PNC Exam final
A female patient who is receiving chemotherapy for breast cancer tells the nurse, "The
treatment for this cancer is worse than the disease itself. I'm not going to come for my
therapy anymore." The nurse responds by using critical thinking skills to address this
patient problem. Which action is the first step the nurse would take in this process?
A. The nurse judges whether the patient database is adequate to address the problem.
B. The nurse considers whether or not to suggest a counseling session for the patient.
C. The nurse reassesses the patient and decides how best to intervene in her care.
D. The nurse identifies several options for intervening in the patient's care and critiques
the merit of each option. - answerC
The nursing process ensures that nurses are person centered rather than task
centered. Rather than simply approaching a patient to take vital signs, the nurse thinks,
"How is Mrs. Barclay today? Are our nursing actions helping her to achieve her goals?
How can we better help her?" This demonstrates which characteristic of the nursing
process?
A.Systematic
B. Interpersonal
C. Dynamic
D. Universally applicable in nursing situations - answerB
An experienced nurse tells a beginning nurse not to bother studying too hard, since
most clinical reasoning becomes "second nature" and "intuitive" once you start
practicing. What thinking below should underlie the beginning nurse's response?
A. Intuitive problem solving comes with years of practice and observation, and novice
nurses should base their care on scientific problem solving.
B. For nursing to remain a science, nurses must continue to be vigilant about stamping
out intuitive reasoning.
C. The emphasis on logical, scientific, evidence-based reasoning has held nursing back
for years; it is time to champion intuitive, creative thinking!
D. It is simply a matter of preference; some nurses are logical, scientific thinkers, and
some are intuitive, creative thinkers. - answerA
The nurse uses blended competencies when caring for patients in a rehabilitation
facility. Which examples of interventions involve cognitive skills? Select all that apply.
A. The nurse uses critical thinking skills to plan care for a patient.
B. The nurse correctly administers IV saline to a patient who is dehydrated.
,C. The nurse assists a patient to fill out an informed consent form.
D. The nurse learns the correct dosages for patient pain medications.
E. The nurse comforts a mother whose baby was born with Down syndrome.
F. The nurse uses the proper procedure to catheterize a female patient. - answerA
D
A nurse uses critical thinking skills to focus on the care plan of an older adult who has
dementia and needs placement in a long-term care facility. Which statements describe
characteristics of this type of critical thinking applied to clinical reasoning? Select all that
apply.
A. It functions independently of nursing standards, ethics, and state practice acts.
B. It is based on the principles of the nursing process, problem solving, and the
scientific method.
C. It is driven by patient, family, and community needs as well as nurses' needs to give
competent, efficient care.
D. It is not designed to compensate for problems created by human nature, such as
medication errors.
E. It is constantly re-evaluating, self-correcting, and striving for improvement.
F. It focuses on the big picture rather than identifying the key problems, issues, and
risks involved with patient care. - answerB
C
E
A nurse is caring for a patient who has complications related to type 2 diabetes mellitus.
The nurse researches new procedures to care for foot ulcers when developing a care
plan for this patient. Which QSEN competency does this action represent?
A. Patient-centered care
B. Evidence-based practice
C. Quality improvement
D. Informatics - answerC
A nurse is assessing a patient who is diagnosed with anorexia. Following the
assessment, the nurse recommends that the patient meet with a nutritionist. This action
best exemplifies the use of:
A. Clinical judgment
B. Clinical reasoning
C. Critical thinking
D. Blended competencies - answerA
A nurse working in a long-term care facility bases patient care on five caring processes:
knowing, being with, doing for, enabling, and maintaining belief. This approach to
patient care best describes whose theory?
,A. Travelbee's
B. Watson's
C. Benner's
D. Swanson's - answerD
The nurse practices using critical thinking indicators (CTIs) when caring for patients in
the hospital setting. The best description of CTIs is:
A. Evidence-based descriptions of behaviors that demonstrate the knowledge that
promotes critical thinking in clinical practice
B. Evidence-based descriptions of behaviors that demonstrate the knowledge and skills
that promote critical thinking in clinical practice
C. Evidence-based descriptions of behaviors that demonstrate the knowledge,
characteristics, and skills that promote critical thinking in clinical practice
D. Evidence-based descriptions of behaviors that demonstrate the knowledge,
characteristics, standards, and skills that promote critical thinking in clinical practice -
answerC
The nurse practitioner is performing a short assessment of a newborn who is displaying
signs of jaundice. The nurse observes the infant's skin color and orders a test for
bilirubin levels to report to the primary care provider. What type of assessment has this
nurse performed?
A. Comprehensive
B. Initial
C. Time-lapsed
D. Quick priority - answerD
The nurse is admitting a 35-year-old pregnant woman to the hospital for treatment of
preeclampsia. The patient asks the nurse: "Why are you doing a history and physical
exam when the doctor just did one?" Which statements best explain the primary
reasons a nursing assessment is performed? Select all that apply.
A. "The nursing assessment will allow us to plan and deliver individualized, holistic
nursing care that draws on your strengths."
B. "It's hospital policy. I know it must be tiresome, but I will try to make this quick!"
C. "I'm a student nurse and need to develop the skill of assessing your health status
and need for nursing care."
D. "We want to make sure that your responses to the medical exam are consistent and
that all our data are accurate."
E. "We need to check your health status and see what kind of nursing care you may
need."
F. "We need to see if you require a referral to a physician or other health - answerA
E
F
, A nurse notes that a shift report states that a patient has no special skin care needs.
The nurse is surprised to observe reddened areas over bony prominences during the
patient bath. What nursing action is appropriate?
A. Correct the initial assessment form.
B. Redo the initial assessment and document current findings.
C. Conduct and document an emergency assessment.
D. Perform and document a focused assessment of skin integrity. - answerD
A student nurse attempts to perform a nursing history for the first time. The student
nurse asks the instructor how anyone ever learns all the questions the nurse must ask
to get good baseline data. What would be the instructor's best reply?
A. "There's a lot to learn at first, but once it becomes part of you, you just keep asking
the same questions over and over in each situation until you can do it in your sleep!"
B. "You make the basic questions a part of you and then learn to modify them for each
unique situation, asking yourself how much you need to know to plan good care."
C. "No one ever really learns how to do this well because each history is different! I
often feel like I'm starting afresh with each new patient."
D. "Don't worry about learning all of the questions to ask. Every facility has its own
assessment form you must use." - answerB
The nurse collects objective and subjective data when conducting patient assessments.
Which patient situations are examples of subjective data? Select all that apply.
A. A patient tells the nurse that she is feeling nauseous.
B. A patient's ankles are swollen.
C. A patient tells the nurse that she is nervous about her test results.
D. A patient complains that the skin on her arms is tingling.
E. A patient rates his pain as a 7 on a scale of 1 to 10.
F. A patient vomits after eating supper. - answerA
C
D
E
When a nurse enters the patient's room to begin a nursing history, the patient's wife is
there. After introducing herself to the patient and his wife, what should the nurse do?
A. Thank the wife for being present.
B. Ask the wife if she wants to remain.
C. Ask the wife to leave.
D. Ask the patient if he would like the wife to stay. - answerD
A nurse is performing an initial comprehensive assessment of a patient admitted to a
long-term care facility from home. The nurse begins the assessment by asking the
patient, "How would you describe your health status and well-being?" The nurse also