Chapter 1: Introduction to Nursing

The nurse preparing a lecture on the history of nursing should include which international organization as the first for professional nurses? International Council of Nurses National League for Nursing Sigma Theta Tau International American Nurses Association

International Council of Nurses Rationale: The first international organization for professional nurses was the International Council of Nurses. American Nurses Association and National League for Nursing are U.S. nursing organizations. Sigma Theta Tau International is the international nursing honor society.

The nurse understands that for nursing to be considered a profession, many things need to be in place. Which element is not part of those considerations? Well-defined body of knowledge Strong service orientation Code of ethics Ongoing research Multidisciplinary approach

Multidisciplinary approach Rationale: Having a well-defined body of knowledge, strong service orientation, a code of ethics, ongoing research, a professional organization that sets standards, autonomy and self regulation, and recognized authority by a professional group are all criteria for a profession. Having a multidisciplinary approach is not a criteria of a profession.

Which is the best example of a nurse demonstrating the role of caregiver? starting an intravenous line in the client's arm referring the client to a mental health clinic assigning a room for a new hospital client reporting lab values to a client's physician

starting an intravenous line in the client's arm Rationale: In the role of caregiver, the nurse provides care to clients to meet their needs, such as when starting an intravenous line. The role of caregiver is the primary role of the nurse. Teaching a client about medication is the role of educator. Telling a doctor a lab value is the role of communicator. Securing a referral to the local clinic is the role of counselor. Assigning rooms is a management role.

Which individual provided community-based care and founded public health nursing? Mary Adelaide Nutting Lillian Wald Sojourner Truth Clara Barton

Lillian Wald Rationale: Lillian Wald established a neighborhood nursing service for the sick and poor in New York City and is considered the founder of public health nursing. The other women were important to the development of nursing, but not to public health nursing. Nutting helped to found a modern nursing program at the school. Sojourner Truth was an African-American abolitionist and women's rights activist who was a nurse. Clarissa "Clara" Harlowe Barton was a pioneering nurse who founded the American Red Cross.

A nurse is considering relocating to another state to practice nursing. Which is the most appropriate action by the nurse to ensure ability to practice in the new state? asking the current state to transfer the license applying for a reciprocal license in the new state taking the new state's licensing exam No action is needed by the nurse.

applying for a reciprocal license in the new state Rationale: Nurses gain legal rights to practice nursing in another state by applying to that state's board of nursing and receiving reciprocal licensure. The nurse does not need to retake the licensure exam. The nursing licenses are not transferable.

Which organization has established standards that help the nurse determine which clinical actions fall under the scope of nursing practice? American Nurses Association National League for Nursing International Council of Nurses National Council of State Boards of Nursing

American Nurses Association Rationale: The American Nurses Association (ANA) has established standards of clinical nursing practice that define the specific and unique activities of nurses. Standards serve as protection for the nurse, the client, and the institution where health care is given. The other organizations provide valuable services that differ from those of ANA. The National Council of State Boards of Nursing have the nurse practice acts which define state specific guidelines for nurses to practice. The National League for Nursing is a national organization for faculty nurses and leaders in nurse education. The International Council of Nurses is a federation of more than 130 national nurses associations.

For the nurse become a nurse practitioner, what is the minimal degree the nurse will need to acquire? Diploma Associate's Master's Baccalaureate

Master's Rationale: A master's degree is the minimal degree for a nurse to become a nurse practitioner. Diploma, associate, and baccalaureate degrees are the minimal degree for an RN.

In what time period did nursing care as we now know it begin? pre-civilization early civilization to 16th century 16th to 17th century 18th to 19th century

18th to 19th century Rationale: From the middle of the 18th century to the 19th century, social reforms changed the roles of nurses and of women in general. It was during this time that nursing as we now know it began, based on the beliefs of Florence Nightingale.

Florence Nightingale was a nursing pioneer who challenged prejudices against women and elevated the status of all nurses. Which statement accurately describes one of her accomplishments? She established the fact that nursing is the same as medicine. She promoted the addition of nursing education as part of a medical degree. She established the tenets of the American Red Cross. She promoted the publication of books about nursing and health care.

She promoted the publication of books about nursing and health care. Rationale: Florence Nightingale elevated the status of nursing to a respected occupation, improved the quality of nursing care, and founded modern nursing education. She promoted the publication of books about nursing education and health care. Her belief regarding nursing was that it was separate and distinct from the practice of medicine. She did not believe that nursing education should be a part of a medical degree. Clara Barton established the American Red Cross in 1882.

The need for university-based nursing education programs was brought to light during which important historical time? Spanish-American War World War I World War II Korean War

World War II Rationale: During the middle of the twentieth century, Esther Lucile Brown, in her report on nursing education published at that time, wrote that nursing education belonged in colleges and universities, not in hospitals. During the Spanish-American War, nursing was still in its earliest phase of development. Even with the input of Florence Nightingale and her followers after WWI, nursing continued to struggle. Professional nursing began during the period and crisis needs of WWII. Nursing continues to evolve today.

The nurse is caring for a postoperative client, and administers a pain medication prescribed on a PRN basis by the health care provider. What best describes the type of intervention the nurse is demonstrating? dependent intervention collaborative intervention client advocacy intervention nurse-prescribed intervention

collaborative intervention Rationale: The administration of a PRN medication requires a health care provider-prescribed intervention (the medication prescription) as well as a nurse-prescribed intervention (determining when the prescription should be carried out and proper administration of the medication); therefore, this action would be considered a collaborative intervention. Nurse-initiated interventions, such as turning and repositioning a client, are described as nurse-prescribed interventions. Health care provider-directed actions are described as health care provider-prescribed interventions. Client advocacy refers to communicating the needs and protecting the needs of the client. Interventions are not normally categorized as being independent or dependent.

The nurse is caring for a client who ascribes to the theory of animism. When attempting to explain this theory to other staff members, the nurse should state: "Everything in nature is alive with invisible forces." "The physician is viewed as a god-like figure." "The nurse is the handmaiden of the physician." "Pets can help heal clients."

"Everything in nature is alive with invisible forces." Rationale: The theory of animism attempts to explain the cause of mysterious changes in bodily functions. This theory is based on the belief that everything in nature is alive with invisible forces and endowed with power. Good spirits bring health; evil spirits bring sickness and death. In cultures that ascribe to animism, the roles of the physician and the nurse are separate and distinct. The physician is the medicine man who treats disease by chanting, inspiring fear, or opening the skull to release evil spirits (Dolan, Fitzpatrick, & Herrmann, 1983). The nurse usually is the mother who cares for her family during sickness by providing physical care and herbal remedies. Pets are not involved in the theory of animism.

The nurse is evaluating client health. Which client should the nurse determine to be exhibiting the most signs of health? A client with diabetes who is in denial of the diabetes and refuses to take insulin A client in acute emotional distress due to spouse's death A client with a leg amputation who performs activities of daily living with a prosthesis A client with depression who refuses to get out of bed

A client with a leg amputation who performs activities of daily living with a prosthesis Rationale: As defined by the World Health Organization, one's health includes physical, social, and mental components and is not merely the absence of disease or infirmity. Health is often a subjective state—a person may be medically diagnosed with an illness, but still consider himself or herself healthy. The client with an amputation is performing activities of daily living, thereby demonstrating healthy behaviors. A client with diabetes who is refusing to take insulin is in denial of the illness. A client in acute emotional distress related to the spouse's death is experiencing a normal pattern but not demonstrating a healthy behavior. A client with depression who will not get out of bed is also experiencing denial as opposed to a healthy behavior and coping.

Based on its jurisdiction, which actions may a state licensing board of nursing take? Select all that apply. Allow graduates of approved schools of nursing to take the NCLEX Authorize nurses to practice nursing in any state License nurses during the lifetime of the holder Deny licensing due to criminal actions Protect nurses from being suspended for professional misconduct Issue special licenses to nurses practicing in long-term care facilities as a priority

Allow graduates of approved schools of nursing to take the NCLEX License nurses during the lifetime of the holder Deny licensing due to criminal actions Rationale: The jurisdiction of a state licensing board of nursing typically enables it to: allow only graduates of approved schools of nursing to take the NCLEX exam, license nurses during the lifetime of the holder of the license, and deny licensing due to criminal actions. A state licensing board may not authorize nurses to practice nursing in any state other than the state of the board. A state licensing board also may not protect nurses from being suspended for professional misconduct nor issue special licenses to nurses practicing in long-term care facilities as a priority.

Which scenario is the best example of a nurse implementing care according to the ANA standards of practice? Providing nutrition teaching to a client with diabetes Analyzing a client's blood glucose levels Taking a client's apical and radial pulse rates Determining that a client is at risk for falls

Providing nutrition teaching to a client with diabetes Rationale: According to the ANA standards of practice, standard 5 is implementation. This is when the registered nurse implements the identified plan, coordinates care delivery, and employs strategies to promote health and a safe environment. When providing nutrition education to a client with diabetes, the nurse is implementing the teaching plan. When the nurse is analyzing a client's blood glucose level or taking a pulse rate, the nurse is performing the standard related to assessment. When the nurse is determining that a client is at risk for falls, the nurse is implementing the standard relating to diagnosis.

Which is the best example of a client-centered approach to care? The nurse helps a client ambulate. The nurse asks the client about health goals. The nurse asks the client what the client would like to order from the menu. The nurse draws a blood sample from a client.

The nurse asks the client about health goals. Rationale: Client-centered care is one of the quality and safety education requirements for nursing competencies (QSEN). The intent of client-centered care is to ensure that care is centered on the client, and not the needs of the nurse. An example of this is the nurse asking the client about personal health goals so that they can be addressed on the client's plan of care. Helping the client ambulate, asking the client what he or she would like from the menu, and drawing a blood sample are examples of client care, but are not client-centered care.

A school nurse is preparing an information session for a group of high school seniors which will provide them with basic information concerning choosing a nursing program. Which factor(s) should the school nurse point out in the presentation? Select all that apply. What are my main goals? How much will this cost me? Can I choose between part-time and full-time classes? Does the program guarantee employment after graduation? How many graduates are still in the field 1 year later? 5 years later? 10 years later?

What are my main goals? How much will this cost me? Can I choose between part-time and full-time classes? How many graduates are still in the field 1 year later? 5 years later? 10 years later? Rationale: Factors which can influence the choices of a nursing program include: career goals, geographic location of schools; costs involved, length of program, reputation and success of graduates, flexibility in course scheduling, opportunity for part-time versus full-time employment, and ease of movement into the next level of education. Guarantee of employment is not a factor.

The nurse is caring for a postoperative client. The health care provider has written a prescription for a pain medication, and the prescription gives a dosage range for the amount the nurse may give depending on the severity of the client's pain. This type of functioning within the health care team is called: authoritative functioning. independent functioning. assistive functioning. collaborative functioning.

collaborative functioning. Rationale: Nurses manage collaborative problems using both nurse- and health care provider-prescribed interventions to reduce the risk of complications. In this situation, the nurse is not operating authoritatively or independently, but within the parameters established by the health care provider. The nurse is not merely acting in an assistive capacity, as the nurse is performing interventions in the absence of the health care provider.

A nurse educator is discussing the criteria that define nursing as a profession. Which nursing actions are based on these criteria? Select all that apply. A nurse uses diagnosis, interventions and evaluation to plan nursing care for clients. A nurse performs actions based on the standards of performance determined by the medical community. A nurse follows an established code of ethics when performing actions for clients who are in hospice. A nurse is committed to using ongoing research when planning nursing care for clients. A nurse graduate applies for membership in the American Nurses Association.

A nurse uses diagnosis, interventions and evaluation to plan nursing care for clients. A nurse follows an established code of ethics when performing actions for clients who are in hospice. A nurse is committed to using ongoing research when planning nursing care for clients. Rationale: Nursing actions that would define nursing as a profession would include using diagnosis, interventions, and evaluation to plan nursing care, following an established code of ethics when caring for clients, and using research when planning nursing care for clients. Another nursing action that would define nursing as a profession would be independently choosing nursing intervention for a client. Examples would not include performing action based on standards established by the medical community or applying for membership in the American Nurses Association.

After hearing a presentation about the American Nurses Association (ANA), a nurse decides to join the organization based on the understanding that: membership is open to all nurses in the United States. ANA aims at fostering high standards of nursing in the United States. members include nurses, other health care providers, and lay people. ANA invites students showing excellence in scholarship to become members.

ANA aims at fostering high standards of nursing in the United States. Rationale: ANA aims at fostering high standards of nursing in the United States. Membership is not open to all nurses in the United States; only registered nurses can become members. Members of the National League for Nursing, not the ANA, include nurses, other health care providers, and lay people. Sigma Theta Tau, not ANA, invites students showing excellence in scholarship to become members.

The new nursing graduate is concerned about some of the critical changes that will be occurring in nursing. What changes does the nurse anticipate will impact nursing care? Difficulty for nurses to remain current in a rapidly changing medical and technology environment Rapid growth of nurses and shortage of job opportunities Decrease in health care costs Limitations that nurses have in the workforce

Difficulty for nurses to remain current in a rapidly changing medical and technology environment Rationale: The National Advisory Council on Nurse Education and Practice (NACNEP) identifies critical challenges to nursing practice in the 21st century: a growing population of hospitalized clients who are older and more acutely ill, increasing health care costs, and the need to stay current with rapid advances in medical knowledge and technology. Nursing is limitless and, with opportunities for furthering education, there are many various ways nurses can practice. Health costs are rising and there are more citizens needing health care. There is a projected nursing shortage that may be severe and there are no shortages of jobs for nurses.

Which nursing actions are characteristic of the nurse's role as communicator? Assessing, implementing, and evaluating individual teaching plans to meet learning needs Establishing and maintaining helping relationships with clients of all ages in a variety of settings Facilitating clients' problem-solving and decision-making skills Effecting change within a group

Establishing and maintaining helping relationships with clients of all ages in a variety of settings Rationale: The nurse acting in the role of communicator uses effective interpersonal and therapeutic communication skills to establish and maintain helping relationships with clients of all ages in a wide variety of health care settings. The nurse in the role of the teacher/educator uses communication skills to assess learning needs, implement, and evaluate individualized teaching plans to meet those learning needs of patients and their families. The nurse in the role of counselor uses therapeutic interpersonal communication skills to provide information, make appropriate referrals, and facilitate the patient's problem-solving and decision-making skills. The nurse in the role of leader is assertive and self-confident in the practice of nursing when providing care, effecting change, and functioning with groups.

Which standards are monitored by the Quality and Safety Education for Nurses (QSEN)? Select all that apply. Evidence-based practice Client-centered care Informatics Quality improvement Nursing certification

Evidence-based practice Client-centered care Informatics Quality improvement Rationale: The Quality and Safety Education for Nurses (QSEN, 2014) initiative has identified key quality and safety competencies for nurses: client-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. These competencies support the responsibilities defined previously. Providing care focused on clients requires the nurse to balance client advocacy with safety. Effective management and coordination of care requires teamwork and collaboration. Evidence-based practice leads to safe and effective care. Nurses must continually evaluate and improve the quality of care. Competence in informatics allows nurses to use the latest technology in the provision, documentation, and evaluation of care. Nurses who achieve these competencies are able to improve the quality and safety of client care wherever they work. Nursing certification is not supported by QSEN.

A client is distraught because a recent computed tomography (CT) scan shows that the client's colon cancer has metastasized to the lungs. Which nursing aim should the nurse prioritize in the immediate care of this client? Facilitating coping Preventing illness Restoring health Promoting health

Facilitating coping Rationale: This client's care in the coming weeks or months will likely encompass all of the four foundational roles of the nurse. However, because the client has just recently received bad news and is emotionally distraught, helping the client cope is an appropriate priority in immediate care. Preventing illness is focused on preventing an infection or disease from occurring such as through immunizations, hand hygiene, exercising and diet. Restoring health would more appropriately occur after the client has accepted the disease and would involve taking medication and working to get back to baseline with the disease. Health promotion is the process of enabling people to increase control over, and to improve, their health.

Which is a characteristic of nursing practiced from early civilization to the 16th century? Most early civilizations believed that illness had supernatural causes. The physician was the priest who treated disease with prayer. The nurse was a nun committed to caring for the needy and homeless. Nursing changed from a spiritual focus to an emphasis on knowledge expansion.

Most early civilizations believed that illness had supernatural causes. Rationale: Most early civilizations believed that illness had supernatural causes. The physician was the medicine man who treated disease by chanting, inspiring fear, or opening the skull to release evil spirits (Dolan, Fitzpatrick, & Herrmann, 1983). The nurse usually was the mother who cared for her family during sickness by providing physical care and herbal remedies. As civilizations grew, temples became the centers of medical care because of the belief that illness was caused by sin and the gods' displeasure.

The American Nurses Association (ANA) Standards of Professional Nursing Practice provides standard of care for all nurses. Which statement on the assessment of the nursing process is accurate? The nurse collects comprehensive data pertinent to the client's health or situation. The nurse dictates the plan that prescribes strategies of care. The nurse monitors the ethical conduct of authorities and clients. The nurse evaluates progress toward implemented actions.

The nurse collects comprehensive data pertinent to the client's health or situation. Rationale: The nursing process is used for all nurses as the standard of care. In the assessment phase, the RN collects comprehensive data pertinent to the client's health or situation. In the diagnosis phase, the RN analyzes the assessment data to determine the diagnoses or issues pertinent to the client. Next the RN identifies expected outcomes for a plan individualized to the client or the situation and develops a plan that prescribes strategies and alternatives to attain expected outcomes. The nurse does not dictate the plan. The RN implements the identified plan. This includes coordination of care, health teaching and health promotion, consultation, and prescriptive authority and treatment. Finally, in the evaluation phase, the RN evaluates progress toward attainment of outcomes. From the ethical standpoint, the nurse advocates for the client and makes sure that ethical standards are upheld, but this is not part of the nursing process.

The nurse is caring for a client after a stroke rendered the client's right side weaker than the left. The nurse coordinates the plan of care with the physical therapist. The nurse's interventions reflect which one of nursing's four broad goals? To restore health To prevent illness To promote health To facilitate coping

To restore health Rationale: The four broad aims of nursing practice are to promote health, prevent illness, restore health, and facilitate coping with death and/or disability. In the example, the nurse is coordinating care with the other disciplines in an attempt regain some of the strength in the client's right side. This is an example of restoring a client's health. The nurse is not preventing the stroke or promoting health prior to the stroke. The nurse is not facilitating coping with the stroke.

The primary aim of the Healthy People 2020 initiative is: health promotion. illness prevention. health restoration. coping with disability

health promotion. Rationale: Healthy People 2020 establishes health promotion guidelines for the nation as a whole. The guidelines contain Leading Health Indicators, which are used to measure the health of the nation over a 10-year period. Illness prevention, health restoration, and coping with disability are components of the Healthy People 2030 guidelines, but are not considered as the primary goal of the initiative.

A prospective nursing student desires a career that will allow the opportunity to provide client care and to assist professional nurses with routine technical procedures. The prospective student needs to be employed in a full-time position quickly due to economic hardship. What type of nursing program would best suit this student? associate of science registered nursing program baccalaureate of science registered nursing program licensed or vocational nursing program diploma nursing program

licensed or vocational nursing program Rationale: A licensed practical or vocational nursing program will allow the student to earn a technical certificate in 1 year and sit for the state board of nursing examination to be licensed as an LPN or LVN. This would allow employment that will allow the graduate to provide client care and to assist professional nurses with routine technical procedures as desired. An associate program will take 2 years and a baccalaureate program will take 4 years; additionally these prepare new nurses to work in a more independent role than this person is seeking. There are very few diploma programs remaining in the U.S., and these programs typically take 3 years to complete.

In the role of entrepreneur, the nurse's primary responsibility is: managing a health-related business. administering resources. managing personnel involved in client care. teaching in a clinical setting.

managing a health-related business. Rationale: A nurse entrepreneur is primarily concerned with organizing, developing, and managing a clinic or health-related business. Although a nurse entrepreneur may also administer resources, manage personnel, and teach, the primary responsibility of this role is managing a health-related business. A nurse administrator is primarily concerned with administering resources and managing personnel. A nurse educator is primarily concerned with teaching in a clinical setting.