TEAS Reading Practice Test #4 2 — Questions and Answers
Question 1: A nursing journal article states: 'Despite widespread adoption of fall prevention protocols, hospital fall rates have plateaued at approximately 3.5 per 1,000 patient-days. New research suggests that individualized risk assessments, rather than standardized checklists, may be more effective at reducing falls among high-risk populations.' What is the author's main argument?
- Fall prevention protocols should be eliminated entirely
- Standardized approaches have reached their limit and individualized methods may work better (Correct answer)
- Hospital fall rates are acceptable at current levels
- High-risk populations should not be admitted to hospitals
Correct answer: Standardized approaches have reached their limit and individualized methods may work better
The author presents the plateau in fall rates despite current protocols and suggests individualized approaches as a potentially superior alternative.
The author's main argument is that standardized fall prevention protocols have reached a ceiling of effectiveness (plateaued at 3.5 per 1,000 patient-days) and that moving toward individualized risk assessments may achieve further reductions, particularly for high-risk patients. The author does not argue for eliminating protocols entirely or accepting current rates—rather, they advocate for evolving the approach from one-size-fits-all to personalized prevention strategies.
Question 2: Read the following passage from a pharmacology text: 'First-generation antihistamines such as diphenhydramine readily cross the blood-brain barrier, causing drowsiness. Second-generation antihistamines like loratadine were designed to be less lipophilic, significantly reducing CNS penetration and sedative effects while maintaining peripheral H1 receptor blockade.' The relationship between the two sentences is best described as:
- The second sentence provides an exception to the first
- The second sentence describes a solution developed in response to the limitation in the first (Correct answer)
- The second sentence contradicts the claim made in the first
- The second sentence provides statistical evidence for the first
Correct answer: The second sentence describes a solution developed in response to the limitation in the first
The first sentence identifies a problem (drowsiness from first-generation antihistamines), and the second describes how second-generation drugs were designed to address that limitation.
The two sentences follow a problem-solution relationship. The first sentence identifies the limitation of first-generation antihistamines: they cross the blood-brain barrier and cause drowsiness. The second sentence explains that second-generation antihistamines were specifically 'designed to be less lipophilic' to solve this problem—reducing sedation while preserving the desired antihistamine effect. This reflects the iterative nature of pharmaceutical development.
Question 3: A clinical guideline reads: 'For patients with Type 2 diabetes, metformin remains the first-line pharmacological therapy (Level A evidence). When glycemic targets are not met with metformin alone, adding a second agent should be individualized based on patient characteristics, comorbidities, and cost considerations (Level B evidence).' What does the difference in evidence levels suggest?
- Metformin is more expensive than second-line agents
- There is stronger research support for metformin as first-line therapy than for choosing specific second-line agents (Correct answer)
- Level B evidence is more recent than Level A evidence
- Second-line agents are less effective than metformin
Correct answer: There is stronger research support for metformin as first-line therapy than for choosing specific second-line agents
Level A evidence typically indicates the strongest research support (e.g., multiple large RCTs), while Level B suggests good but less robust evidence, indicating more certainty about metformin as first-line treatment.
In clinical practice guidelines, evidence levels indicate the strength of supporting research. Level A generally represents the highest quality evidence (multiple well-designed randomized controlled trials), while Level B represents good evidence but with some limitations. The difference suggests that the recommendation for metformin as first-line therapy is supported by stronger research than the guidance on choosing second-line agents, which involves more clinical judgment and less definitive evidence.
Question 4: An instruction manual for a blood glucose monitor states: 'Step 1: Wash hands with warm soapy water and dry thoroughly. Step 2: Insert a new test strip into the monitor. Step 3: Use the lancing device to obtain a blood sample from the side of a fingertip. Step 4: Touch the blood drop to the edge of the test strip.' Why does the manual specify 'the side of a fingertip' in Step 3?
- The side of the fingertip produces more blood than the pad
- Blood from the side of the fingertip gives more accurate readings
- The side of the fingertip has fewer nerve endings, causing less pain (Correct answer)
- The monitor can only read blood from the side of the fingertip
Correct answer: The side of the fingertip has fewer nerve endings, causing less pain
The sides of fingertips have fewer nerve endings than the pads, so lancing there causes less pain while still providing an adequate blood sample.
The manual specifies lancing the side of the fingertip because this area has fewer nerve endings compared to the fingertip pad, resulting in significantly less pain. This is especially important for diabetic patients who must test their blood glucose multiple times daily—minimizing pain improves compliance with monitoring regimens. The fingertip side still has adequate capillary blood flow for accurate readings. This is a standard recommendation in diabetes education.
Question 5: A research abstract concludes: 'Our findings suggest that nurse staffing ratios are inversely associated with patient mortality rates. Hospitals with ratios below 1:4 showed a 14% increase in 30-day mortality compared to those maintaining 1:4 or better.' What does 'inversely associated' mean in this context?
- As staffing ratios improve, mortality rates also increase
- As staffing ratios worsen (fewer nurses per patient), mortality rates increase (Correct answer)
- Staffing ratios and mortality rates change at the same rate
- There is no relationship between staffing and mortality
Correct answer: As staffing ratios worsen (fewer nurses per patient), mortality rates increase
An inverse association means the variables move in opposite directions—as nurse-to-patient ratios worsen (fewer nurses), mortality increases.
In this context, 'inversely associated' means that as one variable increases, the other decreases (and vice versa). Better staffing ratios (more nurses per patient, like 1:3 or 1:4) are associated with lower mortality, while worse ratios (fewer nurses per patient, like 1:5 or 1:6) are associated with higher mortality. The supporting data confirms this: hospitals below the 1:4 threshold showed 14% higher mortality. Understanding inverse relationships is essential for interpreting health research.
Question 6: A passage reads: 'Florence Nightingale's use of statistical graphics to illustrate mortality causes during the Crimean War was revolutionary. Her polar area diagrams demonstrated that preventable diseases killed far more soldiers than battle injuries, ultimately convincing Parliament to improve sanitary conditions in military hospitals.' The word 'revolutionary' as used here most nearly means:
- Related to political uprising
- Groundbreaking and transformative (Correct answer)
- Controversial and disputed
- Scientifically precise
Correct answer: Groundbreaking and transformative
In this context, 'revolutionary' means groundbreaking or transformative—Nightingale's approach was innovative and changed how data was used to influence healthcare policy.
While 'revolutionary' can mean related to a revolution or political uprising, in this context it means groundbreaking and transformative. Nightingale's use of statistical graphics was innovative for her time and had a transformative impact—her visual presentation of data directly influenced Parliament to improve military hospital conditions. The passage emphasizes the novelty and effectiveness of her approach, not controversy or political revolt.
TEAS Reading Practice Test #4 2
A nursing journal article states: 'Despite widespread adoption of fall prevention protocols, hospital fall rates have plateaued at approximately 3.5 per 1,000 patient-days.
New research suggests that individualized risk assessments, rather than standardized checklists, may be more effective at reducing falls among high-risk populations.' What is the author's main argument?