Chapter 2: Nursing Process and Client Teaching(FREE) Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 2: Nursing Process and Client Teaching

Test Bank

MULTIPLE CHOICE

1. Which is the sequence of steps in the nursing process?

a.

Implementation, evaluation, planning, assessment

b.

Planning, assessment, implementation, evaluation

c.

Assessment, planning, implementation, evaluation

d.

Evaluation, implementation, assessment, planning

ANS: C

The four phases of the nursing process are assessment, planning, implementation, and evaluation.

DIF: Cognitive Level: Comprehension REF: pp. 14-15

TOP: Nursing Process: All

MSC: CONTENT CATEGORY: Management of Care

2. The clients knowledge base about the drugs used is part of the:

a.

plan.

b.

analysis.

c.

subjective database.

d.

objective database.

ANS: C

The clients knowledge about a drug and its side effects would be part of the subjective database.

DIF: Cognitive Level: Comprehension REF: p. 15

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Health Promotion and Maintenance

3. Attainment of goals is associated with which phase of the nursing process?

a.

Implementation

b.

Planning

c.

Assessment

d.

Evaluation

ANS: D

The effectiveness of health teaching about drug therapy and the attainment of goals are associated with evaluation.

DIF: Cognitive Level: Comprehension REF: pp. 19-20

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Management of Care

4. During which phase of the nursing process would the nurse identify client perceptions and expectations of the drugs effectiveness?

a.

Planning

b.

Assessment

c.

Evaluation

d.

Implementation

ANS: B

This information consists of subjective data.

DIF: Cognitive Level: Comprehension REF: p. 15

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Management of Care

5. The nurse is establishing goals for a client related to medication administration. Which of the phases of the nursing process is characterized by goal setting?

a.

Planning

b.

Evaluation

c.

Implementation

d.

Assessment

ANS: A

The planning phase of the nursing process is characterized by goal setting or expected outcomes.

DIF: Cognitive Level: Comprehension REF: p. 16

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Management of Care

6. During which phase of the nursing process will the nurse include nursing actions or interventions necessary to accomplish expected outcomes?

a.

Assessment

b.

Planning

c.

Implementation

d.

Evaluation

ANS: C

The implementation phase of the nursing process includes the nursing actions/interventions necessary to accomplish the established goals or expected outcomes.

DIF: Cognitive Level: Comprehension REF: pp. 16-19

TOP: Nursing Process: Implementation

MSC: CONTENT CATEGORY: Management of Care

7. Which is a correctly written goal?

a.

The client will independently administer a prescribed dose of antibiotic by the end of the first teaching session.

b.

The client will learn to take an antibiotic correctly.

c.

The client will administer a prescribed dose.

d.

The client will know how to administer antibiotics.

ANS: A

The goal should be client centered, have a realistic deadline, be measurable, and contain components for evaluation.

DIF: Cognitive Level: Application REF: p. 16

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Management of Care

8. Upon physical assessment, a nurse notes that a client has visual impairment. The nurse is concerned that the clients visual changes may affect her ability to self-administer medications. Which nursing diagnosis best describes this situation?

a.

Risk for ineffective therapeutic regimen management related to medication secondary to visual impairment

b.

Deficient knowledge related to medication administration

c.

Ineffective family therapeutic regimen management related to visual impairment

d.

Ineffective coping related to lack of ability to self-administer medications

ANS: A

The nurse would need more information to determine whether an actual nursing diagnosis exists. This diagnosis would best represent this problem.

DIF: Cognitive Level: Analysis REF: p. 16

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Management of Care

9. During assessment, a client reports a reaction to a medication. What is the next nursing intervention?

a.

Let the physician know that the client cannot receive the medication.

b.

Ask the client the type of reaction experienced.

c.

Reassure the client that the reaction will not occur again.

d.

Note the comment in the clients chart and give the medication.

ANS: B

It is important for the nurse to know what type of reaction occurred in order to plan action.

DIF: Cognitive Level: Application REF: p. 15

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Management of Care

10. A nurse is caring for a client who takes a chewable medication. The client does not take the medication because his teeth and gums have pain when chewing. The nurse establishes the following nursing diagnosis for the client: impaired dentition related to chronic gum inflammation secondary to poor dental hygiene. Which nursing goal is most appropriate for the client?

a.

The client will verbalize the pathophysiology of gum disease.

b.

The client will demonstrate the procedure for brushing teeth.

c.

The client will understand the need for dental hygiene.

d.

The client will discuss the reasons dental hygiene is important.

ANS: B

An important intervention would be to teach the client how to take care of his teeth, which would alleviate the pain and allow for greater adherence to the medication regimen.

DIF: Cognitive Level: Application REF: p. 16

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Management of Care

11. A nurse is teaching a client about a medication that is scheduled to be administered q.i.d. The client states that she does not use a watch or clock and lives without a daily routine. Which teaching would be most helpful for the client?

a.

Instruct the client to take the medication each morning and evening when brushing her teeth.

b.

Teach the client to take the medication at lunch every day.

c.

Provide the client with a watch to ensure she takes the medication at correct times.

d.

Instruct the client to take the medication with meals and at bedtime each day.

ANS: D

For a client who is not time oriented and needs to take the medication 4 times a day, this is the only answer that is feasible.

DIF: Cognitive Level: Application REF: pp. 17-19

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Health Promotion and Maintenance

12. A nurse is teaching a client about his medications. In his care plan, a previous nurse indicated that the client was a visual learner. Which teaching strategy would be indicated for this client?

a.

Pamphlets or videos about the medication

b.

Opportunities for practicing the administration of medication

c.

A discussion about the medication

d.

An audiotape describing the medication and its actions

ANS: A

A visual learner would respond best to teaching strategies that can be seen (e.g., pamphlets, videos).

DIF: Cognitive Level: Application REF: pp. 17-19

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Health Promotion and Maintenance

13. A nurse is establishing a plan of care for a client who has been ordered to receive antibiotic therapy. The client does not read English but is able to understand spoken English. She is of a lower-income socioeconomic group. Which strategy would be most appropriate for teaching this client?

a.

Provide a video going over the information.

b.

Give the client several pamphlets and asking her to go over them with her family.

c.

Provide a teaching sheet with simple words and pictures.

d.

Arrange a quiet time to discuss the medication regimen with the client.

ANS: D

This strategy takes both the clients strengths and cultural factors into account.

DIF: Cognitive Level: Application REF: pp. 17-19

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Management of Care

14. A client with AIDS-defined disease is ordered to receive two different medications. The primary care nurse notes that he has not been taking his medications as ordered. The client says, I dont like the side effects of the drugs. Which is an appropriate nursing diagnosis?

a.

Knowledge deficit related to progression of the AIDS disease

b.

Grieving related to diagnosis of terminal disease

c.

Risk for infection related to impaired immune function

d.

Noncompliance related to medication side effects and lack of knowledge

ANS: D

This nursing diagnosis reflects analysis of the client subjective data.

DIF: Cognitive Level: Analysis REF: p. 15

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Management of Care

15. The nurse is working with an Asian client to provide instruction regarding his medication regimen. The nurse is planning to provide the client with pamphlets to take with him as part of the follow-up to his instructional sessions. What is the most appropriate action on the part of the nurse?

a.

Make prolonged eye contact with the client.

b.

Use both hands as a show of respect.

c.

Show flexibility in making follow-up appointments.

d.

Speak clearly in a loud voice.

ANS: B

Use both hands to show respect when offering a prescription, instructions, or pamphlets to Asians and Pacific Islanders.

DIF: Cognitive Level: Application REF: p. 18

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Management of Care

16. The nurse has decided to add a nursing diagnosis to the clients drug therapy plan of care that represents wellness/health promotion. What is the most appropriate diagnosis to add to promote these areas?

a.

Ineffective health maintenance related to not having recommended preventive care

b.

Risk for injury related to side effect if drugs

c.

Therapeutic regimen management, readiness for enhanced

d.

Ineffective therapeutic regimen management related to lack of finances

ANS: C

This is the only diagnosis that would be classified as promoting wellness/health.

DIF: Cognitive Level: Comprehension REF: p. 16

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Health Promotion and Maintenance

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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