TEST BANK WILLIAMS DEWIT'S FUNDAMENTAL CONCEPTS AND SKILLS FOR NURSING 5TH EDITIONChapter1 MULTIPLE CHOICE 1. Florence Nightingale’s contributions to
... [Show More] nursing practice and education:
a. are historically important but have no validity for nursing today. b. were neither recognized nor appreciated in her own time. c. were a major factor in reducing the death rate in the Crimean War. d. were limited only to the care of severe traumatic wounds.
ANS: C By improving sanitation, nutrition ventilation, and handwashing techniques, Florence Nightingale’s nurses dramatically reduced the death rate from injuries in the Crimean War.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #1TOP: Nursing History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 2. Early nursing education and care in the United States:
a. were directed at community health. b. provided independence for women through education and employment.
c. were an educational model based in institutions of higher learning. d. have continued to be entirely focused on hospital nursing. ANS: B
Because of the influence of early nursing leaders, nursing education became more formalized through apprenticeships in Nightingale schools that offered independence to women through
1 | P a g eeducation and employment.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ:
Theory #4TOP: Nursing History KEY: Nursing
Process Step: N/A MSC: NCLEX: N/A
3. In order to fulfill the common goals defined by nursing theorists (promote wellness, prevent
illness, facilitate coping, and restore health), the LPN must take on the roles of:
a. caregiver, educator, and collaborator.
b. nursing assistant, delegator, and environmental specialist.
c. medication dispenser, collaborator, and transporter.
d. dietitian, manager, and housekeeper.
ANS: A
In order for the LPN to apply the common goals of nursing, he or she must assume the roles of
caregiver, educator, collaborator, manager, and advocate.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory
#2 TOP: Art and Science of Nursing KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
4. Although nursing theories differ in their attempts to define nursing, all of them base their
beliefs on common concepts concerning:
a. self-actualization, fundamental needs, and belonging.
b. stress reduction, self-care, and a systems model.
c. curative care, restorative care, and terminal care.
2 | P a g ed. human relationships, the environment, and health.
ANS: D
Although nursing theories differ, they all base their beliefs on human relationships, the
environment, and health.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ:
Theory #2TOP: Nursing Theories KEY: Nursing
Process Step: N/A
MSC: NCLEX: N/A
5. Standards of care for the nursing practice of the LPN are established by the:
a. Boards of Nursing Examiners in each state.
b. National Council of States Boards of Nursing (NCSBN).
c. American Nurses Association (ANA).
d. National Federation of Licensed Practical Nurses.
ANS: D
The National Federation of Licensed Practical Nurses modified the standards published by theANA
in 2004 to better fit the role of the LPN.
DIF: Cognitive Level: Comprehension REF: p. 5 OBJ:
Theory #2TOP: Standards of Care KEY: Nursing
Process Step: N/A
MSC: NCLEX: N/A
6. The LPN demonstrates an evidence-based practice by:
a. using a drug manual to check compatibility of drugs.
3 | P a g eb. using scientific information to guide decision making.
c. using medical history of a patient to direct nursing interventions.
d. basing nursing care on advice from an experienced nurse.
ANS: B
The use of scientific information from high-quality research to guide nursing decisions is
reflective of the application of evidence-based practice.
DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: Theory
#3 TOP: Evidence Based Practice KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
7. Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New Yorkin
1893 in order to:
a. offer a shelter to injured war veterans.
b. found a nursing apprenticeship.
c. provide health care to poor persons living in tenements.
d. offer better housing to low-income families.
ANS: C
Henry Street Settlement Service brought the provision of community health care to the poor
people living in tenements.
DIF: Cognitive Level: Comprehension REF: p. 2 OBJ:
Theory #4TOP: Growth of Nursing KEY: Nursing
Process Step: N/A
MSC: NCLEX: N/A
4 | P a g e8. An educational pathway for an LPN refers to an LPN:
a. learning on the job and being promoted to a higher level of responsibility.
b. moving from a maternity unit to a more complicated surgical unit.
c. obtaining additional education to move from one level of nursing to another.
d. learning that advancement requires consistent work and commitment.
ANS: C
By broadening the educational base, an LPN may advance and build a nursing career.
DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory #7
TOP: Nursing Education Pathways KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
9. When diagnosis-related groups (DRGs) were established by Medicare in 1983, the purpose
was to:
a. put patients with the same diagnosis on the same unit.
b. attempt to contain the costs of health care.
c. increase availability of medical care to the elderly.
d. identify a patient’s condition more quickly.
ANS: B
The purpose of instituting DRGs was to contain skyrocketing costs of health care.
DIF: Cognitive Level: Knowledge REF: p. 8 OBJ:
Theory #10TOP: Health Care Delivery KEY: Nursing
5 | P a g eProcess Step: N/A MSC: NCLEX: N/A
10. The advent of diagnosis-related groups (DRGs) required that nurses working in health care
agencies:
record supportive documentation to confirm a patient’s need for care in order to qualify for
a. reimbursement.
b. use the DRG rather than their own observations for patient assessment.
c. be aware of the specific drugs related to the diagnosis.
d. acquire cross-training to make staffing more flexible.
ANS: A
DRGs required that nurses provide more supportive documentation of their assessments and
identified patient needs to qualify the facility for Medicare reimbursement. Observant assessment
might also indicate another DRG classification and consequently more reimbursement for the
facility.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ:
Theory #10TOP: Managed Care KEY: Nursing Process
Step: N/A
MSC: NCLEX: N/A
11. If a member of a health maintenance organization (HMO) is having respiratory problems such
as fever, cough, and fatigue for several days and wants to see a specialist, the person is required
to go:
a. directly to an emergency room for treatment.
b. to any general practitioner of choice.
6 | P a g ec. directly to a respiratory specialist.
d. to a primary care physician for a referral.
ANS: D
Participants in an HMO must see their primary physician to receive a referral for a specialist in
order for the HMO to pay for the care.
DIF: Cognitive Level: Comprehension REF: p. 9 OBJ: Theory #11
TOP: Managed Care KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
12. An advantage of preferred provider organizations (PPOs) is that:
a. they make insurance coverage of employees less expensive to employers.
b. there are fewer physicians to choose from than in an HMO.
c. long-term relationships with physicians are more likely.
d. patients may go directly to a specialist for care.
ANS: A
The use of PPOs allows insurance companies to keep their premiums low and in turn makes
insurance coverage less expensive for the employers. There are usually more physicians from
which to choose than from a HMO, but long-term relationships between physician and patient
cannot be established easily. Patients still must see their primary physician before being referred
to other specialties.
DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory #11
TOP: Preferred Provider Organizations KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
13. After passing the National Council Licensure Examination for Practical Nurses (NCLEX-
PN), the nurse is qualified to take an additional certification in the field of:
7 | P a g ea. pharmacology.
b. care of infants and children.
c. operating room technology.
d. community health.
ANS: A
After becoming an LPN, the nurse may apply for additional certification in pharmacology or
long-term care.
DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory
#6 TOP: Educational Opportunities KEY: Nursing
Process Step: N/AMSC: NCLEX: N/A
14. Nursing interventions are best defined as activities that:
a. are taken to improve the patient’s health.
b. involve researching methods to maintain asepsis.
c. include the family in nursing care.
d. review guidelines for handling infectious wastes.
ANS: A
Interventions are actions taken to improve, maintain, or restore health.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory #2
TOP: Art and Science of Nursing KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease
15. Nurse Practice Acts define the legal scope of an LPN’s practice, which are written and
8 | P a g eenforced by:
a. the American Nurses Association.
b. the National Council Licensure Examiners.
c. each state.
d. each health care agency.
ANS: C
Each state writes and enforces the Nurse Practice Act, which defines the legal scope of nursing
practice.
DIF: Cognitive Level: Comprehension REF: p. 5 OBJ:
Theory #3TOP: Nurse Practice Act KEY: Nursing
Process Step: N/A
MSC: NCLEX: N/A
16. Women volunteers were organized to give nursing care to the wounded soldiers during the
Civil War by:
a. Florence Nightingale.
b. Dorothea Dix.
c. Clara Barton.
d. Lillian Wald.
ANS: B
9 | P a g eThe Union government appointed Dorothea Dix, a social worker, to organize women volunteers
to provide nursing care for the soldiers during the Civil War.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ:
Theory #4TOP: Nursing History KEY: Nursing
Process Step: N/A MSC: NCLEX: N/A
17. The nursing theory presented by Sister Calista Roy is based on:
a. reduction of stress.
b. achievement of maximum level of wellness.
c. relief of self-care deficit.
d. adaptation modes.
ANS: D
Adaptation modes (physiologic, psychological, sociologic, and independence) are the basis of the
nursing theory of Sister Calista Roy.
DIF: Cognitive Level: Knowledge REF: p. 4, Table 1-1
OBJ: Theory #2 TOP: Nursing Theories KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
18. The founding of the Red Cross is attributed to:
a. LillianWald.
b. Dorothea Dix.
c. Florence Nightingale.
10 | P a g ed. Clara Barton.
ANS: D
Clara Barton founded the Red Cross.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ:
Theory #4TOP: Nursing History KEY: Nursing
Process Step: N/A MSC: NCLEX: N/A
19. The nursing theorist whose practice framework is based on 14 fundamental needs is:
a. Dorothy Johnson.
b. Jean Watson.
c. Virginia Henderson.
d. Martha Rogers.
ANS: C
Virginia Henderson’s nursing theory framework is based on 14 fundamental needs.
DIF: Cognitive Level: Knowledge REF: p. 4, Table 1-1
OBJ: Theory #2 TOP: Nursing Theorists KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
20. The nursing theory that uses seven behavioral subsystems in an adaptation model is:
a. Betty Neumann.
b. Sister Calista Roy.
c. Dorothy Johnson.
11 | P a g ed. Patricia Benner.
ANS: C
Dorothy Johnson’s practice framework is based on seven behavioral subsystems in an adaptation
model.
DIF: Cognitive Level: Knowledge REF: p. 4, Table 1-1
OBJ: Theory #2 TOP: Nursing Theorists KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
21. The Standards ofClinical Nursing Practice are designed to direct LPNs to:
a. advance their nursing career.
b. seek a scientific basis for their interventions.
c. deliver safe, knowledgeable care.
d. a leadership role.
ANS: C
The Standards ofClinical Nursing Practice are designed to guide the LPN to deliver safe,
knowledgeable care.
DIF: Cognitive Level: Knowledge REF: p. 5 OBJ:
Theory #2TOP: Nursing Standards KEY: Nursing
Process Step: N/A MSC: NCLEX: Safe Effective Care
Environment
22. A state’s Nurse Practice Act is designed to protect the:
12 | P a g ea. physician.
b. nurse.
c. public.
d. hospital.
ANS: C
Nurse Practice Acts are designed to protect the public.
DIF: Cognitive Level: Knowledge REF: p. 6 OBJ:
Theory #5TOP: Nurse Practice Act KEY: Nursing
Process Step: N/A MSC: NCLEX: N/A
23. It is appropriate for practical nurses to provide direct patient care to persons in a
hospitalunder the supervision of a:
a. physician’s assistant.
b. registered nurse on the unit.
c. supervising nurse who is responsible for care on several units.
d. more experienced LPN on the unit.
ANS: B
Practical nurses provide direct patient care under the direct supervision of a registered
nurse,physician, or dentist.
DIF: Cognitive Level: Knowledge REF: p. 6 OBJ:
Theory #9TOP: Scope of Practice KEY: Nursing
Process Step: N/A MSC: NCLEX: N/A
13 | P a g e24. An example of tertiary health care is
a. hospice
b. restorative
c. emergency
d. home health
ANS: A
Tertiary health care includes extended care, chronic disease management, medical homes, in-home
personal care, and hospice care.
DIF: Cognitive Level: Comprehension REF: p. 9, Box 1-2
OBJ: Theory #8 TOP: Health Care Services KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
COMPLETION
25. Preferred provider organizations (PPOs) use
to finance their services and pay the
physical cost of the service.
ANS:
capitated cost
The capitated cost is the set fee that is paid to the network for each patient enrolled to finance its
services.
DIF: Cognitive Level: Knowledge REF: p. 9 OBJ:
Theory #8TOP: Capitated Cost KEY: Nursing
Process Step: N/A
MSC: NCLEX: N/A
26. In the United States, the Young Women’s Christian Association (YMCA) in New York openedThe
School, the first practical nursing school.
ANS:
14 | P a g e
care.Ballard
In 1892, the YMCA opened The Ballard School, a 3-month course in practical nursing that wasthe
first school of practical nursing.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ:
Theory #4TOP: Ballard School KEY: Nursing
Process Step: N/A MSC: NCLEX: N/A
27. Such health services as surgical procedures, restorative care, and home health care would be
classified as
care.
ANS:
secondary
Surgical procedures, restorative care, and home health are part of the many services classified as
secondary care.
DIF: Cognitive Level: Comprehension REF: p. 9, Box 1-2
OBJ: Theory #10 TOP: Health Care Services KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
MULTIPLE RESPONSE
28. Characteristics of primary nursing include which of the following? (Select all that apply.)
a. Elimination of fragmentation of care between shifts
b. Evolved in the mid-1950s
c. Planning and direction performed by one nurse
d. Ancillary workers used to increase productivity
e. The care plan covering the entire day
f. Associate nurses taking over care and planning when the primary nurse is off duty
15 | P a g eANS: A, C, D, E, F
Primary care reduces fragmentation of care between shifts. Care is planned by one nurse to cover
a 24-hour period using ancillary workers to increase productivity. An associate nurse may take
on direction of care in the absence of the primary nurse.
DIF: Cognitive Level: Knowledge REF: p. 8 OBJ: Theory
#8 TOP: Nursing Care Delivery KEY: Nursing Process
Step: N/A
MSC: NCLEX: N/A
29. In 1991, the American Nurses Association (ANA) published the Standards ofClinical
Nursing Practice. These standards are designed to: (Select all that apply.)
a. set standards for safe nursing care delivery.
b. define the legal scope of practice.
c. establish state legal requirements for clinical practice.
d. protect the nurse, patient, and health care agency.
e. regulate the nursing profession.
f. define activities in which nurses may engage.
ANS: A, D, F
The Standards ofClinical Nursing Practice generally define activities in which nurses may engage,
set standards for nursing care and delivery, and thereby protect the nurse, patient, andhealth care
agency.
DIF: Cognitive Level: Knowledge REF: p. 5 OBJ:
Theory #2TOP: Nursing Practice KEY: Nursing
Process Step: N/A MSC: NCLEX: N/A
16 | P a g e30. An example of the role of an LPN as a delegator is: (Select all that apply.)
a. changing a patient’s wound dressing.
b. assisting a patient to complete his or her bath.
c. assigning patient care tasks to certified nursing assistants.
d. requesting the housecleaning staff to mop the floor of a patient’s room.
e. instructing the unit secretary to page a physician to the floor.
ANS: C, D, E
Delegation under the scope of the practice of an LPN is the assignment of a certified nursing
assistant to certain nursing care or other non-medical staff to aspects of patient care.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory
#5 TOP: Art and Science of Nursing KEY: Nursing Process
Step: N/AMSC: NCLEX: N/A
31. During the Civil War, nursing schools offered education to women both in England and in the
United States. The schools in the United States differed from those in Europe because in U.S.
schools: (Select all that apply.)
a. students worked without pay.
b. the core curriculum was the same.
c. instruction was presented by physicians at the bedside.
d. the educational focus was on nursing care.
e. classes were held separately from the clinical experience.
17 | P a g eANS: A, C
In the United States, the students staffed the hospital and worked without pay. There were no
formal classes; education was achieved through work. There was no set curriculum, and content
varied depending on the type of cases present in the hospital. Instruction was done at the bedside
by the physician and therefore came from a medical viewpoint.
Chapter 2
MULTIPLE CHOICE
1. The nurse is aware that any description of health would include the concept that:
a. health is the absence of illness, and illness is the presence of chronic disease.
b. culture, education, and socioeconomic status influence one’s definition of health or illness.
c. illness is a biologic malfunction, and health is biologic soundness.
d. lifestyle factors are the major determinant of health or illness.
ANS: B
The concept of health is influenced by culture, education, and socioeconomic factors.
DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: Theory #1
TOP: Views of Health and Illness KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease
2. The nurse takes into consideration that the patient with an admitting diagnosis of type
2diabetes mellitus and influenza is described as having:
a. two chronic illnesses.
18 | P a g eb. two acute illnesses.
c. one chronic and one acute illness.
d. one acute and one infectious illness.
ANS: C
Chronic illnesses are those that develop slowly over a long period and last throughout a lifetime.
Acute illnesses develop suddenly and resolve in a short time. Type 2 diabetes mellitus would be
considered chronic, whereas influenza would be considered acute.
DIF: Cognitive Level: Application REF: p. 15 OBJ: Theory #1
TOP: Classification of Illnesses KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease
3. The nurse explains that an idiopathic disease is one that:
a. is caused by inherited characteristics.
b. develops suddenly, related to new viruses.
c. results from injury during labor or delivery.
d. has an unknown cause.
ANS: D
Idiopathic disease is defined as disease whose cause is unknown.
DIF: Cognitive Level: Knowledge REF: p. 13 OBJ: Theory #1
TOP: Classification of Illnesses KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease
4. The nurse assesses a terminal illness in a:
19 | P a g e76 year old admitted to a nursing home with Alzheimer’s disease who is pacing and asking
a. to go home.
b. 43 year old with Lou Gehrig’s disease who is refusing food and fluid.
2 year old child who burned her esophagus by drinking drain cleaner and who is being fed
c. by a tube.
52 year old diagnosed with lung cancer who had part of one lung removed and has a closed
d. chest drainage device in place.
ANS: B
A terminal illness is defined as one in which a person will live only a few months, weeks, ordays.
A person who refuses food and hydration will generally not live more than a few days.
DIF: Cognitive Level: Comprehension REF: p. 13 OBJ:
Theory #1TOP: Stages of Illness KEY: Nursing Process
Step: Assessment
MSC: NCLEX: Physiological Integrity: physiological adaptation
5. The nurse clarifies to a patient who now has an abscess following a ruptured appendix that the
abscess is considered to be:
a. a secondary illness.
b. a life threatening complication.
c. an expected event following any surgery.
d. a disorder easily treated with antibiotics.
20 | P a g eANS: A
A secondary illness is an illness that arises from a primary disorder.
DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: Theory #1
TOP: Views of Health and Illness KEY: Nursing Process Step:
InterventionMSC: NCLEX: Physiological Integrity: physiological
adaptation
6. The nurse uses a diagram to demonstrate how Dunn’s theory of health and illness can be
compared with a:
a. plant that grows from a seed, blossoms, wilts, and dies.
continuum, with peak wellness and death at opposite ends; the person moves back and forth
b. in a dynamic state of change.
ladder; from birth to death the individual moves progressively downward a ladder to
c. eventual death.
d. state of mind dependent on the individual perception of their own health or illness.
ANS: B
Dunn’s theory of a health continuum shows how an individual moves between peak wellness and
death in a constant process.
DIF: Cognitive Level: Knowledge REF: p. 14 OBJ: Theory #1
TOP: Views of Health and Illness KEY: Nursing Process Step:
InterventionMSC: NCLEX: Physiological Integrity: physiological
adaptation
7. A patient has been advised by the physician to take medication for high cholesterol and to
change eating habits after discharge home. The home health nurse discovered that the patient
refused to follow the medical and nutritional directions. The nurse’s best initial response to this
situation is to:
21 | P a g ea. emphasize to the patient how important it is to follow the doctor’s advice.
determine whether any cultural, socioeconomic, or religious values conflict, thus interfering
b. with the patient’s compliance.
explain that without diet and medication the condition will worsen and serious problems
c. will develop.
d. inform the physician that the patient is unable to understand the instructions.
ANS: B
The patient may have cultural, socioeconomic, or religious values that cause conflicts that
prevent her from following the doctor’s instructions.
DIF: Cognitive Level: Application REF: p. 15 OBJ:
Theory #5TOP: Concepts of Health and Illness |
Cultural Influences
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychological Integrity: coping and adaptation
8. A nurse practicing a holistic approach to nursing care must:
recognize that a change in one aspect of the person’s life can alter the whole of that person’s
a. life.
b. take responsibility for health care decisions.
c. promote state of the art technology.
d. discourage the use of more natural remedies and alternative methods of health care.
ANS: A
22 | P a g eHolistic nursing requires that the nurse recognize that a change in one aspect of the patient’s life (biological, sociological, psychological, and spiritual) will bring about changes in that patient’s whole life.
DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: Theory #6 TOP: Holistic Approach to Caring KEY: Nursing Process Step: AssessmentMSC: NCLEX: N/A 9. According to Maslow’s hierarchy, physiological needs are those that:
a. nurture intimacy. b. foster independence. c. encourage social interaction.
d. are essential to human life. ANS: D
Physiological needs are those that are essential to human life, such as oxygenation, nutrition, and elimination. DIF: Cognitive Level: Application REF: p. 17 OBJ: Theory #7 TOP: Maslow’s Hierarchy of Needs KEY: Nursing Process Step: N/AMSC: NCLEX: N/A
10. The factors involved in assessing the importance the patient attaches to the relief [Show Less]