Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a postoperative client who is unable to sleep and refusing to see their partner. The client states, “I'm feeling anxious.” Using Maslow's hierarchy of needs, which area should the nurse prioritize when planning care for the client?
A. Anxiousness
Anxiety is a psychological concern that falls under safety and emotional needs. While important, it is secondary to physiological needs such as wound care, which directly impacts survival and physical integrity.
B. Refusal to see partner
Refusal to see a partner relates to love and belonging needs. These are higher-level needs in Maslow’s hierarchy and are not prioritized over basic physiological or safety needs.
C. Inability to sleep
Inability to sleep affects physiological well-being but is not as immediately critical as wound care in a postoperative client. Sleep disturbances can be addressed after ensuring physical recovery.
D. Wound care
Wound care addresses the most fundamental physiological need—physical health and healing. In Maslow’s hierarchy, physiological needs are the foundation and must be met before addressing emotional or social concerns.
This question is an excerpt from Nurse Dive's nursing test bank - Med surg proctored exam (examplify). Take the full exam now
Full Explanation
Choice A reason: Anxiety is a psychological concern that falls under safety and emotional needs. While important, it is secondary to physiological needs such as wound care, which directly impacts survival and physical integrity.
Choice B reason: Refusal to see a partner relates to love and belonging needs. These are higher-level needs in Maslow’s hierarchy and are not prioritized over basic physiological or safety needs.
Choice C reason: Inability to sleep affects physiological well-being but is not as immediately critical as wound care in a postoperative client. Sleep disturbances can be addressed after ensuring physical recovery.
Choice D reason: Wound care addresses the most fundamental physiological need—physical health and healing. In Maslow’s hierarchy, physiological needs are the foundation and must be met before addressing emotional or social concerns.
Similar Questions
Which factor(s) contribute to food insecurity in low-income families? Select all that apply.
A. Lack of affordable housing
Lack of affordable housing diverts financial resources away from food purchases. When families spend a disproportionate amount of income on rent, they may struggle to afford nutritious food, contributing to food insecurity.
B. High medical costs
High medical costs can consume a significant portion of a family’s budget, leaving less money available for food. This is especially true for families managing chronic illnesses or lacking comprehensive insurance coverage.
C. Stable employment
Stable employment generally provides income and access to benefits, reducing the risk of food insecurity. It is not a contributing factor but rather a protective one.
D. Chronic health problems
Chronic health problems can limit earning potential, increase medical expenses, and reduce the ability to shop or prepare meals. These factors compound financial strain and increase vulnerability to food insecurity.
E. Food allergies
While food allergies may limit dietary options, they do not inherently cause food insecurity unless compounded by financial constraints. Alone, they are not a primary contributing factor.
Full Explanation
Choice A reason: Lack of affordable housing diverts financial resources away from food purchases. When families spend a disproportionate amount of income on rent, they may struggle to afford nutritious food, contributing to food insecurity.
Choice B reason: High medical costs can consume a significant portion of a family’s budget, leaving less money available for food. This is especially true for families managing chronic illnesses or lacking comprehensive insurance coverage.
Choice C reason: Stable employment generally provides income and access to benefits, reducing the risk of food insecurity. It is not a contributing factor but rather a protective one.
Choice D reason: Chronic health problems can limit earning potential, increase medical expenses, and reduce the ability to shop or prepare meals. These factors compound financial strain and increase vulnerability to food insecurity.
Choice E reason: While food allergies may limit dietary options, they do not inherently cause food insecurity unless compounded by financial constraints. Alone, they are not a primary contributing factor.
A nurse manager is interviewing a new graduate for a job in a healthcare clinic. The nurse manager asks the new graduate, “What is the role of the nurse in helping clients achieve their optimal levels of health?” How should the graduate nurse respond? Select all that apply.
A. Screen clients for modifiable risk factors at every encounter.
Nurses play a critical role in preventive care by identifying modifiable risk factors such as smoking, poor diet, sedentary lifestyle, and unmanaged chronic conditions. Screening at every encounter allows for early intervention and personalized health promotion strategies that align with evidence-based practice.
B. Administer vaccines according to guidelines.
Administering vaccines according to current guidelines is a cornerstone of public health and disease prevention. Nurses ensure immunization schedules are followed, educate clients on vaccine benefits, and monitor for adverse reactions, thereby contributing to herd immunity and individual protection.
C. Encourage overweight clients to reduce their caloric intake.
Encouraging overweight clients to adopt healthier eating habits is part of lifestyle counseling. Nurses use motivational interviewing and culturally sensitive education to help clients understand the impact of caloric intake on weight, cardiovascular health, and metabolic conditions, promoting sustainable behavior change.
D. Focus solely on the client's presenting concern.
Focusing solely on the presenting concern is a limited approach that neglects the holistic nature of nursing care. Optimal health requires addressing underlying risk factors, psychosocial needs, and preventive strategies, not just acute symptoms.
E. Educate clients on various methods to improve their health literacy.
Improving health literacy empowers clients to make informed decisions about their care. Nurses educate clients on navigating the healthcare system, understanding medication regimens, interpreting health information, and advocating for themselves, which enhances adherence and outcomes.
Full Explanation
Choice A reason: Nurses play a critical role in preventive care by identifying modifiable risk factors such as smoking, poor diet, sedentary lifestyle, and unmanaged chronic conditions. Screening at every encounter allows for early intervention and personalized health promotion strategies that align with evidence-based practice.
Choice B reason: Administering vaccines according to current guidelines is a cornerstone of public health and disease prevention. Nurses ensure immunization schedules are followed, educate clients on vaccine benefits, and monitor for adverse reactions, thereby contributing to herd immunity and individual protection.
Choice C reason: Encouraging overweight clients to adopt healthier eating habits is part of lifestyle counseling. Nurses use motivational interviewing and culturally sensitive education to help clients understand the impact of caloric intake on weight, cardiovascular health, and metabolic conditions, promoting sustainable behavior change.
Choice D reason: Focusing solely on the presenting concern is a limited approach that neglects the holistic nature of nursing care. Optimal health requires addressing underlying risk factors, psychosocial needs, and preventive strategies, not just acute symptoms.
Choice E reason: Improving health literacy empowers clients to make informed decisions about their care. Nurses educate clients on navigating the healthcare system, understanding medication regimens, interpreting health information, and advocating for themselves, which enhances adherence and outcomes.
Complete the following sentence by choosing from the list of options. The nurse is developing a care plan for a client to meet basic physiological needs. The nurse consults with social services to assist with food benefits and medication delivery.
A. Social services
Social services are essential in coordinating resources for clients who face socioeconomic barriers to health. Nurses collaborate with social workers to secure housing, transportation, and access to food and medications, addressing determinants of health.
B. Food benefits
Food benefits help clients meet nutritional needs, which are foundational to physiological well-being. Nurses assess for food insecurity and refer clients to programs like SNAP or local food banks to ensure adequate intake.
C. Medication delivery
Medication delivery services ensure clients receive prescribed treatments, especially those with mobility issues, transportation barriers, or complex regimens. Nurses facilitate these services to promote adherence and prevent complications.
D. Opening a bank account
Opening a bank account is not directly related to meeting basic physiological needs. While financial stability is important, it does not address immediate health concerns like nutrition or medication access.
Full Explanation
Choice A reason: Social services are essential in coordinating resources for clients who face socioeconomic barriers to health. Nurses collaborate with social workers to secure housing, transportation, and access to food and medications, addressing determinants of health.
Choice B reason: Food benefits help clients meet nutritional needs, which are foundational to physiological well-being. Nurses assess for food insecurity and refer clients to programs like SNAP or local food banks to ensure adequate intake.
Choice C reason: Medication delivery services ensure clients receive prescribed treatments, especially those with mobility issues, transportation barriers, or complex regimens. Nurses facilitate these services to promote adherence and prevent complications.
Choice D reason: Opening a bank account is not directly related to meeting basic physiological needs. While financial stability is important, it does not address immediate health concerns like nutrition or medication access.