might be a relative of the identified

Tips for taking the sick person, or even a staff member.

Nursing Board Exam C. PROBLEM/BEHAVIOR

THE PROBLEM MAY BE A DISEASE,

A SYMPTOM OR A BEHAVIOR.
THE QUESTION CONTAINS SEVERAL
DETAILS OF THE PROBLEM
PARTS:
 Is the question asking for nursing
 The Case (sometimes called Scenario)
actions or client symptoms or family
– the description of the client and
responses?
what is happening to him/her
 Does the question ask about a
 The Stem – the part of the question specific aspect of nursing care
that asks the question assessment, planning,
implementation, evaluation?
 The Correct Response  Does the question ask details
 Distracters – incorrect but feasible relevant to a specific symptom or
choices behavior the client exhibits?
 Is there additional information
about the client or the problem that
is important?
A. KEY WORDS
D. PRIORITY SETTING
 The most important skill for the test
taker is the ability to read the 1. “What action takes priority?”
question carefully and determine the
key elements in each question. 2. “What should the nurse do first?”

 Each question has key words. 3. “What should the nurse do

initially?”
 Key words relate to the client; to the
problem; and to specific aspects of 4. “What is essential for the nurse to
the problem. do?”

B. CLIENT MASLOW’S HIERARCHY OF NEEDS

 Factors such as age, sex, and marital  PHYSIOLOGIC NEEDS are first,
status may be relevant.  Followed by SAFETY NEEDS,
 When a child’s age is given, it often  Then LOVE AND BELONGING,
is very relevant to the answer.
 SELF-ESTEEM AND SELF-
 Vital signs vary with age. ACTUALIZATION.
 Preoperative teaching methods vary The first step of the nursing process is
with age. Appropriate toys and ASSESSMENT!
diversional activities vary with age.
 When the stem of a question asks for
 Always pay special attention to the the initial nursing action always
age of a client when it is given. look to see if there is a relevant
 Also consider who is the client for assessment answer. The nurse will
this question. That is, who is the take an action only when there is
focus of the question. The client may enough data to act.
be the identified sick person, or it

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  Call the physician only when there is  If the answers are too alike, then
not a nursing action that should be neither one is correct.
taken first.
I. ODD ANSWER WINS
 The stem of the question may ask for
a nursing action and the correct  The answer that is different from the
answer may be to assess. others is apt to be the correct
answer.
 When the stem of the question asks
what is essential for the nurse to do,  It may be the longest or the shortest
think safety. or simply very different in content or
style.
 Remember many of the test
questions are safety questions. J. UMBRELLA ANSWER

 One answer includes the others.

E. WHAT IS THE TIME FRAME?  There may be more than one correct
answer.
 Whenever a specific time frame is
 One answer is better than all the
indicated in a question it is very
others because it includes them.
important.
K. TEST ITEM CHECK LIST
 Pay attention to it. Time related
words may be like early or late in Use this handy list to check yourself every
relation in symptoms, preoperative time you answer a test question.
or post-operative, care on the day of
surgery or later postoperative care. Say to yourself, DID I CAREFULLY…

F. REPEATED WORDS 1) Read the stem?

 Words from the question are 2) Read all the options?

repeated in the answer.
3) Read the stem again?
 Frequently the same word or a
4) Look for key words?
synonym will be in both the question
and the answer. 5) Eliminate obviously incorrect options?
G. OPPOSITES L. ABSOLUTES

 When two answers are opposite such  Answers containing universal or

as high blood pressure and low blood absolute words are very apt to be
pressure incorrect.

 Or increase the drip rate and stop  Very little in life or nursing is always
the IV correct or incorrect.

 Or turn on the right side and turn on  Answers stated in absolute terms should
the left side be looked at with great caution.
 The answer is usually one of the two. M. DEADLY WORDS
H. SAME ANSWER ❌ All
 If two or three answers say the same ❌ Every
thing in different words none can be
correct. ❌ Total

❌ Nothing

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 ❌ Always ✅ Essentially

❌ Each ✅ Generally

❌ Only ✅ Occasionally

❌ Any ✅ Nearly

❌ Nobody ✅ Maybe

❌ Never ✅ Could

❌ None ✅ Commonly

N. DANGEROUS WORDS ✅ Average

⁉ All ✅ Seldom
⁉ Every ✅ Often
⁉ Total ✅ Normally
⁉ Nothing P. CHOOSING BETWEEN THE TWO
⁉ Always BEST OPTIONS

⁉ Each After eliminating the incorrect options and

you are having difficulty choosing between
⁉ Only two seemingly correct responses, use the
following strategies:
⁉ Any
1. ELIMINATE SIMILAR DISTRACTERS
⁉ Nobody
 If two options are essentially
⁉ Never
saying the same thing or include
⁉ None the same idea, then neither of
them can be the answer.
O. SAFE WORDS
 The answer has to be the option
✅ Usually that is different.

✅ Almost 2. REREAD TWO SEEMINGLY CORRECT

OPTIONS
✅ Frequently
 If two options seem equally
✅ Probably correct, reread them carefully;
there must be some difference
✅ Potentially
between them.
✅ May
 Reread the stem; you may notice
✅ Sometimes something you missed before.

✅ Partial 3. LOOK FOR A GLOBAL RESPONSE

✅ Some A more general statement may also include

correct ideas from other options.
✅ Might

✅ Should

✅ Few

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GUIDELINES TO FOLLOW DURING THE 5) Leave early so you will arrive early.
EXAM:
6) Do NOT study while you wait for
1. Budget your time – Although you your examination.
may not know exactly how many
7) Read, listen to music, relax.
questions you’ll be asked to answer,
you can estimate a little over 1 8) Leave notes and books at home.
minute per question. Keep moving at
a steady pace. 9) Listen carefully to the instructions
2. Read each question thoroughly but given by the test administrators.
quickly – In general, your first
10) Say a little Prayer before you begin.
reaction to a question is the correct
one. Remember that the
examination is designed to
determine if you’re minimally
competent and safe.
NCE Review
3. Concentrate on one item at a time.
Don’t worry about how many
questions you’ll have to answer. NURSING JURISPRUDENCE,
4. Answer questions as if the situation LEADEARSHIP, &MANAGEMENT
were IDEAL. Assume the nurse had
all the time and resources needed. Nurses need to understand the
You’re only concerned about one legalities involved in the delivery of
patient, the one in the question. safe and effective health care that
5. Focus on the key words in the stem. promotes positive outcomes.
6. Identify whether the stem is seeking It is important to be familiar with the
a true response or a false response. standards of care established within
Those stems asking for false your institution and the rules and
responses are easily misread. regulations that govern nursing
7. Reword a difficult stem. practice within your state because
8. Try answering the question before these are the standards to which you
you’ve read the options provided. will be held accountable.
9. Always read all options before
selecting the best one. Health-care consumers have a right
10. Relate each option to the stem. to expect quality care and that their
11. Use LOGIC AND COMMON health information will remain
SENSE to figure out the correct confidential.
response.
Caring for clients safely and avoiding
12. Remember that the correct option
legal difficulties requires nurses to
will tend to have greater
adhere to standards of care and their
applicability and flexibility.
scope of practice and carefully
13. Clueless? Look for clues in answer
document changes in client
choices instead of in the stem of the
conditions.
question.

10 THINGS TO REMEMBER ON THE DAY

CHAPTER 1 (CHARACTERISTICS
OF THE EXAMINATION: OF A PROFESSION)
1) Get up early. 1. Who stated that the “function of the nurse
is to assist the individual, sick or well,
2) Wear comfortable clothes. in the performance of those activities
3) Check your things (pencils, pens, etc.) contributing to health or its recovery (or to
peaceful death)”?
4) Eat breakfast.

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 a) Henderson c) All individuals are entitled to
equitable care; however, nursing
b) Rogers
care is patient- centered, so care,
c) Robbs although equitable, may not be
identical.
d) Nightingale
d) Codes of ethics provide guidelines for
Answer: D appropriate professional behaviors
and guide practice.
Rationales:
3. Nurses at a community hospital are in an
a) Henderson built on Nightingale’s
education program to learn how to use
theory.
a new pressure-relieving device for
b) Rogers developed a theory of nursing patients at risk for pressure ulcers. This is
known as the Science of Unitary which type of education?
Human Beings.
a) Continuing education
c) Robb was the first superintendent of
b) Graduate education
nurses at Johns Hopkins School of
Nursing. c) In-service education
d) Florence Nightingale defined nursing d) Professional registered nurse
function in both the sick and well education
state
Answer: C
2. You are participating in a clinical care
coordination conference for a patient with Rationales:
terminal cancer. You talk with your a) Continuing education furthers
colleagues about using the nursing knowledge and skills within the
code of ethics for professional registered professional domain.
nurses to guide care decisions. A
non-nursing colleague asks about this b) Graduate education leads to a
code. Which of the following statements best higher-level degree such as a
describes this code? master’s or doctorate.

a) Improves communication between the c) In-service education takes place

nurse and the patient within an institution or agency. It is
usually directed at teaching nurses
b) Protects the patient’s right of
who work in the institution about a
autonomy
new policy, standard, or type of
c) Ensures identical care to all patients equipment.

d) Acts as a guide for professional d) Professional registered nurse

behaviors in giving patient care education is the basic nursing
education to sit for licensure.
Answer: D
4. Which of the following is unique to a
Rationales: professional standard of decision
making? Select all that apply.
a) Although good communication is
expected, it is not considered an 1. Weighs benefits and risks when
“ethical code.” making a decision
b) Protecting autonomy is part of the 2. Analyzes and examines choices more
ethical code. independently

3. Concrete thinking

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 4. Anticipates when to make choices 6. Which of the following represent the
without others' assistance knowledge and skills expected of the
professional nurse? Select all that apply.
a) 1, & 2
1. Accountability
b) 1, 2 & 3
2. Advocacy
c) 1, & 3
3. Autonomy
d) 1, 2, 3, & 4
4. Social networking
Answer: A
5. Participation in nursing blogs
Rationales: Professional behaviors include
accountability and sound decision-making a) 1, 2, & 3
abilities.
b) 1, & 2
1. Professionals look at risks and
c) 1, & 4
benefits before making a decision.
d) 1, 2, 3, & 4
2. They analyze choices in order to
make sound decisions. Answer: A
3. Concrete thinking is literal and Rationales: Professional behaviors include:
focuses on the physical world.
1. Accountability for one's work and
4. Professional decision making occurs responsibilities.
independently.
2. Advocating for patients and families.
5. Nursing practice in the 21st century is an
art and science that focuses on: 3. Autonomy in making decisions
within the scope of practice.
a) The client
4. Social networking is not considered a
b) The nursing process knowledge or skill unique to
professional nursing.
c) Cultural diversity

d) The health-care facility 5. Participation in nursing blogs is not

considered a knowledge or skill
Answer: A unique to professional nursing.

Rationales: 7. Professional accountability serves the

following purpose: Select all that apply.
a) Health-care reform and nursing
practice focus on client or patient- 1. To provide a basis for ethical
centered care. decision making

b) The nursing process is a scientific 2. To respect the decision of the client

method used by nurses to ensure the
quality of patient care. 3. To maintain standards of health

4. To evaluate new professional

c) Cultural diversity is the existence
practices and reassess existing ones
and understanding that various
cultures exist within populations. 5. To belong to a professional
organization
d) The health-care facility is the
physical place where care occurs. a) 1, 2, & 3

b) 1, & 2

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 c) 1, 2, 3, & 4 ethical care of patients. There may
be times when it is difficult to
d) All of the above
discern the most ethical action,
Answer: A particularly when the lines are
blurred as to the correct decision.
Rationales: The Code of Ethics provides some
guidance that nurses can follow as
1. To provide a basis for ethical
part of the profession of nursing to
decision making is a characteristic of
uphold standards of ethical care.
professional accountability.
b) Improving care environments is
2. To respect the decision of the client
important but does not address the
is a characteristic of professional
ANA Code.
accountability.
c) Maintaining professional
3. To maintain standards of health is a
boundaries comes under
characteristic of professional
professional behaviors.
accountability.
d) Caring for self is important;
4. To evaluate new professional
however, it does not address quality
practices and reassess existing ones
and ethical car
is a characteristic of professional
accountability. 9. In several situations, confidentiality can
be breached, and information can be
5. Belonging to a professional
reported to other entities. Which of
organization demonstrates
the following meet these criteria? Select
commitment to the profession, not
all that apply.
necessarily accountability.
1. The patient is from a correctional
CHAPTER 2 (PROFESSIONAL institution.
ETHICS AND VALUES)
2. The situation involves child abuse.
8. Nursing Code of Ethics says: “The nurse
promotes, advocates for, and strives to 3. An injury occurred from a firearm
protect the health, safety, and rights of the 4. The patient is a physician
patient.” Which of the following best
describes an example of this provision? 5. The breach of information was
unintentional.
a) Respecting the patient’s privacy and
confidentiality when caring for him a) 2&3
b) 2,3, & 4
b) Serving on a committee that will c) 2&4
improve the environment of patient d) All of the above
care
Answer: A
c) Maintaining professional
boundaries when working with a Rationales:
patient
1. The health information of
d) Caring for oneself before trying to incarcerated patients is still
care for another person protected under the Health
Insurance Portability and
Answer: A Accountability Act (HIPAA).
Rationales: 2. Although HIPAA provides
a) The ANA Code of Ethics is designed protections for patient privacy,
to guide nurses toward quality, there are some cases in which

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 health-care providers can disclose c) Veracity is to be truthful.
patient information to other
providers and caregivers. These d) Justice is to treat all patients
equally.
exceptions typically include care
related to criminal acts, such as 11. Which best describes the difference
child or elder abuse, or when a between patient privacy and patient
patient is injured because of a confidentiality?
firearm or some other weapon.
a) Confidentiality occurs between
3. Although HIPAA provides persons who are close, whereas
protections for patient privacy, privacy can affect anyone.
there are some cases in which
health-care providers can disclose b) Privacy is the right to be free
patient information to other from intrusion into personal
providers and caregivers. These matters, whereas confidentiality
exceptions typically include care is protection from sharing a
related to criminal acts, such as person’s information.
child or elder abuse, or when a
c) Confidentiality involves the use
patient is injured because of a
of technology for protection,
firearm or some other weapon.
whereas privacy uses physical
4. Individual occupations and components of protection.
vocations are protected.
d) Privacy involves protection from
5. Any breach of information, being watched, whereas
intentional or unintentional, confidentiality involves
violates HIPAA. 2, & 3 protection from verbal
exchanges.
10. A patient asks a nurse if he has to agree
to the health provider’s treatment plan. Answer: B
The nurse asks the patient about his
Rationales:
concerns. Which ethical principle is the
nurse applying in this situation? a) Confidentiality is an expectation
of anyone who is under treatment.
a) Beneficence
b) Privacy is the condition of being
b) Autonomy
free from being observed or
c) Veracity disturbed by other people.
Confidentiality has to do with the
d) Justice sharing of someone else’s
information.
Answer: B

Rationales: c) Technology often causes breaches

in confidentiality.
a) Beneficence is to do good.
d) Confidentiality goes beyond verbal
b) The principle of autonomy exchanges; breaches can occur
indicates that the client has electronically or in writing.
independence to make decisions
and take action for himself or 12. A nurse is working on an ethics
herself. When the nurse asks the committee to determine the best course
patient about his concerns, the of action for a patient who is dying.
The nurse considers the positive and
nurse is exploring the reasons and
negative outcomes of the decision to assist
allowing the patient to make his
own decision. with choices. Which best describes the

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distinction of using a list when making an b) Choosing a value
ethical decision?
c) Prizing a value
a) The nurse can back up her reasons
d) Reflecting a value
for why she has decided to provide
a certain type of care. Answer: C
b) The nurse can compare the Rationales:
benefits of one choice over
another. a) To affirm means to strongly state
a fact, not indicating satisfaction
c) The nurse can communicate the with the choice.
best choice of action to the
interdisciplinary team. b) Choosing is to decide what is
important.
d) The nurse can provide care based
on developed policies and c) Prizing a value means being
standards. satisfied with a choice and being
willing to declare the choice to
Answer: B others. The patient made her
Rationales: choice clear to her family and
provider.
a) Although important to be able to
d) Reflecting a value means
support reasons, lists do not help
considering it
with this.

b) Creating a list of positives and 14. Which of the following demonstrates a

nurse as advocating for a patient? The
negatives helps when difficult
nurse
choices need to be made. The list
outlines the positive and negative a) Calls a nursing supervisor in
aspects of a decision. It allows the conflicting situations.
nurse to compare the benefits of
making a choice versus the b) Reviews and understands the law
potential disadvantages. When as it applies to the client’s clinical
compared side by side, it could condition.
help the nurse to make a difficult
c) Documents all clinical changes in
decision through an easier
the medical record in a timely
method.
manner.
c) Communicating the choice occurs
d) Assesses the client’s point of view
after the list is created.
and prepares to articulate this
d) Providing care should always be point of view.
based on policies and standards.
Answer: D
13. A nurse is caring for a patient who feels
Rationales:
that life should not be prolonged when hope
is gone. She has decided that she does not a) Calling the supervisor does not
want extraordinary measures taken when demonstrate speaking or
her life is at its end. She has discussed her advocating for the patient.
feelings with her family and health-care
provider. The nurse realizes that this is an b) Values and ethics are beliefs.
example of: c) Documenting clinical changes is
a) Affirming a value important however, this is not
advocating.

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 d) Nurses strengthen their ability to c) Autonomy
advocate for a client when nurses
d) Nonmaleficence
are able to identify personal
values and then accurately Answer: A
identify the values of the client
and articulate the client's point of Rationales:
view.
a) All patients are entitled to the best
15. A nurse’s significant other undergoes possible care regardless of their
exploratory surgery at the hospital socioeconomic status, culture, or
where the nurse is an employee. Which situations.
practice is most appropriate?
b) Veracity refers to truthfulness.
a) The nurse is an employee;
c) Autonomy is the right to make one’s
therefore, access to the chart is
own decisions.
permissible.
d) Nonmaleficience means to do no
b) Access to the chart requires a
harm.
signed release form.
17.Which common practice puts the nurse at
c) The relationship with the client
liability for invasion of patient privacy?
provides the nurse special access
to the chart. a) During care, the nurse reveals
information about the patient to
d) The nurse can ask the surgeon to
those in the room.
discuss the outcome of the
surgery. b) The nurse releases information
about the patient to nursing
Answer: B
students who will be caring for the
Rationales: patient the next day.

a) Being an employee does not give c) The nurse conducts a patient care
permission to access the chart. session about a patient whose care
is difficult and challenging.
b) Unless the significant other has
authorized any access to d) Confidential information regarding
information, the only people an admitted patient is released to
entitled to information without third-party payers.
written consent are the client and
Answer: A
those providing direct care.
Rationales:
c) The patient still needs to give
consent. a) Giving out information about a
patient without permission is an
d) The surgeon cannot discuss the
invasion of privacy.
patient’s health without consent
from the patient. b) Providing information about the
patient to those who will be caring
16.A nurse is providing care to a patient
for him or her is appropriate.
whose family has previously brought suit
against another hospital and two c) Sharing information with those who
physicians. Under which ethical are responsible for the patient’s care
principle should the nurse practice? in order to ensure safe and effective
care is appropriate.
a) Justice

b) Veracity

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 d) Patients sign release of information a) The hospital was supportive
forms to allow this; if a form has not and assistive as the nurse
been signed, third-party payers will coped with this event.
not reimburse.
b) The nurse was dismissed for
CHAPTER 3 (NURSING PRACTICE incompetence.
AND THE LAW) c) The hospital quality
department advised the nurse
18.The health-care facility has sponsored a
not to tell the patient about the
continuing education offering on
error.
emergency management of pandemic
COVID 19. At lunch, a nurse is overheard d) The nurse was reassigned to an
saying, “I’m not going to take care of area in which there is no direct
anyone who might have that flu. I have kids patient care responsibility.
to think about.” What is True of this
statement? Select all that apply. Answer: A

a) The nurse has a greater obligation Rationales:

than a layperson to care for the
a) Nurses must be held
sick or injured in an emergency.
accountable for errors but
b) This statement reflects should be treated in a
defamation and may result in professional and assistive
legal action against the nurse. manner.

c) This statement is a breach of the b) Dismissal for incompetence

Code of Ethics for Nurses. fails to demonstrate ethical or
supportive behavior.
d) The nurse has this right as no
nurse–patient contract has been c) Advising a professional not to
established. discuss the error is unethical.

Answer: 1, 3 d) Reassigning is punitive.

Rationales: 20. An RN new to the emergency

department documented that “the patient
1. Because nurses have greater was intoxicated and acted in a crazy
ability to provide care, their manner.” The team leader told the RN
obligation to provide care is that this type of documentation can
higher than that of laypersons. lead to:
2. The nurse has not made an a) Assault
inflammatory or false statement.
b) Wrongful publication
3. According to the Code of Ethics,
nurses need to care for patients c) Defamation of character
without judgment.
d) Slander
4. Caring for a patient is an
Answer: C
expectation of the role. Nurses do
not establish contracts with Rationales:
patients to deliver care.
a) Assault is a threat to do harm.
19. After 3 years of uneventful employment,
the nurse made a medication error that b) Wrongful publication refers to
resulted in patient injury. What hospital erroneous information in
response to this event is ethical? writing.

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 c) Charting or saying d) Malpractice
unsupported defamatory
Answer: D
statements can lead to tort
litigation. Rationales:
d) Slander is making an untrue a) Although this was performed
statement that causes harm to without malice and is considered
someone’s reputation. an unintentional tort, harm
21.An RN sees an older woman fall in the occurred, making the action
malpractice.
mall. The RN helps the woman. The
woman later complains that she twisted b) The licensed practical nurse
and sprained her ankle. The RN is (LPN) did not intend to hurt the
protected from litigation under: patient.
a) Hospital malpractice insurance c) Negligence falls in the category
b) Good faith agreement of an unintentional tort.

c) Good Samaritan law d) Malpractice occurs when an

unintentional tort causes an
d) Personal professional insurance injury to a client.

Answer: C 23.An RN is obtaining a signature on a

surgical informed consent document.
Rationales:
Before obtaining the signature, the
a) The incident occurred outside of the RN must ensure which of the
hospital. following? Select all that apply.

b) A good-faith agreement implies that 1. The client is not sedated.

a contract exists. 2. The doctor is present.
c) The Good Samaritan law protects 3. A family member is a witness.
persons who assist at an accident
scene if they act in good faith. 4. The signature is in ink.
Professional insurance is not in
effect because the actions were not 5. The patient understands the
performed while on duty. procedure.

Answer: 1, 5
d) Professional liability insurance does
not necessarily cover this type of Rationales:
litigation.
1. & 5. Before surgery, the nurse
22.An RN has asked a licensed practical needs to ensure that the patient
nurse (LPN) to trim the toenails of a fully understands what the
diabetic patient. The LPN trims physician told him or her about
them too short, which results in a toe the procedure and that the
amputation from infection. The patient files consent form has been signed
a lawsuit against the hospital, the RN, before any preoperative sedation
and the LPN. What might all three is administered.
be found guilty of?
2. The physician needs to provide the
a) Unintentional tort information so that the patient is
b) Intentional tort fully informed; the nurse may
obtain the signature but needs to
c) Negligence ensure that the patient is aware
and understands.

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 3. The nurse acts as the witness. 3. Do not resuscitate orders

4. Although the signature should be 4. Who should be notified in the

in ink, often electronic signatures case of illness, injury, or death
are obtained.
5. Durable power of attorney for
24.A patient is transported to the emergency health care
department by rescue after being involved
Answer: 1, 2, 3, 5
in a motor vehicle accident. The
patient is alert and oriented but Rationales:
keeps stating he is having trouble
breathing. Oxygen is started, but the patient The advance directive provides instructions
is still showing signs of dyspnea. The for future health-care decisions if the patient
patient suddenly develops becomes unable to make personal treatment
respiratory arrest and dies. During choices.
the resuscitation process, it is
26. An RN calls a health-care provider to
discovered that the nurse failed to open the
report that a patient’s condition is
correct oxygen valve. The family sues the
deteriorating. The physician gives
hospital and the nurse for:
orders on the telephone to draw
a) Malpractice arterial blood gases. What should the
nurse do next when receiving telephone
b) Negligence orders from a health-care provider?
c) Nonmaleficence a) Call the respiratory therapist to
d) Equipment failure obtain the blood gases.

Answer: A b) Give the order to the unit secretary

to ensure it is entered quickly.
Rationales:
c) Enter the order directly into the
a) Malpractice occurs when an system as it was given to the RN.
unintentional tort causes an
injury to a client. d) Write the order down and read it
back to the provider.
b) Malpractice falls under
Answer: D
negligence.
Rationales:
c) Nonmaleficence is an ethical
principle. 1, 2, and 3 are all steps the nurse needs to
d) The nurse failed to open the take; however, verifying the order is the
most important action to take first.
valve; there is not any evidence
that the equipment 4. The Joint Commission on National Safety
malfunctioned. Goals requires that all telephone orders be
25.A patient tells a nurse that he has an written down and read back. This ensures
the accuracy of the order. Failure to
advance directive from 6 years ago. The
follow this procedure leaves the nurse and
nurse looks at the medical record for the
the facility open to negligence because it is a
advance directive. What content should the
standard of care.
nurse expect to find in the advance
directive? Select all that apply. 27. An important competency that nurse
1. Decisions regarding treatments leaders need to develop in order to lead
effectively is the:
2. When to take the patient to the
a) Ability to be firm and inflexible
hospital

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 b) Ability to be close-minded and to c) Autocratic leaders are often too
ignore negative feedback directive and controlling.

c) Ability to communicate effectively d) Situational leaders are adaptive but

with others will spell out team members’
responsibilities.
d) Ability to follow orders without
questioning them 29. A democratic nurse leader consistently
works to:
Answer: C
a) Move the group toward the leader’s
Rationales:
goals
a) Inflexibility is not a leadership
b) Make little or no attempt to move
competency. In fact, it impedes the group
leadership effectiveness.
c) Share leadership with the group
b) Leaders who ignore negative
feedback may lose opportunities to d) Dampen creativity
improve their leadership
Answer: C
effectiveness.
Rationales:
c) Ability to communicate effectively
with other people is one of the three a) Democratic leaders do not set goals
competencies identified by Hersey without consulting with or
and Campbell. recognizing the group’s goals.
d) Nurse leaders need to be critical b) Democratic leaders are active, not
thinkers. There are times when they passive.
are obligated as caring professionals
to question directions, requests, or c) Democratic or participative leaders
medical orders. are characterized by their inclusion
of team members in important
CHAPTER 4 (LEADERSHIP AND decisions.
FOLLOWERSHIP)
d) Autocratic leadership squelches
28. A unit team leader who fails to provide creativity, whereas democratic
direction to his or her nursing care team leadership fosters it.
is a(n):
30. The Situational Leadership Model
a) Democratic leader focuses on:

b) Laissez-faire leader a) Both followers and the task

c) Autocratic leader b) The task

d) Situational leader c) The follower

Answer: B d) The behavior of others

Rationales: Answer: A

a) Democratic leaders are active Rationales:

leaders, not passive leaders.
a) The situational leadership approach
b) Laissez-faire leaders are passive, considers the complexity of a
inactive leaders who would not situation, which would include
provide direction. followers and the task at hand.

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 b) A focus only on the task(s) to be done a) An effective leader would increase
is too limited for the situational the positivity of the team, not its
approach. negativity.

c) Likewise, a focus only on the b) Transformational leaders work with

follower would be too limited. others, not alone.

d) Behavior is an important, but not c) Transformational leaders help their

the only, focus of situational teams define their mission and see
leadership. how their work helps them achieve
their mission.
31. An emotionally intelligent nurse leader:
d) Transformational leaders do not
a) Seeks the emotional support of focus their attention on team
others members’ weaknesses.
b) Cannot juggle multiple demands
33. An effective leader will have: Select all
c) Works alone without help that apply.

d) Welcomes constructive criticism 1. Courage and integrity

Answer: D 2. A critical mind-set

Rationales: 3. The ability to set priorities

a) Emotionally intelligent leaders 4. The ability to provide feedback

understand and manage their own Answer: 1, 2, 3, 4
emotions.
Rationales:
b) Emotionally intelligent leaders are
able to juggle multiple demands. 1. Integrity and courage are qualities
of an effective leader.
c) Emotionally intelligent leaders
actively work with members of their 2. Thinking critically is a behavior of
team rather than alone. effective leaders.

d) Emotionally intelligent leaders 3. Setting priorities is another behavior

welcome criticism that is of effective leaders.
constructive and acknowledges other
team members’ perspectives. 4. Skillful communication includes
providing constructive feedback.
32. Transformational nursing leaders have
the ability to: 34. Effective nurse leaders: Select all that
apply.
a) Increase the negativity of the team
1. Are also good followers
b) Work best alone
2. Effectively work together with
c) Define the group’s mission and shared goals
communicate that mission to others
3. Never act on their ideas
d) Pay close attention to the
4. Have master’s degrees
weaknesses and shortcomings of
others Answer: 1, 2
Answer: C Rationales:
Rationales: 1. Every leader is at times a follower.

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 2. Effective leaders work with their a) Postponing decision making is a
teams on shared goals. characteristic of laissez-faire leaders;
autocratic leaders are more active.
3. Although they are not always able to
act on their ideas, effective leaders b) Autocratic leaders make decisions
do so as much as they can if the independently; they generally do not
ideas are constructive. share decision making with their
teams.
4. Earning a master’s degree would be
helpful but is not required for c) Autocratic leaders frequently give
effective leadership. orders and make decisions without
consulting with team members.
35. Effective followers are those who are:
d) Encouraging creativity when
a) Passive employees
problem- solving is more
b) Skilled and self-directed employees characteristic of democratic
(participative) leaders.
c) Less valuable employees
CHAPTER 5 (THE NURSE AS
d) Employees who are never
MANAGER OF CARE)
supportive of new ideas
37. What is the difference between
Answer: B
management and leadership?
Rationales:
a) Management focuses on budget.
a) Effective followers are actively
b) Management is an assigned
involved in the work of the team.
position.
b) The most effective followers are not
c) Leadership is not concerned with
only competent but self-directed.
getting work done.
c) Effective followers are very valuable
d) Leadership is more focused on
employees.
people
d) Although they cannot be expected to
Answer: B
support every new idea, effective
followers support constructive new Rationales:
ideas.
a) Budgets are a concern of nurse
36. Autocratic leaders: managers but not their major focus.
a) Postpone decision making as long as b) Everyone can exert leadership at
possible various times, but manager is a
designated position, assigned by
b) Share leadership with members of
upper-level administration.
the team
c) Nurse leaders are definitely
c) Give orders and make decisions
concerned that the work of the team
without consulting the team
gets done.
d) Encourage creativity when problem
d) Both management and leadership
solving
focus on people.
Answer: C
38. Theory Y emphasizes:
Rationales:
a) Guidance, development, and reward

b) Leadership, not management

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 c) Supervision, monitoring, and that is best for all, even if it takes
reprimands some time.

d) Evaluation, budgeting, and time 40. Effective nurse managers have: Select all
studies that apply.

Answer: A 1. Leadership capabilities

Rationales: 2. Clinical expertise

a) A Theory Y manager employs staff 3. Business sense

guidance, staff development, and
4. Budgeting savvy
rework as opposed to Theory X's
emphasis on control, close Answer: 1, 2, 3, 4
monitoring, and punishment, if
needed. Rationales:
1, 2, 3, and 4.
b) Theory Y is a management theory,
not a leadership theory. To be maximally effective, nurse managers
need a constellation of skills: people skills
c) These are the focus of Theory X, not (leadership), expertise (clinical experience),
Theory Y. and financial skills (business sense and
budget savvy).
d) Time studies are used primarily by
those managing in the scientific 41. Informational aspects of a nurse
management mode. manager’s job include:
39. Servant leadership focuses on: a) Evaluation
a) Helping patients care for b) Resource allocation
themselves
c) Being a coach
b) Removing incompetent managers
d) Being a spokesperson
c) Creating a supportive work
environment Answer: D

d) Resolving conflicts quickly Rationales:

Answer: C a) Evaluation is one of the decisional

activities of a nurse manager.
Rationales:
b) Resource allocation is also a
a) Helping patients care for themselves decisional activity.
is a nursing care approach, not a
management approach. c) Being a coach is one of the
interpersonal activities of a nurse
b) Removal or demotion is sometimes manager.
necessary but not the focus of
servant leadership. d) Being a spokesperson for staff,
patients, and administration is an
c) Servant leadership employs a informational activity.
“people first” approach to improving
how employees are treated. 42. When should a new graduate consider
taking on management
d) Resolving conflicts as quickly as responsibilities?
possible would not be the goal of a
servant leader or manager, who a) As soon as they are offered
would try to come to a resolution
b) After developing clinical expertise

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 c) After 15 years on the job d) It is preferable to take a positive
approach, emphasizing a willingness
d) Before developing leadership to learn.
expertise
44. Ms. T wants to become a nurse manager.
Answer: B
She has been offered an opportunity
Rationales: to take a nursing management course.
Which topic is most important for her to
a) Very few new graduates have either learn?
the preparation or experience to
assume management responsibilities a) Managing people
soon after graduation. b) Managing the unit’s budget
b) Development of clinical expertise is c) Planning for the future
an essential part of preparing to be a
nurse manager. d) Redesigning the unit’s workflow

c) It is the amount of preparation and Answer: A

experience gained, not the number of
Rationales:
years, that is critical in making this
decision. a) Managing people is probably the
d) Nurse managers need to have most challenging task for nurse
leadership expertise. managers. It is fundamental to good
management.
43. Mr. Ree has just become a nurse
manager in a long- term care facility. He b) The unit budget is important but not
as complex as managing people.
knows he has a lot to learn— what should
he tell his staff? c) Planning for the future is also
a) Nothing; he should pretend he has important but not as fundamental as
managing people.
experience

b) That he is still learning, too, and d) Redesigning the unit’s workflow is

values their input usually a task that should be done
only after gaining familiarity with
c) That the staff needs to manage all aspects of the unit’s operation.
themselves
45. Scientific management focuses on:
d) How little he knows about
management a) Interpersonal relations

Answer: B b) Servant leadership

c) Staff development
Rationales:
d) Efficiency
a) Pretending to have experience is
likely to cause him to lose credibility Answer: D
and the trust of his staff.
Rationales:
b) This is an accurate description of his
situation and is likely to engage staff a) Interpersonal relations are not the
in supporting his growth and focus of scientific management.
development as a nurse manager.
b) Servant leadership is also more
c) Staff need to contribute to the focused on interpersonal relations
leadership of the team but are not than is scientific management.
expected to “manage themselves.”

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 c) Likewise, staff development is not d) The nursing assistant positions the
emphasized in scientific client on the left side, head
management. elevated.

d) The focus on increasing efficiency is Answer: A

the hallmark of scientific
management. Rationales:

46. Which of the following is a major reason a) The gloves are contaminated and
why newly licensed nurses resign? should be removed before answering
the phone.
a) Poor pay scale
b) Log rolling is an appropriate action.
b) Needlestick injuries
c) Using an incontinence diaper is an
c) Unsupportive management appropriate action.

d) Lack of advancement opportunities d) Keeping the head elevated is an

appropriate action.
Answer: C
48. A nurse is caring for a patient who has a
Rationales:
pulmonary embolus. The patient is
a) Newly licensed nurses face many receiving anticoagulation with IV heparin.
challenges, but poor pay is usually What instructions should the nurse give
not the reason for resignation. the NA who will help the patient with
activities of daily living? Select all that
b) Needlestick injuries are a concern, of apply.
course, but most facilities have
developed adequate prevention 1. Use a lift sheet when moving and
programs. positioning the patient in bed.

c) Newly licensed nurses, in particular, 2. Use an electric razor when shaving

need supportive management and the patient each day.
may resign if it is not present.
3. Use a soft-bristled toothbrush or
d) A lack of advancement opportunities tooth sponge for oral care.
becomes more important after the 4. Use a rectal thermometer to obtain
initial adjustment to this new role. a more accurate body temperature.
CHAPTER 6 (DELEGATION AND 5. Be sure the patient’s footwear has a
PRIORITIZATION OF CLIENT non-slip sole when the patient
CARE STAFFING) ambulates.

47. A nurse is helping an NA provide a bed Answer: 1, 2, 3, & 5

bath to a comatose patient who is
Rationales:
incontinent. Which of the following actions
requires the nurse to intervene? 4. This is inappropriate. Although a patient
is receiving anticoagulation therapy, it is
a) The nursing assistant answers the
important to avoid trauma to the rectal
phone while wearing gloves.
tissue, which could cause bleeding (e.g.,
b) The nursing assistant log-rolls the avoid rectal thermometers and
client to provide back care. enemas).

c) The nursing assistant places an 1, 2, 3, and 5. These are appropriate to the

incontinence diaper under the care of a patient receiving
client. anticoagulants.

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49. A nurse is caring for a patient who has d) Administer modafinil (Provigil) to
chronic obstructive pulmonary disease promote daytime wakefulness.
(COPD) and is 2 days postoperative after
Answer: C
a laparoscopic cholecystectomy.
Which intervention for airway management Rationales:
should the nurse delegate to an NA?
a) Discussing weight-loss strategies
a) Assisting the patient to sit up on requires additional education and
the side of the bed training.
b) Instructing the patient to cough b) Teaching requires additional
effectively education and training. These
c) Teaching the patient to use actions are within the scope of
incentive spirometry practice of the registered nurse (RN).

d) Auscultating breath sounds every 4 c) The nursing assistant can remind

hours patients about actions that have
already been taught by the nurse
Answer: A and are part of the patient's plan of
care.
Rationales:
d) The RN can delegate the
a) Assisting patients with positioning
administration of medication to a
and activities of daily living is licensed practical nurse (LPN) or
within the educational preparation licensed vocational nurse (LVN).
and scope of practice of a nursing
assistant. 51. A nurse is assigned to care for the
following patients. Which patient
b) Instructing requires additional should the nurse assess first?
education and skills and is more
appropriate for a licensed nurse. a) A 60-year-old patient on a
ventilator for whom a sterile
c) Teaching patients requires sputum specimen must be sent to
additional education and skills and the laboratory
is more appropriate for a licensed
nurse. b) A 55-year-old with COPD and a
pulse oximetry reading from the
d) Assessing patients requires previous shift of 90% saturation
additional education and skills and
is more appropriate for a licensed c) A 70-year-old with pneumonia who
nurse. needs to be started on IV antibiotics

50. A nurse is caring for a patient who is d) A 50-year-old with asthma who
diagnosed with coronary artery complains of shortness of breath
disease and sleep apnea. Which action after using a bronchodilator
should the nurse delegate to the NA?
Answer: D
a) Discuss weight-loss strategies such
Rationales:
as diet and exercise with the
patient. a) This patient’s needs are not urgent
or emergent.
b) Teach the patient how to set up the
CPAP machine before sleeping. b) In chronic obstructive pulmonary
disease (COPD), patients’ pulse
c) Remind the patient to sleep on his
side instead of his back. oximetry oxygen saturations of more
than 90% are acceptable.

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 c) The IV needs to be started; however, 2. Administer medications via
there is not an indication that the metered-dose inhaler (MDI).
patient is in an urgent or emergent
situation. 3. Complete in-depth admission
assessment.
d) The patient with asthma did not
4. Initiate the nursing care plan.
achieve relief from shortness of
breath after using the 5. Evaluate the patient’s technique
bronchodilator and is at risk for for using MDIs.
respiratory complications. This
patient's needs are urgent. Answer: 1, 2

52. A respiratory therapist performs Rationales:

suctioning on a patient with a closed head
1. & 2. The experienced licensed
injury who has a tracheostomy. Afterward,
practical nurse (LPN) is capable of
the NA obtains vital signs. The nurse
gathering data and making
should communicate that the NA needs
observations, including noting
to report which vital sign value or values
breath sounds and performing pulse
immediately? Select all that apply.
oximetry. Administering
1. Heart rate of 96 beats/min medications, such as those delivered
via metered dose inhalers (MDIs), is
2. Respiratory rate of 24 breaths/min within the scope of practice of the
3. Pulse oximetry of 95% LPN.

4. Tympanic temperature of 101.4°F 3. Independently completing the

(38.6°C) admission assessment is within the
scope of practice of the professional
Answer: D registered nurse (RN).

Rationales: 4. Initiating the nursing care plan is

within the scope of practice of the
a) Suctioning will increase the heart professional RN.
rate. This needs reporting and
reassessment and may be related to 5. Evaluating a patient’s abilities
the increased temperature. requires additional education and
skills. These actions are within the
b) Respiratory rate is often increased scope of practice of the professional
with a fever. RN.
c) Pulse oximetry of 95% is acceptable.
54. An assistant nurse manager is making
d) The patient has a tracheostomy and assignments for the next shift. Which
is at risk for infection. A tympanic patient should the assistant nurse manager
temperature of 101.4°F (38.6°C) assign to a nurse with 6 months of
indicates an infection and needs to experience and who has been floated from
be reported immediately. the surgical unit to the medical unit?

53. An experienced LPN is working under a) A 58-year-old on airborne

the supervision of the RN. The LPN precautions for tuberculosis (TB)
is providing nursing care for a patient who b) A 68-year-old who just returned
has a respiratory problem. Which from bronchoscopy and biopsy
activities should the RN delegate to the
experienced LPN? Select all that apply. c) A 69-year-old with COPD who is
ventilator dependent
1. Auscultate breath sounds.

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 d) A 72-year-old who needs teaching also help decrease mucosal
about the use of incentive irritation.
spirometry
b) This does not treat the problem.
Answer: D
c) This does not treat the problem.
Rationales:
d) This does not treat the problem.
a) To care for the patient with
56. The patient with COPD has a nursing
tuberculosis (TB) in isolation, the
diagnosis of Ineffective Breathing
nurse must be fitted for a high-
Pattern. Which is an appropriate action to
efficiency particulate air (HEPA)
respirator mask. delegate to the experienced LPN
under your supervision?
b) The bronchoscopy patient needs
a) Observe how well the patient
specialized procedure care and a
more experienced nurse. performs pursed-lip breathing.

b) Plan a nursing care regimen that

c) The ventilator-dependent patient
gradually increases activity
needs a nurse who is familiar with
ventilator care. intolerance.

c) Assist the patient with basic

d) Many surgical patients are taught
activities of daily living.
about coughing, deep breathing, and
the use of incentive spirometry d) Consult with the physical therapy
preoperatively. department about reconditioning
exercises.
55. The nursing assistant tells a nurse that
a patient who is receiving oxygen at a Answer: A
flow rate of 6 L/min by nasal cannula is
complaining of nasal passage discomfort. Rationales:
What intervention should the nurse
a) Experienced licensed practical
suggest to improve the patient’s
nurses (LPNs) and licensed
comfort for this problem?
vocational nurses (LVNs) can use
a) Suggest that the patient’s oxygen be observation of patients to gather
humidified. data regarding how well patients
perform interventions that have
b) Suggest that a simple face mask be already been taught.
used instead of a nasal cannula.
b) Planning requires additional
c) Suggest that the patient be education and skills, appropriate to
provided with an extra pillow. a registered nurse (RN).
d) Suggest that the patient sit up in a c) Assisting patients with activities of
chair at the bedside. daily living (ADLs) is more
Answer: A appropriately delegated to a nursing
assistant.
Rationales:
d) Consulting requires additional
a) When the oxygen flow rate is higher education and skills, appropriate to
than 4 L/min, the mucous an RN.
membranes can be dried out. The
best treatment is to add
humidification to the oxygen
delivery system. Application of a
water-soluble jelly to the nares can

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 CHAPTER 7 (COMMUNICATING a) The charge nurse is unavailable to
WITH OTHERS & WORKING WITH help the nurses when they have
questions about policies.
INTERPROFESSIONAL TEAM)
b) Some staff are afraid to ask
57. Ms. Chief is a new nurse manager who
particular charge nurses for help for
will be holding her first staff meeting
fear of retribution.
tomorrow. She has learned that the staff
members have not been following c) The use of acronyms is confusing to
important patient care policies. What is the staff members who are new to the
most important communication skill that unit.
she should use at the meeting?
d) All of the above
a) Talking to the staff
Answer: D
b) Laughing with them
Rationales:
c) Listening
a) Physical barriers—such as the
d) Crying absence of the charge nurse to
answer questions— could prevent
Answer: C
the staff from following policies.
Rationales:
b) Emotional barriers—such as a
a) Although answer 1—talking to the nurse's fear of retribution from a
staff—is important, the best answer colleague—can cause nurses to seek
is 3. out answers, which can delay care or
compromise safety.
b) This is incorrect. Laughing with
staff can confuse the audience and c) Semantic barriers—such as
cause them to misconstrue the acronyms or nicknames—can
seriousness of the message from confuse or mislead staff unfamiliar
Manager Jane. with their meaning.

c) Listening to staff is the most critical d) All of the above

communication skill because it helps
59. Bedside shift report is one of the things
the manager understand the
that Jane reviews at the staff meeting. She
situation and the staff 's rationale
stresses the way she would prefer the report
for their actions. It also
to start. Which of these would be the
demonstrates empathy and
least important to share with the
openness, which can lead to
oncoming nurse?
agreement on better adherence to
the policies. a) Telling the oncoming nurse what
happened on the unit during the
d) 4. This is incorrect. Demonstrating
shift.
emotions such as crying can confuse
the audience and cause them to b) Introducing the client and his or her
misconstrue the seriousness of the diagnosis to the oncoming nurse.
message from Manager Jane.
c) Sharing the nurse’s personal
58. As Ms. Chief speaks with the team, she opinion of the client.
learns why the staff members have had
difficulty following policies. Which of these d) Reviewing new medication orders
would be considered barriers to and the medication administration
effective communication? record (MAR)

Answer: B

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Rationales: b) Implicit bias can influence clinical
decision making and treatment.
a) & d). Although answers (a) and (d)
should be included in the bedside c) Implicit bias contributes to an
shift report, they are not the best individual’s social behavior.
answer.
d) All of the above
b) Introducing the client and his
Answer: D
diagnosis ensures that the sender
and receiver of the communication Rationales:
are familiar with the client and
share pertinent care needs, nursing a) Implicit bias is formed during a
interventions, and client progress lifetime because it is formed based
with goals of care. on an individual's culture, which
shapes attitudes, beliefs, and
c) This is incorrect. Personal opinions actions.
may prejudice the oncoming nurse’s
view of the patient, which could b) Implicit bias is automatic and
compromise care. subconscious during our interactions
with others and can influence our
60. The Joint Commission attributes 80% of clinical decision making and even
all medical errors to: treatment.
a) Poor hygiene and hand washing c) Implicit bias contributes to social
b) Poor hand-off communication behavior because it is derived from
an individual's cultural norms.
c) Poor work environment
d) All of the above
d) Lack of care
63. Social media is commonly used to update
Answer: B friends and groups on things we have
going on in our lives. Health-care
Rationales:
organizations routinely use social media to
b. Ineffective hand-off communication or promote medical facts, services, and
miscommunication between caregivers recognitions. What is important for nurses
during the transfer of care is estimated to remember when deciding to post
to contribute to 80% of serious medical something work related on a social media
errors. Poor hand-offs can lead to delays in site?
treatment, inappropriate treatment, and a) Nurses should never post
prolonged hospital stays.
protected health information on a
Answers 1, 3, and 4 contribute to medical social media site.
error but not to the same degree as b) Stories with good outcomes can be
ineffective hand-off communication. posted to your media page.
61. Implicit bias affects our understanding
c) Stories and photos can always be
in an unconscious manner. A person’s ability shared if the patient’s name or
to recognize these biases can improve face is not visible.
communication with patients and colleagues
alike. Which of the following statements is d) Posting stories on personal time is
true about implicit bias? OK because the nurse is not
working.
a) Implicit bias forms during a
lifetime. Answer: A

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Rationales: the patient’s history, focus your
assessment, and determine what
a) Protected health information (PHI) you need for the patient.
must be protected and never shared
without expressed written Answer: D
permission. A patient's privacy and
confidentiality are paramount. Rationales:

b) Nurses and other health a) Paging the MD to the bedside

professionals should never post without any information may cause
stories about patients the MD to just add visiting the
or work on social media sites. People patient to his list rather than
familiar with you may easily put 2 conveying the urgency of the
patient’s change in condition.
and 2 together and surmise the
situation and patient involved, b) Placing a STAT page to the MD may
which could be a breach in patient get the MD there quickly; however,
privacy. This could be grounds for without the necessary information
disciplinary action. about the patient, the MD may think
that you overreacted and dismiss the
c) Photos of patients or work areas
severity of the clinical change.
should not be shared on social
media. Although innocent, a photo c) Rather than bother the MD, you
may include an assignment board or medicate the patient for pain and
other information that could continue to observe the patient.
inadvertently display PHI.
d) Describing the situation,
d) The time of social media posting is background, assessment, and
irrelevant; the issue is the recommendations (SBAR) is best.
confidentiality and privacy of the Reporting on situational change is
patients and the staff caring for designed to provide concise,
them. pertinent, and factual information to
64. You are working on the trauma unit members of the health-care team.
today, and your new patient with a femur This approach to a sudden change in
patient condition allows you to
fracture complains of leg pain and seems a
communicate information, your
little diaphoretic and short of breath. You
concerns, and the need for action.
assess the patient and prepare to contact the
surgeon. In preparation for contacting 65. ISBARR provides a framework for
the physician, you: communicating critical client
information. ISBARR is an acronym for:
a) Immediately page the MD; it could
be a pulmonary embolism, and a) Identify, Study, Background,
time is of the essence. You will Assess, Recognize, Readback
give him the particulars when the
MD arrives. b) Issue, Situation, Better, Advise,
Refer with Recommendations
b) Wait for the MD to round on his
patient because it should be c) Introduce, Situation, Background,
within the next hour or so. Assess, Recommend, Readback

c) Medicate the patient for pain and d) None of the above

plan to contact the MD when he
Answer: C
rounds.

d) Jot down notes about the situation

as it is presented to you, review

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Rationales: a) Eliminate conflict entirely

The ISBARR is an acronym for a concise b) Resolve conflicts more effectively

review of the client with other team
c) Win
members to ensure timely intervention and
feedback. d) Reduce stress
It includes introducing the patient, the Answer: C
current situation, any pertinent background
that could be contributing to the situation, a Rationales:
clinical assessment with recommendations,
a) Public hospitals are funded by
and finally, a readback of the instructions or
federal, state, or local funds and are
orders to ensure accuracy.
considered not-for-profit.
66. Who is responsible for accepting,
b) Voluntary not-for-profit hospitals
transcribing, and implementing physician
are usually private or community
orders?
hospitals and are privately funded.
a) Unit clerk
c) For-profit hospitals are corporately
b) Medical intern or resident owned and listed on the stock
market. Decisions are driven by the
c) Professional nurse shareholders.
d) Medical assistant d) All of the above
Answer: C 68. Differences in status and authority
Rationales: within the health-care team can
generate conflict. What is the
a) Unit secretaries may enter orders most common cause of conflict?
into a patient record; however, it is
a) Disrespect and incivility
the responsibility of the professional
nurse to accept or sign off on the b) Inappropriate language and
order before it is implemented. sarcasm
b) Medical students may write orders; c) Blaming and finger pointing
however, they must first be signed
off by the faculty physician before d) Physical violence
being accepted by the professional
Answer: C
nurse, who can then ensure they are
implemented. Rationales:

c) The professional nurse is responsible a) Providing adequate resources such

for accepting, transcribing, and as support services makes care
implementing health-care provider delivery easier, which can reduce
orders. safety risks.

d) Medical assistants may not accept or b) The use of interprofessional teams

implement physician or health-care improves root cause analysis, which
provider orders without being improves problem-solving and
accepted by a professional nurse. contributes to sustained
improvement.
CHAPTER 8 (RESOLVING
PROBLEMS & CONFLICTS) c) Although staffing ratios may
improve patient safety, they are not
67. The purpose of learning how to negotiate required to ensure a culture.
conflict is to:

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 d) Work environments free of d) Work intensification
reprimand and punishment create
Answer: D
an atmosphere of trust and result in
open sharing to solve problems in Rationales:
care and practice.
a) Adequate staffing ensures that staff
69. The hospital has recently reorganized; members have time to provide care
therefore, several departments were closed. to clients. The number of patients
The patient census on the unit has assigned to a nurse can affect
increased. The staff have always had a patient clinical outcomes.
strong team spirit, but the nurse manager
knows that workflow changes can cause b) Collegial relationships contribute to
conflict. What can the nurse manager do to staff engagement, teamwork, and
reduce the possibility of conflict among her morale, which are linked to better
team? outcomes.

a) Monitor the quality of patient care. c) Staff development ensures clinical

competence and promotes learning,
b) Ensure that supplies and which enhances the capabilities of
equipment are readily available. nursing staff.
c) Assess the equity of nursing d) All of the above
assignments.
71. What is the most desirable result of a
d) All of the above problem resolution?
Answer: D a) Win-lose
Rationales: b) Lose-lose
a) An organization’s philosophy, c) Win-win
mission, and vision are based on its
values. d) None of the above

b) Policies and procedures are written Answer: C

to translate mission, vision, and
Rationales:
values into action.
a) Organic structure is more dynamic,
c) An organization’s décor may be
more flexible, and less centralized
selected based on its mission, vision,
than the static traditional
and values.
hierarchical structure. In organically
d) Shared values and beliefs are the structured organizations, many
foundation of organizational culture. decisions are made by the people
who will implement them, not by
70. Nursing and respiratory departments their bosses.
both experienced job cuts. The nurse
manager notices that members of his staff b) Flexible teams are organic in nature.
are having more trouble getting a fast These teams are responsible for
response from a respiratory therapist. their own self- correction and self-
What source of conflict is probably control; although they may also have
operating here? a designated leader, the teams
supervise and manage themselves.
a) Union–management conflict
c) Rigid unit structures are
b) Interpersonal problem characteristic of a bureaucratic
c) Cultural differences organization. They are very
organized and formal.

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 Organizational charts depict each being told to stop. Which approach is
department, and decision making is the most appropriate for this situation?
a very formal, organized process.
a) Refer each of them for employee
d) Self-correction and self-control are counseling.
characteristics of an organic
structure. b) Engage in problem resolution.

72. What is brainwriting? c) Bring in a union representative.

d) Engage in a formal negotiation

a) A strategy to encourage the free
process.
flow of ideas
Answer: A
b) A mutually beneficial negotiation
result Rationales:
c) A winning approach to formal a) Nurses do have the authority to
negotiation control clinical resources and make
d) A devaluation reaction to patient care decisions by virtue of
their position and licensure.
negotiation

Answer: A b) Bedside nurses are limited in their

ability to tangibly reward staff in
Rationales: any organization.

a) Authority is position dependent. It is c) Nurses control information about

assigned based on the organization's their clients and daily clinical care
hierarchy. For example, a nurse that, if shared or withheld, can
manager has authority over the staff directly impact care delivery and
nurses on that unit. Unless a job outcomes.
description or the person hiring
d) Unfortunately, coercion—whether
requires expertise, leadership, or
real or implied—exists. Threatening
collaboration with this manager's
to report a colleague or giving
staff, authority is entirely dependent
someone a perception that a call
on where the position falls on the
organizational chart. The higher the light may not be answered are two
position, the more authority. examples.

74. Which of the following issues may be

b) This manager’s authority is not
derived from his or her ability to addressed in a collective bargaining
lead people. agreement?

a) Shift differentials
c) This manager may not be required to
have expertise even though he or she b) Safe working environment
may be expected to manage a group
of experts. c) Grievance procedures

d) Staff members reporting to this d) All of the above

position have no formal authority
Answer: B
over this manager based on the fact
that the manager is in a position Rationales:
above them on the organizational
chart. a) Belonging to a professional
organization can offer nurses a sense
73. Ms. U has two team members who of support from a larger group. It
continually criticize each other despite can offer ways to grow professionally

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 through continuing education and a) Professional governance rarely
allow the nurse to have a stronger requires working longer hours;
voice on community and legislative rather, it enhances communication
issues. and can streamline or simplify
nursing practice.
b) Direct control over work and the
ability to influence clinical and b) Although meetings are necessary for
organizational decisions are professional governance, they are
essential to feeling empowered. kept to a minimum.
Participating on a unit practice
c) Nurses set nursing standards of
council is an opportunity to
practice for their organization.
contribute to the nursing unit and
Because you
even the organization, make a
difference in clinical practice, and are closest to the bedside, you see
know that her opinion and ideas are and experience the realities of
valued and important. clinical practice. Your input ensures
that clinical practice standards are
c) Reasonable work assignments can relevant and that nursing care is
help nurses by giving them time to delivered in a safe, high- quality
accomplish tasks and may contribute manner.
to a nurse feeling empowered; work
assignments are not essential to a d) 4. Professional governance sets
nurse’s ability to feel empowered. nursing standards that may or may
not influence the culture of an
d) Rewards and recognition programs organization.
are not necessary for nurse
76. If an informal negotiation session
empowerment but can contribute by
becomes too highly emotional, what
creating an environment where staff
should the nurse manager do?
accomplishments and actions are
publicly recognized, which can make a) Let the feelings flow.
a nurse feel valued.
b) Cancel the negotiation.
75. Nursing management and the nursing
union are having differences on c) Deal with the feelings first.
several issues. There may be a need for
d) Tell them to ignore the feelings and
negotiation. Which of the following is a
deal with the issues.
serious disadvantage to using collective
bargaining to resolve this conflict? Answer: A

a) Protecting the right to fair Rationales:

treatment
a) Professional organizations create a
b) Creating an adversarial collective voice for nurses that can
relationship between staff and be stronger and more likely to be
management heard, especially at the national,
state, and local levels. Your
c) Lacking professionalism on the part
membership and participation let
of the collective bargaining unit
your voice be heard.
members
b) Professional organizations have no
d) Failing to uphold important
involvement in the management of
standards of care
hospital and health-care
Answer: C organizations, but they do provide
opportunities for nurses to work
Rationales:

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 with the professional organization harm. Which of the following is not a
membership on nursing issues. key feature of a culture of safety?

c) Opportunities for promotion come a) Provision of adequate resources to

from the health-care organization, provide care and service
not memberships in professional
organizations. However, professional b) Use of interprofessional
organizations may enhance nurse collaboration to solve problems
and assess risk
competence through publications,
continuing education, and c) Adherence to staffing ratios
certifications, which can prepare a
nurse for promotion. d) Encourages the reporting of errors
and near misses
d) Health-care and other benefits are
provided by a nurse’s employer. Answer: C
Some professional organizations may
Rationales:
offer liability insurance for their
membership but seldom, if ever, a) Providing adequate resources such
health-care benefits. as support services makes care
delivery easier, which can reduce
CHAPTER 9 (ORGANIZATIONS, safety risks.
POWER, & PROFESSIONAL
b) The use of interprofessional teams
EMPOWERMENTS)
improves root cause analysis, which
77. If you are employed at a hospital owned improves problem-solving and
by a corporation listed on the stock contributes to sustained
market, in which category does your improvement.
facility belong?
c) Although staffing ratios may
a) Publicly (government) supported improve patient safety, they are not
required to ensure a culture.
b) Voluntary, not-for-profit
d) Work environments free of
c) For-profit reprimand and punishment create
d) All of the above an atmosphere of trust and result in
open sharing to solve problems in
Answer: C care and practice.

Rationales: 79. Organizational culture is best defined as:

a) Public hospitals are funded by a) The stated vision and mission of

federal, state, or local funds and are an organization
considered not-for-profit.
b) Policies and procedures
b) Voluntary not-for-profit hospitals
are usually private or community c) The type of décor that was chosen
hospitals and are privately funded. for the facility

c) For-profit hospitals are corporately d) An enduring set of shared values

owned and listed on the stock and beliefs
market. Decisions are driven by the Answer: D
shareholders.

d) All of the above

78. Creating a culture of safety requires

organizational commitment to preventing

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Rationales: a) Organic structure

a) An organization’s philosophy, b) Flexible teams

mission, and vision are based on its
values. c) Rigid unit structures

d) Self-correction and self-control

b) Policies and procedures are written
to translate mission, vision, and Answer: C
values into action.
Rationales:
c) An organization’s décor may be
selected based on its mission, vision, a) Organic structure is more dynamic,
and values. more flexible, and less centralized
than the static traditional
d) Shared values and beliefs are the hierarchical structure. In organically
foundation of organizational culture. structured organizations, many
decisions are made by the people
80. Communities and regulatory agencies
who will implement them, not by
continually challenge hospitals, skilled
their bosses.
nursing facilities, and home health
companies to enhance, improve, or b) Flexible teams are organic in nature.
change care delivery and the care These teams are responsible for
environment to ensure safe, high- their own self- correction and self-
quality care. Which factors are control; although they may also have
important in improving a hospital’s a designated leader, the teams
care environment? supervise and manage themselves.
a) Adequate staffing c) Rigid unit structures are
b) Collegial relationships among staff characteristic of a bureaucratic
organization. They are very
c) Emphasis on staff development organized and formal.
Organizational charts depict each
d) All of the above
department, and decision making is
Answer: D a very formal, organized process.

Rationales: d) Self-correction and self-control are

characteristics of an organic
a) Adequate staffing ensures that staff structure.
members have time to provide care
to clients. The number of patients 82. What is the best explanation of
assigned to a nurse can affect authority?
patient clinical outcomes.
a) It is position dependent.
b) Collegial relationships contribute to
b) It is based upon the ability to lead
staff engagement, teamwork, and others.
morale, which are linked to better
outcomes. c) It is expertise-driven.

c) Staff development ensures clinical d) It resides primarily in the clients

competence and promotes learning, served.
which enhances the capabilities of
Answer: A
nursing staff.

d) All of the above Rationales:

81. Which of the following is a characteristic a) Authority is position dependent. It is

of a bureaucratic organization? assigned based on the organization's

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 hierarchy. For example, a nurse d) Unfortunately, coercion—whether
manager has authority over the staff real or implied—exists. Threatening
nurses on that unit. Unless a job to report a colleague or giving
description or the person hiring someone a perception that a call
requires expertise, leadership, or light may not be answered are two
collaboration with this manager's examples.
staff, authority is entirely dependent
84. Nurses who feel empowered can make
on where the position falls on the
significant contributions to a health-
organizational chart. The higher the
position, the more authority. care organization. Feeling empowered
includes feeling as if you make a
b) This manager’s authority is not difference, that colleagues value your
derived from his or her ability to opinion, and that your voice is
lead people. important. What is essential to nurse
empowerment?
c) This manager may not be required to
have expertise even though he or she a) Belonging to a professional
may be expected to manage a group organization
of experts.
b) Participating on a unit practice
d) Staff members reporting to this council
position have no formal authority
c) Reasonable work assignments
over this manager based on the fact
that the manager is in a position d) A rewards and recognition
above them on the organizational program
chart.
Answer: B
83. There are numerous sources of power in
an organization. Several are available Rationales:
to nurses. Which one is not?
a) Belonging to a professional
a) Authority organization can offer nurses a sense
of support from a larger group. It
b) Reward can offer ways to grow professionally
c) Control of information through continuing education and
allow the nurse to have a stronger
d) Coercion voice on community and legislative
issues.
Answer: A
b) Direct control over work and the
Rationales:
ability to influence clinical and
a) Nurses do have the authority to organizational decisions are
control clinical resources and make essential to feeling empowered.
patient care decisions by virtue of Participating on a unit practice
their position and licensure. council is an opportunity to
contribute to the nursing unit and
b) Bedside nurses are limited in their even the organization, make a
ability to tangibly reward staff in difference in clinical practice, and
any organization. know that her opinion and ideas are
valued and important.
c) Nurses control information about
their clients and daily clinical care c) Reasonable work assignments can
that, if shared or withheld, can help nurses by giving them time to
directly impact care delivery and accomplish tasks and may contribute
outcomes. to a nurse feeling empowered; work

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 assignments are not essential to a influence the culture of an
nurse’s ability to feel empowered. organization.

d) Rewards and recognition programs 86. Several of your colleagues are going to
are not necessary for nurse join the Philippine Nurses Association
empowerment but can contribute by (PNA). You know the annual dues are a
creating an environment where staff little more than you can afford right
accomplishments and actions are now, but you want to learn more. Your
publicly recognized, which can make friends think that joining the PNA
a nurse feel valued. will help empower them. How do
professional organizations empower nurses?
85. You have been asked to serve on your
unit practice council. This is an a) They represent nurses in the
important role and one that you are excited political arena.
to perform. What should you know about
b) They equalize power between
professional governance so that you
employees and staff.
are prepared for this work? Professional
governance in nursing involves: c) They provide opportunities for
promotion.
a) Working longer hours
d) They provide health insurance.
b) Attending a lot of meetings
Answer: A
c) Nurses setting nursing standards
for daily practice Rationales:
d) Changing the organization’s a) Professional organizations create a
culture collective voice for nurses that can
Answer: C be stronger and more likely to be
heard, especially at the national,
Rationales: state, and local levels. Your
membership and participation let
a) Professional governance rarely your voice be heard.
requires working longer hours;
rather, it enhances communication b) Professional organizations have no
and can streamline or simplify involvement in the management of
nursing practice. hospital and health-care
organizations, but they
b) Although meetings are necessary for do provide opportunities for nurses
professional governance, they are to
kept to a minimum.
work with the professional
c) Nurses set nursing standards of organization membership on nursing
practice for their organization. issues.
Because you
c) Opportunities for promotion come
are closest to the bedside, you see
from the health-care organization,
and experience the realities of
not memberships in professional
clinical practice. Your input ensures
organizations. However, professional
that clinical practice standards are
organizations
relevant and that nursing care is may enhance nurse competence
delivered in a safe, high- quality through publications, continuing
manner.
education, and certifications, which
d) Professional governance sets nursing can prepare a nurse for promotion.
standards that may or may not d) Health-care and other benefits are
provided by a nurse’s employer.

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 Some professional organizations may familiarize herself with her
offer liability insurance for their assignment and new expectations
membership but seldom, if ever, that would put her out of her comfort
health-care benefits. zone.

CHAPTER 10 (ORGANIZATIONS, b) The nurse is accustomed to the daily

PEOPLE, & CHANGE) routine, knows what to expect, and
understands what is expected. This
87. Which of the following is a macro-level puts the nurse in his or her comfort
change? zone.

a) Shift in Medicare payment policies c) Moving to a shift where a nurse is

unfamiliar with the surroundings,
b) Change in shift differentials the people, or the workflow puts the
c) Opening a new unit nurse out of his or her comfort zone.

d) Changing visiting hours d) Adding new tasks or duties can put

the nurse out of his or her comfort
Answer: A zone because the nurse may not
know what to expect or how to deal
Rationales:
with complications that arise when
a) Macro-level changes happen on a carrying out these duties.
large scale. Changes to national
88. How can you increase your staff ’s
Medicare payment policies are large
receptivity to an important change in
and far reaching because Medicare
procedures?
encompasses the U.S. health-care
system. a) Assign the new procedure to the
newest staff member.
b) Changing shift differentials is a
small-scale or micro-level change. It b) Apologize for making their work
is made at a local level such as a more complicated.
hospital or a nursing unit.
c) Provide them with a booklet on
c) Opening a new unit is a small-scale preparing for change.
or micro-level change.
d) Give them time to learn the new
d) Changing visiting hours is a local or procedure.
micro- level change.
Answer: D
88. Which of the following best describes
what is most likely to be within a Rationales:
nurse’s comfort zone? a) Staff receptivity is critical to the
a) A new assignment successful introduction of an
important practice change. The
b) Tasks she’s done many times nurse manager should involve both
experienced and new staff in the
c) Change to a different shift
process. This gives the staff an
d) Addition of several new tasks opportunity to ask questions and
express their feelings about the
Answer: B anticipated change. It also gives
Rationales: them some ownership in the process,
which can lower resistance to the
a) A new assignment moves the nurse change.
to the unknown even though it may
occur on the same unit. She must

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 b) There is no need to apologize. staff to consider the benefits of this
Change does not automatically change.
translate to complicating work for
staff. The purpose of the change and b) Sharing information about the new
anticipated benefits should be scheduling process and how it can
benefit the staff offers them time to
shared with the staff with the
learn about the new process and
understanding that their work may
possibly have input into the
be affected but not necessarily
proposed change.
complicated.
c) Dictating change by posting the
c) Providing additional information
schedule as is can result in
about change does not address the
heightened resistance to change.
proposed change and how it may
impact the staff ’s daily routine. It d) Providing the staff with the
may leave the staff with more opportunity to come up with an
questions and concerns. alternative could be seen as passive
d) Allowing time to learn or practice resistance to change if the staff
the new procedure lets staff gain members are allowed to drag the
confidence and reduces the threat of process out. Disregarding the staff ’s
failure. This can make the staff more efforts could threaten their
receptive to the proposed change. psychological safety.

89. Anew nurse manager plans to implement 89. There has been a sudden increase in
a new scheduling process. This was met catheter-associated urinary tract
with resistance from the staff who were very infections that must be addressed on Mr. U’s
unit. What is the best way for Mr. U
happy with the current scheduling
to persuade the staff to implement a
process. How can the nurse manager lower
new Foley catheter care protocol?
their resistance to this change?
a) Tell them the change has been
a) Tell the staff that their concerns
ordered by the administration.
about the new schedule are
unfounded and plan to post the b) Present statistics proving the
new schedule. need to change
b) Share information about the new c) Tell a compelling story about
schedule and discuss its impact on why change is needed.
the unit.
d) Explain the importance of the
c) Post the schedule and deal with change in simple terms.
staff on an individual basis.
Answer: C
d) Ask the staff to come up with an
alternative for the nurse Rationales:
manager’s consideration.
a) Change ordered by the
Answer: B administration could be perceived as
a threat by the staff, which could
Rationales: create more resistance to the new
protocol.
a) This approach discounts the staff ’s
currently held beliefs about the b) Statistics will show the staff the
schedule and may create more number of infections but may not
resistance to change. The nurse compel them to make changes to
manager should have introduced their practice.
information that would allow the

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 c) Telling a story about a patient gives acknowledged, this resistance to
the nurse manager an opportunity to change can be addressed.
appeal to the staff members’
emotions, which compels staff to act, d) Resistance based on the fear of
can increase receptivity to change, losing one's job is the most difficult
type of resistance to overcome
and may even create a sense of
urgency for change. because the person perceives that
there is a threat to his or her way of
d) Explaining the importance of change life, which the person will guard at
in simple terms helps staff all costs. The individual does not feel
understand that change is that he or she can speak freely
necessary; however, it does not without jeopardizing his or her job,
appeal to their emotions, which may so although the individual disagrees
affect the implementation of the with the change, he or she keeps
protocol. silent to stay employed.

90. What type of resistance to a change is 91. When is it most appropriate to dictate
the hardest to overcome? (order) change?

a) The resistance that comes from a) When the change is very

inertia: “We always do it this way.” complicated

b) Active resistance to changing a b) In an emergency

preferred procedure.
c) When resistance is very high
c) Passive resistance to an unpopular
d) If the change is unimportant
change.
Answer: B
d) Resistance based upon fear of losing
one’s job Rationales:
Answer: D a) When change is complicated,
Rationales: involving staff in the change can
help to lower resistance and improve
a) Resistance caused by inertia or the the adoption of the proposed change.
status quo is both passive and
active. Both can be acknowledged; by b) In an emergency, there is little time
providing more information and for discussion or debate around
involving the staff in the proposed taking action. In this situation, it is
change, resistance to the change is appropriate for someone in authority
lowered. to take charge and dictate how the
department will proceed. This is
b) Active resistance is direct and easy most common during life-
to recognize. Things such as flat-out threatening events such as a Code
refusal to change or a memo are Blue, a fire, or a natural disaster.
examples of tangible indicators of
c) When resistance is high, it is
resistance. The nurse manager can
important to share information with
acknowledge the resistors and
address their concerns as needed. the staff to increase understanding,
which lowers resistance to change.
c) Passive resistance is more difficult
d) Change is seldom unimportant.
to identify because it manifests itself
Even the smallest change can impact
in things such as staff agreeing to
make the change but not adhering to a person or a department in a
their commitment or avoiding significant way. The impact of
meetings on the subject. Once

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 change should be considered before Rationales:
implementation.
a) It is important to know whether the
92. In which of the following situations process really warrants change. If
would a personal change probably be the process under review is working
the hardest to make? well as part of current practice,
there may be no benefit to making a
a) When the need is immediate
change. Rather, this would exhaust
b) If the benefits will be realized resources and create unnecessary
years from now stress.

c) When the reward is immediate b) It is important to examine whether

the change is needed. Is the change
d) If it is change that keeps you in part of
your comfort zone a bigger change that will better
prepare the organization for the
Answer: B
future? Research could support the
Rationales: need for change and allow the
department to make a more
a) When there is an immediate need, informed decision.
making a personal change is easy
because the benefits are realized as c) The proposed change should address
soon as the change is made. the problem to be solved. Confirming
the merit of the initiative and
b) If the benefits will not be realized for understanding the easiest way to
several years (e.g., going back to make the technical change are
school so that you can advance your important.
career), it makes it harder to make
the change because there may be d) All of the above
more at risk (e.g., your dream job
94. Which of the following is the best
may not be available).
indication that a change has been
c) Being immediately rewarded for integrated?
making a change can be an easy
a) When no one talks about it anymore
decision, for example, receiving a
sign-on bonus for taking a new job. b) If adoption occurred rapidly
d) Making a change that keeps you in c) When resistance turns from active
your comfort job is one with little to passive
risk. You know what to expect and
know the daily routine. d) When a full year has passed since
the change was introduced
93. When designing a technical change,
which of the following should be Answer: A
considered? Rationales:
a) Will it work better than the old a) When a change has truly been
way?
incorporated into the daily routine,
b) Is this change needed? it has been integrated. Usually staff
will no longer refer to the practice as
c) Is there a simple way to do this? new or a change because they have
integrated it into their work. Results
d) All of the above
of the change will be present, too.
Answer: D

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 b) A quick adoption of change can be a reducing risk or harm to patients by
good sign as long as the department staff reporting errors or near misses
sustains the change over time. If the without fear of punishment or
staff members still continue to reprisal.
discuss the change in practice, they
b) Subscribing to International
have not truly adopted it as part of
their daily routine. Organization for Standardization
(ISO) safety publications is a good
c) When resistance turns from active to way to stay current on trends and
passive, this is indicative that the best practices; however, unless the
change has not been integrated. hospital uses this information in
Passive resistance is more difficult practice, it would not contribute to
to identify, making the chance of improving patient safety.
acknowledging the staff ’s resistance
to change more difficult. c) Measuring quality performance may
not include safety indicators.
d) Time may have little to do with the
d) All of the above
integration of change into the
department’s daily routine, 96. Your new organization is committed to
especially if the staff members quality patient care. Which of these are
continually discuss the change and considered characteristics of quality health
demonstrate active or passive care?
resistance every time there is talk of
the initiative in the department. a) The nurses use evidence-based
research to guide care delivery.
CHAPTER 11 (QUALITY, AND
b) The nurses are respectful and
SAFETY)
responsive to their clients’
95. You are a new nurse. The hospital where individual preferences.
you work is committed to providing
c) The nurses perform an independent
safe, high- quality care. Which of the
double check when administering
following activities would let you know
chemotherapy medication.
that your organization is committed to
improving patient safety? d) All of the above

a) The hospital has a good catch Answer: D

program for staff who recognize
errors and near misses. Rationales:

b) The hospital subscribes to ISO a) There are six characteristics of

safety publications. quality health care. The use of
evidence-based research (EBR)
c) The hospital measures ensures that care delivery is
performance every month, effective and efficient, which avoids
monitors quality indicators, and overuse and waste.
regularly reports on quality.
b) Respectful and responsive to client
d) All of the above preferences is patient-centered.

Answer: A c) Independent double checks avoid

possible injury to the patient,
Rationales:
making the call safe.
a) The good catch program is a strategy
d) All of the above
designed to identify system
improvement opportunities aimed at

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97. Medical errors account for 250,000 d) Wrong procedure event
deaths per year. It is estimated that
Answer: C
as many as 50% of these errors may be
preventable. What steps would you Rationales:
take to avoid a medication error?
a) Sentinel events are unexpected
a) Review the patient’s medication events that result in death or serious
administration record during physical or psychological injury.
bedside shift report. These events are rare, and
b) Ask your colleagues to get your investigation and learning happen
after harm to the patient.
medication so that you can give it
on time. b) Adverse events are injuries caused
c) Call the pharmacist. by the care providers and are
studied after the fact.
d) Review the medication
administration policy. c) Near misses are potential errors
interrupted before they occur. They
Answer: A are useful in identifying and
remedying vulnerabilities in the
Rationales: system before harm can occur.
a) Review of the medication
d) Wrong-procedure events are
administration record (MAR) with considered sentinel events because
the off-going nurse allows you to they should never occur.
review the list of medications and
learn of any issues, possible 99. Nursing standards of care and the
reactions to medication, or missed organization’s policies and procedures
doses. greatly decrease risk to patient safety.
Which of the following steps can a
b) It is always safer to obtain your nurse take to further reduce risk?
patient’s medication yourself to
ensure it is the right medication for a) Submit event or incident reports for
the right patient. near misses.

c) Unless there is an issue or question b) Follow medication administration

about a particular medication, this policies and procedures.
may not be indicated.
c) Always report significant data on
d) Reviewing the medication policy is care to patients and providers in a
helpful; however, it will not offer timely manner.
specific information about your
d) All of the above
patient’s possible condition or
situation. Answer: D
98. Studying errors and identifying how they Rationales:
occur helps organizations improve
patient safety. Which category of errors a) Events that are not the expected
is the most useful in identifying and response or activity may constitute a
remedying vulnerabilities in an near miss or adverse event and
organization? should be reported. It is better to
overreport events.
a) Sentinel event
b) Documenting in real time reduces
b) Adverse event the incidence of forgetting important
c) Near miss event

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 patient information, which reduces a) It is independent of teamwork.
risk to the patient.
b) It is a data-driven approach to
c) Failure to communicate significant improving process.
information in real time may result
in harm to a patient. c) Common safety indicators are not
used to evaluate quality of care.
d) All of the above
d) Opportunities for QI are selected
100. To achieve safe patient care, a culture by organization leadership.
of safety must exist. What are
Answer: B
characteristics of an organization with a
culture of safety? Rationales:
a) Transparency, openness, reporting a) The quality improvement (QI)
of errors is rewarded, blame-free process is dependent on teamwork.
environment
b) Data are used to identify
b) Honesty, studying of serious events opportunities for improvement and
to monitor performance.
c) Privacy, reporting of errors
appreciated c) Common safety indicators such as
d) Blame-free environment, openness, falls and infections are regularly
used to evaluate the quality of care.
error reporting is encouraged

Answer: A d) Identifying opportunities for QI is

everyone’s responsibility.
Rationales:
102. Structured care methodologies (SCM)
a) A culture of safety requires a blame- are;
free environment where error
reporting is rewarded; this promotes a) Nursing tools designed to identify
trust, honesty, and transparency, best practices and facilitate
standards of care
which have been shown to reduce
cases of adverse events. b) Used to create a stable set of
b) Honesty is important in a culture of performance indicators to measure
outcomes
safety, but all event reports should
be studied—not just the unexpected, c) Used to assist employees with
serious ones. wellness and injury prevention
c) Event reports are protected d) Helpful when making staffing
confidential documents, but they can assignments
be shared with the organization for
warning purposes. Answer: B

d) A blameless environment lacks Rationales:

personal accountability, which is an
a) Structured care methodologies
important requirement in a culture
(SCMs) involve interprofessional
of safety.
tools such as clinical pathways,
101. The purpose of QI is to continuously guidelines, or protocols designed to
improve the capability of everyone involved facilitate care standards.
to provide safe, high-quality patient care.
b) SCMs facilitate the standardization
What is important to know about the QI
of patient care and provide a
process?
mechanism for quality enhancement,

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 outcomes measurement, and b) Active shooters
research that informs nursing
practice. c) Nosocomial infection

d) Back injuries
c) SCMs are tools used in the delivery
of patient care. Answer: D
d) Staffing assignments are based on Rationales:
patient acuity, staff competence, and
resource availability. a) The term ergonomic refers to the
design of equipment and the use of
103. When evaluating the quality of care, a equipment and other procedures in a
health-care organization must consider safe and healthy manner. Indoor air
structures, processes, and outcomes of pollution is concerned with exposure
care delivery. Which of the following is a to toxic substances in the air.
good example of an organizational
process? b) Active shooters are human rather
than equipment or procedural risks.
a) Budgeting adequate money for
nursing salaries c) Nosocomial infections are not
ergonomic risks.
b) Preparing a patient for discharge
d) Back injuries are a very common
c) Monitoring for infections ergonomic risk in health care.
d) Increasing time between clinic visits 105. A suburban hospital recently
Answer: B announced that staff nurses could no longer
choose their shift. Instead, they
Rationales: would be assigned to either a 12-hour day
shift or a 12-hour night shift on
a) Budgets are considered to be a an as-needed basis. An informal group of
structural aspect of care quality
staff nurses met to discuss this new
because they support the
policy. They came up with several
organization’s ability to support
arguments against it. Which of the
patient care.
following suggestions would help to
b) Preparing a patient for discharge is alleviate the deleterious effects of
a care delivery process that consists this new policy?
of care interventions and decision
a) Allow self-scheduling by staff
making between the care team and nurses in each unit.
the patient.
b) Provide free dinner for nursing staff
c) This can be considered a quality at the end of the night shift.
outcome of safe care delivery.
c) Allow staff members to request
d) Measuring the time between clinic consistent days off.
visits can be a measure of the
efficiency of care delivery. d) End visiting hours before the day
shift ends so that the night shift
CHAPTER 12 (MAINTAINING nurses do not have to deal with
SAFE WORK ENVIRONMENT) visitors.

104. A common ergonomic occupational- Answer: A, & C

related risk in the health-care environment
Rationales:
is:
a) Self-scheduling allows staff to
a) Indoor air pollution
consider both their personal needs

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 and the unit’s needs in assigning c) Selection of products with more
work shifts. polyvinyl chloride (PVC)

b) A large meal at the end of a night d) Increased use of medical waste

shift may make it more difficult to incinerators
sleep after work.
Answer: B
c) Consistent days off reduce the
circadian rhythm disturbance. Rationales:

a) Windows that can be opened by

d) Adjusting visiting hours to end with
patients or visitors may present a
the end of the day shift may prevent
employed visitors from seeing their fall risk; outdoor air may not be less
polluted.
loved ones and places responsibility
for consulting with them entirely on b) Improved ventilation and filtration
the day shift. may reduce indoor air pollution.
106. Which of the following are considered c) Polyvinyl chloride (PVC) is a source
reasonable accommodations for an of indoor air pollution.
employee with a disability? Select all
that apply. d) Medical waste incinerators are also
potential sources of air pollution.
a) Modification of the work schedule
108. Ms. T was a little nervous during her
b) Salary reduction to reflect lower first week of work as a licensed
output nurse. Distracted by a lead nurse
behind her, her hand slipped, and she
c) Additional days off and extended
vacations was stuck by the needle she had just used.
What is most important for Ms. T to do?
d) Adjustment of work procedures
a) Disinfect the site of the needlestick.
Answer: A, & D
b) Apologize to the patient, clean the
Rationales: site, and properly dispose of the
needle.
a) Modification of a work schedule is a
reasonable accommodation. c) Update her hepatitis B
immunization.
b) Salary reduction would be
discriminatory. d) Report the incident and obtain post
exposure prophylaxis (PEP) within
c) Additional days off or extended 2 hours.
vacations would be costly and unfair
to nondisabled employees. Answer: D

d) Adjustment of work procedures to Rationales:

accommodate a person's disability is
also a reasonable response. a) Disinfection of the site is
insufficient.
107. Which of the following procedures and
modifications contributes to reducing b) These actions are also inadequate
indoor air pollution? given the risks associated with a
sharps injury.
a) Windows that may be opened by
staff as needed c) Hepatitis B immunization is
appropriate but not sufficient.
b) More powerful ventilation systems
and air filtration

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 d) PEP (post-exposure prophylaxis) b) High workloads, especially
includes the necessary actions to be insufficient numbers of RNs, have
taken. been shown to reduce the quality of
care and even increase patient
CHAPTER 13 (PROMOTING A HEALTHY mortality.
WORK ENVIRONMENT)
c) Working in an environment where
109. An incident of sexual harassment as conflict is virtually continuous is a
identified below are: Select all that source of stress for most staff.
apply.
d) On the other hand, showing civility
a) Telling jokes about sexual identity and respect to one another creates
issues
an environment in which most
b) Separate restrooms nurses can thrive.

c) Providing coffee and doughnuts to 111. Enhancing the quality of work life can
the nursing staff be achieved by:

d) Demanding a daily kiss for writing a) Encouraging critical thinking

a favorable evaluation and new ideas

Answer: A, & D b) Discouraging a working

relationship with one’s peers
Rationales:
c) Being negative
a) Many people would find this
behavior offensive in a workplace d) Endangering a client’s health or
environment. safety

b) Separate restrooms are the norm in Answer: A

our society. Rationales:
c) Providing coffee and doughnuts to a) Opportunities to express ideas and
everyone on the staff would not make suggestions are empowering.
constitute harassment.
b) Discouraging the development of
d) Demanding a daily kiss for writing a working relationships creates
favorable evaluation could be isolation and a sense of
interpreted as a quid pro quo. powerlessness.
110. Factors found to increase nurses’ joy at c) Negativity, especially if it is
work include: Select all that apply.
frequent, can create an atmosphere
a) Ability to provide quality care of powerlessness, inadequacy, and
hopelessness.
b) Consistently high workload
d) Endangering a client’s health or
c) A pattern of continuous conflict safety is not an acceptable strategy.
and disagreement
112. Burnout at work can be identified best
d) Civility and respect by:
Answer: A, & D a) Expressions of frustration and
powerlessness
Rationales:
b) Fatigue and refusal to work double
a) One of nurses’ greatest sources of
shifts
satisfaction derived from their work
is providing high quality care. c) Allergic reactions

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 d) A preference for efficiency c) Promote uniformity in
communication styles
Answer: A
d) Establish an English-only policy
Rationales: institution-wide
a) Expressions of frustration or Answer: A
powerlessness are clear warnings of
burnout. Rationales:

b) These may be related to burnout but a) Providing equal opportunities for

to other factors as well. raises and promotions is an excellent
approach to managing a diverse
c) This is clearly not a symptom of team.
burnout.
b) Ignoring cultural differences does
d) Efficiency is not a symptom of not help staff work with them.
burnout, although inefficiency might
be. c) Promoting uniformity may appear to
be an attempt to diminish diversity.
113. New graduates usually experience a
“honeymoon” period at their first job, d) An English-only policy may be
which is characterized by: troublesome for non-English-
speaking
a) Extreme criticism from colleagues
115. Which of the following events should be
b) Long hours and low pay reported? Select all that apply.
c) Feeling undervalued
a) A patient is placed in a broken
d) Excitement about the new position wheelchair that tips over.

Answer: D b) A staff member tells a neighbor

about the famous athlete who is a
Rationales: patient.
a) Colleagues rarely criticize a brand c) An employee reports to work under
new nurse in the first few weeks or the influence of alcohol.
“honeymoon” period.
d) A patient spills her supplemental
b) New graduates are not usually protein drink on the floor; the
assigned long hours. Their pay may nursing assistant (aide) mops it up.
reflect the amount of training time
they require, however. Answer: A, B, & C

c) Most new graduates find themselves Rationales:

welcomed by their colleagues.
a) Unprepared equipment should not
d) Excitement about the new (usually be used, as it may cause injury or
first) registered nurse (RN) position death.
is common in the honeymoon phase.
b) This represents a violation of patient
114. An effective way to help a diverse staff privacy.
work together is to:
c) This is an example of an impaired
a) Provide equal opportunities for employee.
advancement
d) Although an accident occurred, no
b) Pretend there are no cultural one was hurt, and the risk to others
differences

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 (wet floor) was addressed d) “We’re all burned out. Welcome to
immediately. the club.”

116. A new nurse manager has observed Answer: C

several instances of horizontal violence
between staff members on her unit,
primarily verbal abuse and Rationales:
malicious gossip. What should she do?
a) Although time away from work may
a) 1. Ignore it because it is not help address fatigue, it is more likely
physical violence and will not hurt to be an escape from the causes of
anyone. burnout instead of a solution to it.
b) Model this bullying behavior so that b) It is likely that your colleague will
staff can see how it affects people. encounter the same concerns at the
c) Keep a log of observed bullying next hospital and will not have
behavior to discuss during the learned anything about managing
employees’ annual evaluation. stress or preventing burnout.

d) Confront the bullying behavior and c) These are good opening questions to
discuss strategies for lead into learning how to manage
stress and burnout.
responding to it.
d) Although it may help to know others
Answer: D have the same problem, it does not
solve the problem.
Rationales:
CHAPTER 14 (LAUNCHING YOUR
a) Verbal abuse may also become very
harmful and should not be ignored. CAREEER)

b) A nurse manager’s bullying behavior 118. A nursing student is preparing for a

may confuse staff. It may appear first job interview. What should the
that the manager is encouraging it. nursing student research about the
organization before going to the
c) Presenting these concerns at the interview?
annual evaluation delays dealing
with it for too long. a) Review the salary scale.

d) Direct but carefully worded b) Research the benefits package

confrontations will make it clear offered to employees.
that bullying is not tolerated.
c) Become familiar with the
117. A colleague tells you, “I’m so burned organization’s mission and core
out, I think it’s time for me to resign.” values.
What can you tell your colleague?
d) Ask nurses who work at the agency
a) “You probably need a break from how many patients they are
work. Why don’t you ask for a 6- assigned.
month leave of absence?”
Answer: C
b) “Why don’t you apply for a
Rationales:
position at our rival hospital?”
a) Reviewing the salary scale does not
c) “Tell me how you take care of
show an interest in the organization.
yourself and what you like about
your work.” b) Researching the benefits package is
important when comparing

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 organizations but does not show a Rationales:
prospective employer your interest.
a) A standard resumé́ in a
c) Before attending an interview, professional, modern format gives
review the organization’s philosophy, specific details about your skills and
mission, and values. This experience.
demonstrates to the prospective
employer that you have an interest b) The chronological resumé́ lists
in the position and the organization. work experiences in order of time,
with the most recent experience
d) Asking other nurses about the listed first. This style is useful in
number of patients is not relevant. showing stable employment without
gaps or many job changes. The
119. A nursing student is preparing a
objective and qualifications are
resumé́ to send to prospective listed at the top.
employers. What qualities should the
nursing student emphasize? Select c) Functional resumés focus on your
all that apply. skills and experience, rather than on
chronological work history.
a) Responsibility and accountability
d) A combination resumé is organized
b) Integrity
into two parts or pages.
c) Interpersonal skills
121. A nursing student who is graduating in
d) Social skills a few weeks is preparing a resumé. What
should the nursing student highlight
e) Family values first? Select all that apply.
Answer: A, B, & C a) Family status
Rationales: b) Educational degrees
a) ,b), & c) In addition to passing the c) Community service
Nursing Licensure Examination
employers cite responsibility, d) Employment experience
integrity, and interpersonal skills, e) Leadership experiences in school
along with oral and written
communication skills. Answer: B, & D

b) Social skills are not qualities of Rationales:

interest for an employer.
a) Family status is not necessary for a
c) Family values are not of interest to resumé́.
an employer.
b) ,& d) If you are a new nursing
120. What type of resumé́ is useful in graduate and have little or no job
showing stable employment without experience, list your educational
gaps or many job changes? background first. Remember that
positions you held before you entered
a) Standard
nursing might support experience
b) Chronological that will be relevant in your nursing
career.
c) Functional
c) Community service is of interest;
d) Combination however, your education is of
primary importance. 5. Employers
Answer: B
are interested in your leadership

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 abilities; however, your education is b) Many employers use the STAR
of primary importance. method, which focuses on behaviors.
Be prepared to discuss a
122. What is the purpose of a cover letter SITUATION and describe the TASK,
when applying for a position?
the ACTION TAKEN, and the
a) Introduces the applicant RESULT.

b) States the employment goal c) Personal questions should not be

part of an interview.
c) Outlines the applicant’s position in
the community d) Many interviewers attempt to create
a relaxed environment, but STAR is
d) Describes the reason for entering a technique.
nursing
124. When conducting a SWOT analysis, the
Answer: A “T” represents:
Rationales: a) Time spent in education
a) The cover letter will be your b) Threats to obtaining a position
introduction. If it is true that first
impressions are lasting ones, the c) Terminal degree expectations
cover letter will have a significant d) Talking points for the interview
impact on your prospective
employer. Answer: B

b) Your employment goal should be on Rationales:

your resumé.
SWOT
c) The position in the community may S = Strengths
be included but is not the purpose of
the letter. W = Weaknesses
O = Opportunities
d) The reason for entering nursing is T = Threats
more appropriate for a school Increased competition among
application. healthcare facilities or changes in
government regulation represent
123. What is the STAR method of threats.
interviewing?
125. Which of the following represents the
a) Focuses on communication “S” in a SWOT analysis?
b) Emphasizes behaviors a) Flexibility
c) Allows the employer to ask personal b) Difficulty adapting to change
questions
c) Nursing shortage
d) Creates a relaxed interviewing
environment d) Competition among health-care
facilities
Answer: B
Answer: A
Rationales:
Rationales:
a) Communication is part of any
interview; STAR (situation, task, a) Strengths include the following:
action, result) is specific. Relevant work experience Advanced
education. Product knowledge. Good
communication and people skills

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 Computer skills. Self managed  This nursing practice delves into the
learning skills. Flexibility. ethico-moral, legal, spiritual, and
cultural aspects of practicing the
b) Difficulty adapting to change would nursing profession.
be a weakness.
 The scope of this 25- item test covers
c) The nursing shortage is an the following topics given:
opportunity.
1) Nursing ethics
d) Competition among health-care
facilities is a threat or opportunity. 2) Laws, principles, and rules
governing nursing
126. A new graduate plans on moving into
nursing administration. What steps 3) Legal liabilities in nursing
should the graduate take to ensure this goal practice
is reached? Select all that apply.
4) Informed consent, incident
a) Further professional education. report, and wills

b) Meet the specific requirements for QUESTION 1

the entry-level job position.
1. Mr. Yus is to be discharged soon but is
c) Seek new experiences. still not knowledgeable about how to
use his cane. What underlying principle
d) Volunteer to work on committees.
in nursing ethics should guide the nurse
e) Find a mentor. in doing his duty?

Answer: A, C, D, & E a) Responsibility

Rationales: b) Competence

a) Furthering professional education c) Accountability

and obtaining advanced degrees and d) Advocacy
certifications indicates to an
organization that you want to move Answer: C
forward with your professional
career. Accountability can be referred to as a
nurse’s ability to answer for his own actions.
b) Meeting the specific requirements If the nurse knows that his client is still not
for an entry-level job position does knowledgeable
not indicate a commitment to the
in using his cane, he might request for more
organization or desire to advance a
career. hospitalization or arrange with his caregiver
to continue providing health teaching at
c) Seeking new experiences home.
demonstrates a commitment to the
organization. QUESTION 2

2. The following statements are stated in the

d) Volunteering to work on committees
Dying Patient’s Bill of Rights, except
demonstrates a commitment to the
organization. for one:

a) I have the right to feel the pain of

e) Finding a mentor demonstrates a
dying.
commitment to the organization.

NURSING JURISPRUDENCE b) I have the right to participate in

decisions concerning my care.

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 c) I have the right to die in peace and  RA 8187 corresponds to the 7- day
dignity. Paternity leave.

d) I have the right to have my QUESTION 5

questions answered honestly.
5. Mr. Ree was diagnosed with terminal
Answer: A cancer. His family asked his physician
to explain to him his illness on their
The statement should be – “I have the right behalf. What principle guides this situation?
to be free from pain”.
a) Autonomy
QUESTION 3
b) Veracity
3. This corresponds to the personal belief of
a client regarding a given idea, c) Beneficence
custom, attitude, or anything that
d) The principle of double effect
influences her behavior and decisions.

a) Ethics Answer: B

b) Morals  Veracity guides the practice of truth.

c) Values  Autonomy is the client’s right to

decision making;
d) Bioethics
 Beneficence refers to actions that
Answer: C prevent harm;

 Ethics refers to the study of what is  Principle of double effect pertains to

good and just for clients. outweighing the harmful secondar
effects by the intended good
 Morals reflect the character of the outcomes.
social setting from where the client
bases his behavior. QUESTION 6

 Bioethics, on the other hand, 6. The ethical principle stating that a

pertains to the study of what is right registered nurse is the client’s advocate
and wrong behavior in the is stated on what section of the code
healthcare setting. of ethics for registered nurses?

QUESTION 4 a) Section 11

4. This law focuses on the prevention and b) Section 10

control of the Diabetes Mellitus Act,
known as: c) Section 9

a) R.A. No. 8172 d) Section 8

Answer: D
b) R.A. No. 8976

c) R.A. No. 8187  Section 11: involves the nursing

ethics with his co-workers;
d) R.A. No. 8191
 Section 10: ethical guidelines
Answer: D. R.A. No. 8191 requiring professional conformity
with existing laws;
 RA 8172 refers to the promotion of
salt iodization;  Section 9: reflects that nurses should
be aware that their actions have
 RA 8976 pertains to the Philippine corresponding ethical, moral, and
Food Fortification Program; legal aspects.

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QUESTION 7 d) All of the above

7. The Board of Nursing is composed of how Answer: C

many governing bodies?
Under section 10 of the code of ethics,
a) 5
a registered nurse must not allow herself to
b) 6 be used in advertisements that should
demean the image of the profession.
c) 4
QUESTION 10
d) 7
10. Who of them below is considered an
Answer: D accessory to a crime?
According to the Philippine Nursing Act of a) Nurse Koko, who administered the
2002 or R.A. No. 9173, section 4. The Board wrong medication
created under section 3 of Article III of the
said nursing act is composed of a b) Nurse Milo, who was there on the
chairperson and 6 members. act of the incident

QUESTION 8 c) Nurse Manager Oval who arranged

a discreet agreement with the
8. Which is incorrect about the qualifications client’s folks to resolve the conflict
of a Nursing Service Administrator?
d) All of them
a) A registered nurse in the
Philippines Answer: C

b) At least 5 years of experience in  Nurse Koko was the Principal who

the managerial position in nursing committed the direct harm to the
client,
c) Possess a degree of Bachelor of
Science in Nursing with at least 9  Nurse Milo was an Accomplice.
units in management and
 Nurse Manager Oval tried to conceal
administration courses at the
graduate level the escape of his staff members by
discreetly arranging the resolution
d) A member of good standing of the with the client’s family members.
accredited professional
QUESTION 11
organization of nurses

Answer B 11. The following statements below are acts

of nursing negligence, except for one:
Refers to the qualification of a Chief Nurse/
Director of Nursing a) Use of defective equipment

QUESTION 9 b) Disagreeing with the physician

c) Careless execution of doctor’s order

9. Ms. U is a nurse and was asked to pose for
a TV commercial wearing her uniform. If d) Errors in administering medications
she agrees to it, what will she
violate? Answer: B

a) R.A. No. 9173 Disagreeing with the physician; especially

knowing what is good and right for the
b) R.A. No. 7164 client and rationalizing it to his physician,
c) The code of ethics for registered does not mean negligence since there is no
nurses unreasonable risk for harming the client,
there is no failure to perform any task, and

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no physical, emotional, or mental damage to They must be of legal age reflected on option
the client. B, and parents sign the consent form for
pediatric clients.

QUESTION 14
QUESTION 12
14. It is a kind of will that is entirely
12. Situation: Mr. Clean is not compliant to
written, dated, and signed by the client
his treatment ECT (electroconvulsive himself. It is called:
therapy) and does not take his medications
due to his suspicious personality. His a) Notarial will
nurse was so hopeless that she threatened
b) Nuncupative will
Mr. Clean not to give him his regular meals
if he will not submit himself to his c) Holographic will
therapy and treatments. What kind of
malpractice was committed in this d) None of the above
situation?
Answer: C
a) False imprisonment
 Notarial will is only signed by the
b) Battery testator or by another person in the
presence of the testator,
c) Assault
 Nuncupative will is also called an
d) Fraud oral will.
Answer: C QUESTION 15
Threatening the client to submit himself to 15. Board of Nursing Resolution No. 110 s.
therapy or treatment he did not want is 1998 is also known as:
considered an ASSAULT as long as no
physical harm was done since it could then a) Adoption of Nursing Specialty
be referred to as BATTERY. Certification Program

QUESTION 13 b) Adoption to a guide to evaluate

compliance with Standards for Safe
13. Informed consent is an agreement that Nursing Practice
allows a certain procedure to happen.
Which is true about it? c) Specialty training on intravenous
injections for registered nurses
a) Sisa is being given all the relevant
information of her chemotherapy. d) Promulgation of standards of safe

b) Pepito, 18 years old, who refuses nursing practice

treatment, is allowed to sign his
Answer: B
waiver in the absence of his
guardians.  BON Res. No. 14 s. 1999 : Adoption
of Nursing Specialty Certification
c) Neneng, mother of Baby T, signed
Program
the consent form for his blood
transfusion.  BON Res. No. 08 s. 1994: Specialty
training on intravenous injections
d) All of the Above
for registered nurses
Answer: D
 PRC- BON Res. No. 82 s. 1998:
All the options above describe an informed Promulgation of standards of safe
consent. The client must be informed of all nursing practice
the relevant information.
QUESTION 16

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16. The Unang Yakap Campaign advocates b) Have 9 units in management and
the interrupted mother and child administration courses at the
bonding through Rooming–in and early graduate level
breastfeeding. What law governs
Rooming-in and Breastfeeding? c) Have at least 5 years in teaching
and supervising
a) P.D. 148
d) Have a good standing in an
b) R.A. 7600 accredited professional
organization of nurses
c) R.A. 7432
Answer: D
d) R.A. 7877
To be a faculty of the college of nursing: one
Answer: B must be an R.N. in the Philippines, have at
least 1 year of clinical practice, a member of
 P.D. 148 is called Woman and child good standing in an organization for nurses,
labor law; and must have a master’s degree in nursing,
education, or any allied medical or health
 R.A. 7432 is about Senior Citizen’s
sciences.
Act,
QUESTION 19
 R.A. 7877 corresponds to Anti sexual
harassment act of 1995. 19. Who among the individuals below cannot
make a will?
QUESTION 17
a) NN who is 19 years old and has
17. You are one of the vaccinators in the
Leukemia.
Measles-Rubella Campaign. One mother
hesitated since she verbalized that it would b) RR, who is married and has
hurt her son. As a well-versed nurse about prostate cancer.
ethical considerations, you explained to
the mother that it might cause discomfort, c) GG who is 28 years old married,
but it will protect her son from and is suffering postpartum
acquiring the said diseases. What principle psychosis.
did you utilize?
d) JJ who is 18 years old and has
a) Nonmaleficence acute renal failure.

b) Justice Answer: C

c) Beneficence GG is of legal age, but she has postpartum

psychosis, implying that she is not of sound
d) Autonomy mind. A person should have a sound mind at
the time of execution of the will.
Answer: C
QUESTION 20
Beneficence focuses on promoting the best
interest of the client despite some risks like 20. Ms. Chief is to appear and testify in the
discomfort. court as a witness. What should she
receive prior to that?
QUESTION 18
a) Subpoena duces tecum
18. Ms. Chin is an experienced registered
nurse and wants to be a clinical b) Subpoena testificandum
instructor. What qualification does she need
to have? c) Subpoena ut des

a) Have at least 2 years of experience d) None of the above

in general nursing administration

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Answer: B a) It is utilized to document any
common nursing duties.
This subpoena is given to witnesses and
respondents to appear in court. b) It is written in the nurse’s notes.

 Subpoena duces tecum is issued for c) It is not a means of punishment.

respondents to produce necessary
documents. d) It does not protect the person
involved.
QUESTION 21
Answer: C
21. It refers to the act of adopting a foreigner
 An incident report is to document an
and clothing him with the privileges of a
unusual occurrence or incident.
native citizen?

a) Alienation  It is not advised to be written in the

nurse’s notes.
b) Naturalization
 It is not a means of punishment.
c) Expatriation
 It is filed to protect the individual
d) Repatriation involved.

Answer: B QUESTION 24

 Expatriation is the voluntary act of 24. In order to pass the licensure

abandoning one’s country and examination, what is the general weighted
become a citizen of another country; average to be reached by the test taker?

 Repatriation refers to regaining a) 75%

one’s nationality after expatriation;
b) 60%
 Alien is also known as a foreigner, or
a person born abroad. c) 65%

QUESTION 22 d) 70%

Answer: A
22. According to the preamble of the code of
ethics for registered nurses, what are the According to section 15 of R.A. 9173, an
fundamental aspects of nursing? examinee needs to reach at least a 75%
general average to pass the exam.
a) Restoration of health
25. You are a public health nurse and there
b) Alleviation of suffering are cases of dengue fever in your town.
You should report this according to what
c) Only answer A
law?
d) A & B
a) R.A. 7610
Answer: D b) R.A. 1082
The 4 fundamentals of nursing: include
Promotion of health; Prevention of illness; c) R.A. 3573
Alleviation of suffering; and Restoration of
health. d) R.A. 1811

QUESTION 23 Answer: C

23. As a nurse manager, one of your staff It corresponds to reporting communicable

diseases.
asked you about incident report. What are
you going to include in your explanation?

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  R.A. 7610 refers to the law against
child abuse;

 R.A. 1082 pertains to the Rural

health act;

 R.A. 1811 pertains to strengthening

health and dental services to rural
areas.

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