Adult Health Chapter 1 Prep U
Which of the following are the major roles of nurses working in institutional, community-oriented, or community-based settings? Select all that apply. Practitioner Leader Researcher Healer Organizer Problem-solver
Practitioner Leader Researcher
A Jewish patient, who adheres to the dietary laws of his faith, is in traction and confined to bed. He needs assistance with his evening meal of chicken, rice, beans, a roll, and a carton of milk. Choose the nursing approach that is most representative of promoting wellness. The nurse: A. Removes items from the over-bed table, sets up the dinner tray, and leaves the patient so he can enjoy time with his family. B. Pushes the over-bed table toward the bed so that it will be within the patient's reach when the dinner tray arrives. C. Asks a family member to assist the patient with the tray and the over-bed table while the nurse straightens the surrounding area in an attempt to provide a pleasant atmosphere for eating. D. Prepares the environment and the over-bed table and inspects the contents of the dinner tray. The nurse asks the patient whether he would like to make any substitutions in the foods and fluids he has received.
Prepares the environment and the over-bed table and inspects the contents of the dinner tray. The nurse asks the patient whether he would like to make any substitutions in the foods and fluids he has received.
According to the American Nurses Association (1995), the advanced practice registered nurse is distinguished from other registered nurses according to scope of practice. Select the activity that would distinguish the advanced practice nurse from other RNs. A. Interprets health care provider orders B. Develops nursing care plans C. Prescribes medications D. Reports abnormal test results
Prescribes medications
According to Maslow, which category of needs represents the most basic on the hierarchy? A. Physiologic needs B. Self-actualization C. Safety and security D. Sense of belonging
Physiologic needs
According to Maslow's hierarchy of needs, which of the following is the lowest-level need? A. Physiological needs B. Safety and security C. Sense of belonging and affection D. Esteem and self-respect
Physiological needs
A client is experiencing anorexia related to the adverse effects of cancer treatment. Using Maslow's hierarchy, the nurse identifies this need as reflecting which of the following? A. Esteem and self-respect B. Safety and security C. Physiology D. Belongingness and affection
Physiology
After teaching nursing students about the health-illness continuum, the instructor determines that teaching was successful when the students state which of the following? A. "A patient's care must be focused on treating the disease." B. "A person can be both healthy and ill at the same time." C. "A patient with a disease typically falls on the far end of the continuum." D. "A patient with a chronic illness is considered ill."
"A person can be both healthy and ill at the same time."
A nurse is describing her role as a home care nurse to students. A student asks, "Why do you need such high-level assessment and clinical decision-making skills in this practice?" Which response by the nurse would be most appropriate? A. "The patients I care for usually are much more acutely ill than most patients seen." B. "No other health care professionals are around to confirm my observations." C. "The patient is usually alone in the home and has no one to support him or her." D. "I need to be very alert for changes in patients because I don't have the usual equipment available."
"No other health care professionals are around to confirm my observations."
A student nurse observes a nurse case manager coordinating discharge for a patient diagnosed with congestive heart failure (CHF). Which statement made by the patient indicates to the student that the patient understands the role of the case manager? A. "The nurse case manager contacted my insurance company and has arranged for the home health nurse and physical therapist to visit me as soon as I get home." B. "The nurse case manager organized my daily nursing care during my hospitalization and arranged for the dietitian to teach me the importance of consuming a diet low in sodium." C. "The nurse case manager worked with my physician to coordinate my admission from his office to the hospital." D. "The nurse case manager arranged to have a wheelchair waiting to take me to my room. I was so short of breath I could not walk very far."
"The nurse case manager contacted my insurance company and has arranged for the home health nurse and physical therapist to visit me as soon as I get home."
Which statement by the nurse shows an understanding of the focus of the quality assurance programs developed in the 1980s? A. "The quality assurance programs focus on individual incidents or errors and minimal expectations." B. "The quality assurance programs focus on decreasing the cost of health care for the consumer." C. "The quality assurance programs focus on processes used to provide care and improving those processes." D. "The quality assurance programs focus on coordinating care for patients."
"The quality assurance programs focus on processes used to provide care and improving those processes."
The nurse informs the administrative assistant that a client is expected to come in for lab work. The administrative assistant inquires about why the nurse refers to the individual as a client. What is the best response by the nurse? A. "We should refer to everyone as a client. They pay for our service." B. "That's how the physician wants us to refer to them." C. "Using the term client implies that they are an active partner in nursing care." D. Using the term client is more respectful that using the term patient.
"Using the term client implies that they are an active partner in nursing care."
The World Health Organization defines health as: A. "a condition of homeostasis and adaptation." B. "reflecting an individual's location along a wellness--illness continuum." C. "a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity." D. "a fluid, ever-changing balance reflected through physical, mental, and social behavior."
"a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity."
A nurse working in an acute care setting volunteers to participate in a research study. The nurse understands that research findings add to the scientific base of nursing practice. Evidence-based practice (EBP) accomplishes which results? Select all that apply. - Improve patient outcomes - Establish best nursing practices - Decrease health care costs - Validate nursing diagnoses - Delineate the health-illness continuum - Provides answers to ethical questions
- Improve patient outcomes - Establish best nursing practices - Decrease health care costs
Using Maslow's hierarchy of needs, place the following problems in their order of priority.
1. Constipation 2. Fear 3. Loneliness 4. Helplessness 5. Failure to achieve potential
Which of the following best reflects the rationale for evidence-based practice? A. A means to ensure quality care B. A process for accreditation C. A method for determining reimbursement D. A way to establish accountability
A means to ensure quality care
What is the primary focus of the nurse advocacy role in managing a clinical pathway? A. Continuity of care B. Cost-containment practices C. Effective utilization of services D. A patient's progress toward desired outcomes
A patient's progress toward desired outcomes
A nurse is using an evidence-based practice tool to plan care for a patient with acute abdominal pain who is admitted to the health care facility. Which tool would the nurse most likely expect to use? A. Care map B. Multidisciplinary action plan C. Clinical guideline D. Algorithm
Algorithm
An 83-year-old female demonstrating early-stage dementia has just had surgical repair to her fractured left hip. No family member is present at the discharge planning conference to discuss the next appropriate actions. Which members of the healthcare team will be instrumental in securing the client's placement in a rehabilitation center? A. Physicians B. Social workers C. Nurses D. All of the responses are correct
All of the responses are correct
Although nurse practice acts may vary state by state, all recognize several basic principles supporting the legal parameters for all registered nurses. Select the activity that falls under the scope of nursing practice. A. Appraising and enhancing an individual's health-seeking perspective B. Changing a patient's health care treatment plan C. Diagnosing pathology based on the patient's response to treatment D. Prescribing a physical therapy program to treat a flare-up of a chronic condition
Appraising and enhancing an individual's health-seeking perspective
Which element would be included as a goal of case management? A. Appropriateness of services B. Prescriptive authority C. Attainment of fixed-price reimbursement D. Utilization of the nursing process
Appropriateness of services
Which of these roles would be considered an expanded nursing role? A. Certified nurse's aide (CNA) B. Certified nurse practitioner (CNP) C. Respiratory therapist D. Social worker
Certified nurse practitioner (CNP)
The American Nurses Association's Code of Ethics provides practice guidelines, based on universal moral principles, for all nurses. Select the statement that reflects the nurse's primary commitment within this framework. The nurse is: A. Committed to the patient, whether an individual, family, group or community, to promote health, safety and individual rights. B. Responsible for enhancing the profession of nursing practice, working within its set parameters. C. Expected to collaborate with other health care professionals. D. Expected to maintain competence and professional development.
Committed to the patient, whether an individual, family, group or community, to promote health, safety and individual rights.
The nurse is providing care for a patient in the hospital scheduled for discharge in the morning. The patient will require further services after discharge since recovery is not complete. What can the nurse do to ensure quality care delivery for this patient? A. Inform the family members that someone will have to stay with the patient after discharge. B. Inform the physician that the patient is not ready to go home yet. C. Contact the case manager for coordination of care prior to discharge of the patient. D. Call social services to check on the patient after discharge.
Contact the case manager for coordination of care prior to discharge of the patient.
What is the first step in becoming culturally competent? A. Exploring one's own cultural beliefs B. Visiting as many cultures as possible C. Maintaining eye contact at all times D. Using touch as a method of maintaining rapport
Exploring one's own cultural beliefs
While interviewing a patient, the nurse notices that the patient is wearing a medallion around his neck. The patient tells the nurse, "It's a medal that everyone in my family wears to protect against cancer." The nurse interprets this statement as most likely reflecting which of the following? A. Culture B. Race C. Religion D. Morality
Culture
Which of the following would least likely impact health care delivery and nursing? A. Growth in the population B. Cultural diversity C. Increased consumer knowledge D. Decline in genetic focus
Decline in genetic focus
To address the needs of a chronically ill patient and promote the concept of wellness, a nursing care plan should outline steps to: A. Inform the patient about all the possible complications of the disease process. B. Encourage positive health characteristics within the limits of the disease. C. Restrict most activities to protect the patient from additional deterioration. D. Encourage activity, beyond the scope of tolerance, to prevent progressive deterioration.
Encourage positive health characteristics within the limits of the disease.
Using the concept of the wellness-illness continuum, what would the nurse include in the development of a nursing care plan for a chronically ill patient? A. Educate the patient about every possible complication associated with the specific illness. B. Encourage positive health characteristics within the limits of the specific illness. C. Limit all activities because of the progressive deterioration associated with all chronic illnesses. D. Recommend activity beyond the scope of tolerance to prevent early deterioration.
Encourage positive health characteristics within the limits of the specific illness.
A nursing instructor is describing to a class the various roles that nurses assume. The instructor determines that teaching has been effective when the students identify which of the following as the focus of the nursing researcher role? A. Achievement of patient outcomes through direct intervention B. Provision of cost-effective, high-quality nursing care C. Establishment of a scientific basis for action D. Promotion of health through screening and early detection
Establishment of a scientific basis for action
Which is not an important reason that nurses utilize research in nursing practice? A. Validation B. Dissemination C. Replication D. Financial obligation
Financial obligation
The nurse is providing a program at the local YMCA about stress-reduction techniques combined with a 1-mile walk around the indoor track once a week. What does this type of program address for the community? A. Health promotion B. Health maintenance C. Illness prevention D. Early detection of illness
Health promotion
The National Center for Health Statistics uses data from healthcare agencies to issue quarterly and annual reports on performance related to goals for improving the health of the U.S. population. Which initiative is targeted with improving the health of all Americans? A. Healthy People 2020 B. The Joint Commission C. Agency for Healthcare Research and Quality D. Quality Indicators
Healthy People 2020
Which is an important role for a nurse in the health care delivery system? A. Balancing work with leisure activities B. Participating in the diagnosis and treatment of disease C. Participating in treatment decisions regarding health restoration D. Identifying patient needs and working with patients to address them
Identifying patient needs and working with patients to address them
The nurse is making a referral to physical therapy for a client who has had a hip replacement and is going to be discharged in 2 days. The nurse understands that physical therapy as part of the client's plan of care includes the client in what discipline? A. Inclusion in the collaborative healthcare team B. A discipline unto themselves C. Inclusion in the administrative team D. Inclusion in the supervisory team
Inclusion in the collaborative healthcare team
The Healthy People 2020 initiative targets the improvement of health for all. In addition to eliminating health disparities, what are the broad goals of this plan? A. Increasing technological innovations B. Preventing treatable problems C. Applying a systematic approach to health improvement D. Increasing the quality and length of a healthy life
Increasing the quality and length of a healthy life
A nurse is working as a member of a quality assurance program. Which of the following would be the focus? A. Clinical processes B. Individual incidents C. Financial processes D. Operational processes
Individual incidents
The nurse educator is planning a teaching session for nursing students related to the treatment and management of gestational diabetes. The nurse educator arranges for a dietitian, pharmacist, and physician assistant to participate in the lesson plan. Which professional nurse competency is the nurse educator demonstrating? A. Interdisciplinary teamwork B. Patient-centered care C. Evidence-based practice D. Quality improvement measures
Interdisciplinary teamwork
A group of students are reviewing various evidence-based practice (EBP) tools used for planning client care. The students demonstrate understanding when they identify which of the following as the most detailed type? A. Care map B. Multidisciplinary action plan C. Clinical guidelines D. Algorithms
Multidisciplinary action plan
A group of nursing students are reviewing the various types of advanced practice nurses. The students demonstrate the need for additional review when they identify which of the following as an advanced practice nurse? A. Certified nurse midwife B. Nurse practitioner C. Clinical nurse specialist D. Nurse manager
Nurse manager
Which of the following would NOT be categorized as a mid-level practitioner? A. Nurse midwives B. Nurse practitioners C. Nursing assistants D. Certified registered nurse anesthetists
Nursing assistants
Students are reviewing information about community health nursing. The students demonstrate understanding of the term "community-oriented nursing practice" by describing it as which of the following? A. Nursing interventions that can promote wellness, reduce illness spread, and improve the health status of groups B. Nursing care directed to specific client groups with identified needs, usually related to illness C. Provision of primary care services, often with care being provided to underserved populations D. Nursing care of clients with complex needs who are discharged from acute care institutions early in the recovery process
Nursing interventions that can promote wellness, reduce illness spread, and improve the health status of groups
A nurse, working in a health clinic, treats a variety of conditions on a daily basis. One disorder that is rapidly increasing and is the leading cause of secondary morbidity is: A. Kidney disease B. Coronary heart disease C. Obesity D. Pneumonia
Obesity
A nurse is preparing a presentation for a local community group addressing the influences on health care delivery. Which of the following would the nurse include in presentation when describing disease patterns? A. Most infectious diseases have been controlled or eradicated. B. The prevalence of chronic illness is decreasing due to the emphasis on healthy living. C. Obesity along with conditions associated with it has become a major health concern. D. People with acute illnesses are considered the largest group of health care consumers.
Obesity along with conditions associated with it has become a major health concern.
A nursing student is preparing for a class presentation addressing the collaborative practice model. Which of the following would the student expect to include? A. A discussion of a centralized organizational structure B. Participation in decision making that is shared by all involved C. Accountability that is primarily attributed to the patient D. Nurses and physicians playing major roles in clinical decisions
Participation in decision making that is shared by all involved
A 54-year-old client on a fixed income has had an electrocardiogram (ECG) as part of an annual physical examination. The physician notes an abnormal Q wave on an otherwise unremarkable ECG. What legislation supports the focus on chronic disease prevention, health promotion, and quality, affordable health care for everyone? A. Patient Protection and Affordable Care Act B. Building a Safer Health System Act C. A New Health System for the 21st Century Bill D. Healthcare Research and Quality Improvement Bill
Patient Protection and Affordable Care Act
Nursing students are reviewing the roles that a nurse may assume. The students demonstrate understanding of the information when they identify which of the following as characteristic of the research role? A. Achieving patient outcomes through direct intervention B. Assuming responsibility for unlicensed assistive personnel C. Replicating findings to further the science of nursing D. Promoting health through screening and early detection
Replicating findings to further the science of nursing
Which of the following delineates actions that are legally permitted for a particular profession based on specific educational qualifications A. Scope of practice B. Job description C. Code of ethics D Occupational Health and Safety Administration (OSHA)
Scope of practice
According to Maslow's hierarchy of human needs, which of the following is the highest level of need? A. Safety and security B. Physiological C. Self-actualization D. Sense of belonging
Self-actualization
When applying Maslow's hierarchy of needs to patient care, the nurse determines that the patient has reached the ultimate goal indicating integrated human functioning and health when which level is met? A. Safety and security B. Belongingness and affection C. Esteem and self-respect D. Self-actualization
Self-actualization
The nurse is working at an institution that uses a collaborative practice model. Which of the following would most likely be reflected at this institution? A. Centralized organizational structure B. Physician as the primary decision-maker C. Isolated participation from the patient D. Shared accountability for care
Shared accountability for care
An acute care nurse practitioner planning care for a client with rheumatoid arthritis reviews treatment guidelines developed by the American Nurses' Association (ANA). Which ANA document is the nurse accessing? A. Standards of Professional Performance B. Code of Ethics C. Nursing's Standards of Practice D. Social Policy Statement
Standards of Professional Performance
Which tool is often used by case managers? A. Service cost measurement B. Bottom line C. Outcome criteria D. Standards of care
Standards of care
A local college is having a career-day seminar for student nurses. Booths from various agencies and facilities have been set up. One of the students approaches the booth of a home care agency and asks the nurse there about what is required to become a home care nurse. Which of the following would the nurse incorporate into the response? A. Need for at least a master's degree in nursing B. Specialization in a specific area of practice C. Strong clinical decision-making skills D. Expert case management abilities
Strong clinical decision-making skills
A client has been admitted in the emergency care unit with conditions of respiratory distress and pneumonia. The client's condition worsens and requires mechanical ventilation. While visiting this client in the hospital, the family observes members of the health care team washing their hands upon entering and leaving the room. By implementing recommended hand hygiene measures, which organization's goals is the health care team supporting? A. The Joint Commission B. The National Council of State Boards of Nursing (NCSBN) C. Institute of Medicine (IOM) D. Agency for Healthcare Research and Quality (AHRQ)
The Joint Commission
Which statement is true regarding population demographics? A. Homelessness is decreasing. B. The culturally diverse population is increasing. C. The birth rate is increasing. D. Life spans are decreasing.
The culturally diverse population is increasing.
What is the primary basis for growth in home care nursing? A. Recent changes in healthcare legislation B. The growth of complementary and alternative medicine C. The aging of the population D. The discharge of patients who are more critically ill
The discharge of patients who are more critically ill
Changes in population demographics over the next 40 years will significantly affect the delivery of health care services. Select the one change that will have the most impact on the practice of nursing. A. Immigration patterns will result in a more diverse population. It is projected that, by 2030, more than 20% of Americans will be immigrants. B. Hispanics will become the largest minority group in the United States, constituting about 29% of the population. C. The non-Hispanic, white population will reach 47%. D. The number of adults over age 65 will double in size.
The number of adults over age 65 will double in size
Future healthcare policy in the United States will be significantly affected by a population that is: A. aging and becoming more culturally diverse. B. becoming skeptical about conventional medicine's reliance on pharmaceuticals and surgery. C. becoming more knowledgeable about nutrition and more likely to undertake dietary changes. D. aging and includes a higher percentage of people with addictions.
aging and becoming more culturally diverse.
A nurse is a member of which entity within the larger healthcare environment? A. healthcare team B. healthcare delivery system C. health maintenance organization D. physician hospital organization
healthcare team
Which strategy would a nurse likely discuss with a client as part of health promotion? A. making positive dietary changes B. evaluating the merits of various diagnostic procedures C. locating a therapist for a child with emotional problems D. determining how often blood glucose levels should be monitored at home
making positive dietary changes