1.

The best explanation of what Title

VI of the Civil Rights Act mandates is
the freedom to:
A. Pick any physician and insurance
company despite ones income
B. Receive free medical benefits as
needed within the county of residence
C. Have equal access to all health care
regardless of race and religion
D. Have basic care with a sliding scale
payment plan from all health care
facilities
2. Which statement would best
explain the role of the nurse when
planning care for a culturally diverse
population? The nurse will plan care
to:
A. Include care that is culturally
congruent with the staff from
predetermined criteria
B. Focus only on the needs of the client,
ignoring the nurses beliefs and practices
C. Blend the values of the nurse that are
for the good of the client and minimize
the clients individual values and beliefs
during care
D. Provide care while aware of ones own
bias, focusing on the clients individual
needs rather than the staffs practices
3. Which factor is least significant
during assessment when gathering
information about cultural practices?
A. Language, timing
B. Touch, eye contact
C. Biocultural needs
D. Pain perception, management
expectations
4. Transcultural nursing implies:
A. Using a comparative study of cultures
to understand similarities and differences
across human groups to provide specific
individualized care that is culturally
appropriate
B. Working in another culture to practice
nursing within their limitations
C. Combining all cultural beliefs into a
practice that is a non-threatening
approach to minimize cultural barriers for
all clients equality of care
D. Ignoring all cultural differences to
provide the best generalized care to all
clients.
5. What should the nurse do when
planning nursing care for a client
with a different cultural background?
The nurse should:

A. Allow the family to provide care during

the hospital stay so no rituals or customs
are broken
B. Identify how these cultural variables
affect the health problem
C. Speak slowly and show pictures to
make sure the client always understands
D. Explain how the client must adapt to
hospital routines to be effectively cared
for while in the hospital
6. Which activity would not be
expected by the nurse to meet the
cultural needs of the client?
A. Promote and support attitudes,
behaviors, knowledge, and skills to
respectfully meet clients cultural needs
despite the nurses own beliefs and
practices
B. Ensure that the interpreter
understands not only the language of the
client but feelings and attitudes behind
cultural practices to make sure an ethical
balance can be achieved
C. Develop structure and process for
meeting cultural needs on a regular basis
and means to avoid overlooking these
needs with clients
D. Expect the family to keep an
interpreter present at all times to assist in
meeting the communication needs all day
and night while hospitalized
7. Ethical principles for professional
nursing practice in a clinical setting
are guided by the principles of
conduct that are written as the:
A. American Nurses Associations (ANAs)
Code of Ethics
B. Nurse Practice Act (NPA) written by
state legislation
C. Standards of care from experts in the
practice field
D. Good Samaritan laws for civil
guidelines
8. A bioethical issue should be
described as:
A. The physicians making all decisions of
client management without getting input
from the client
B. A research project that included
treating all the white men and not
treating all the black men to compare the
outcomes of a specific drug therapy.
C. The withholding of food and treatment
at the request of the client in a written
advance directive given before a client
acquired permanent brain damage from

an accident.
D. After the client gives permission, the
physicians disclosing all information to
the family for their support in the
management of the client.
9. When the nurse described the
client as that nasty old man in
354, the nurse is exhibiting which
ethical dilemma?
A. Gender bias and ageism
B. HIPAA violation
C. Beneficence
D. Code of ethics violation
10. The distribution of nurses to
areas of most need in the time of a
nursing shortage is an example of:
A. Utilitarianism theory
B. Deontological theory
C. Justice
D. Beneficence
11. Nurses are bound by a variety of
laws. Which description of a type of
law is correct?
A. Statutory law is created by elected
legislature, such as the state legislature
that defines the Nurse Practice Act (NPA).
B. Regulatory law includes prevention of
harm for the public and punishment for
those laws that are broken.
C. Common law protects the rights of the
individual within society for fair and equal
treatment.
D. Criminal law creates boards that pass
rules and regulations to control society.
12. Besides the Joint Commission on
Accreditation of Healthcare
Organizations (JACHO), which
governing agency regulates
hospitals to allow continued safe
services to be provided, funding to
be received from the government
and penalties if guidelines are not
followed?
A. Board of Nursing Examiners (BNE)
B. Nurse Practice Act (NPA)
C. American Nurses Association (ANA)
D. Americans With Disabilities Act (ADA)
13. When a client is confused, left
alone with the side rails down, and
the bed in a high position, the client
falls and breaks a hip. What law has
been broken?
A. Assault
B. Battery
C. Negligence
D. Civil tort

14. When signing a form as a

witness, your signature shows that
the client:
A. Is fully informed and is aware of all
consequences.
B. Was awake and fully alert and not
medicated with narcotics.
C. Was free to sign without pressure
D. Has signed that form and the witness
saw it being done
15. Which criterion is needed for
someone to give consent to a
procedure?
A. An appointed guardianship
B. Unemancipated minor
C. Minimum of 21 years or older
D. An advocate for a child
16. Which statement is correct?
A. Consent for medical treatment can be
given by a minor with a sexually
transmitted disease (STD).
B. A second trimester abortion can be
given without state involvement.
C. Student nurses cannot be sued for
malpractice while in a nursing clinical
class.
D. Nurses who get sick and leave during a
shift are not abandoning clients if they
call their supervisor and leave a message
about their emergency illness.
17. Most litigation in the hospital
comes from the:
A. Nurse abandoning the clients when
going to lunch
B. Nurse following an order that is
incomplete or incorrect
C. Nurse documenting blame on the
physician when a mistake is made
D. Supervisor watching a new employee
check his or her skills level
18. The nurse places an aquathermia
pad on a client with a muscle sprain.
The nurse informs the client the pad
should be removed in 30 minutes.
Why will the nurse return in 30
minutes to remove the pad?
A. Reflex vasoconstriction occurs.
B. Reflex vasodilation occurs.
C. Systemic response occurs.
D. Local response occurs.
19. A client has recently been told he
has terminal cancer. As the nurse
enters the room, he yells, My eggs
are cold, and Im tired of having my
sleep interrupted by noisy nurses!

The nurse may interpret the clients

behavior as:
A. An expression of the anger stage of
dying
B. An expression of disenfranchised grief
C. The result of maturational loss
D. The result of previous losses
20. When helping a person through
grief work, the nurse knows:
A. Coping mechanisms that were effective
in the past are often disregarded in
response to the pain of a loss
B. A persons perception of a loss has
little to do with the grieving process.
C. The sequencing of stages of grief may
occur in order, they may be skipped, or
they may recur.
D. Most clients want to be left alone.
21. A client is hospitalized in the end
stage of terminal cancer. His family
members are sitting at his bedside.
What can the nurse do to best aid
the family at this time?
A. Limit the time visitors may stay so they
do not become overwhelmed by the
situation.
B. Avoid telling family members about the
clients actual condition so they will not
lose hope.
C. Discourage spiritual practices because
this will have little connection to the
client at this time.
D. Find simple and appropriate care
activities for the family to perform.
22. When caring for a terminally ill
client, it is important for the nurse
maintain the clients dignity. This can
be facilitated by:
A. Spending time to let clients share their
life experiences
B. Decreasing emphasis on attending to
the clients appearance because it only
increases their fatigue
C. Making decisions for clients so they do
not have to make them
D. Placing the client in a private room to
provide privacy at all times
23. What are the stages of dying
according to Elizabeth Kubler-Ross?
A. Numbing; yearning and searching;
disorganization and despair; and
reorganization.
B. Accepting the reality of loss, working
through the pain of grief, adjusting to the
environment without the deceased, and
emotionally relocating the deceased and

moving on with life.

C. Anticipatory grief, perceived loss,
actual loss, and renewal.
D. Denial, anger, bargaining, depression,
and acceptance.
24. Bereavement may be defined as:
A. The emotional response to loss.
B. The outward, social expression of loss.
C. Postponing the awareness of the reality
of the loss.
D. The inner feeling and outward
reactions of the survivor.
25. A client who had a Do Not
Resuscitate order passed away.
After verifying there is no pulse or
respirations, the nurse should next:
A. Have family members say goodbye to
the deceased.
B. Call the transplant team to retrieve
vital organs.
C. Remove all tubes and equipment
(unless organ donation is to take place),
clean the body, and position
appropriately.
D. Call the funeral director to come and
get the body.
26. A clients family member says to
the nurse, The doctor said he will
provide palliative care. What does
that mean? The nurses best
response is:
A. Palliative care is given to those who
have less than 6 months to live.
B. Palliative care aims to relieve or
reduce the symptoms of a disease.
C. The goal of palliative care is to affect
a cure of a serious illness or disease.
D. Palliative care means the client and
family take a more passive role and the
doctor focuses on the physiological needs
of the client. The location of death will
most likely occur in the hospital setting.
27. Which of the following is not
included in evaluating the degree of
heritage consistency in a client?
A. Gender
B. Culture
C. Ethnicity
D. Religion
28. When providing care to clients
with varied cultural backgrounds, it
is imperative for the nurse to
recognize that:
A. Cultural considerations must be put
aside if basic needs are in jeopardy.
B. Generalizations about the behavior of a

particular group may be inaccurate.

C. Current health standards should
determine the acceptability of cultural
practices.
D. Similar reactions to stress will occur
when individuals have the same cultural
background.
29. To respect a clients personal
space and territoriality, the nurse:
A. Avoids the use of touch
B. Explains nursing care and procedures
C. Keeps the curtains pulled around the
clients bed
D. Stands 8 feet away from the bed, if
possible.
30. To be effective in meeting various
ethnic needs, the nurse should:
A. Treat all clients alike.
B. Be aware of clients cultural
differences.
C. Act as if he or she is comfortable with
the clients behavior.
D. Avoid asking questions about the
clients cultural background.
31. The most important factor in
providing nursing care to clients in a
specific ethnic group is:
A. Communication
B. Time orientation
C. Biological variation
D. Environmental control
32. A health care issue often
becomes an ethical dilemma
because:
A. A clients legal rights coexist with a
health professionals obligation.
B. Decisions must be made quickly, often
under stressful conditions.
C. Decisions must be made based on
value systems.
D. The choices involved do not appear to
be clearly right or wrong.
33. A document that lists the medical
treatment a person chooses to
refuse if unable to make decisions is
the:
A. Durable power of attorney
B. Informed consent
C. Living will
D. Advance directives
34. Which statement about an
institutional ethics committee is
correct?
A. The ethics committee is an additional
resource for clients and healthcare
professionals.

B. The ethics committee relieves health

care professionals from dealing with
ethical issues.
C. The ethics committee would be the
first option in addressing an ethical
dilemma.
D. The ethics committee replaces
decision making by the client and health
care providers.
35. The nurse is working with
parents of a seriously ill newborn.
Surgery has been proposed for the
infant, but the chances of success
are unclear. In helping the parents
resolve this ethical conflict, the
nurse knows that the first step is:
A. Exploring reasonable courses of action
B. Collecting all available information
about the situation
C. Clarifying values related to the cause
of the dilemma.
D. Identifying people who can solve the
difficulty.
36. Miss Mary, an 88-year old
woman, believes that life should not
be prolonged when hope is gone. She
has decided that she does not want
extraordinary measures taken when
her life is at its end. Because she
feels this way, she has talked with
her daughter about her desires,
completing a living will and left
directions with her physician. This is
an example of:
A. Affirming a value
B. Choosing a value
C. Prizing a value
D. Reflecting a value
37. The scope of Nursing practice is
legally defined by:
A. State nurses practice acts
B. Professional nursing organizations
C. Hospital policy and procedure manuals
D. Physicians in the employing
institutions
38. A student nurse who is employed
as a nursing assistant may perform
any functions that:
A. Have been learned about in school
B. Are expected of a nurse at that level
C. Are identified in the positions job
description
D. Require technical rather than
professional skill.
39. A confused client who fell out of
bed because side rails were not used

is an example of which type of

liability?
A. Felony
B. Assault
C. Battery
D. Negligence
40. The nurse puts a restraint jacket
on a client without the clients
permission and without the
physicians order. The nurse may be
guilty of:
A. Assault
B. Battery
C. Invasion of privacy
D. Neglect
41. In a situation in which there is
insufficient staff to implement
competent care, a nurse should:
A. Organize a strike
B. Inform the clients of the situation
C. Refuse the assignment
D. Accept the assignment but make a
protest in writing to the administration.
42. Which statement about loss is
accurate?
A. Loss is only experienced when there is
an actual absence of something valued.
B. The more the individual has invested in
what is lost, the less the feeling of loss.
C. Loss may be maturational, situational,
or both.
D. The degree of stress experienced is
unrelated to the type of loss.
43. Trying questionable and
experimental forms of therapy is a
behavior that is characterized of
which stage of dying?
A. Anger
B. Depression
C. Bargaining
D. Acceptance
44. All of the following are crucial
needs of the dying client except:
A. Control of pain
B. Preservation of dignity and self-worth
C. Love and belonging
D. Freedom from decision making
45. Cultural awareness is an in-depth
self-examination of ones:
A. Background, recognizing biases and
prejudices.
B. Social, cultural, and biophysical factors
C. Engagement in cross-cultural
interactions
D. Motivation and commitment to caring.

46. Cultural competence is the

process of:
A. Learning about vast cultures
B. Acquiring specific knowledge, skills,
and attitudes
C. Influencing treatment and care of
clients
D. Motivation and commitment to caring.
47. Ethnocentrism is the root of:
A. Biases and prejudices
B. Meanings by which people make sense
of their experiences.
C. Cultural beliefs
D. Individualism and self-reliance in
achieving and maintaining health.
48. When action is taken on ones
prejudices:
A. Discrimination occurs
B. Sufficient comparative knowledge of
diverse groups is obtained.
C. Delivery of culturally congruent care is
ensured.
D. People think/know you are a dumbass
for being prejudiced.
49. The dominant value orientation
in North American society is:
A. Use of rituals symbolizing the
supernatural.
B. Group reliance and interdependence
C. Healing emphasizing naturalistic
modalities
D. Individualism and self-reliance in
achieving and maintaining health.
50. Disparities in health outcomes
between the rich and the poor
illustrates: a (an)
A. Illness attributed to natural,
impersonal, and biological forces.
B. Creation of own interpretation and
descriptions of biological and
psychological malfunctions.
C. Influence of socioeconomic factors in
morbidity and mortality.
D. Combination of naturalistic, religious,
and supernatural modalities.
51. Culture strongly influences pain
expression and need for pain
medication. However, cultural pain:
A. May be suffered by a client whose
valued way of life is disregarded by
practitioners.
B. Is more intense, thus necessitating
more medication.
C. Is not expressed verbally or physically
D. Is expressed only to others of like
culture.

52. The dominant values in American

society on individual autonomy and
self-determination:
A. Rarely have an effect on other cultures
B. Do have an effect on health care
C. May hinder ability to get into a hospice
program
D. May be in direct conflict with diverse
groups.
53. In the United States, access to
health care usually depends on a
clients ability to pay for health care,
either through insurance or by
paying cash. The client the nurse is
caring for needs a liver transplant to
survive. This client has been out of
work for several months and does
not have insurance or enough cash.
A discussion about the ethics of this
situation would involve
predominantly the principle of:
A. Accountability, because you as the
nurse are accountable for the well being
of this client.
B. Respect of autonomy, because this
clients autonomy will be violated if he
does not receive the liver transplant.
C. Ethics of care, because the caring thing
that a nurse could provide this patient is
resources for a liver transplant.
D. Justice, because the first and greatest
question in this situation is how to
determine the just distribution of
resources.
54. The code of ethics for nurses is
composed and published by:
A. The national league for Nursing
B. The American Nurses Association
C. The Medical American Association
D. The National Institutes of Health,
Nursing division.
55. Nurses agree to be advocates for
their patients. Practice of advocacy
calls for the nurse to:
A. Seek out the nursing supervisor in
conflicting situations
B. Work to understand the law as it
applies to the clients clinical condition.
C. Assess the clients point of view and
prepare to articulate this point of view.
D. Document all clinical changes in the
medical record in a timely manner.
56. Successful ethical discussion
depends on people who have a clear
sense of personal values. When
many people share the same values

it may be possible to identify a

philosophy of utilitarianism, with
proposes that:
A. The value of people is determined
solely by leaders in the Unitarian church.
B. The decision to perform a lover
transplant depends on a measure of the
moral life that the client has led so far.
C. The best way to determine the solution
to an ethical dilemma is to refer the case
to the attending physician.
D. The value of something is determined
by its usefulness to society.
57. The philosophy sometimes called
the code of ethics of care suggests
that ethical dilemmas can best be
solved by attention to:
A. Relationships
B. Ethical principles
C. Clients
D. Code of ethics for nurses.
58. In most ethical dilemmas, the
solution to the dilemma requires
negotiation among members of the
health care team. The nurses point
of view is valuable because:
A. Nurses have a legal license that
encourages their presence during ethical
discussions.
B. The principle of autonomy guides all
participants to respect their own selfworth.
C. Nurses develop a relationship to the
client that is unique among all
professional health care providers.
D. The nurses code of ethics
recommends that a nurse be present at
any ethical discussion about client care.
59. Ethical dilemmas often arise over
a conflict of opinion. Once the nurse
has determined that the dilemma is
ethical, a critical first step in
negotiating the difference of opinion
would be to:
A. Consult a professional ethicist to
ensure that the steps of the process occur
in full.
B. Gather all relevant information
regarding the clinical, social, and spiritual
aspects of the dilemma.
C. List the ethical principles that inform
the dilemma so that negotiations agree
on the language of the discussion.
D. Ensure that the attending physician
has written an order for an ethics

consultation to support the ethics

process.
60. The nurse practice acts are an
example of:
A. Statutory law
B. Common law
C. Civil law
D. Criminal law
61. The scope of Nursing Practice,
the established educational
requirements for nurses, and the
distinction between nursing and
medical practice is defined by:
A. Statutory law
B. Common law
C. Civil law
D. Nurse practice acts
62. The clients right to refuse
treatment is an example of:
A. Statutory law
B. Common law
C. Civil laws
D. Nurse practice acts
63. Even though the nurse may
obtain the clients signature on a
form, obtaining informed consent is
the responsibility of the:
A. Client
B. Physician
C. Student nurse
D. Supervising nurse.
64. The nurse is obligated to follow a
physicians order unless:
A. The order is a verbal order
B. The physicians order is illegible
C. The order has not been transcribed
D. The order is an error, violates hospital
policy, or would be detrimental to the
client.
65. The nursing theorist who
developed transcultural nursing
theory is
A. Dorothea Orem
B. Madeleine Leininger
C. Betty Newman
D. Sr. Callista Roy
Answers and Rationale
1. Answer: C. Have equal access to
all health care regardless of race and
religion
2. Answer: D. Provide care while
aware of ones own bias, focusing on
the clients individual needs rather
than the staffs practices
Without understanding ones own beliefs
and values, a bias or preconceived belief

by the nurse could create an unexpected

conflict or an area of neglect in the plan
of care for a client (who might be
expecting something totally different from
the care). During assessment values,
beliefs, practices should be identified by
the nurse and used as a guide to identify
the choices by the nurse to meet specific
needs/outcomes of that client. Therefore
identification of values, beliefs, and
practices allows for planning meaningful
and beneficial care specific for this client.
3. Answer: C. Biocultural needs
Cultural practices do not influence
biocultural needs because they are inborn
risks that are related to a biological need
and not a learned cultural belief or
practice.
4. Answer: A. Using a comparative
study of cultures to understand
similarities and differences across
human groups to provide specific
individualized care that is culturally
appropriate
Transcultural care means that by
understanding and learning about specific
cultural practices the nurse can integrate
these practices into the plan of care for a
specific individual client who has the
same beliefs or practices to meet the
clients needs in a holistic manner of care.
5. Answer: B. Identify how these
cultural variables affect the health
problem
Without assessment and identification of
the cultural needs, the nurse cannot
begin to understand how these might
influence the health problem or health
care management.
6. Answer: D. Expect the family to
keep an interpreter present at all
times to assist in meeting the
communication needs all day and
night while hospitalized
It is not the familys responsibility to
assist in the communication process.
Many families will leave someone to help
at times, but it is the hospitals legal
obligation to find an interpreter for
continued understanding by the client to
make sure the client is fully informed and
comprehends in his or her primary
language.
7. Answer: A. American Nurses
Associations (ANAs) Code of Ethics

This set of ethical principles provides the

professional guidelines established by the
ANA to maintain the highest standards for
ideal conduct in practice. As a profession,
the ANA wanted to establish rules and
then incorporate guidelines for
accountability and responsibility of each
nurse within the practice setting.
8. Answer: B. A research project that
included treating all the white men
and not treating all the black men to
compare the outcomes of a specific
drug therapy.
The ethical issue was the inequality of
treatment based strictly upon racial
differences. Secondly, the drug was
deliberately withheld even after results
showed that the drug was working to cure
the disease process in the white men for
many years. So after many years, the
black men were still not treated despite
the outcome of the research process that
showed the drug to be effective in
controlling the disease early in the
beginning of the research project.
Therefore harm was done.
Nonmaleficence, veracity, and justice
were not followed.
9. Answer: A. Gender bias and
ageism
Stereotyping an old man as nastyis a
gender bias and an ageism issue. The
nurse is verbalizing a negative descriptor
about the client.
10. Answer: C. Justice
Justice is defined as the fairness of
distribution of resources. However,
guidelines for a hierarchy of needs have
been established, such as with organ
transplantation. Nurses are moved to
areas of greatest need when shortages
occur on the floors. No floor is left without
staff, and another floor that had five staff
will give up two to go help the floor that
had no staff.
11. Answer: A. Statutory law is
created by elected legislature, such
as the state legislature that defines
the Nurse Practice Act (NPA).
Statutory law is created by legislature. It
creates statues such as the NPA, which
defines the role of the nurse and
expectations of the performance of ones
duties and explains what is
contraindicated as guidelines for breach
of those regulations.

12. Answer: D. Americans With

Disabilities Act (ADA)
If the hospital fails to follow ADA
guidelines for meeting special needs, the
facility loses funding and status for
receiving low-income loans or
reimbursement of expenses. ADA protects
the civil rights of disabled people. It
applies to both the hospital clients and
hospital staff. Privacy issues for persons
who are positive for human
immunodeficiency virus (HIV) have been
one issue in relationship to getting
information when hospital staff have been
exposed to unclean sticks. The ADA
allows the infected client the right to
choose whether or not to disclose that
information.
13. Answer: C. Negligence
Knowing what to do to prevent injury is a
part of the standards of care for nurses to
follow. Safety guidelines dictate raising
the side rails, staying with the client,
lowering the bed, and observing the client
until the environment is safe. As a nurse,
these activities are known as basic safety
measures that prevent injuries, and to not
perform them is not acting in a safe
manner. Negligence is conduct that falls
below the standard of care that protects
others against unreasonable risk of harm.
14. Answer: D. Has signed that form
and the witness saw it being done
Your signature as a witness only states
that the person signing the form was the
person who was listed in the procedure.
15. Answer: A. An appointed
guardianship
A guardian has been appointed by a court
and has full legal rights to choose
management of care.
16. Answer: A. Consent for medical
treatment can be given by a minor
with a sexually transmitted disease
(STD).
Anyone, at any age, can be treated
without parental permission for an STD
infection. The client is advised to
contact sexual partners but is not
required to give names. Permission
from parents is not needed, based upon
current privacy laws.
17. Answer: B. Nurse following an
order that is incomplete or incorrect
The nurse is responsible for clarifying all
orders that are illegible, unreasonable,

unsafe, or incorrect. The failure of the

nurse to question the physician about an
order creates an area of liability on the
nurses part because this is perceived as
a medical action and not the role of the
nurse to write orders. Some RNs do have
prescriptive privileges based upon
advanced degrees and certification.
Therefore the nurse who cannot correct
the order must document that the
physician was called and clarification or a
new order was given to correct the
unclear or illegible one that was currently
on the chart. Phone calls, follow-up, and
lack of follow-up by the physician should
also be documented if there is a problem
with getting the information in a timely
manner. The nurse must show the
sequence of events of a situation in a
clear manner if there is any conflict or
question about any orders or procedures
that were not appropriate. Assessments
and documentation of the clients status
should also be included if there is a
potential risk for harm present. Contact of
the staffs chain of command should also
be specifically stated for the proof of the
responsibilities being followed according
to hospital policy.
18. Answer: A. Reflex
vasoconstriction occurs.
If heat is applied for 1 hour or more, blood
flow is reduced by reflex vasoconstriction.
Vasoconstriction is the opposite of the
desired effect of heat application
19. Answer: A. An expression of the
anger stage of dying
In the anger stage of Kubler-Rosss stages
of dying, the individual resists the loss
and may strike out at everyone and
everything, in this case, the nurse.
20. Answer: C. The sequencing of
stages of grief may occur in order,
they may be skipped, or they may
recur.
Grief is manifested in a variety of ways
that are unique to an individual and
based on personal experiences, cultural
expectations, and spiritual beliefs. The
sequencing of stages or behaviors of grief
may occur in order, they may be skipped,
or they may recur. The amount of time to
resolve grief also varies among
individuals.

21. Answer: D. Find simple and

appropriate care activities for the
family to perform.
It is helpful for the nurse to find simple
care activities for the family to perform,
such as feeding the client, washing the
clients face, combing hair, and filling out
the clients menu. This helps the family
demonstrate their caring for the client
and enables the client to feel their
closeness and concern. a. Older adults
often become particularly lonely at night
and may feel more secure if a family
member stays at the bedside during the
night. The nurse should allow visitors to
remain with dying clients at any time if
the client wants them. It is up to the
family to determine if they are feeling
overwhelmed, not the nurse.
22. Answer: A. Spending time to let
clients share their life experiences
A. Spending time to let clients share their
life experiences enables the nurse to
know clients better. Knowing clients then
facilitates choice of therapies that
promote client decision making and
autonomy, thus promoting a clients selfesteem and dignity.
23. Answer: D. Denial, anger,
bargaining, depression, and
acceptance.
24. Answer: D. The inner feeling and
outward reactions of the survivor.
25. Answer: C. Remove all tubes and
equipment (unless organ donation is
to take place), clean the body, and
position appropriately.
The body of the deceased should be
prepared before the family comes into
view and say their goodbyes. This
includes removing all equipment, tubes,
supplies, and dirty linens according to
protocol, bathing the client, applying
clean sheets, and removing trash from
the room.
26. Answer: B. Palliative care aims
to relieve or reduce the symptoms of
a disease.
The goal of palliative care is the
prevention, relief, reduction, or soothing
of symptoms of disease or disorders
without effecting a cure.
27. Answer: A. Gender
28. Answer: B. Generalizations about
the behavior of a particular group
may be inaccurate.

29. Answer: B. Explains nursing care

and procedures
30. Answer: B. Be aware of clients
cultural differences.
31. Answer: A. Communication
32. Answer: D. The choices involved
do not appear to be clearly right or
wrong.
33. Answer: D. Advance directives
34. Answer: A. The ethics committee
is an additional resource for clients
and healthcare professionals.
35. Answer: B. Collecting all
available information about the
situation.
36. Answer: C. Prizing a value.
37. Answer: A. State nurses practice
acts.
38. Answer: C. Are identified in the
positions job description.
39. Answer: D. Negligence
40. Answer: B. Battery
41. Answer: A. Organize a strike
42. Answer: C. Loss may be
maturational, situational, or both.
43. Answer: C. Bargaining
44. Answer: D. Freedom from
decision making
45. Answer: A. Background,
recognizing biases and prejudices.
Cultural awareness is an in-depth
examination of ones own background,
recognizing biases and prejudices and
assumptions about other people.
46. Answer: B. Acquiring specific
knowledge, skills, and attitudes
Cultural competence is the process of
acquiring specific knowledge, skills, and
attitudes that ensure delivery of culturally
congruent care.
47. Answer: A. Biases and prejudices
48. Answer: A. Discrimination occurs
49. Answer: D. Individualism and
self-reliance in achieving and
maintaining health.
50. Answer: C. Influence of
socioeconomic factors in morbidity
and mortality.
Disparities in health outcomes between
the rich and the poor illustrate the
influence of socioeconomic factors in
morbidity and mortality. Social factors
such as poverty and lack of universal
medical insurance compromise the health
status of the poor and unemployed.

51. Answer: A. May be suffered by a

client whose valued way of life is
disregarded by practitioners.
Nurses need not assume that pain relief is
equally valued across groups. Cultural
pain may be suffered by a client whose
valued way of life is disregarded by
practitioners.
52. Answer: D. May be in direct
conflict with diverse groups.
The dominant value in American society
of individual autonomy and selfdetermination may be in direct conflict
with diverse groups. Advance directives,
informed consent, and consent for
hospice are examples of mandates that
may violate clients values.
53. Answer: D. Justice, because the
first and greatest question in this
situation is how to determine the
just distribution of resources
Justice refers to fairness. Health care
providers agree to strive for justice in
health care. The term often is used during
discussions about resources. Decisions
about who should receive available
organs are always difficult.
54. Answer: B. The American Nurses
Association
The ANA has established widely accepted
codes that professional nurses attempt to
follow.
55. Answer: C. Assess the clients
point of view and prepare to
articulate this point of view.
Nurses strengthen their ability to
advocate for a client when nurses are
able to identify personal values and then
accurately identify the values of the client
and articulate the clients point of view.
56. Answer: D. The value of
something is determined by its
usefulness to society.
A utilitarian system of ethics proposes
that the value of something is determined
by its usefulness.
57. Answer: A. Relationships.
The ethic of care explores the notion of
care as a central activity of human
behavior. Those who write about the
ethics of care advocate a more female
biased theory that is based on
understanding relationships, especially
personal narratives.
58. Answer: C. Nurses develop a
relationship to the client that is

unique among all professional health

care providers
When ethical dilemmas arise, the nurses
point of view unique and critical. The
nurse usually interacts with clients over
longer time intervals than do other
disciples.
59. Answer: B. Gather all relevant
information regarding the clinical,
social, and spiritual aspects of the
dilemma
Each step in the processing of an ethical
dilemma resembles steps in critical
thinking. The nurse begins by gathering
information and moves through
assessment, identification of the problem,

planning, implementation, and

evaluation.
60. Answer: A. Statutory law
61. Answer: D. Nurse practice acts
62. Answer: B. Common law.
63. Answer: B. Physician
64. Answer: D. The order is an error,
violates hospital policy, or would be
detrimental to the client.
65. Answer: B. Madeleine Leininger
Madeleine Leininger developed the theory
on transcultural theory based on her
observations on the behavior of selected
people within a culture.