SIXTH EDITION - JULY 2012

CGFNS Qualifying Exam

THE OFFICIAL

Study Guide Preparation for the CGFNS Qualifying Exam® and the NCLEX-RN® examination.

SIXTH EDITION - JULY 2012

®

iThe Official Study Guide for the CGFNS Qualifying Exam® Notice to the reader CGFNS International, Inc. (CGFNS) has designed the information in this study guide to test nursing knowledge and to provide the opportunity to gain English language proficiency. This information is not designed to form the basis of the reader’s nursing practice or patient care recommendations.The CGFNS Official Study Guide for the CGFNS Qualifying Exam® is not a substitute for basic education or an in-depth review of nursing textbooks. It does not guarantee success on the CGFNS Qualifying Exam for any of the CGFNS programs nor on the U. S. licensure exam, the National Council Licensure Exam for Registered Nurses (NCLEX–RN® examination).

Publisher: CGFNS International, Inc.

Content Editor: Catherine R. Davis, PhD, RN

Content Assistant: Monique D. Rawls, RT (R)(T)

Contributors: Linda Burnes, MSN, RN, Professor, Delaware County Community College School of Nursing, Media, Pennsylvania; Carol Carofigilio, MSN, RN, Nursing Faculty, Helen Fuld School of Nursing at Camden County, Blackwood, New Jersey; Susan Burrows-Clark, MSN, RN, CNS, C, Nursing Faculty, Helen Fuld School of Nursing at Camden County, Blackwood, New Jersey; Normajean Colby, MSN, RN, CPN, Professor, Widener University School of Nursing, Chester, Pennsylvania; Barbara Ferris, RN, BSN, C, Administrative Shift Coordinator, Underwood Memorial Hospital, Woodbury, New Jersey; Carol Hanna, DNSc, RN, Assistant Professor, Delaware County Community College, Media, Pennsylvania; Nancy Sharts-Hopko, PhD, RN, FAAN, Nursing Faculty, College of Nursing at Villanova University, Villanova, Pennsylvania; Rochell Kuhn, MS, CRNP, Instructor, Episcopal Hospital, Philadelphia, Pennsylvania; Susan M. Landon, MSN, RN, Instructor, Episcopal Hospital, Philadelphia, Pennsylvania; Karen Montalto, DNSc, RN, Nursing Faculty, Helen Fuld School of Nursing at Camden County, Blackwood, New Jersey; Kathleen Mulcahey, MSN, RN, CNAA, Adjunct Faculty, Helen Fuld School of Nursing at Camden County, Blackwood, New Jersey; Elizabeth W. O’Brien, MSN, RN, Helen Fuld School of Nursing at Camden County, Blackwood, New Jersey; Sandra Opfer, MSN, RN, Coordinator of Patient Care Services/Mental Health, Underwood Memorial Hospital, Woodbury, New Jersey; Patricia Price, MSN, RN, Nursing Faculty, Helen Fuld School of Nursing at Camden County, Blackwood, New Jersey; Catherine Staines, MSN, RN, C, Nursing Faculty, Helen Fuld School of Nursing at Camden County, Blackwood, New Jersey; Doris Vallone, PhD, RN, Assistant Professor, Widener University School of Nursing, Chester, Pennsylvania For further information, contact: Business Development, Planning and Marketing Department, CGFNS International Inc., 3600 Market Street, Suite 400, Philadelphia, PA 19104–2651 USA.

Web site: www.cgfns.org

Copyright © 2011 by CGFNS International, Inc. All rights reserved. Certain portions of this work © 1986, 1990, 1995, 2000, 2003 and 2011.No part of this work covered by the copyright hereon may be reproduced or used in any form or by any means — graphic, electronic or mechanical, including photocopying, recording, taping or information storage and retrieval systems — without written permission from the publisher.CGFNS International, Inc., CGFNS, the CGFNS logo and the CGFNS Qualifying Exam are registered trademarks of CGFNS International, Inc.Library of Congress Catalogue Card Number 95-067493 ISBN Number 0-9630592-2-X First Edition printed in the United States of America, 1986. Second Printing, 1987. Third Printing, 1989.Second Edition printed in the United States of America, 1990. Second Printing, 1991. Third Printing, 1993.Third Edition printed in the United States of America, 1995. Second Printing, 1998. Third Printing, 1998. Fourth Printing, 1999.Fourth Edition printed in the United States of America, 2000. Second Printing, 2001. Third Printing, 2002.Fifth Edition printed in the United States of America, 2003. Second Printing 2004. Third Printing 2005. Fourth Printing 2006.Sixth Edition published in the United States of America, 2011, Second Publishing 2012.Additional copies of this study guide may be purchased online at https://www.cgfns.org/cerpassweb/login.jsp

iiThe Official Study Guide for the CGFNS Qualifying Exam® Table of contents Foreword: About CGFNS International® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .I Establishment of CGFNS International . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .I Our mission. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I The CGFNS Certification Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .I Other CGFNS services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .I VisaScreen®: Visa Credentials Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .II International Standards for Professional Nurses® Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II Credentials Evaluation Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .II Credential Verification Service for New York State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .II International Consultants of Delaware . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .II General information about CGFNS International . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .II Chapter 1: Earning a certificate from CGFNS International . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .1.1 Earning your CGFNS (Certification Program) certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.1 Earning your VisaScreen certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .1.1 Study Guide Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .1.2 For more help preparing for the CGFNS Qualifying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.2 Chapter 2: Applying for the CGFNS Qualifying Exam® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .2.1 How CGFNS International determines your eligibility for the exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.1 Are you a first-level, general nurse? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .2.1 Do you meet the educational requirements? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.1 Do you have appropriate licensure/registration documents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.1 Application procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .2.1 Chapter 3: About the CGFNS Qualifying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .3.1 Registered nurse (RN) licensure in the United States and the NCLEX-RN® examination . . . . . . . . . . . . . . . . . . . . . . . . .3.1 Overview of the content of the CGFNS Qualifying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.1 Format of the CGFNS Qualifying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .3.1 Internet-based administration of the CGFNS Qualifying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.2 CGFNS Qualifying Exam schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .3.2 CGFNS Qualifying Exam scoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .3.2 CGFNS Qualifying Exam results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .3.2 Validity of the CGFNS Qualifying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .3.2 Chapter 4: Design of the CGFNS Qualifying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .4.1 Factors influencing the registered nurse’s role in the U.S. health care system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.1 Shortened stays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .4.1 Efficiency in staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .4.1 Advanced practice nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .4.1 Expanded home health and community services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.1 Advanced technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .4.1 Human rights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .4.1 Malpractice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .4.2 The Foundation of the CGFNS Qualifying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .4.2 The CGFNS Qualifying Exam structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .4.2 Client needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .4.2 Client need category 1: Safe, Effective Care Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.3 Client need category 2: Health Promotion and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.3 Client need category 3: Psychosocial Integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.4 Client need category 4: Physiological Integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.5 Summary of client needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .4.6

iiiThe Official Study Guide for the CGFNS Qualifying Exam® Integrated content areas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .4.6 The five phases of the nursing process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .4.6 Step 1: Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .4.7 Step 2: Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .4.7 Step 3: Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .4.8 Step 4: Implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .4.9 Step 5: Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .4.9 Summary of the nursing process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .4.10 The CGFNS Qualifying Exam reflects nursing education in the United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.10 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .4.11 Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .4.11 Chapter 5: Suggested study resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .5.1 Adult Health Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .5.1 Community Health Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .5.1 Fundamentals Of Nursing, Nursing Diagnosis and Nursing Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.1 Nutrition and Diet Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .5.2 Maternal-Infant Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .5.2 Nursing Of Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .5.2 Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .5.2 Psychiatric/Mental Health Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .5.2 Chapter 6: CGFNS International practice test instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .6.1 General description of the CGFNS Qualifying Exam® questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6.1 Suggestions on how to answer exam questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6.1 CGFNS International practice test instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1 Chapter 7: CGFNS practice test questions and rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .7.1 Practice test questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .7.1 Practice test rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .7.8 Appendix A: Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A.1 Table of contents