
d.
g.
a.
b.
e.
f.
g.
h.
i. Situation: Holistic nursing care requires Spiritual Care.
j.
88. Seeking answers to lifes philosophic questions and seeking a higher level of consciousness
or a deeper
k.
awareness of spiritual life is:
a. Spiritual well-being
c. Spiritual distress.
b. Spiritual quest.
d. Spiritual dimension.
e.
89. A 47-year-old client is experiencing altered spiritual functioning. Which of the following
manifestations
f.
should alert the nurse that the client is experiencing spiritual concerns?
a. Statements of feeling no good
c. Well-organized and clear conversation
anymore
d. Sleeping well through the night
b. Quiet and calm appearance
e.
90. Which of the following nursing interventions would the nurse caring for this client select to
promote
f.
spiritual health?
a. Building a relationship of pity and sympathy
b. Encouraging the treatment regimen, even if variation in spiritual practice is required
c. Active listening and using good communication skills
d. Relying only on the nurses own spiritual tradition
g.
h. Situation: Enhancing, Empowering and Enabling competencies assist the nurse in the delivery of
safe, effective and quality nursing care with a difference. They are useful tools in the performance
of professional nursing functions.
i.
91. You have just entered Mr. Bradfords room and observed him lying on the floor next to the bed.
The side rails on the bed are down. When you ask Mr. Bradford what happened, he replies, I was sleep
and the next thing I knew i was on the floor. Which of the following samples of documentation is most
appropriate for this situation?
a. Mr. Bradford fell out of bed while asleep. Both side rails were left down
b. Mr, Bradford was found lying on the floor next to his bed. When asked what happened, he stated, I was
asleep and the next thing I knew I was on the floor.
c. Lying on the floor, side rails down. Rolled out of bed while asleep.
d. Lying on floor next to bed. No complaints verbalized. Side rails down. Appears to have fallen out of bed
while asleep.
j.
k.
92. Mr. Tyna suffered a massive heart attack and was placed on life support. Prior to this incident,
Mr. Tyna
l.
has completed a living will or durable power of attorney for healthcare while in a mentally
alert and

m.

health state requesting that he not be kept alive with life support equipment. Which of the
following

n.
statements is correct about his situation?
a. Mr. Tyna can be removed from life support because he was mentally alert when he completed the living
will, and he is now unable to talk while he is on a respirator and recovering from the heart attack.
b. Mr. Tynas surrogate decision maker would make decisions with the healthcare team regarding whether
Mr. Tynas condition is terminal, and his wishes regarding life support would be honoured at this time.
c. Mr. Tyna can be removed from life support because a massive heart attack always results in dealth.
d. Mr. Tyna should remain on life support because a massive heart attack is very seldom life threatening and
the recovery rate is high.
o.
93. During an emergency, the nurse executive would most appropriately use which of the
following
p.
leadership styles?
a. Democratic
c. Participative
b. Directive
d. Republican
e.
94. Paula is very effective at inspiring and motivating her staff to give highly skilled, efficient
nursing care.
f.
She demonstrates which of the following ?
a. Controlling leadership
c. Good leadership
b. Directive management
d. Strong management

e.
f.
a.
b.
c.
d.
g.
a.
b.
c.
d.
h.
a.
b.
c.
d.
i.
a.
b.
c.
d.
j.
k.
l.
a.
b.
c.
d.
m.
n.
a.
b.
c.
d.

95. Nurse managers recognize that to achieve effective communication, the listener should do
which of the
following?
Attempt to judge the meaning of the speakers words as the words are being spoken.
Avoid questioning the speaker regarding the meaning of statements.
Formulate responses as the speaker talks to avoid an uncomfortable delay in the conversation.
Give full attention to what the speaker is saying verbally and nonverbally.
96. To decrease resistance to the change process, nurse managers should do which of the
following?
Avoid changes that might be perceived as learning opportunities.
Assess the implications of any change for themselves and their followers.
Limit the information to staff regarding the change being made.
Use a directive leadership style while initiating the change.
97. Which of the following might prevent the conducting of a research study?
Costs for conducting the study are low compared to the potential benefits from the research.
In order to gather data for the research, excessive risk to the subject is required.
The identified problem is covered in the literature.
The research problem is based on untested nursing theories.
98. The beginning practicing nurse usually participates in research at which of the following stages?
Statistical design
Findings dissemination
Treatment administration
Hypothesis formulation
99. The nurse is talking with a pregnant client who has not yet decided what type of pain control
she will use
during her labor experience. Which of the following statements by the nurse represents an
advocacy
approach toward the client?
You should let your doctor decide what is best for you.
There is no right or wrong choice; what counts is what you want.
If you do not want to hurt, youd better get an epidural.
The choice is yours, but going natural will allow you to be more active in the process.
100. The circle of confidentiality within which the nurse may share information about a client
includes which
of the following?
All people on the nursing staff
All people in the nursing unit who are responsible for the client
Any licensed healthcare provider in the system
All family members who inquire about the client
o.
p.

q.

s.

r.

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