Chapter 1 - PrepU - The Nurse's Role in Adult Health Nursing

Which of the following would be categorized as a mid-level practitioner? 1- Nurse midwives 2- Nursing assistants 3- Registered nurse 3- Licensed practical nurse

1

Nursing students are reviewing information about expanded nursing roles. They demonstrate understanding of the information when they identify which of the following as roles of an advanced practice nurse? Select all that apply. 1- Certified nurse-midwife 2- Certified critical care nurse 3- Nurse practitioner 4- Clinical nurse specialist 5- Certified registered nurse anesthetist 6- Certified medical-surgical nurse

1,3,4,5

The models of nursing care delivery have been numerous and varied throughout the history of nursing. What is a model for the delivery of nursing care in today's health care arena? 1- Team nursing 2- Patient-centered care 3- Primary nursing 4- Functional nursing

2

The nurse working in the clinic has had several incidences of positive chlamydia cultures return in women with pelvic pain. The nurse understands that early diagnosis and treatment are essential measures in which to reduce contagion and limit the complications related to this infection. What type of prevention will the nurse use when these infections are treated? 1- Primary prevention 2- Secondary prevention 3- Tertiary prevention 4- Prevalence

2

According to Maslow's hierarchy of human needs, which of the following is the highest level of need(s)? 1- Safety and security 2- Physiological needs 3- Self-actualization 4- Sense of belonging

3

Which of the following would least likely impact health care delivery and nursing? 1- Growth in the population 2- Cultural diversity 3- Increased consumer knowledge 4- Decline in genetic focus

4

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? 1- Nursing interventions that can promote wellness, reduce illness spread, and improve the health status of groups 2- Nursing care directed to specific client groups with identified needs, usually related to illness 3- Provision of primary care services, often with care being provided to underserved populations 4- Nursing care of clients with complex needs who are discharged from acute care institutions early in the recovery process

1

Future healthcare policy in the United States will be significanly affected by a population that is: 1- aging and becoming more culturally diverse. 2- becoming skeptical about conventional medicine's reliance on pharmaceuticals and surgery. 3- becoming more knowledgeable about nutrition and more likely to undertake dietary changes. 4- aging and includes a higher percentage of people with addictions.

1

Quality Assurance (QA) focuses on which of the following? 1- Individual incidents or errors and minimal expectations 2- Processes used to provide care 3- Analyzation of operational processes 4- Improvement in financial processes

1

A nursing student is preparing for a class presentation addressing the collaborative practice model. Which of the following would the student expect to include? 1- A discussion of a centralized organizational structure 2- Participation in decision making that is shared by all involved 3- Accountability that is primarily attributed to the patient 4- Nurses and physicians playing major roles in clinical decsions

2

A registered nurse is providing care to several clients on the unit. Which task would be appropriate for the nurse to delegate to a nursing assistant? 1- administering an opioid pain medication 2- obtaining a client's vital signs 3- assessing a client's leg wound 4- inserting an intravenous catheter device

2

After teaching nursing students about the health-illness continuum, the instructor determines that teaching was successful when the students state which of the following? 1- "A patient's care must be focused on treating the disease." 2- "A person can be both healthy and ill at the same time." 3- "A patient with a disease typically falls on the far end of the continuum." 4- "A patient with a chronic illness is considered ill."

2

An example of a dependent nursing action is: 1- Auscultating breath sounds on a postoperative patient. 2- Administering insulin, on a sliding scale, to a patient with diabetes. 3- Rotating a patient's position to prevent the formation of bed sores. 4- Changing the frequency of vital signs assessment based on the patient's condition.

2

Which is an important role for a nurse in the health care delivery system? 1- Balancing work with leisure activities 2- Participating in the diagnosis and treatment of disease 3- Participating in treatment decisions regarding health restoration 4- Identifying patient needs and working with patients to address them

4

A nurse is preparing a presentation for a local community group about health, wellness, and illness. When describing the concept of wellness, which of the following features would the nurse include? Select all that apply. 1- Performing to one's best ability 2- Being completely without illness 3- Feeling that everything is together 4- Being able to adjust and adapt 5- Experiencing a feeling of well-being

1,3,4,5

The statements below reflect interventions to address a person's needs. Arrange each need based on Maslow's hierarchy from most basic to highest level. 1 Providing nasogastric tube feedings 2 Explaining a new procedure 4 Encouraging a patient to start a hobby that he or she has always wanted to try 3 Referring a patient to a cancer support group

1234

What is the primary focus of the nurse advocacy role in managing a clinical pathway? 1- Continuity of care 2- Cost-containment practices 3- Effective utilization of services 4- A patient's progress toward desired outcomes

4

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? 1- The Joint Commission 2- The National Council of State Boards of Nursing (NCSBN) 3- Institute of Medicine (IOM) 4- Agency for Healthcare Research and Quality (AHRQ)

1

A client who has no health insurance asks if there is any chance that they will benefit from healthcare reform. What should the nurse tell the client about the goal of the Patient Protection and Affordable Care Act? 1- The goal of the Patient Protection and Affordable Care Act is to provide affordable healthcare to U.S. citizens who previously had no access to health insurance. 2- The Patient Protection and Affordable Care Act applies only to people who are eligible for Medicaid, so it will not apply to the client's situation. 3- The Patient Protection and Affordable Care Act applies only to people who are eligible for Medicare, so it will not apply to the client's situation. 4- The goal of the Patient Protection and Affordable Care Act is to provide affordable healthcare to U.S. citizens who have at least three dependents.

1

A group of students are reviewing information on the roles of a nurse. The students demonstrate understanding of the information when they identify which activity as associated with the nurse's role as a leader? 1- Supervision of unlicensed assistive personnel 2- Identification of a problem related to patient care 3- Client education about a disease condition 4- Development of a plan of care for a client

1

A group of students is reviewing the phenomena as the focus of nursing care and research identified by the American Nurses Association. The group demonstrates the need for additional review when they identify which of the following as a phenomenon? 1- Ethical actions 2- Self-care processes 3- Lifespan transitions 4- Environmental systems

1

A nurse is a member of which entity within the larger healthcare environment? 1- healthcare team 2- healthcare delivery system 3- health maintenance organization 4- physician hospital organization

1

A nurse is employed by a community organization engaged in health promotion. In this role, the nurse teaches clients steps they can take toward achieving wellness. The nurse would explain "wellness" to a client as: 1- an ongoing and intentional effort to achieve the highest potential for total well-being. 2- the absence of disease. 3- a state of complete physical, mental, and social well-being. 4- viewing one's health in terms of a balance of body, mind, and spirit, which means being open to alternative treatment options.

1

A nurse who provides care in a postsurgical care unit of a hospital is aware that reimbursement to the hospital for Medicare patients is based on diagnosis-related groups (DRGs). How are DRGs used to determine reimbursement for Medicare patients? 1- Hospitals receive payment at a fixed rate for patients with diagnoses that fall into a specific DRG. 2- Medicare patients match the hospital's reimbursement from Medicare at a dollar-for-dollar rate. 3- A Medicare patient's minimum levels of care are established by the DRG that best relates to the patient's care needs. 4- Hospitals do not receive reimbursement if it can be demonstrated that a patient falls within a DRG.

1

A nurse with 20 years' experience attends a hospital-required training session and learns a new method for assessing nasogastric (NG) tube placement. During the training the nurse educator provides the nurse with a bibliography of peer-reviewed articles related to NG tube placement. The nurse recognizes the change in procedure developed from which method? 1- Evidence-based practice 2- Knowledge, skills, and attitude 3- Institute of Medicine (IOM) research 4- Core measures

1

A nurse working in a community-based health center is engaged in teaching a client about her medications. The nurse is acting as which of the following? 1- Practitioner 2- Leader 3- Researcher 4- Delegator

1

A type of nursing that includes individualized care provided by the same nurse throughout the period of care is defined as 1- primary nursing. 2- case management. 3- patient-focused nursing. 4- functional nursing.

1

According to Maslow's hierarchy of needs, which of the following is the lowest-level need? 1- Physiological needs 2- Safety and security 3- Sense of belonging and affection 4- Esteem and self-respect

1

According to Maslow, which category of needs represents the most basic on the hierarchy? 1- Physiologic needs 2- Self-actualization 3- Safety and security 4- Sense of belonging

1

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? 1- All of the responses are correct 2- Physicians 3- Social workers 4- Nurses

1

An advanced practice registered nurse (APRN) specializing in adult-gerontology has accepted a new position in a different state. Which governing body does the APRN need to consult to verify prescriptive authority in the new state? 1- The new state's boards of nursing 2- The new state's APRN Advisory Committee 3- The National Council of State Boards of Nursing (NCSBN) 4- The new employers' board of directors

1

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? 1- Healthy People 2020 2- The Joint Commission 3- Agency for Healthcare Research and Quality 4- Quality Indicators

1

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? 1- Interdisciplinary teamwork 2- Patient-centered care 3- Evidence-based practice 4- Quality improvement measures

1

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? 1- Inclusion in the collaborative healthcare team 2- A discipline unto themselves 3- Inclusion in the administrative team 4- Inclusion in the supervisory team

1

Under the Occupational Safety and Health Act (OSHA) of 1970, employers are responsible for providing a safe and healthy workplace for their employees. Which of the following would be inconsistent with the role of OSHA? 1- Financial assistance 2- Outreach 3- Education 4- Establishing partnerships

1

What is the first step in becoming culturally competent? 1- Exploring one's own cultural beliefs 2- Visiting as many cultures as possible 3- Maintaining eye contact at all times 4- Using touch as a method of maintaining rapport

1

What underlying focus in any definition of nursing is the registered nurse's responsibility in practice? 1- Appraise and enhance an individual's health-seeking perspective. 2- Coordinate a patient's total health management with all disciplines. 3- Diagnose acute pathology. 4- Treat acute clinical reactions to chronic illness.

1

Which element would be included as a goal of case management? 1- Appropriateness of services 2- Prescriptive authority 3- Attainment of fixed-price reimbursement 4- Utilization of the nursing process

1

Which is a goal of case management? 1- Appropriateness of services 2- Prescriptive authority 3- Attainment of fixed price reimbursement 4- Utilization of the nursing process

1

Which of the following patient age groups is currently one of the fastest growing age groups in the population? 1- 85 years of age and older 2- 65 to 70 years of age 3- children under 5 4- 15-19 years of age

1

Which program focuses on processes used to provide care? 1- Continuous quality improvement (CQI) 2- Quality assurance (QA) 3- Health maintenance organization (HMO) 4- Preferred provider organization (PPO)

1

Which strategy would a nurse likely discuss with a client as part of health promotion? 1- making positive dietary changes 2- evaluating the merits of various diagnostic procedures 3- locating a therapist for a child with emotional problems 4- determining how often blood glucose levels should be monitored at home

1

As part of a clinical post-conference discussion, an instructor is showing the students examples of clinical pathways used in the facility. When explaining these examples, the instructor identifies which of the following as being commonly used as a basis for developing these tools? Select all that apply. 1- Diagnosis related groups 2- Common health problems 3- Diagnostic tests 4- Treatments 5- Nursing diagnosis 6- Medications

1,2

The nurse is practicing in a community-based setting. What outcomes may be achieved by the nurse's community interventions? (Select all that apply.) 1- Promote wellness. 2- Reduce the spread of disease. 3- Improve the health status of the community. 4- Prevent hospital-acquired illness. 5- Promote the financial health of the community.

1,2,3

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? 1- Care map 2- Multidisciplinary action plan 3- Clinical guidelines 4- Algorithms

2

A nurse is caring for a patient who is experiencing fear, anxiety, and feelings of powerlessness after receiving a diagnosis of cancer. The nurse develops a teaching plan focusing on the patient's diagnosis and treatment options to promote the patient's sense of control over the situation. Using Maslow's Hierarchy of Human Needs, which of the following categories is the nurse attempting to meet? 1- Esteem and self-respect 2- Safety and security 3- Physiology 4- Belongingness and affection

2

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? 1- "The patients I care for usually are much more acutely ill than most patients seen." 2- "No other health care professionals are around to confirm my observations." 3- "The patient is usually alone in the home and has no one to support him or her." 4- "I need to be very alert for changes in patients because I don't have the usual equipment available."

2

A nurse is working as a member of a quality assurance program. Which of the following would be the focus? 1- Clinical processes 2- Individual incidents 3- Financial processes 4- Operational processes

2

Based on DRGs, prospective payment sets the rates of reimbursement for hospital services for Medicare patients. Which of the following is an accurate statement regarding the use of DRGs? 1- If the cost of the patient's care is lower than the payment, the hospital takes a loss. 2- If the cost of the patient's care is higher than the payment, the hospital takes a loss. 3- Hospitals receive various payments for every patient with a given diagnosis. 4- If the cost of the patient's care is higher than the payment, the hospital makes a profit.

2

Case management has gained such prominence in health care because of 1- longer hospital stays. 2- lower costs of care associated with inpatient stay. 3- ability to discharge from specialty care units to home. 4- limited availability for inter-unit hospital transfers.

2

Nurses have different educational backgrounds and function under many titles in their practice setting. If a nurse were practicing in an oncology clinic and performed a role that included clinical practice, education, management, consultation, and research, what would most accurately describe this nurse's title? 1- Midwife 2- Clinical nurse specialist (CNS) 3- Nurse manager 4- Staff nurse

2

Nursing has evolved from the hospital or home care of the individual during illness to caring for individuals, communities, and populations across the health care continuum. Which of the following necessitated changes in models of nursing care? 1- Fewer individuals with chronic disease 2- Increased aging population 3- Fewer inpatient settings 4- Lengthened hospital stays

2

The leadership of a private hospital have chosen to begin the process of accreditation in order to enhance the credibility and status of the hospital. The accreditation process and necessary performance improvements that the hospital will undertake will most likely occur under the auspices of what regulatory body? 1- Occupational Health and Safety Administration (OSHA) 2- The Joint Commission 3- Centers for Medicare and Medicaid Services (CMS) 4- The state Department of Public Health (DPH)

2

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? 1- Educate the patient about every possible complication associated with the specific illness. 2- Encourage positive health characteristics within the limits of the specific illness. 3- Limit all activities because of the progressive deterioration associated with all chronic illnesses. 4- Recommend activity beyond the scope of tolerance to prevent early deterioration.

2

Which of the following best describes the health-illness continuum? 1- A person with chronic illness is at the far end of the continuum reflecting illness. 2- A person may be considered neither completely healthy or completely ill. 3- A person with high-level wellness is free of any disease or infirmity. 4- A person on the continuum remains at the point based on his or her initial state of health.

2

Which of these roles would be considered an expanded nursing role? 1- Certified nurse's aide (CNA) 2- Certified nurse practitioner (CNP) 3- Respiratory therapist 4- Social worker

2

A client is experiencing anorexia related to the adverse effects of cancer treatment. Using Maslow's hierarchy, the nurse identifies this as a reflection of which need? 1- Esteem and self-respect 2- Safety and security 3- Physiologic needs 4- Belongingness and affection

3

A home care nurse is preparing a presentation for a group of nursing students about the area of practice. Which statement would the nurse most likely include when describing this practice area? 1- "Home care requires that the nurse has an advanced degree in nursing." 2- "The major emphasis of care involves accessing community resources." 3- "Home care nurses need to have high-level assessment skills." 4- "Decision-making is shared among the other health care professionals."

3

A hospital has recently begun the process of achieving Magnet status within the Magnet Recognition Program®. What characteristic of the hospital would be indicated by Magnet status? 1- Leaders and administrators at the hospital come from nursing backgrounds. 2- The hospital does not involve unlicensed assistive personnel (UAP) in patient care. 3- The hospital attracts and retains high-functioning nursing staff. 4- The hospital has an esteemed reputation in the local community.

3

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? 1- Need for at least a master's degree in nursing 2- Specialization in a specific area of practice 3- Strong clinical decision-making skills 4- Expert case management abilities

3

A nurse is interested in obtaining additional education to become a nurse practitioner and is reviewing various course programs. Which of the following would the nurse expect to find? 1- Specialty in a circumscribed area of care 2- Primarily acting as a educator for clients and families 3- Provision of a broad range of direct care to clients 4- Practice most often in acute care settings

3

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? 1- Achievement of patient outcomes through direct intervention 2- Provision of cost-effective, high-quality nursing care 3- Establishment of a scientific basis for action 4- Promotion of health through screening and early detection

3

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. 1- Interprets health care provider orders 2- Develops nursing care plans 3- Prescribes medications 4- Reports abnormal test results

3

An occupational nurse is working with patients at a construction site. According to Maslow's Hierarchy of Needs, what dimension of care should the nurse make the highest priority in working with these clients? 1- Spiritual 2- Esteem 3- Physiologic 4- Safety

3

Based on Maslow's hierarchy of needs, when prioritizing a patient's plan of care, what would be the nurse's first priority? 1- Allowing the family to see a newly admitted patient 2- Ambulating the patient in the hallway 3- Administering pain medication 4- Teaching the patient to self-administer insulin

3

Collaborative practice has been identified as a model of care that maximizes patient outcomes. A nurse can best implement the principles of collaborative practice by: 1- Ensuring that decisions around patient care are discussed in detail with other nurses 2- Consulting the nursing literature when choosing assessments, making diagnoses, and performing interventions 3- Adopting an attitude of "teachability" when planning and performing patient care 4- Making decisions around patient care in consultation with members of other health disciplines

3

Economics have dictated many significant changes in the health care delivery system. What is one major effect that economic factors have had on the patient population? 1- Patients are in the hospital for a longer period of time. 2- Patients have access to greater technology at lower costs. 3- Patients with high home-care needs are being discharged into the community. 4- Patient use of ambulatory care has decreased.

3

In an effort to manage time effectively and ensure good care, a registered nurse (RN) has chosen to delegate some tasks to a licensed practical nurse (LPN). In doing so, the RN has given consideration to the LPN's scope of practice. A scope of practice is best described as: 1- The degree of intervention that may be safely undertaken by a caregiver 2- The knowledge and skill set that is possessed by a professional 3- The actions that are legally permitted for a particular profession 4- The job description that is provided to an employee at the commencement of service

3

Nurses should consider their own cultural orientation when interacting with patients. Which of the following is a technique that can be used to overcome a language barrier when interacting with a patient? 1- Talk loudly so that the patient will understand. 2- Give the patient a substantial amount of information. 3- Give instructions in proper sequence. 4- Talk directly to the person that accompanied the patient.

3

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? 1- Achieving patient outcomes through direct intervention 2- Assuming responsibility for unlicensed assistive personnel 3- Replicating findings to further the science of nursing 4- Promoting health through screening and early detection

3

One of the primary tasks of a nurse researcher is to generate evidence. What is the most appropriate application of the evidence that nurse researchers generate? 1- Enhancing the credibility of the nursing profession 2- Disseminating it in the nursing literature 3- Using it to formulate guidelines for nursing practice 4- Using it to question established medical practices

3

The definition of nursing has evolved over time since Florence Nightingale first attempted, in 1859, to explain nursing's scope of practice. In 2003, the American Nurses' Association, in its Social Policy Statement, included which of the following activities as a significant role of nursing? 1- Modifying a medical plan of care to include nursing activities 2- Diagnosing chronic illness in the elderly 3- Identifying human responses to illness 4- Diagnosing acute illnesses in children

3

The hospital is having a problem with healthcare-associated infections. A committee has been established to study the problem and make recommendations. The nurse working on the committee knows that this work addresses what? 1- Inpatient quality indicators 2- Prevention quality indicators 3- National Patient Safety Goals 4- Patient safety indicators

3

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? 1- Safety and security 2- Belongingness and affection 3- Esteem and self-respect 4- Self-actualization

4

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? 1- "We should refer to everyone as a client. They pay for our service." 2- "That's how the physician wants us to refer to them." 3- "Using the term client implies that they are an active partner in nursing care." 4- "Using the term client is more respectful that using the term patient."

3

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? 1- Inform the family members that someone will have to stay with the patient after discharge. 2- Inform the physician that the patient is not ready to go home yet. 3- Contact the case manager for coordination of care prior to discharge of the patient. 4- Call social services to check on the patient after discharge.

3

The past century has seen a dramatic shift in disease patterns, which is generally considered to be a move from the predominance of infectious disease to that of chronic illness. This shift has been most clearly demonstrated by the recent patterns of incidence and prevalence of what disease? 1- Osteoporosis 2- Chronic renal failure (CRF) 3- Diabetes mellitus 4- Chronic obstructive pulmonary disease (COPD)

3

Which is an element of nursing as defined by the American Nurses Association? 1- Putting the patient in the best condition for nature to act upon him or her 2- Helping people to carry out activities contributing to health, recovery, or a peaceful death 3- Alleviating suffering by diagnosing and treating human responses to health problems 4- Discussing what nurses would do for themselves if they had the necessary strength, will, or knowledge

3

Which of the following entities is charged with the protection of health and well-being of the state's population and environment? 1- Joint Commission 2- Occupational Health and Safety Administration 3- Department of Public Health 4- Centers of Medicare and Medicaid Services

3

Which of the following would NOT be categorized as a mid-level practitioner? 1- Nurse midwives 2- Nurse practitioners 3- Nursing assistants 4- Certified registered nurse anesthetists

3

Which statement by the nurse shows an understanding of the focus of the quality assurance programs developed in the 1980s? 1- "The quality assurance programs focus on individual incidents or errors and minimal expectations." 2- "The quality assurance programs focus on decreasing the cost of health care for the consumer." 3- "The quality assurance programs focus on processes used to provide care and improving those processes." 4- "The quality assurance programs focus on coordinating care for patients."

3

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: 1- Removes items from the over-bed table, sets up the dinner tray, and leaves the patient so he can enjoy time with his family. 2- Pushes the over-bed table toward the bed so that it will be within the patient's reach when the dinner tray arrives. 3- 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. 4- 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.

4

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? 1- Certified nurse midwife 2- Nurse practitioner 3- Clinical nurse specialist 4- Nurse manager

4

After teaching a group of students about health, wellness and illness, a nursing instructor determines that additional instruction is necessary when the students identify which of the following as a component of wellness? 1- Performing to the best of one's ability 2- Reporting a feeling of well-being 3- Adjusting to varying situations 4- Feeling together about one part of life

4

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. 1- Immigration patterns will result in a more diverse population. It is projected that, by 2030, more than 20% of Americans will be immigrants. 2- Hispanics will become the largest minority group in the United States, constituting about 29% of the population. 3- The non-Hispanic, white population will reach 47%. 4- The number of adults over age 65 will double in size.

4

The home health nurse is assisting a patient and his family in planning the patient's return to work after an extensive illness. On which level of Maslow's hierarchy of basic needs does the patient's need for self-fulfillment fit? 1- Physiologic 2- Safety and security 3- Love and belonging 4- Self-actualization

4

The nurse is collecting data at the clinic from a new client who is being seen for an employee physical. The client informs the nurse that both parents have a history of high blood pressure and his father had a stroke at age 52 years. The nurse discusses diet and exercise programs that may benefit the client. What is the nurse displaying with this information? 1- Early detection 2- Health maintenance 3- Health promotion 4- Illness prevention

4

Today, increasing emphasis is placed on health, health promotion, wellness, and self-care. Which of the following activities in the care of a female patient with a recent diagnosis of diabetes mellitus is most congruent with the philosophy of health promotion? 1- Providing the patient with a new glucometer and test strips which have been recently brought to market 2- Introducing the patient to a diabetes educator who is in charge of a diabetes support group in the community 3- Helping the patient to schedule hemoglobin A1C testing at an outpatient laboratory 4- Teaching the patient about measures that she can take to minimize the long-term health effects of her disease

4

What is the primary basis for growth in home care nursing? 1- Recent changes in healthcare legislation 2- The growth of complementary and alternative medicine 3- The aging of the population 4- The discharge of patients who are more critically ill

4