Concepts Exam #3
responsibility of providing regulatory excellence for public health, safety and welfare, and protecting the public by ensuring that safe and competent nursing care is provided by licensed nurses
National Council for State Boards of Nursing
who writes the NCLEX
National Council for State Boards of Nursing
Laws established in each state in the United States to regulate the practice of nursing
Nurse Practice Acts
abstract impressions organized into symbols of reality
concepts
superintendent of nurses for the union army during the civil war
dorothea dix
ESFT Model what does the F stand for?
fears and concerns
What did the ANA do for nursing?
first time nurses started getting professional training and when respect for profession really started growing
why is florence nightingale called the "lady of the lamp"?
she would visit soldiers at night with a small lantern in her hand
who established the first collegiate nursing program at marquette university?
sister mary b. beck
who is the first doctoral prepared nurse in religious order?
sister mary b. beck
ESFT Model what does the S stand for?
social and environmental factors
upholding moral, legal, and human rights
social justice
most important concept in nursing theory?
the recipient of care
a group of concepts that describe a pattern of reality and can be tested, changed, or used to guide research
theory
Integration of _______ and ________ is the basis for professional nursing
theory and nursing process
this type of communication is goal oriented and is healing
therapeutic communication
ESFT Model what does the T stand for?
therapeutic contracting
what does nutrive mean?
to nourish
being completely truthful
veracity
who is considered the florence nightingale of her time because of her work as a teacher and researcher?
virginia a. henderson
who is the most influential nurse of the 20th century?
virginia a. henderson
who wrote the textbook on nursing practice?
virginia a. henderson
who is known as the angel of the battlefield?
clara barton
who started the american red cross?
clara barton
Nursing has an estimated job growth of ___% from 2018-2028
12%
Nursing is a therapeutic, interpersonal, and goal-oriented process A. Peplau B. Roy C. Newman D. Henderson E. Nightingale F. Orem G. Rogers H. Watson I. Leininger
A.
Scope and Standards of Nursing Practice was established by ______
ANA
who protects us nurses
ANA
First president of ANA A. Virginia A. Henderson B. Sister Mary B. Beck C. Linda Richards D. Mary Eliza Mahoney E. Clara Barton F. Dorothea Dix G. Lillian Wald H. Isabel Adams Hampton Robb I. Susie Walking Bear Yellowtail
H.
who protects the public
Texas Board of Nursing
concern for welfare and well being of others/concerned about patients and their well being
altruism
benefit the patient ex: providing vaccinations, providing pain meds ASAP to an injured patient in the ED, resuscitating a drowning victim, etc.
beneficence
if a patient asks you if you have ever given injections and you lie
deception
an action is right or wrong independent of its consequences (the end DOES NOT justify the means)
deontologic
What is the main purpose of ANA?
establish standards of care and standards of professional performance (standards of nursing practice)
two or more clear moral principles apply, but support mutually inconsistent courses of action
ethical dilemma
respect for the inherent worth and uniqueness of individuals and populations
human dignity
who was the first president of ANA?
isabel adams hampton robb
who established henry street settlement in 1893 which became new york visiting nursing services?
lillian wald
what does nutrix mean?
nursing mother
describes, explains, predicts, and controls outcomes in nursing practice
nursing theory
term generally used to refer to employees who report their employers' violation of the law to appropriate law enforcement agencies outside the employer's facilities ex: telling the admin your assignment is unsafe
whistle-blowing
Which of the following statements related to theory-based nursing practice are correct? (Select all that apply). a. Nursing theory differentiates nursing from other disciplines. b. Nursing theories are standardized and do not change over time. c. Integrating theory into practice promotes coordinated care delivery. d. Nursing knowledge is generated by theory. e. The theory of nursing process is used in planning patient care. f. Evidence-based practice results from theory-testing research.
A, C, D, F - The overall goal of nursing knowledge is to explain the practice of nursing as different and distinct from the practice of medicine, psychology, and other health care disciplines. Theory generates nursing knowledge for use in practice, thus supporting evidence-based practice. The integration of theory into practice leads to coordinated care delivery and therefore serves as the basis for nursing. Although the nursing process is central to nursing, it is not a theory. Nursing theories are not stagnant and continue to evolve over time.
Wrote the textbook on nursing practice - most influential nurse of the 20th century A. Virginia A. Henderson B. Sister Mary B. Beck C. Linda Richards D. Mary Eliza Mahoney E. Clara Barton F. Dorothea Dix G. Lillian Wald H. Isabel Adams Hampton Robb I. Susie Walking Bear Yellowtail
A.
A charge nurse meets with staff to outline a plan to provide transcultural nursing care for patients in their health care facility. Which theorist promoted this type of caring as the central theme of nursing care, knowledge, and practice? a. Madeleine Leininger b. Jean Watson c. Dorothy E. Johnson d. Betty Newman
A. Madeline Leininger's theory provides the foundations of transcultural nursing care by making caring the central theme of nursing. Jean Watson stated that nursing is concerned with promoting and restoring health, preventing illness, and caring for the sick. The central theme of Dorothy E. Johnson's theory is that problems arise because of disturbances in the system or subsystem or functioning below optimal level. Betty Newman proposed that humans are in constant relationship with stressors in the environment and the major concern for nursing is keeping the patient system stable through accurate assessment of these stressors.
A student nurse interacting with patients on a cardiac unit recognizes the four concepts in nursing theory that determine nursing practice. Of these four, which is most important? a. Person b. Environment c. Health d. Nursing
A. Of the four concepts, the most important is the person. The focus of nursing, regardless of definition or theory, is the person.
A nurse manager schedules a clinic for the staff to address common nursing interventions used in the facility and to explore how they can be performed more efficiently and effectively. The nurse manager's actions to change clinical practice are an example of a situation described by which nursing theory? a. Prescriptive theory b. Descriptive theory c. Developmental theory d. General systems theory
A. Prescriptive theories address nursing interventions and are designed to control, promote, and change clinical nursing practice. Descriptive theories describe a phenomenon, an event, a situation, or a relationship. Developmental theory outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death. General systems theory describes how to break whole things into parts and then to learn how the parts work together in "systems."
what defines nursing as the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities and populations?
ANA (American Nurses Association)
A patient is diagnosed with advanced leukemia. The patient is hopeless about the treatment. Which nursing interventions would help the patient to overcome the lack of hope? Select all that apply. A. Treating chronic pain B. Advising dietary modification C. Providing economical support D. Identifying sources of social support E. Providing opportunities to express positive life events
Answer: A, D, E. Treatment of pain can make the patient more comfortable and help in building a positive outlook. The nurse can approach family members, friends, and support groups for help. Providing opportunities to express positive life events helps the patient to focus on positivity rather than negativity related to the ailment. Dietary modification and economical support do not relieve hopelessness.
A patient comes to the emergency department complaining of severe, substernal chest pain. He is restless and anxious. Which statement by the nurse appropriately offers reassurance? A. I'll give you some medication to help relieve the pain. B. If you lie still and relax, you'll be fine in a little while. C. Everything is going to be okay. D. Don't worry; were going to take good care of you.
Answer: A. By telling the patient that she is going to give him some medication to help relieve his pain, the nurse is offering him realistic reassurance. The other options offer false reassurance and minimize patient concerns.
When designing a plan for pain management for a postoperative patient, the nurse assesses that the patient's priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient's priority is met. Which principle is used to encourage the nurse to monitor the patient's response to the pain? a. Fidelity b. Beneficence c. Nonmaleficence d. Respect for autonomy
Answer: A. Fidelity means keeping promises. Keeping the promise in this case includes not just tending to the clinical need, but evaluating the effectiveness of the interventions.
When caring for patients, a nurse must understand the difference between religion and spirituality. Religious care helps patients maintain their faithfulness to: A. Their belief systems and worship practices. B. A relationship to a higher being or life force. C. A sense of connectedness. D. The awareness of one's inner self.
Answer: A. Religious care helps patients follow their belief systems and worship practices. Spirituality is an awareness of one's inner self and a sense of connection to a higher being, nature, or some purpose greater than oneself. Spirituality offers a sense of connectedness. Spirituality is unique for each person. It is a unifying theme in life and a state of being.
What is the primary purpose of the American Nurses Association Standards of Clinical Nursing Practice? a. Establish criteria for quality practice b. Define the philosophy of nursing practice c. Identify the legal definition of nursing practice d. Determine educational standards for nursing practice
Answer: A. The ANA standards of clinical nursing practice describe the nature and scope of nursing practice and the responsibilities for which nurses are accountable. The ANA standards of clinical nursing practice reflect, not define, a philosophy of nursing. The laws of each state define the practice of nursing within the state.
What is the main purpose of the American Nurses Association? a. Establish standards of nursing practice b. Recognize academic achievement in nursing c. Monitor educational institutions granting degrees in nursing d. Prepare nurses to become members of the nursing profession
Answer: A. The American Nurses Association has established Standards of Care and Standards of Professional Performance. These standards reflect the values of the nursing profession, provide expectations for nursing practice, facilitate the evaluation of nursing practice, and define the profession's accountability to the public. 2. Sigma Theta Tau, the international honor society of nursing, recognizes academic achievement. 3. The National League for Nursing Accrediting Commission, the Commission on Collegiate Nursing Education, and state education departments monitor educational institutions granting degrees in nursing. 4. Schools of nursing (diploma, associate degree, and baccalaureate) educate individuals for entry into the practice of nursing.
The word spirituality comes from the Latin word spiritus, which refers to breath or wind. Today, spirituality is A. Awareness of one's inner self and a sense of connection to a higher being B. Less important than coping with the patient's illness C. Patient-centered and has no bearing on the nurse's belief patterns D. Equated to formal religious practice and has a minor effect on health care.
Answer: A.Spirituality is defined as an awareness of one's inner self and a sense of connection to a higher being, to nature, or to some purpose greater than oneself. Spirituality is an important factor that helps individuals achieve the balance needed to maintain health and well-being and to cope with illness. It positively affects and enhances health, quality of life, health promotion behaviors, and disease prevention activities. Nurses need an awareness of their own spirituality to provide appropriate and relevant spiritual care to others. The concepts of spirituality and religion are often interchanged, but spirituality is a much broader and more unifying concept than religion. The human spirit is powerful, and spirituality has different meanings for different people.
Which statements by the nurse demonstrate that active listening has occurred? Choose all that apply. A. I listened to my patient while I was changing his IV site. B. I made eye contact and listened to my patient to find out his concerns. C. I took detailed notes when I listened to my patient describe his symptoms. D. I sat with my patient and his wife to talk about their fears about the surgery.
Answer: B, D. The nurse demonstrates active listening by facing the patient, making eye contact, and listening while he expresses concerns. Arranging time to sit with the patient and his wife to discuss fears about an upcoming surgery also indicates active listening. Listening to the patient while performing activities, such as hanging an IV infusion or bathing him, distracts the nurse from active listening. Although taking detailed notes can help the nurse to accurately recall the patients words, this activity while listening to the patient speak can also be a distraction and could reduce eye contact and nonverbal cues of care and concern.
A patient tells the nurse, I'm having a lot of pain in my hip. Which response(s) by the nurse is/are open-ended and would stimulate the patient to provide the most complete data? Choose all that are correct. A. Is your pain severe? B. Tell me about your pain. C. When did you first notice this pain? D. How would you describe your pain?
Answer: B, D. The responses, Tell me about your pain and How would you describe your pain? are open-ended responses that stimulate conversation. Although it is important information, the question, Is your pain severe? prompts a yes or no response. When did you first notice this pain? also important information is likely to stimulate a brief, factual answer. Such questions allow the nurse to control the patient's response. Limiting the response might lead to an incomplete assessment.
When communicating with a client who speaks a different language, which best practice should the nurse implement? A. Speak loudly and slowly. B. Arrange for an interpreter to translate. C. Speak to the client and family together. D. Stand close to the client and speak loudly.
Answer: B. Arranging for an interpreter would be the best practice when communicating with a client who speaks a different language. Options 1 and 4 are inappropriate and ineffective ways to communicate. Option 3 is inappropriate because it violates privacy and does not ensure correct translation.
A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? a. Fidelity b. Beneficence c. Nonmaleficence d. Respect for autonomy
Answer: B. Beneficence means "doing well" by taking positive actions. It implies that the best interest of the patient (and society) outweighs self-interest.
Which most essential element should the nurse consider to promote client adherence to care recommendations? A. Following the client's medication regimen B. Adhering to the client's cultural preferences C. Following the client's pain management goal D. Using the client's communication preferences
Answer: B. The client's care should encompass her or his perspective and beliefs about health. Understanding the client's cultural preferences will allow the nurse to create a plan of care that is realistic and acceptable to the client. Although options 1, 3, and 4 are important, they are not the most essential.
A patient refuses to remove a specific spiritual garment for daily bathing. The most appropriate action for the nurse would be to: A. Remove the article anyway because the garment hinders daily care delivery. B. Respect the patient's wishes and work around it. C. Explain to the patient that the garment has no real spiritual value. D. Identify the refusal as a sign of spiritual distress.
Answer: B. To care for and meet the spiritual needs of your patients, it is essential to respect each patient's personal beliefs. People experience the world and find meaning in life in different ways and the spiritual garment has meaning for the patient. Caring for your patients' spiritual needs requires you to be compassionate and remove any personal biases or misconceptions. You need to recognize that not all patients have spiritual problems. Patients bring certain spiritual resources that help them assume healthier lives, recover from illness, or face impending death.
The nurse is preparing to provide preoperative teaching to a Spanish-speaking client and the client's family. Which nursing action would be most effective for teaching the client? A. The nurse asks 1 of the client's English-speaking relatives to interpret. B. The nurse secures the assistance of a professional interpreter to communicate with the client. C. The nurse obtains a Spanish-language dictionary for help in conducting the teaching session. D. The nurse obtains a preoperative Spanish-language teaching brochure and gives it to the client.
Answer: B. Using the services of a professional interpreter is the most effective way to provide preoperative instructions. Asking a family member to interpret is not acceptable because that client may interpret different or erroneous meanings from the nurse's instructions. Non-Spanish-speaking nurses should never attempt to do the teaching themselves with only the help of a Spanish dictionary. A Spanish-language brochure may be given to the client as an adjunct to interpreted verbal instructions but would not be adequate by itself.
A dying patient is withdrawn and depressed. Which nursing action is most therapeutic? A. Assisting the patient to focus on positive thoughts daily B. Explaining that the patient still can accomplish goals C. Accepting the patient's behavioral adaptation D. Offering the patient advice when appropriate
Answer: C. Focusing on positive thoughts is inappropriate because it denies the patient's feelings; the patient needs to focus on the future loss. 2. Focusing on positive thoughts is inappropriate because it denies the patient's feelings; the patient needs to focus on the future loss. 3. Depression is the fourth stage of grieving according to Kübler-Ross; patients become withdrawn and uncommunicative when feeling a loss of control and recognizing future losses. The nurse should accept the behavior and be available if the patient wants to verbalize feelings. 4. It is never appropriate to offer advice; people must explore their alternatives and come to their own conclusions.
The nurse is providing care to a Puerto Rican-American client who is terminally ill. Numerous family members are present most of the time, and many of the family members are very emotional. What is the most appropriate nursing action for this client? A. Restrict the number of family members visiting at one time. B. Inform the family that emotional outbursts are to be avoided. C. Make the necessary arrangements so that family members can visit. D. Contact the primary health care provider to speak to the family regarding their behaviors.
Answer: C. In the Puerto Rican-American culture, loud crying and other physical manifestations of grief are considered socially acceptable. Of the options provided, the correct option is the only one that identifies a culturally sensitive approach on the part of the nurse. Options 1, 2, and 4 are inappropriate nursing interventions.
The ANA code of nursing ethics articulates that the nurse "promotes, advocates for, and strives to protect the health, safety, and rights of the patient." This includes the protection of patient privacy. On the basis of this principal, if you participate in a public online social network such as Facebook, could you post images of a patient's x-ray film if you deleted all patient identifiers? a. Yes because patient privacy would not be violated as long as the patient identifiers were removed b. Yes because respect for autonomy implies that you have the autonomy to decide what constitutes privacy c. No because even though patient identifiers are removed, someone could identify the patient based on other comments that you make online about his or her condition and your place of work d. No because the principal of justice requires you to allocate resources fairly
Answer: C. No because, even though patient identifiers are removed, someone could identify the patient based on other comments that you make online about his or her condition and your place of work. Comments, photos, etc. on social media are widely distributed and become a risk for violation of privacy. People often inadvertently give "clues" or hints to the identity of a person plus people accessing your site could know your actual assignment or put "two and two" together.
The point of the ethical principle to "do no harm" is an agreement to reassure the public that in all ways the healthcare team not only works to heal patients but agree to do this in the least painful and harmful way possible. Which principle describes this agreement? a. Beneficence b. Accountability c. Nonmaleficence d. Respect for autonomy
Answer: C. Nonmaleficence is an important concept, but can be difficult to grasp at first. It refers to balancing the risks and benefits of care while doing least amount of harm and suffering.
The nurse is annoyed by a healthy Hispanic American client who had minor abdominal surgery 2 days ago. The client claims he cannot get out of bed by himself, and the nurse lectures the client and tells him to try to be tough. What type of cultural behavior is this called? A. Cultural ignorance B. Cultural blindness C. Cultural imposition D. Cultural transmission
Answer: C. Nurses and other primary health care providers who have cultural ignorance or cultural blindness about differences generally resort to cultural imposition. They use their own values and lifestyles as the absolute guide in dealing with clients and interpreting their behaviors.
When caring for a terminally ill patient, the nurse should focus on the fact that A. Spiritual care is possibly the least important nursing intervention. B. Spiritual needs often need to be sacrificed for physical care priorities. C. The nurse's relationship with the patient allows for an understanding of patient priorities. D. Members of the church or synagogue play no part in the patient's plan of care.
Answer: C. The nurse's relationship with the patient allows the nurse to understand the patient's priorities. Spiritual priorities do not need to be sacrificed for physical care priorities. When a patient is terminally ill, spiritual care is possibly the most important nursing intervention. If the patient participates in a formal religion, involve in the plan of care members of the clergy or members of the church, temple, mosque, or synagogue.
Action has been taken against a nurse's license based on a claim that the nurse acted outside of nursing's scope of practice. The nurse's attorney determines that the nurse needs more education about the purpose of the board of nursing when the nurse makes which statement? a. "The board of nursing is established by state legislation." b. "Board of nursing rules keep unlicensed people from practicing nursing." c. "The board of nursing exists to protect the safety of the public." d. "The rules made by the board of nursing don't reflect my practice."
Answer: D. A nurse's practice should reflect the rules of the board of nursing rather than vice versa. Boards of nursing are established by state legislation through the state's nurse practice act and exist to protect the public. These rules help to keep unlicensed people from practicing nursing.
Which of the following is not a purpose of the Nurse Practice Acts? a. Define important terms and activities in nursing, including legal requirements and titles for RN's and LVN's b. Define a legal scope of nursing practice in each state c. Establish criteria for the education and licensure of nurses d. Provide leadership and scholarship in practice, education, and research to enhance the health of all people
Answer: D. Providing leadership and scholarship in practice, education, and research is a function of special interest associations such as Sigma Theta Tau or the Texas Nurses Association. All of the other choices describe parts of the function of the Nurse Practice Acts.
Which intervention by the nurse helps to establish a trusting nurse-patient relationship? a. Avoiding topics that may provoke emotional responses from the patient b. Listening to the patient while performing care activities c. Performing care interventions quietly without explanation d. Greeting the patient by name whenever entering the patient's room
Answer: D. The nurse can establish a trusting nurse-patient relationship by always greeting the patient by name, listening actively, responding honestly to the patient's concern, providing explanations for care interventions, and providing care competently and consistently.
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which of the following statements best describes this code? A. Improves self-health care B. Protects the patient's confidentiality C. Ensures identical care to all patients D. Defines the principles of right and wrong to provide patient care
Answer: D. When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. The code of ethics is the philosophical ideals of right and wrong that define the principles you will use to provide care to your patients. It serves as a guide for carrying out nursing responsibilities to provide quality nursing care and the ethical obligations of the profession.
A nurse attempts to obtain an order for a feeding tube for an anorexic teenager who refuses to eat. What is the term for the ethical problem this nurse is experiencing? a. Deception b. Confidentiality c. Allocation of scarce nursing resources d. Advocacy in market-driven environment e. Paternalism
Answer: E. Paternalism occurs when the nurse acts for a patient without consent to secure good or prevent harm. Deception occurs when a nurse deceives a person for a perceived benefit. Patient confidentiality is questioned when a patient's confidence may lead to harm. Allocation of scarce nursing resources and advocacy in a market - driven environment involves patient harm due to inadequate staffing/finances.
A hospice nurse is caring for a patient with end-stage cancer. What action demonstrates this nurse's commitment to the principle of autonomy? a. The nurse helps the patient prepare a durable power of attorney document. b. The nurse gives the patient undivided attention when listening to concerns. c. The nurse keeps a promise to provide a counselor for the patient. d. The nurse competently administers pain medication to the patient.
Answer: a. The principle of autonomy obligates nurses to provide the information and support patients and their surrogates need to make decisions that advance their interests. Acting with justice means giving each person his or her due, acting with fidelity involves keeping promises to patients, and acting with nonmaleficence means avoiding doing harm to patients.
A nurse wants to call an ethics consult to clarify treatment goals for a patient no longer able to speak for himself. The nurse believes his dying is being prolonged painfully. The patient's doctor threatens the nurse with firing if the nurse raises questions about the patient's care or calls the consult. What ethical conflict is this nurse experiencing? a. Ethical uncertainty b. Ethical distress c. Ethical dilemma d. Ethical residue
Answer: b. Ethical distress results from knowing the right thing to do but finding it almost impossible to execute because of institutional or other constraints (in this case, the nurse fears the loss of job). Ethical uncertainty results from feeling troubled by a situation but not knowing if it is an ethical problem. Ethical dilemmas occur when the principles of bioethics justify two or more conflicting courses of action. Ethical residue is what nurses experience when they seriously compromise themselves or allow themselves to be compromised.
A nurse caring for patients in an institutional setting expresses a commitment to social justice. What action best exemplifies this attribute? a. Providing honest information to patients and the public b. Promoting universal access to health care c. Planning care in partnership with patients d. Documenting care accurately and honestly
Answer: b. The American Association of Colleges of Nursing lists promoting universal access to health care as an example of social justice. Providing honest information and documenting care accurately and honestly are examples of integrity, and planning care in partnership with patients is an example of autonomy.
A nurse incorporates the "five values that epitomize the caring professional nurse" (identified by the American Association of Colleges of Nursing) into a home health care nursing practice. Which attribute is best described as acting in accordance with an appropriate code of ethics and accepted standards of practice? a. Altruism b. Autonomy c. Human dignity d. Integrity
Answer: d. The American Association of Colleges of Nursing defines integrity as acting in accordance with an appropriate code of ethics and accepted standards of practice. Altruism is a concern for the welfare and well-being of others. Autonomy is the right to self-determination, and human dignity is respect for the inherent worth and uniqueness of individuals and populations.
A home health nurse performs a careful safety assessment of the home of a frail older adult to prevent harm to the patient. The nurse's action reflects which principle of bioethics? a. Autonomy b. Beneficence c. Justice d. Fidelity e. Nonmaleficence
Answer: e. Nonmaleficence is defined as the obligation to prevent harm. Autonomy is respect for another's right to make decisions, beneficence obligates us to benefit the patient, justice obligates us to act fairly, and fidelity obligates us to keep our promises.
The nurse is caring for a non-English-speaking client and is attempting to integrate the client's cultural practices into Western medicine. What are some other aspects of culturally competent care the nurse can employ? Select all that apply. A. Increasing client safety B. Using spiritual practices C. Reducing health disparities D. Increasing client satisfaction E. Maintaining eye contact when conversing with clients F. Preventing misunderstandings between the nurse and the client
Answers: A, B, C, D, F. Besides integrating cultural practices into Western medicine, other aspects of culturally competent care include the following: increasing client safety, reducing health disparities, increasing client satisfaction, and preventing misunderstandings between the nurse and the client. Incorporating spiritual practices as appropriate to the client's culture is also important. Maintaining eye contact when having a conversation with a client is not always part of culturally competent practices.
What elements are essential for the nurse to address to be able to deliver culturally competent care? Select all that apply. A. Assessing the client's health preferences B. Having knowledge of various racial and ethnic groups C. Acknowledging personal misconceptions of various ethnic groups D. Diagnosing health conditions commonly seen within the ethnic group E. Recognizing that subcultures exist and not every characteristic of the cultural group is present
Answers: A, B, C, E. The nurse always determines the client's health preferences in order to create an individualized plan of care. Health care providers must have awareness of their own beliefs and values, as well as being aware that others hold different values and beliefs based on personal preferences or ethnic, cultural, and racial backgrounds. Recognizing one's own biases and respecting all people despite differences can influence satisfaction in care. It is imperative for health care providers to understand that cultural groups share dominant characteristics; however, subcultures exist and stereotyping must be avoided. It is not within the nurse's role to diagnose health conditions.
Spiritual distress has been identified in a patient who has been diagnosed with AIDS. Upon evaluating the following interventions, which are appropriate for the diagnosis of Spiritual distress? Select all that apply. A. Develop activities to heal body, mind, and spirit. B. Assess for potential suicide. C. Offer to pray with the patient. D. Teach relaxation, guided imagery, and meditation. E. Have patient avoid church attendance.
Answers: A, C, D. Interventions that are appropriate for the nursing diagnosis of Spiritual distress include (1) helping the patient develop/identify activities to heal body, mind, and spirit; (2) offering to pray with the patient; and (3) teaching relaxation, guided imagery, and medication. Assessing for potential suicide would be appropriate for the nursing diagnosis of Hopelessness. Attendance at church should be encouraged.
The charge nurse is educating a new nurse on culturally competent communication techniques. Which response(s) made by the new nurse indicates a need for follow-up? Select all that apply. A. "I should identify the clients' needs to create the plan of care." B. "I should use a language interpreter for all culturally diverse groups." C. "I should use the client's perspective on health to help lead the conversation." D. "I should use a communication style that promotes optimal health outcomes." E. "I should recognize my own biases and address known stereotypes with the client."
Answers: B, E. Knowing and understanding the client's needs and his or her beliefs about health help to guide the plan of care. Health care providers should know the client's perspectives and cultural preferences to create a treatment plan that is realistic, acceptable, and individualized for each client. Communicating in a professional and respectful manner will optimize client outcomes. A language interpreter may not be necessary for some ethnic groups that speak English. It is also important to have self-awareness about any biases or misconceptions regarding other ethnic groups. It is not appropriate to address these directly with the client.
The nurse is demonstrating client advocacy in which of these situations? Select all that apply. a. Helping a client bathe b. Changing a client's abdominal dressing c. Including the client in the formulation of a nursing care plan d. Ensuring that the client has been informed of the treatment plan e. Sharing the client's viewpoint regarding treatment during an interdisciplinary health care conference
Answers: C, D, E - The nurse must act as a client advocate and speak up for or act on the behalf of the client, protect the client's right to make his or her own decisions, and uphold the principle of fidelity. The nurse serves as an advocate by ensuring that the client has been informed of the treatment plan and including the client in developing the plan of care. The nurse should also share the client's viewpoint with others, such as the interdisciplinary health care team, involved in the client's care. Helping a client bathe and changing a client's abdominal dressing are nursing interventions but are not specifically associated with the role of advocacy.
The nurse manager is giving a staff in-service on providing culturally sensitive education to clients. Which statements indicate to the nurse manager that the staff understands providing culturally sensitive education? Select all that apply. A. "Educational topics are always determined by the nurse." B. "All clients view education about their health status as important." C. "The population served will determine the culturally sensitive resources to use for teaching." D. "Assessment of a client's preferred learning approach is essential to facilitate the learning process." E. "It is important to have an accurate translator when the nurse and client do not speak the same language."
Answers: C, D, E. Test taking tip: if the answer says "Everyone" or "All" and stereotypes large groups, it is probably not correct. Providing culturally competent care or education is an important aspect of nursing. Care or education must be emphatically based on the client's culture; otherwise, the care or education is not specific to the client. The correct options address culturally specific and individualized care. Options 1 and 2 are not individually focused.
A patient is upset due to a terminal illness of a parent. How should the nurse educate the patient about anticipatory grief and its management? Select all that apply. A. Emphasize high-dose sedation B. Instruct the patient to avoid meeting with the parent to overcome grief C. Explain to the patient that grief may aggravate the situation D. Explain that the patient will eventually get mentally prepared for the loss E. Explain that this grief cannot be controlled by willpower, because it is an unconscious process
Answers: D, E. Because the parent has a terminal illness, the patient will eventually prepare for the inevitability that the parent will die. Grief cannot be controlled by willpower, because it is an unconscious process. High-dose sedation should be advised only after obtaining the opinion of the health care provider and only for severe grief. Avoiding the parents is not a justifiable way of escaping grief. Grief does not last long and the patient may even experience relief once the parent passes away.
A student nurse begins a clinical rotation in a long-term care facility and quickly realizes that certain residents have unmet needs. The student wants to advocate for these residents. Which statements accurately describe this concept? Select all that apply. a. Advocacy is the protection and support of another's rights. b. Patient advocacy is primarily performed by nurses. c. Patients with special advocacy needs include the very young and the older adult, those who are seriously ill, and those with disabilities. d. Nurse advocates make good health care decisions for patients and residents. e. Nurse advocates do whatever patients and residents want. f. Effective advocacy may entail becoming politically active.
Answers: a, c, f. Advocacy is the protection and support of another's rights. Among the patients with special advocacy needs are the very young and the older adult, those who are seriously ill, and those with disabilities; this is not a comprehensive list. Effective advocacy may entail becoming politically active. Patient advocacy is the responsibility of every member of the professional caregiving team—not just nurses. Nurse advocates do not make health care decisions for their patients and residents. Instead, they facilitate patient decision making. Advocacy does not entail supporting patients in all their preferences.
Needs are created within interrelated adaptive modes; physiological, self-concept, role function, and independence A. Peplau B. Roy C. Newman D. Henderson E. Nightingale F. Orem G. Rogers H. Watson I. Leininger
B.
Received first doctorate in nursing education, established first code of ethics for nursing profession and first collegiate nursing program at Marquette University A. Virginia A. Henderson B. Sister Mary B. Beck C. Linda Richards D. Mary Eliza Mahoney E. Clara Barton F. Dorothea Dix G. Lillian Wald H. Isabel Adams Hampton Robb I. Susie Walking Bear Yellowtail
B.
You administer a once-a-day cardiac medication at the wrong time, but nobody sees it. However, you contact the primary care provider and your head nurse and follow agency procedure. A. Responsibility B. Accountability C. Advocacy D. Confidentiality
B. Accountability
The nurse is caring for a patient admitted to the neurological unit with the diagnosis of a stroke and right-sided weakness. The nurse assumes responsibility for bathing and feeding the patient until the patient is able to begin performing these activities. The nurse in this situation is applying the theory developed by: a. Newman b. Orem c. Roy d. Peplau
B. Orem - When applying Orem's self-care deficit theory, the nurse continually assesses the patient's ability to perform self-care and intervenes as needed to ensure that physical, psychological, sociological, and developmental needs are being met. As the patient's condition improves, the nurse encourages the patient to begin doing these activities independently.
First hospital-trained nurse in the US. Introduced concept of patient records and wearing uniforms A. Virginia A. Henderson B. Sister Mary B. Beck C. Linda Richards D. Mary Eliza Mahoney E. Clara Barton F. Dorothea Dix G. Lillian Wald H. Isabel Adams Hampton Robb I. Susie Walking Bear Yellowtail
C.
Humans are in constant relationship with stressors in the environment A. Peplau B. Roy C. Newman D. Henderson E. Nightingale F. Orem G. Rogers H. Watson I. Leininger
C.
A patient at the end of life wants to go home to die, but the family wants every care possible. The nurse contacts the primary care provider about the patient's request. A. Responsibility B. Accountability C. Advocacy D. Confidentiality
C. Advocacy
The first trained African-American nurse to graduate in the US (from New England Hospital for Women and Children Training School for Nurses) A. Virginia A. Henderson B. Sister Mary B. Beck C. Linda Richards D. Mary Eliza Mahoney E. Clara Barton F. Dorothea Dix G. Lillian Wald H. Isabel Adams Hampton Robb I. Susie Walking Bear Yellowtail
D.
The patient is a person who requires help to reach independence A. Peplau B. Roy C. Newman D. Henderson E. Nightingale F. Orem G. Rogers H. Watson I. Leininger
D.
You see an open medical record on the computer and close it so no one else can read the record without proper access. A. Responsibility B. Accountability C. Advocacy D. Confidentiality
D. Confidentiality
A nurse ensures that each patient's room is clean, well ventilated, and free from clutter, excessive noise, and extremes in temperature. Which theorist's work is the nurse practicing in this example? a. Henderson b. Orem c. King d. Nightingale
D. Nightingale - Nightingale's environmental theory directs the nurse to manipulate the environment to promote rest and healing.
You tell your patient that you will return in 30 minutes to give him his next pain medication. A. Responsibility B. Accountability C. Advocacy D. Confidentiality
D. Responsibility
Meeting the personal needs of the patient within the environment A. Peplau B. Roy C. Newman D. Henderson E. Nightingale F. Orem G. Rogers H. Watson I. Leininger
E.
Volunteered her nursing skills and organized the Red Cross in the US after the civil war. Known as the "Angel of the Battlefield" A. Virginia A. Henderson B. Sister Mary B. Beck C. Linda Richards D. Mary Eliza Mahoney E. Clara Barton F. Dorothea Dix G. Lillian Wald H. Isabel Adams Hampton Robb I. Susie Walking Bear Yellowtail
E.
Self-care is a human need; deficits require nursing works well in all steps of the nursing process A. Peplau B. Roy C. Newman D. Henderson E. Nightingale F. Orem G. Rogers H. Watson I. Leininger
F.
Superintendent of nurses for the Union army. Reformer of mental health nursing and administration A. Virginia A. Henderson B. Sister Mary B. Beck C. Linda Richards D. Mary Eliza Mahoney E. Clara Barton F. Dorothea Dix G. Lillian Wald H. Isabel Adams Hampton Robb I. Susie Walking Bear Yellowtail
F.
Emphasis is on the science and art of nursing, with the unitary human being central to the discipline of nursing. A. Peplau B. Roy C. Newman D. Henderson E. Nightingale F. Orem G. Rogers H. Watson I. Leininger
G.
Established Henry Street Settlement in 1893 which became the New York Visiting Nursing Service - public health nursing A. Virginia A. Henderson B. Sister Mary B. Beck C. Linda Richards D. Mary Eliza Mahoney E. Clara Barton F. Dorothea Dix G. Lillian Wald H. Isabel Adams Hampton Robb I. Susie Walking Bear Yellowtail
G.
Nursing is concerned with promoting and restoring health, preventing illness, and caring for the sick A. Peplau B. Roy C. Newman D. Henderson E. Nightingale F. Orem G. Rogers H. Watson I. Leininger
H.
Brought modern health care to Native Americans, helped to end abuses and decreased death rate of Native American children A. Virginia A. Henderson B. Sister Mary B. Beck C. Linda Richards D. Mary Eliza Mahoney E. Clara Barton F. Dorothea Dix G. Lillian Wald H. Isabel Adams Hampton Robb I. Susie Walking Bear Yellowtail
I .
Caring is the central theme of nursing care, knowledge, and practice. Provides the foundation of transcultural nursing care A. Peplau B. Roy C. Newman D. Henderson E. Nightingale F. Orem G. Rogers H. Watson I. Leininger
I .
Working with a lot of different people with different personalities; if a physician/patient speaks to you inappropriately- you handle it appropriately and speak with whoever is in charge. This is what type or relationship?
Interpersonal
licensing, school approval, enforcement, information-new laws that have been passed
Texas Board of Nursing
A nurse working in a rehabilitation facility focuses on the goal of restoring health for patients. Which examples of nursing interventions reflect this goal? Select all that apply. a. A nurse counsels adolescents in a drug rehabilitation program b. A nurse performs range-of-motion exercises for a patient on bedrest c. A nurse shows a diabetic patient how to inject insulin d. A nurse recommends a yoga class for a busy executive e. A nurse provides hospice care for a patient with end-stage cancer f. A nurse teaches a nutrition class at a local high school
a, b, c. Activities to restore health focus on the person with an illness and range from early detection of a disease to rehabilitation and teaching during recovery. These activities include drug counseling, teaching patients how to administer their medications, and performing range-of-motion exercises for bedridden patients. Recommending a yoga class for stress reduction is a goal of preventing illness, and teaching a nutrition class is a goal of promoting health. A hospice care nurse helps to facilitate coping with disability and death.
A nurse caring for culturally diverse patients in a health care provider's office is aware that patients of certain cultures are more prone to specific disease states than the general population. Which patients would the nurse screen for diabetes mellitus based on the patient's race? Select all that apply. A. A Native American patient B. An African-American patient C. An Alaska Native D. An Asian patient E. A White patient F. A Hispanic patient
a, c, e, f. Native Americans, Alaska Natives, Hispanics, and Whites are more prone to developing diabetes mellitus. African Americans are prone to hypertension, stroke, sickle cell anemia, lactose intolerance, and keloids. Asians are prone to hypertension, liver cancer, thalassemia, and lactose intolerance.
A student nurse begins a clinical rotation in a long-term care facility and quickly realizes that certain residents have unmet needs. The student wants to advocate for these residents. Which statements accurately describe this concept? Select all that apply. A. Advocacy is the protection and support of another's rights. B. Patient advocacy is primarily performed by nurses. C. Patients with special advocacy needs include the very young and the older adult, those who are seriously ill, and those with disabilities. D. Nurse advocates make good health care decisions for patients and residents. E. Nurse advocates do whatever patients and residents want. F. Effective advocacy may entail becoming politically active.
a, c, f. Advocacy is the protection and support of another's rights. Among the patients with special advocacy needs are the very young and the older adult, those who are seriously ill, and those with disabilities; this is not a comprehensive list. Effective advocacy may entail becoming politically active. Patient advocacy is the responsibility of every member of the professional caregiving team—not just nurses. Nurse advocates do not make health care decisions for their patients and residents. Instead, they facilitate patient decision making. Advocacy does not entail supporting patients in all their preferences.
During a nursing staff meeting, the nurses resolve a problem of delayed documentation by agreeing unanimously that they will make sure all vital signs are reported and charted within 15 minutes following assessment. This is an example of which characteristics of effective communication? Select all that apply. A. Group decision making B. Group leadership C. Group power D. Group identity E. Group patterns of interaction F. Group cohesiveness
a, d, e, f. Solving problems involves group decision making; ascertaining that the staff completes a task on time and that all members agree the task is important is a characteristic of group identity; group patterns of interaction involve honest communication and member support; and cohesiveness occurs when members generally trust each other, have a high commitment to the group, and a high degree of cooperation. Group leadership occurs when groups use effective styles of leadership to meet goals; with group power, sources of power are recognized and used appropriately to accomplish group outcomes.
In order to provide culturally competent care, nurses must be alert to factors inhibiting sensitivity to diversity in the health care system. Which nursing actions are examples of cultural imposition? Select all that apply. A. A hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily. B. A nurse treats all patients the same whether or not they come from a different culture. C. A nurse tells another nurse that Jewish diet restrictions are just a way for them to get a special tray of their favorite foods. D. A Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence. E. A nurse directs interview questions to an older adult's daughter even though the patient is capable of answering them. F. A nurse refuses to care for a married gay man who is HIV positive because she is against same-sex marriage.
a, d. Cultural imposition occurs when a hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily, and when a Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence. Cultural blindness occurs when a nurse treats all patients the same whether or not they come from a different culture. Culture conflict occurs when a nurse ridicules a patient by telling another nurse that Jewish diet restrictions are just a way for Jewish patients to get a special tray of their favorite foods. When a nurse refuses to respect an older adult's ability to speak for himself or herself, or if the nurse refuses to treat a patient based on that patient's sexual orientation, the nurse is engaging in stereotyping.
A nurse notices a patient is walking to the bathroom with a stooped gait, facial grimacing, and gasping sounds. Based on these nonverbal clues, for which condition would the nurse assess? A. Pain B. Anxiety C. Depression D. Fluid volume deficit
a. A patient who presents with nonverbal communication of a stooped gait, facial grimacing, and gasping sounds is most likely experiencing pain. The nurse should clarify this nonverbal behavior.
Nurses today work in a wide variety of health care settings. What trend occurred during World War II that had a tremendous effect on this development in the nursing profession? a. There was a shortage of nurses and an increased emphasis on education. b. Emphasis on the war slowed development of knowledge in medicine and technology c. The role of the nurse focused on acute technical skills used in hospital settings. d. Nursing was dependent on the medical profession to define its priorities.
a. During World War II, large numbers of women worked outside the home. They became more independent and assertive, which led to an increased emphasis on education. The war itself created a need for more nurses and resulted in a knowledge explosion in medicine and technology. This trend broadened the role of nurses to include practicing in a wide variety of health care settings.
Nursing in the United States is regulated by the state nurse practice act. What is a common element of each state's nurse practice act? a. Defining the legal scope of nursing practice b. Providing continuing education programs c. Determining the content covered in the NCLEX examination d. Creating institutional policies for health care practices
a. Nurse practice acts are established in each state to regulate the practice of nursing by defining the legal scope of nursing practice, creating a state board of nursing to make and enforce rules and regulations, define important terms and activities in nursing, and establish criteria for the education and licensure of nurses. The acts do not determine the content covered on the NCLEX, but they do have the legal authority to allow graduates of approved schools of nursing to take the licensing examination. The acts also may determine educational requirements for licensure, but do not provide the education. Institutional policies are created by the institutions themselves.
When interacting with a patient, the nurse answers, "I am sure everything will be fine. You have nothing to worry about." This is an example of what type of inappropriate communication technique? A. Cliché B. Giving advice C. Being judgmental D. Changing the subject
a. Telling a patient that everything is going to be all right is a cliché. This statement gives false assurance and gives the patient the impression that the nurse is not interested in the patient's condition.
An older nurse asks a younger coworker why the new generation of nurses just aren't ethical anymore. Which reply reflects the BEST understanding of moral development? A. "Behaving ethically develops gradually from childhood; maybe my generation doesn't value this enough to develop an ethical code." B. "I don't agree that nurses were more ethical in the past. It's a new age and the ethics are new!" C. "Ethics is genetically determined...it's like having blue or brown eyes. Maybe we're evolving out of the ethical sense your generation had." D. "I agree! It's impossible to be ethical when working in a practice setting like this!"
a. The ability to be ethical, to make decisions, and to act in an ethically justified manner begins in childhood and develops gradually.
A nurse is telling a new mother from Africa that she shouldn't carry her baby in a sling created from a large rectangular cloth. The African woman tells the nurse that everyone in Mozambique carries babies this way. The nurse believes that bassinets are safer for infants. This nurse is displaying what cultural bias? A. Cultural imposition B. Clustering C. Cultural competency D. Stereotyping
a. The nurse is trying to impose her belief that bassinets are preferable to baby slings on the African mother—in spite of the fact that African women have safely carried babies in these slings for years.
A public health nurse is leaving the home of a young mother who has a special needs baby. The neighbor states, "How is she doing, since the baby's father is no help?" What is the nurse's BEST response to the neighbor? A. "New mothers need support." B. "The lack of a father is difficult." C. "How are you today?" D. "It is a very sad situation."
a. The nurse must maintain confidentiality when providing care. The statement "New mothers need support" is a general statement that all new parents need help. The statement is not judgmental of the family's roles.
A hospice nurse is caring for a patient with end-stage cancer. What action demonstrates this nurse's commitment to the principle of autonomy? A. The nurse helps the patient prepare a durable power of attorney document. B. The nurse gives the patient undivided attention when listening to concerns. C. The nurse keeps a promise to provide a counselor for the patient. D. The nurse competently administers pain medication to the patient.
a. The principle of autonomy obligates nurses to provide the information and support patients and their surrogates need to make decisions that advance their interests. Acting with justice means giving each person his or her due, acting with fidelity involves keeping promises to patients, and acting with nonmaleficence means avoiding doing harm to patients.
A nurse caring for a patient who is hospitalized following a double mastectomy is preparing a discharge plan for the patient. Which action should be the focus of this termination phase of the helping relationship? A. Determining the progress made in achieving established goals B. Clarifying when the patient should take medications C. Reporting the progress made in teaching to the staff D. Including all family members in the teaching session
a. The termination phase occurs when the conclusion of the initial agreement is acknowledged. Discharge planning coordinates with the termination phase of a helping relationship. The nurse should determine the progress made in achieving the goals related to the patient's care.
The nurse practitioner sees patients in a community clinic that is located in a predominately White neighborhood. After performing assessments on the majority of the patients visiting the clinic, the nurse notes that many of the minority groups living within the neighborhood have lost the cultural characteristics that made them different. What is the term for this process? A. Cultural assimilation B. Cultural imposition C. Culture shock D. Ethnocentrism
a. When minority groups live within a dominant group, many members lose the cultural characteristics that once made them different in a process called assimilation. Cultural imposition occurs when one person believes that everyone should conform to his or her own belief system. Culture shock occurs when a person is placed in a different culture perceived as strange, and ethnocentrism is the belief that the ideas, beliefs, and practices of one's own cultural group are best, superior, or most preferred to those of other groups.
primary commitment to the patient
advocacy
right to self determination; being independent/honoring the patient's right
autonomy
A nurse caring for patients in the intensive care unit develops values from experience to form a personal code of ethics. Which statements best describe this process? Select all that apply. A. People are born with values. B. Values act as standards to guide behavior. C. Values are ranked on a continuum of importance. D. Values influence beliefs about health and illness. E. Value systems are not related to personal codes of conduct. F. Nurses should not let their values influence patient care.
b, c, d. A value is a belief about the worth of something, about what matters, which acts as a standard to guide one's behavior. A value system is an organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct. A person's values influence beliefs about human needs, health, and illness; the practice of health behaviors; and human responses to illness. Values guide the practice of nursing care. An individual is not born with values; rather, values are formed during a lifetime from information from the environment, family, and culture.
A nurse is using general systems theory to describe the role of nursing to provide health promotion and patient teaching. Which statements reflect key points of this theory? Select all that apply. a. A system is a set of individual elements that rarely interact with each other. b. The whole system is always greater than the sum of its parts. c. Boundaries separate systems from each other and their environments. d. A change in one subsystem will not affect other subsystems. e. To survive, open systems maintain balance through feedback. f. A closed system allows input from or output to the environment.
b, c, e. According to general systems theory, a system is a set of interacting elements contributing to the overall goal of the system. The whole system is always greater than its parts. Boundaries separate systems from each other and their environments. Systems are hierarchical in nature and are composed of interrelated subsystems that work together in such a way that a change in one element could affect other subsystems, as well as the whole. To survive, open systems maintain balance through feedback. An open system allows energy, matter, and information to move freely between systems and boundaries, whereas a closed system does not allow input from or output to the environment.
A nurse who is working in a hospital setting uses value clarification to help understand the values that motivate patient behavior. Which examples denote "prizing" in the process of values clarification? Select all that apply. A. A patient decides to quit smoking following a diagnosis of lung cancer. B. A patient shows off a new outfit that she is wearing after losing 20 pounds. C. A patient chooses to work fewer hours following a stress-related myocardial infarction. D. A patient incorporates a new low-cholesterol diet into his daily routine. E. A patient joins a gym and schedules classes throughout the year. F. A patient proudly displays his certificate for completing a marathon.
b, f. Prizing something one values involves pride, happiness, and public affirmation, such as losing weight or running a marathon. When choosing, one chooses freely from alternatives after careful consideration of the consequences of each alternative, such as quitting smoking and working fewer hours. Finally, the person who values something acts on the value by combining choice and behavior with consistency and regularity, such as joining a gym for the year and following a low-cholesterol diet faithfully.
A nurse in the rehabilitation division states to the head nurse: "I need the day off and you didn't give it to me!" The head nurse replies, "Well, I wasn't aware you needed the day off, and it isn't possible since staffing is so inadequate." Instead of this exchange, what communication by the nurse would have been more effective? A. "I placed a request to have 8th of August off, but I'm working and I have a doctor's appointment." B. "I would like to discuss my schedule with you. I requested the 8th of August off for a doctor's appointment. Could I make an appointment?" C. "I will need to call in on the 8th of August because I have a doctor's appointment." D. "Since you didn't give me the 8th of August off, will I need to find someone to work for me?"
b. Effective communication by the sender involves the implementation of nonthreatening information by showing respect to the receiver. The nurse should identify the subject of the meeting and be sure it occurs at a mutually agreed upon time.
A nurse wants to call an ethics consult to clarify treatment goals for a patient no longer able to speak for himself. The nurse believes his dying is being prolonged painfully. The patient's doctor threatens the nurse with firing if the nurse raises questions about the patient's care or calls the consult. What ethical conflict is this nurse experiencing? A. Ethical uncertainty B. Ethical distress C. Ethical dilemma D. Ethical residue
b. Ethical distress results from knowing the right thing to do but finding it almost impossible to execute because of institutional or other constraints (in this case, the nurse fears the loss of job). Ethical uncertainty results from feeling troubled by a situation but not knowing if it is an ethical problem. Ethical dilemmas occur when the principles of bioethics justify two or more conflicting courses of action. Ethical residue is what nurses experience when they seriously compromise themselves or allow themselves to be compromised.
A nurse caring for patients in an institutional setting expresses a commitment to social justice. What action best exemplifies this attribute? A. Providing honest information to patients and the public B. Promoting universal access to health care C. Planning care in partnership with patients D. Documenting care accurately and honestly
b. The American Association of Colleges of Nursing lists promoting universal access to health care as an example of social justice. Providing honest information and documenting care accurately and honestly are examples of integrity, and planning care in partnership with patients is an example of autonomy.
A nurse is using the ESFT model to understand a patient's conception of a diagnosis of chronic obstructive pulmonary disease (COPD). Which interview question would be MOST appropriate to assess the E aspect of this model—Explanatory model of health and illness? A. How do you get your medications? B. How does having COPD affect your lifestyle? C. Are you concerned about the side effects of your medications? D. Can you describe how you will take your medications?
b. The ESFT model guides providers in understanding a patient's explanatory model (a patient's conception of her or his illness), social and environmental factors, and fears and concerns, and also guides providers in contracting for therapeutic approaches. Asking the questions: "How does having COPD affect your lifestyle?" explores the explanatory model, "How do you get your medications?" refers to the social and environmental factor, "Are you concerned about the side effects of your medications?" addresses fears and concerns, and "Can you describe how you will take your medications?" involves therapeutic contracting.
According to the National Advisory Council on Nurse Education and Practice, what is a current health care trend contributing to 21st century challenges to nursing practice? a. Decreased numbers of hospitalized patients b. Older and more acutely ill patients c. Decreasing health care costs owing to managed care d. Slowed advances in medical knowledge and technology
b. The National Advisory Council on Nurse Education and Practice identifies the following critical challenges to nursing practice in the 21st century: A growing population of hospitalized patients 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.
A young Hispanic mother comes to the local clinic because her baby is sick. She speaks only Spanish and the nurse speaks only English. What is the appropriate nursing intervention? A. Use short words and talk more loudly. B. Ask an interpreter for help. C. Explain why care can't be provided. D. Provide instructions in writing.
b. The nurse should ask an interpreter for help. Many facilities have a qualified interpreter who understands the health care system and can reliably provide assistance. Using short words, talking loudly, and providing instructions in writing will not help the nurse communicate with this patient. Explaining why care can't be provided is not an acceptable choice because the nurse is required to provide care; also, since the patient doesn't speak English, she won't understand what the nurse is saying.
A nursing student is preparing to administer morning care to a patient. What is the MOST important question that the nursing student should ask the patient about personal hygiene? A. "Would you prefer a bath or a shower?" B. "May I help you with a bed bath now or later this morning?" C. "I will be giving you your bath. Do you use soap or shower gel?" D. "I prefer a shower in the evening. When would you like your bath?"
b. The nurse should ask permission to assist the patient with a bath. This allows for consent to assist the patient with care that invades the patient's private zones.
A nurse is providing instruction to a patient regarding the procedure to change a colostomy bag. During the teaching session, the patient asks, "What type of foods should I avoid to prevent gas?" The patient's question allows for what type of communication on the nurse's part? A. A closed-ended answer B. Information clarification C. The nurse to give advice D. Assertive behavior
b. The patient's question allows the nurse to clarify information that is new to the patient or that requires further explanation.
A nurse is caring for a patient in the ICU who is being monitored for a possible cerebral aneurysm following a loss of consciousness in the emergency department (ED). The nurse anticipates preparing the patient for ordered diagnostic tests. What aspect of nursing does this nurse's knowledge of the diagnostic procedures reflect? a. The art of nursing b. The science of nursing c. The caring aspect of nursing d. The holistic approach to nursing
b. The science of nursing is the knowledge base for care that is provided. In contrast, the skilled application of that knowledge is the art of nursing. Providing holistic care to patients based on the science of nursing is considered the art of nursing.
A nurse practicing in a primary care center uses the ANA's Nursing's Social Policy Statement as a guideline for practice. Which purposes of nursing are outlined in this document? Select all that apply. a. A description of the nurse as a dependent caregiver b.The provision of standards for nursing educational programs c. A definition of the scope of nursing practice d. The establishment of a knowledge base for nursing practice e. A description of nursing's social responsibility f. The regulation of nursing research
c, d, e. The ANA Social Policy Statement (2010) describes the social context of nursing, a definition of nursing, the knowledge base for nursing practice, the scope of nursing practice, standards of professional nursing practice, and the regulation of professional nursing.
During an interaction with a patient diagnosed with epilepsy, a nurse notes that the patient is silent after communicating the nursing care plan. What would be appropriate nurse responses in this situation? Select all that apply. A. Fill the silence with lighter conversation directed at the patient. B. Use the time to perform the care that is needed uninterrupted. C. Discuss the silence with the patient to ascertain its meaning. D. Allow the patient time to think and explore inner thoughts. E. Determine if the patient's culture requires pauses between conversation. F. Arrange for a counselor to help the patient cope with emotional issues.
c, d, e. The nurse can use silence appropriately by taking the time to wait for the patient to initiate or to continue speaking. During periods of silence, the nurse should reflect on what has already been shared and observe the patient without having to concentrate simultaneously on the spoken word. In due time, the nurse might discuss the silence with the patient in order to understand its meaning. Also, the patient's culture may require longer pauses between verbal communication. Fear of silence sometimes leads to too much talking by the nurse, and excessive talking tends to place the focus on the nurse rather than on the patient. The nurse should not assume silence requires a consult with a counselor.
A nurse instructor outlines the criteria establishing nursing as a profession. What teaching point correctly describes this criteria? Select all that apply. a. Nursing is composed of a well-defined body of general knowledge b. Nursing interventions are dependent upon medical practice c. Nursing is a recognized authority by a professional group d. Nursing is regulated by the medical industry e. Nursing has a code of ethics f. Nursing is influenced by ongoing research
c, e, f. Nursing is recognized increasingly as a profession based on the following defining criteria: well-defined body of specific and unique knowledge, strong service orientation, recognized authority by a professional group, code of ethics, professional organization that sets standards, ongoing research, and autonomy and self-regulation.
A nurse is interviewing a newly admitted patient. Which question is considered culturally sensitive? A. "Do you think you will be able to eat the food we have here?" B. "Do you understand that we can't prepare special meals?" C. "What types of food do you eat for meals?" D. "Why can't you just eat our food while you are here?"
c. Asking patients what types of foods they eat for meals is culturally sensitive. The other questions are culturally insensitive.
A nursing student is nervous and concerned about working at a clinical facility. Which action would BEST decrease anxiety and ensure success in the student's provision of patient care? A. Determining the established goals of the institution B. Ensuring that verbal and nonverbal communication is congruent C. Engaging in self-talk to plan the day and decrease fear D. Speaking with fellow colleagues about how they feel
c. By engaging in self-talk, or intrapersonal communication, the nursing student can plan her day and enhance her clinical performance to decrease fear and anxiety.
A nurse is teaching a novice nurse how to provide care for patients in a culturally diverse community health clinic. Although all these actions are recommended, which one is MOST basic to providing culturally competent care? A. Learning the predominant language of the community B. Obtaining significant information about the community C. Treating each patient at the clinic as an individual D. Recognizing the importance of the patient's family
c. In all aspects of nursing, it is important to treat each patient as an individual. This is also true in providing culturally competent care. This basic objective can be accomplished by learning the predominant language in the community, researching the patient's culture, and recognizing the influence of family on the patient's life.
organized in ww2 to provide training for nurses
cadet nurse corps
-biggest thing is the nurse's relationships with clients and the nurse's "being," or character and identity -promotion of dignity and respect for patients as people
care-based approach
A nurse is caring for patients of diverse cultures in a community health care facility. Which characteristics of cultural diversity that exist in the United States should the nurse consider when planning culturally competent care? Select all that apply. A. The United States has become less inclusive of same-sex couples. B. Cultural diversity is limited to people of varying cultures and races. C. Cultural diversity is separate and distinct from health and illness. D. People may be members of multiple cultural groups at one time. E. Culture guides what is acceptable behavior for people in a specific group. F. Cultural practices may evolve over time but mainly remain constant.
d, e, f. A person may be a member of multiple cultural, ethnic, and racial groups at one time. Culture guides what is acceptable behavior for people in a specific group. Cultural practices and beliefs may evolve over time, but they mainly remain constant as long as they satisfy a group's needs. The United States has become more (not less) inclusive of same-sex couples. The definition of cultural diversity includes, but is not limited to, people of varying cultures, racial and ethnic origin, religion, language, physical size, biological sex, sexual orientation, age, disability, socioeconomic status, occupational status, and geographic location. Cultural diversity, including culture, ethnicity, and race, is an integral component of both health and illness.
A nurse is practicing as a nurse-midwife in a busy OB-GYN office. Which degree in nursing is necessary to practice at this level? a. LPN b. ADN c. BSN d. MSN
d. A master's degree (MSN) prepares advanced practice nurses. Many master's graduates gain national certification in their specialty area, for example, as family nurse practitioners (FNPs) or nurse midwives.
Nurses today complete a nursing education program, and practice nursing that identifies the personal needs of the patient and the role of the nurse in meeting those needs. Which nursing pioneer is MOST instrumental in this birth of modern nursing? a. Clara Barton b. Lilian Wald c. Lavinia Dock d. Florence Nightingale
d. Florence Nightingale elevated the status of nursing to a respected occupation, improved the quality of nursing care, and founded modern nursing education. Clara Barton established the Red Cross in the United States in 1882. Lillian Wald was the founder of public health nursing. Lavinia Dock was a nursing leader and women's rights activist instrumental in establishing women's right to vote.
The role of nurses in today's society was influenced by the nurse's role in early civilization. Which statement best portrays this earlier role? a. Women who committed crimes were recruited into nursing the sick in lieu of serving jail sentences. b. Nurses identified the personal needs of the patient and their role in meeting those needs. c. Women called deaconesses made the first visits to the sick, and male religious orders cared for the sick and buried the dead. d. The nurse was the mother who cared for her family during sickness by using herbal remedies.
d. In early civilizations, the nurse usually was the mother who cared for her family during sickness by providing physical care and herbal remedies. This nurturing and caring role of the nurse has continued to the present. At the beginning of the 16th century, the shortage of nurses led to the recruitment of women who had committed crimes to provide nursing care instead of going to jail. In the early Christian period, women called deaconesses made the first organized visits to sick people, and members of male religious orders gave nursing care and buried the dead. The influences of Florence Nightingale were apparent from the middle of the 19th century to the 20th century; one of her accomplishments was identifying the personal needs of the patient and the nurse's role in meeting those needs.
A patient states, "I have been experiencing complications of diabetes." The nurse needs to direct the patient to gain more information. What is the MOST appropriate comment or question to elicit additional information? A. "Do you take two injections of insulin to decrease the complications?" B. "Most health care providers recommend diet and exercise to regulate blood sugar." C. "Most complications of diabetes are related to neuropathy." D. "What specific complications have you experienced?"
d. Requesting specific information regarding complications of diabetes will elicit specific information to guide the nurse in further interview questions and specific assessment techniques.
A nurse states, "That patient is 78 years old—too old to learn how to change a dressing." What is the nurse demonstrating? A. Cultural imposition B. Clustering C. Cultural competency D. Stereotyping
d. Stereotyping is assuming that all members of a group are alike. This is not an example of cultural competence nor is the nurse imposing her culture on the patient. Clustering is not an applicable concept.
A nurse incorporates the "five values that epitomize the caring professional nurse" (identified by the American Association of Colleges of Nursing) into a home health care nursing practice. Which attribute is best described as acting in accordance with an appropriate code of ethics and accepted standards of practice? A. Altruism B. Autonomy C. Human dignity D. Integrity
d. The American Association of Colleges of Nursing defines integrity as acting in accordance with an appropriate code of ethics and accepted standards of practice. Altruism is a concern for the welfare and well-being of others. Autonomy is the right to self-determination, and human dignity is respect for the inherent worth and uniqueness of individuals and populations.
During rounds, a charge nurse hears the patient care technician yelling loudly to a patient regarding a transfer from the bed to chair. Upon entering the room, what is the nurse's BEST response? A. "You need to speak to the patient quietly so you don't disturb the other patients." B. "Let me help you with your transfer technique." C. "When you are finished, be sure to apologize for your rough demeanor." D. "When your patient is safe and comfortable, meet me at the desk."
d. The charge nurse should direct the patient care technician to determine the patient's safety. Then the nurse should address any concerns regarding the patient care technician's communication techniques privately. The nurse should direct the patient care technician on aspects of therapeutic communication.
A nurse enters a patient's room and examines the patient's IV fluids and cardiac monitor. The patient states, "Well, I haven't seen you before. Who are you?" What is the nurse's BEST response? A. "I'm just the IV therapist checking your IV." B. "I've been transferred to this division and will be caring for you." C. "I'm sorry, my name is John Smith and I am your nurse." D. "My name is John Smith, I am your nurse and I'll be caring for you until 11 PM."
d. The nurse should identify himself, be sure the patient knows what will be happening, and the time period he will be with his patient.
A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and dehydration. During the admission interview, the nurse should implement which communication techniques to elicit the most information from the parents? A. The use of reflective questions B. The use of closed questions C. The use of assertive questions D. The use of clarifying questions
d. The use of the clarifying question or comment allows the nurse to gain an understanding of a patient's comment. When used properly, this technique can avert possible misconceptions that could lead to an inappropriate nursing diagnosis. The reflective question technique involves repeating what the person has said or describing the person's feelings. Open-ended questions encourage free verbalization and expression of what the parents believe to be true. Assertive behavior is the ability to stand up for yourself and others using open, honest, and direct communication.
A nurse enters the room of a patient with cancer. The patient is crying and states, "I feel so alone." Which response by the nurse is the most therapeutic action? A. The nurse stands at the patient's bedside and states, "I understand how you feel. My mother said the same thing when she was ill." B. The nurse places a hand on the patient's arm and states, "You feel so alone." C. The nurse stands in the patient's room and asks, "Why do you feel so alone? Your wife has been here every day." D. The nurse holds the patient's hand and asks, "What makes you feel so alone?"
d. The use of touch conveys acceptance, and the implementation of an open-ended question allows the patient time to verbalize freely.
A pediatric nurse is assessing a 5-year-old boy who has dietary modifications related to his diabetes. His parents tell the nurse that they want him to value good nutritional habits, so they decide to deprive him of a favorite TV program when he becomes angry after they deny him foods not on his diet. This is an example of what mode of value transmission? A. Modeling B. Moralizing C. Laissez-faire D. Rewarding and punishing
d. When rewarding and punishing are used to transmit values, children are rewarded for demonstrating values held by parents and punished for demonstrating unacceptable values. Through modeling, children learn what is of high or low value by observing parents, peers, and significant others. Children whose caregivers use the moralizing mode of value transmission are taught a complete value system by parents or an institution (e.g., church or school) that allows little opportunity for them to weigh different values. Those who use the laissez-faire approach to value transmission leave children to explore values on their own (no single set of values is presented as best for all) and to develop a personal value system.
A home health nurse performs a careful safety assessment of the home of a frail older adult to prevent harm to the patient. The nurse's action reflects which principle of bioethics? A. Autonomy B. Beneficence C. Justice D. Fidelity E. Nonmaleficence
e. Nonmaleficence is defined as the obligation to prevent harm. Autonomy is respect for another's right to make decisions, beneficence obligates us to benefit the patient, justice obligates us to act fairly, and fidelity obligates us to keep our promises.
ESFT Model what does the E stand for?
explanation of cause
keeps promises ex: "i'll be right back with your medications" and the nurse returns quickly
fidelity
Crimean War
florence nightingale
advocated the principles of cleanliness and nutrition in promoting health
florence nightingale
encouraged the belief that there is a body of nursing knowledge distinct from medical knowledge
florence nightingale
who demonstrated the value of nursing care in reducing morbidity rates in the crimean war
florence nightingale
who elevated the status of nursing to a respected occupation, improved the quality of nursing care, and founded modern nursing education?
florence nightingale
who established the first school for nurses that provided theory based knowledge and clinical skill building?
florence nightingale
who is the founder of modern nursing?
florence nightingale
who is reported to be the first nurse researcher and why?
florence nightingale because she recorded deaths and admissions
acting according to code of ethics and standards of practice/admitting mistakes
integrity
who founded the visiting nurse service in new york city?
lillian wald
who is a pioneer in public health nursing?
lillian wald
who was the first hospital trained nurse in the US and introduced the concept of patient records and initiated practice of wearing uniforms?
linda richards
who was the first trained african-american nurse?
mary eliza mahoney
when you know the ethical action to take, but don't feel empowered or supported in taking it ex: know physician is wrong but he threatens you if you "tell"
moral distress
nurse origins in ______ _____
mother-care
do no harm ex: stopping a medication that is harmful
nonmaleficence
occurs when a nurse acts for a patient without consent to secure good or prevent harm
paternalism
who received the first doctorate in nursing education?
sister mary b. beck
who brought modern health care to native americans in the early part of the 20th century?
susie walking bear yellowtail
the rightness or wrongness of an action depends on the consequences of action (the end justifies the means)
utilitarian
beliefs about the worth of something; act as a standard to guide one's behavior -not born with them. shaped by environment, family, culture
values