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NUR304: Adult Systems I Mastery Quiz & Exam Prep Guide, Exams of Nursing

University of Washington (UW) - SeattleNursing

Ace your NUR304 Nursing and the Adult Systems I course with this expertly crafted quiz and exam companion designed for serious nursing students. This powerful resource features clinically relevant, scenario-based questions covering adult health systems, care planning, patient assessment, diagnostics, and real-world nursing judgment. Whether you're reviewing for a class quiz, preparing for a unit exam, or strengthening your critical thinking skills for NCLEX-style questions — this guide ensures you're fully equipped to succeed. ✔️ Realistic clinical scenarios ✔️ Evidence-based rationales ✔️ Prioritization, delegation, and critical thinking coverage ✔️ Perfect for study groups, self-assessment, and last-minute reviews NUR304 success starts here. Let’s get you exam-ready — fast.

Typology: Exams

2024/2025

Available from 06/23/2025

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vincent-muhinja 🇺🇸

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NUR304: Adult Systems I Mastery Quiz & Exam Prep Guide
1. A patient is admitted to a medical unit for a home-acquired pressure ulcer.
The patient has Alzheimer's disease and has been incontinent of urine. The
nurse inserts a Foley catheter. You will identify a link in the infection chain
as:
A. restraints
B. poor hygiene
✅
C. Foley catheter bag
D. improper positioning
Rationale:
✔
The Foley catheter bag could be both a portal of exit and a portal of
entry.
2. Mrs. Eldredge is a 63-year-old woman who underwent a total hip
replacement. Two weeks after surgery, she complains of increased pain in her
hip and low-grade fever. The incision is red, swollen, and warm.
What does fever and warm, swollen incision indicate?
✅
The inflammatory response has been activated and the incision may be
infected.
Is the infection site systemic or localized?
✅
Localized
3. Factors influencing infection prevention and control include:
✅
- Age
✅
- Sex
✅
- Nutritional status
✅
- Stress
✅
- Disease process
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  1. A patient is admitted to a medical unit for a home-acquired pressure ulcer. The patient has Alzheimer's disease and has been incontinent of urine. The nurse inserts a Foley catheter. You will identify a link in the infection chain as: A. restraints B. poor hygiene ✅ C. Foley catheter bag D. improper positioning ✔ Rationale:The Foley catheter bag could be both a portal of exit and a portal of entry.
  2. Mrs. Eldredge is a 63-year-old woman who underwent a total hip replacement. Two weeks after surgery, she complains of increased pain in her hip and low-grade fever. The incision is red, swollen, and warm. What does fever and warm, swollen incision indicate? ✅ The inflammatory response has been activated and the incision may be infected. Is the infection site systemic or localized? ✅ Localized
  3. Factors influencing infection prevention and control include: ✅ - Age ✅ - Sex ✅ - Nutritional status ✅ - Stress ✅ - Disease process
  1. What is granulation tissue? ✅ Granulation tissue is new tissue that is not as strong as tissue collagen and assumes the form of scar tissue.
  2. You are caring for a patient who underwent surgery 48 hours ago. On physical assessment, you notice that the wound looks red and swollen. The patient's WBCs are elevated. You should: A. start antibiotics ✅ B. notify the provider C. document the findings and reassess in 2 hours D. place the patient on isolation precautions ✔ Rationale:When a patient shows signs of infection, the nurse should notify the provider immediately to ensure immediate treatment is given, possibly preventing a systemic infection.
  3. Mrs. Eldredge continues recovering at home. When she visits Mrs. Eldredge, Kathy teaches her about infection prevention and control practices. What outcome would be set for this activity? ✅ Patient will perform self care using proper prevention and control practices. What are some examples of teaching strategies to achieve this outcome? ✅ - Instruct patient about proper hand hygiene before and after wound care. ✅ - Demonstrate hand hygiene and explain when it should be done. ✅ - Educate patient on signs/symptoms of wound infection and when to notify the physician.
  1. You notice that a teenager has an irregular pulse. The best action you should take includes: A. reading the history and physical ✅ B. assessing the apical pulse rate for 1 full minute C. auscultating for strength and depth of pulse D. asking whether the patient feels any palpitations or faintness of breath
  2. A postoperative patient is breathing rapidly. You should immediately: A. call the physician B. count the respirations ✅ C. assess the oxygen saturation D. ask the patient if he feels uncomfortable ✔ Rationale:Shortness of breath is an indicator of hypoxemia. Assessing the oxygen saturation will let the nurse know if the patient’s breathing status is a result of hypoxemia.
  3. Ms. Coburn's blood pressure is 164/98 mm Hg. Ms. Coburn asks "I think that's close to where it was last time I came in. Is that okay?" How would you respond?: ✅ Let Ms. Coburn know that her pressure is high and that it can put her at risk for health problems. Check blood pressure again later in the appointment. Discuss lifestyle changes with her.
  4. What outcome would you suggest for the interventions Ms. Coburn and Miguel have agreed upon?: ✅ It is important to use teaching strategies to inform Ms. Coburn not only of the

lifestyle changes she must accommodate, but the reasons why each change is valuable.

  1. When assessing the blood pressure of a school-age child, using an adult cuff of normal size will affect the reading and produce a value that is: A. accurate B. indistinct C. falsely low ✅ D. falsely high
  2. What evaluation strategies would you suggest for Miguel to use with Ms. Coburn?:  ✅Demonstrate (if necessary) and observe Ms. Coburn practice taking her own blood pressure.  ✅Evaluate her technique and provide guidance as needed.  ✅Ask Ms. Coburn to state three risk factors for hypertension.  ✅Review Ms. Coburn’s walking activity since the last visit. Discuss motivators and offer encouragement to continue.  ✅Ask Ms. Coburn which salty foods she is avoiding, and whether she needs information about the sodium content of foods.  ✅Ask Ms. Coburn if she is ready to discuss quitting smoking.
  3. Mr. Indelicato is hesitant to ambulate or use his continuous positive motion machine. He rates his pain as 6-7 on a scale of 0 to 10 and is using a patient-controlled analgesia (PCA) pump. His degree of knee flexion is now 70 degrees. He can ambulate 10 feet with a walker. He describes the muscle in his right leg as feeling weak and tired after walking a short distance. Marilyn observes Mr. Indelicato using the walker incorrectly.
  1. The nurse is working in a tertiary care setting. Which activity does the nurse perform while providing tertiary care? ✅ Performing endotracheal suctioning for a patient on a ventilator in the medical ICU
  2. A nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is the most appropriate outcome for this patient's restorative care? ✅ Patient will be able to walk 200 feet without shortness of breath
  3. Which of the following describe characteristics of an integrated health care system? ✅ The focus is holistic (involves the whole person, body + spirit) ✅ The system coordinates a continuum of services ✅ Members of the health care team link electronically to use the EMR to share the patient's health record
  4. The school nurse has been following a 9-year-old student who has shown behavioral problems in class. The student acts out and does not follow instructions. The nurse plans to meet with the family to learn more about social determinants. Which of the following potential social determinants should the nurse assess? ✅ The level of support from parents ✅ The level of violence in the neighborhood ✅ The cultural values of the family
  5. Which of the following are evidence-based outcomes from intentional rounding? ✅ Improved patient satisfaction

✅ Reduction in patient falls ✅ Reduction in patient use of nurse call system

  1. Contact Precautions for C. Diff: ✅ Fecal-Oral Route Transmission ✅ Hands always washed with soap and water, not hand sanitizer ✅ Everyone entering the room should wear a gown and gloves
  2. A patient is diagnosed with meningitis. Which type of isolation precaution is MOST appropriate? ✅ Droplet Precaution
  3. Which type of PPE should the nurse wear when caring for a child with Airborne Precaution for confirmed chickenpox/herpes zoster? ✅ Disposable Gown ✅ N95 Respirator Mask ✅ Gloves
  4. Iatrogenic Infection = ✅ An infection after a medical or surgical management whether or not the patient was hospitalized. Relationship between Rx or Procedure
  5. What action on a nurse's part would contribute to reducing health-care acquired infections? ✅ Hand-washing
  1. Intermittent Fever Pattern =  101.6°F  97.9°F  98.4°F  99.6°F  100.9°F ✅ This pattern includes fluctuations above and below normal body temperature
  2. Which of the following patients are most at risk for Tachypnea? ✅ Patient with 4 rib fractures ✅ Woman who is 9 months pregnant ✅ Smoker with pneumonia
  3. What area on the heart would a nurse auscultate for point of maximal impulse (PMI)? ✅ Near the Apex (bottom left)
  4. What are the steps of administering an intradermal injection? 1️⃣ Clean site with antiseptic swab 2️⃣ Using non-dominant hand, stretch skin with your forefinger 3️⃣ Insert needle at a 5–15° angle until resistance is felt 4️⃣ Advance needle to the epidermis (about 3 mm) 5️⃣ Inject medication slowly 6️⃣ Note the presence of a bleb
  1. What does the nurse do in the planning phases of the nursing process? ✅ In the planning phases, the nurse chooses outcomes/goals based on assessments and nursing diagnoses, chooses nursing interventions, and writes the plan of care.
  2. What is the purpose of initial planning? Ongoing planning? Discharge planning?  Initial planning: Identifies patient problems and creates the care plan.  Ongoing planning: Revises and individualizes the care plan as new data are obtained.  Discharge planning: Evaluates health status on leaving the facility, prepares for self-care or family caregiving, and coordinates necessary services.
  3. In addition to care related to the patient's basic needs, what other types of information does a comprehensive care plan contain? ✅ Information about the medical/multidisciplinary plan of care, care related to nursing diagnoses and collaborative problems, and special teaching or discharge needs.
  4. How are critical pathways different from other standardized care plans? ✅ Critical pathways are diagnosis-specific, organized by a timeline to meet length-of-stay goals, and typically include less-detailed instructions for interventions.
  5. What is the main disadvantage of computerized and standardized care plans?
  1. In the following predicted outcomes, identify the components: "After two teaching sessions, (client) will be able to identify foods to avoid on a low-fat diet, by 3/1/10."  Subject: Client  Action verb: identify  Performance criterion: foods to avoid on low-fat diet  Target time: by 3/1/  Special conditions: after two teaching sessions
  2. In the following predicted outcome, identify the components: "Bowel movements will be soft and formed, and of his usual frequency."  Subject: Bowel movements (client assumed)  Action verb: will be  Performance criterion: soft, formed, usual frequency  Target time: assumed (ongoing or needs clarification)  Special conditions: None
  3. In the following predicted outcome, identify the components: "Lung sounds clear to auscultation at all times."  Subject: Lung sounds (client assumed)  Action verb: are (implied)  Performance criterion: clear  Target time: at all times  Special conditions: to auscultation Which standardized classification system was designed specifically for community health nursing? ✅ Omaha System
  1. Which standardized classification system was designed specifically for home healthcare? ✅ Clinical Care Classification (CCC) — also called Saba or Georgetown
  2. Which standardized classification system was designed for use in all areas and specialties of nursing? ✅ NOC (Nursing Outcomes Classification)
  3. List at least eight questions you could use to critically evaluate the quality of your goal/outcome statements:  Is there at least one goal that, when met, resolves the problem in the nursing diagnosis?  Are the predicted outcomes adequate to fully address the diagnosis?  Is each outcome appropriate for the nursing diagnosis?  Is each outcome based on a single diagnosis?  Does each outcome describe only one patient response or behavior?  Is each outcome stated in positive terms?  Is each outcome measurable or observable?  Are performance criteria specific and concrete?  Does each goal include all necessary parts (subject, verb, target time, criteria)?  Is the goal realistic and achievable for the patient?  Is the goal compatible with the medical or collaborative treatment plan?  Is the goal valued by the patient/family/community?  Does the goal respect religious or cultural values?

 Outcome identification describes activities to meet goals → ❌ False (this is planning/intervention)  Key elements of the care plan: diagnosis, client goals, interventions → ✅ True  Aggregate goals are for families, groups, communities → ✅ True

  1. Evaluation can focus on one of three areas: structure, ________, or ________. ✅ Process, Outcome
  2. Essential goals are derived from the ________ clause of the nursing diagnosis: ✅ Problem
  3. Care plans focused on diagnosis-related groups (DRGs) and organized on a timeline are called ________: ✅ Critical pathways
  4. Goals that are specific, measurable, and valued by the patient are called ________: ✅ Realistic goals
  5. Summary of Scherb et al. (2007) Study on dehydration in pediatrics using NANDA, NOC, NIC: If based on this study alone, would you support using standardized nursing languages? ✅ Yes — This system enables clear measurement of outcomes and effectiveness

of nursing care. It supports data extraction, analysis, and improvements in practice quality.

  1. Which is true of unit standards of care? (Select all that apply) ✅ ✓ Written for a specific medical diagnosis/treatments ✅ ✓ Describe the minimal level of care expected
  2. Which is the best example of a well-stated desired outcome? ✅ B. State pain < 4 on a scale of 1 to 10 within 1 hour after receiving pain medication
  3. The client has a diagnosis of Impaired Physical Mobility. Which NOC outcome label is most appropriate? ✅ B. Activities of daily living
  4. How is a critical pathway different from a standardized care plan? ✅ C. Specifies patient outcomes and interventions for each day or time interval
  5. What is wrong with this goal statement: “The patient will walk to the doorway with the help of one person”? ✅ C. Target time — There's no time frame specified.
  1. How are Nursing Outcomes Classification (NOC) outcomes typically used in care planning? ✅ NOC providesstandardized outcome labels to evaluate patient progress. Each outcome includes indicators and a 5-point Likert scale to measure progress from baseline to desired state.
  2. Why is prioritization of nursing diagnoses important in planning? ✅ Prioritization ensures thatlife-threatening or critical needs (such as airway, breathing, circulation) are addressed first, followed by safety, psychological, and educational needs, based on Maslow's hierarchy.
  3. What is a collaborative intervention? ✅ An intervention that isinitiated by the nurse but carried out in collaboration with other members of the health care team, such as physical therapists, physicians, or dietitians.
  4. What are the three types of nursing interventions?  Independent: actions the nurse is licensed to initiate (e.g., teaching, repositioning)  Dependent: require a physician’s order (e.g., administering medication)  Collaborative: require input from other disciplines (e.g., diet changes coordinated with a dietitian)
  5. How should you individualize a standardized care plan? ✅ Review the template,cross out non-relevant interventions, add specific patient needs, modify time frames, and ensure all interventions and goals align with your patient’s assessment data.
  1. Why are evaluation and reassessment essential parts of the nursing process? ✅ Evaluation shows whetheroutcomes are being met. If not, it prompts reassessment and modification of the plan of care to improve results.
  2. What is the difference between a nursing diagnosis and a medical diagnosis? ✅ Anursing diagnosis focuses on patient responses to health problems and life processes, whereas a medical diagnosis identifies a disease or pathology.
  3. Why is documentation of the care plan important? ✅ It provideslegal evidence, supports communication among the care team, ensures continuity of care, and allows for evaluation of patient outcomes.
  4. How can patient involvement improve the nursing care plan? ✅ Patients who participate in planning are more likely toadhere to the plan, feel empowered, and report higher satisfaction with care.
  5. What are the five steps of the nursing process (in order)? ✅ Assessment ✅ Diagnosis ✅ Planning ✅ Implementation ✅ Evaluation