Health Care Delivery & Evidence-Based Practice
A team of community health nurses are planning to draft a proposal for a program that will increase the communitys alignment with the principles contained in the Healthy People 2020report. Which of the following activities would best demonstrate the priorities identified in this report? A) Addressing determinants of health such as clean environments and safety in the community B) Lobbying for increased funding to the county hospital where many residents receive primary care C) Collaborating with health professionals in neighboring communities to pool resources and increase efficiencies D) Creating clinical placements where nursing students and members of other health disciplines can gain experience in a community setting
A) Addressing determinants of health such as clean environments and safety in the community
A nurse on a postsurgical unit is providing care based on a clinical pathway. When performing assessments and interventions with the aid of a pathway, the nurse should prioritize what goal? A) Helping the patient to achieve specific outcomes B) Balancing risks and benefits of interventions C) Documenting the patients response to therapy D) Staying accountable to the interdisciplinary team
A) Helping the patient to achieve specific outcomes
You are admitting a patient to your medical unit after the patient has been transferred from the emergency department. What is your priority nursing action at this time? A) Identifying the immediate needs of the patient B) Checking the admitting physicians orders C) Obtaining a baseline set of vital signs D) Allowing the family to be with the patient
A) Identifying the immediate needs of the patient
A public health nurse has been commissioned to draft a health promotion program that meets the health care needs and expectations of the community. Which of the following focuses is most likely to influence the nurses choice of interventions? A) Management of chronic conditions and disability B) Increasing need for self-care among a younger population C) A shifting focus to disease management D) An increasing focus on acute conditions and rehabilitation
A) Management of chronic conditions and disability
A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse. What is one characteristic the nurse would cite as necessary to possess to be an effective nurse? A) Sensitivity to cultural differences B) Team-focused approach to problem-solving C) Strict adherence to routine D) Ability to face criticism
A) Sensitivity to cultural differences
Nursing is, by necessity, a flexible profession. It has adapted to meet both the expectations and the changing health needs of our aging population. What is one factor that has impacted the need for certified nurse practitioners (CNPs)? A) The increased need for primary care providers B) The need to improve patient diagnostic services C) The push to drive institutional excellence D) The need to decrease the number of medical errors
A) The increased need for primary care providers
Over the past several decades, nursing roles have changed and expanded in many ways. Which of the following factors has provided the strongest impetus for this change? A) The need to decrease the cost of health care B) The need to improve the quality of nursing education C) The need to increase the number of nursing jobs available D) The need to increase the public perception of nursing
A) The need to decrease the cost of health care
A community health nurse has witnessed significant shifts in patterns of disease over the course of a four-decade career. Which of the following focuses most clearly demonstrates the changing pattern of disease in the United States? A) Type 1 diabetes management B) Treatment of community-acquired pneumonia C) Rehabilitation from traumatic brain injuries D) Management of acute Staphylococcus aureus infections
A) Type 1 diabetes management
Which is an element of nursing as defined by the American Nurses Association?
Alleviating suffering by diagnosing and treating human responses to health problems
A nurse is providing care for a patient who is postoperative day one following a bowel resection for the treatment of colorectal cancer. How can the nurse best exemplify the QSEN competency of quality improvement? A) By liaising with the members of the interdisciplinary care team B) By critically appraising the outcomes of care that is provided C) By integrating the patients preferences into the plan of care D) By documenting care in the electronic health record in a timely fashion
B) By critically appraising the outcomes of care that is provided
The ANA has identified several phenomena toward which the focus of nursing care should be directed, and a nurse is planning care that reflects these priorities. Which of the nurses actions best demonstrates these priorities? A) Encouraging the patients dependence on caregivers B) Fostering the patients ability to make choices C) Teaching the patient about nurses roles in the health care system D) Assessing the patients adherence to treatment
B) Fostering the patients ability to make choices
With the changing population of health care consumers, it has become necessary for nurses to work more closely with other nurses, as when acute care nurses collaborate with public health and home health nurses. What nursing function has increased in importance because of this phenomenon? A) Prescribing medication B) Performing discharge planning C) Promoting family involvement D) Forming collegial relationships
B) Performing discharge planning
Leadership of a medical unit have been instructed to integrate the principles of the Quality and Safety Education for Nurses (QSEN) competency of quality improvement. What action should the units leaders take? A) Provide access to online journals and Web-based clinical resources for nursing staff. B) Use flow charts to document the processes of care that are used on the unit. C) Enforce continuing education requirements for all care providers. D) Reduce the use of chemical and physical restraints on the unit.
B) Use flow charts to document the processes of care that are used on the unit.
A nurse working in the intensive care unit refers to the Institute for Healthcare Improvement (IHI) Ventilator Bundle before planning patient care. The nurse realizes nursing interventions outlined in the bundle will improve clients' outcomes. Which statement best describes how nursing interventions established by the IHI should be included in each bundle?
Best practices derived from valid and reliable research studies guided nursing interventions being added to the IHI bundles
A nurse is planning a medical patients care with consideration of Maslows hierarchy of needs. Within this framework of understanding, what would be the nurses first priority? A) Allowing the family to see a newly admitted patient B) Ambulating the patient in the hallway C) Administering pain medication D) Teaching the patient to self-administer insulin safely
C) Administering pain medication
A nurse is aware that an increasing emphasis is being placed on health, health promotion, wellness, and self-care. Which of the following activities would best demonstrate the principles of health promotion? A) A discharge planning initiative between acute care and community care nurses B) Collaboration between several schools of nursing in an urban area C) Creation of a smoking prevention program undertaken in a middle school D) Establishment of a website where patients can check emergency department wait-times
C) Creation of a smoking prevention program undertaken in a middle school
A nurse has integrated the principles of evidence-based practice into care. EBP has the potential to help the nurse achieve what goal? A) Increasing career satisfaction B) Obtaining federal grant money C) Ensuring high quality patient care D) Enhancing the publics esteem for nursing
C) Ensuring high quality patient care
Professional nursing expands and grows because of factors driven by the changing needs of health care consumers. Which of the following is a factor that nurses should reflect in the planning and provision of health care? A) Decreased access to health care information by individuals B) Gradual increases in the cultural unity of the American population C) Increasing mean and median age of the American population D) Decreasing consumer expectations related to health care outcomes
C) Increasing mean and median age of the American population
A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslows hierarchy of needs, what dimension of care should the nurse consider primary in importance when caring for a dying patient? A) Spiritual B) Social C) Physiologic D) Emotional
C) Physiologic
Nurses in acute care settings must work with other health care team members to maintain quality care while facing pressures to care for patients who are hospitalized for shorter periods of time than in the past. To ensure positive health outcomes when patients return to their homes, what action should the nurse prioritize? A) Promotion of health literacy during hospitalization B) Close communication with insurers C) Thorough and evidence-based discharge planning D) Participation in continuing education initiatives
C) Thorough and evidence-based discharge planning
A nurse in a primary care physician's office has a 73-year-old female client who is interested in learning things she can do to maintain movement and flexibility while coping with osteoporosis. In what situation would this client still be considered healthy even though she has been diagnosed with a chronic disease?
Clients with a chronic illness can still achieve a high quality of life within the limits of the illness if they are physiologically stable and mentally healthy.
The Joint Commission and the Centers for Medicare and Medicaid Services (CMS) are evaluating a large, university medical center according to core measures. Evaluators should perform this evaluation in what way? A) By auditing the medical centers electronic health records B) By performing focus groups and interviews with care providers from numerous disciplines C) By performing statistical analysis of patient satisfaction surveys D) By comparing the centers patient outcomes to best practice indicators
D) By comparing the centers patient outcomes to best practice indicators
Nurses now have the option to practice in a variety of settings and one of the fastest growing venues of practice for the nurse in todays health care environment is home health care. What is the main basis for the growth in this health care setting? A) Chronic nursing shortage B) Western focus on treatment of disease C) Nurses preferences for day shifts instead of evening or night shifts D) Discharge of patients who are more critically ill
D) Discharge of patients who are more critically ill
The public health nurse is presenting a health promotion class to a group of new mothers. How should the nurse best define health? A) Health is being disease free. B) Health is having fulfillment in all domains of life. C) Health is having psychological and physiological harmony. D) Health is being connected in body, mind, and spirit.
D) Health is being connected in body, mind, and spirit.
A group of nursing students are participating in a community health clinic. When providing care in this context, what should the students teach participants about disease prevention? A) It is best achieved through attending self-help groups. B) It is best achieved by reducing psychological stress. C) It is best achieved by being an active participant in the community. D) It is best achieved by exhibiting behaviors that promote health.
D) It is best achieved by exhibiting behaviors that promote health.
With increases in longevity, people have had to become more knowledgeable about their health and the professional health care that they receive. One outcome of this phenomenon is the development of organized self-care education programs. Which of the following do these programs prioritize? A) Adequate prenatal care B) Government advocacy and lobbying C) Judicious use of online communities D) Management of illness
D) Management of illness
A group of nursing students are learning about recent changes in the pattern of disease in the United States. Which of the following statements best describes these current changes? A) Infectious diseases continue to decrease in incidence and prevalence. B) Chronic illnesses are becoming increasingly resistant to treatment. C) Most acute, infectious diseases have been eradicated. D) Most, but not all, communicable diseases are declining.
D) Most, but not all, communicable diseases are declining.
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? a) Patient safety indicators b) Inpatient quality indicators c) Prevention quality indicators d) National Patient Safety Goals
National Patient Safety Goals
A nurse, working in a health clinic, treats a variety of conditions on a daily basis. One disorder that is rapidly increasing and is the leading cause of secondary morbidity is:
Obesity Explanation: Currently about 30 % of adults and 16% of children are classified as obese (CDC, 2009). Obesity is the leading cause of secondary illnesses ranging from cancer to diabetes.
According to Maslow, which category of needs represents the most basic on the hierarchy?
Physiologic needs Explanation: Physiologic needs must be met before an individual is able to move toward psychological health and well-being. Self-actualization is the highest level of need. Safety and security, while a lower level of need, are not essential to physiologic survival. A sense of belonging and affection needs are not essential to physiologic survival.
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.
Prescribes medications Explanation: All registered nurses are responsible for interpreting health care provider orders, developing nursing care plans and reporting abnormal diagnostic test results. Only RNs with a master's or doctoral degree and credentialed by the American Nurses Credentialing Center or a Specialties National Certification Body can function as advanced practice nurses and prescribe medications.
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?
Provision of a broad range of direct care to clients
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? a) Practice most often in acute care settings b) Primarily acting as a educator for clients and families c) Provision of a broad range of direct care to clients d) Specialty in a circumscribed area of care
Provision of a broad range of direct care to clients
Which of the following delineates actions that are legally permitted for a particular profession based on specific educational qualifications
Scope of practice Explanation: Scope of practice is used to delineate actions that are legally permitted for a particular profession, based on specific educational qualifications. The job description represents qualifications and duty of employment. The Code of Ethics represents ethical standards. The code is an ideal framework for nurses to use in ethical decision-making. Under the Occupational Safety and Health Act of 1970, employers are responsible for providing a safe and healthy workplace for their employees.
Which of the following would be considered an expanded nursing role? a) Nurse practitioner (NP) b) Certified nurse's aide (CNA) c) Social worker d) Respiratory therapist
a) Nurse practitioner (NP)
A client comes to the clinic with the complaint that he has been ill for several weeks but does not have insurance and has delayed care. What does the nurse understand about the overall healthcare reform goals that will address issues such as this client?
The goal of healthcare reform is to provide affordable healthcare to more citizens. Explanation: The overall goal of healthcare reform is to provide affordable healthcare to more U.S. citizens. Other goals are to reduce the insurance companies' control of healthcare and to provide more assistance to senior citizens on fixed incomes. The other answers address other individual programs but not the broader terms of the healthcare initiative
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.
The number of adults over age 65 will double in size.
The LPN is providing a program at the local YMCA about stress-reduction techniques combined with a 1-mile walk around the indoor track once a week. What does this type of program address for the community? a) Illness prevention b) Early detection of illness c) Health promotion d) Health maintenance
c) Health promotion
The World Health Organization defines health as:
a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity
The LPN informs the secretary that a client is expected to come in for lab work. The secretary inquires about why the nurse refers to the individual as a client. What is the best response by the nurse? a) "Using the term client implies that they are an active partner in nursing care." b) "We should refer to everyone as a client. They pay for our service." c) "Using the term client is more respectful that using the term patient." d) "That's how the physician wants us to refer to them."
a) "Using the term client implies that they are an active partner in nursing care."
The American Nurses Association's Code of Ethics provides practice guidelines, based on universal moral principles, for all nurses. Select the statement that reflects the nurse's primary commitment within this framework. The nurse is: a) Committed to the patient, whether an individual, family, group or community, to promote health, safety and individual rights. b) Expected to maintain competence and professional development. c) Expected to collaborate with other health care professionals. d) Responsible for enhancing the profession of nursing practice, working within its set parameters.
a) Committed to the patient, whether an individual, family, group or community, to promote health, safety and individual rights.
Which of the following would least likely impact health care delivery and nursing? a) Decline in genetic focus b) Growth in the population c) Cultural diversity d) Increased consumer knowledge
a) Decline in genetic focus
The National Center for Health Statistics maintains data from healthcare agencies and issues reports on a quarterly and annually basis on performance related to goals for improving the health of the U.S. population. Which initiative is targeted with improving the health of all Americans? a) Healthy People 2020 b) Quality Indicators c) Agency for Healthcare Research and Quality d) The Joint Commission
a) Healthy People 2020
A 75-year-old woman had surgery for her hip fracture yesterday. She is under stress due to pain, sleep deprivation, and hospital surroundings. The nurse caring for her implements a proactive approach to pain management. Plans include frequent communication to establish an acceptable pain rating, conducting hourly pain assessments, and hourly evaluation of the patient's pain control. In addition to improved patient outcomes, how else might the hospital benefit from the nurse's actions? a) Improved Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores b) Continued accreditation from The Joint Commission c) Improved Quality and Safety Education for Nurses (QSEN) survey scores d) Additional funding from the Institute for Healthcare Improvement (IHI)
a) Improved Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores
The nurse educator is planning a teaching session for nursing students related to treatment and management of gestational diabetes. The nurse educator arranges for a dietitian, pharmacist, and physician assistant to participate in the lesson plan. Which professional nurse competency is the nurse educator demonstrating? a) Interdisciplinary teamwork b) Quality improvement measures c) Patient-centered care d) Evidence-based practice
a) Interdisciplinary teamwork
A nursing student is preparing for a class presentation addressing the collaborative practice model. Which of the following would the student expect to include? a) Participation in decision making that is shared by all involved b) Accountability that is primarily attributed to the patient c) Nurses and physicians playing major roles in clinical decsions d) A discussion of a centralized organizational structure
a) Participation in decision making that is shared by all involved
The LPN is assisting with the development of a program to administer flu shots to a group of senior citizens. What type of prevention does this program reflect? a) Primary prevention b) Secondary prevention c) Tertiary prevention d) Prevalence
a) Primary prevention
The LPN working in the clinic has had several incidence 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? a) Secondary prevention b) Tertiary prevention c) Primary prevention d) Prevalence
a) Secondary prevention
The nurse is working at an institution that uses a collaborative practice model. Which of the following would most likely be reflected at this institution? a) Shared accountability for care b) Physician as the primary decision-maker c) Isolated participation from the patient d) Centralized organizational structure
a) Shared accountability for care
Future healthcare policy in the United States will be significanly affected by a population that is: a) aging and becoming more culturally diverse. b) becoming skeptical about conventional medicine's reliance on pharmaceuticals and surgery. c) becoming more knowledgeable about nutrition and more likely to undertake dietary changes. d) aging and includes a higher percentage of people with addictions.
a) aging and becoming more culturally diverse.
The reason that case management has gained such prominence in health care can be traced to the a) decreased cost of care associated with inpatient stay. b) increased length of hospital stay. c) ability to discharge from specialty care units to home. d) limited availability for inter-unit hospital transfers.
a) decreased cost of care associated with inpatient stay.
What statement by the LPN shows an understanding of the ultimate goal of Healthy People 2020? a) "The ultimate goal is that they will find a cure for diabetes." b) "The ultimate goal is that they provide an overall action plan to improve health and quality of life." c) "The ultimate goal is that everyone be within a normal weight." d) "The ultimate goal is that everyone will exercise once daily."
b) "The ultimate goal is that they provide an overall action plan to improve health and quality of life."
Although nurse practice acts may vary state by state, all recognize several basic principles supporting the legal parameters for all registered nurses. Select the activity that falls under the scope of nursing practice. a) Prescribing a physical therapy program to treat a flare-up of a chronic condition b) Appraising and enhancing an individual's health-seeking perspective c) Diagnosing pathology based on the patient's response to treatment d) Changing a patient's health care treatment plan
b) Appraising and enhancing an individual's health-seeking perspective
A patient who adheres to the dietary laws of Judaism is in traction and confined to bed. The patient needs assistance with the evening meal of chicken, rice, beans, a roll, and a carton of milk. Which nursing approach is most representative of promoting wellness? a) Ask a family member to assist the patient with the tray and the overbed table, then straighten the area in an attempt to provide a pleasant atmosphere for eating. b) Ask whether the patient would like to make any substitutions in the foods and fluids received. c) Push the overbed table toward the bed so that it will be within the patient's reach when the dinner tray arrives. d) Remove items from the overbed table to make room for the dinner tray.
b) Ask whether the patient would like to make any substitutions in the foods and fluids received.
Students are comparing and contrasting the roles and functions of nurse practitioners and clinical nurse specialists. The students demonstrate understanding of these roles when they identify which of the following as associated with nurse practitioners? Select all that apply. a) Counseling of patients and families b) Collaboration with other disciplines c) Consultation with nursing staff d) Direct care provision e) Prescribing of medications
b) Collaboration with other disciplines d) Direct care provision e) Prescribing of medications
Which of the following best reflects the current trends associated with the elderly population? a) The percentage of older adults in the population will gradually decrease in the future. b) Conditions affecting elderly women are a major concern due to undertreatment and underdiagnosis. c) The 65- to 74-year-old age group is the fastest growing segment of the population. d) There are more men than there are women in the older population.
b) Conditions affecting elderly women are a major concern due to undertreatment and underdiagnosis.
The primary task of nursing research includes which of the following? a) Decreasing overall operating costs to the health care system b) Contributing to the scientific base of nursing practice c) Managing the care of an entire caseload of patients d) Determining nursing diagnoses
b) Contributing to the scientific base of nursing practice
To address the needs of a chronically ill patient and promote the concept of wellness, a nursing care plan should outline steps to: a) Restrict most activities to protect the patient from additional deterioration. b) Encourage positive health characteristics within the limits of the disease. c) Inform the patient about all the possible complications of the disease process. d) Encourage activity, beyond the scope of tolerance, to prevent progressive deterioration.
b) Encourage positive health characteristics within the limits of the disease.
A 17-year-old client is having protected sex one to two times a week in a monogamous relationship. What is the client participating in? a) Health promotion b) Health maintenance c) Wellness d) Illness prevention
b) Health maintenance
The Healthy People 2020 initiative targets the improvement of health for all. In addition to eliminating health disparities, what are the broad goals of this plan? a) Preventing treatable problems b) Increasing the quality and length of a healthy life c) Increasing technological innovations d) Applying a systematic approach to health improvement
b) Increasing the quality and length of a healthy life
Students are reviewing information about community health nursing. The students demonstrate understanding of the term "community-oriented nursing practice" by describing it as which of the following? a) Nursing care directed to specific client groups with identified needs, usually related to illness b) Nursing interventions that can promote wellness, reduce illness spread, and improve the health status of groups c) Provision of primary care services, often with care being provided to underserved populations d) Nursing care of clients with complex needs who are discharged from acute care institutions early in the recovery process
b) Nursing interventions that can promote wellness, reduce illness spread, and improve the health status of groups
Which of the following is an important role for a nurse in the health care delivery system? a) Participation in treatment decisions regarding health restoration b) Participation in disease prevention and health promotion activities; Identifying patient needs and working with patients to address them c) Balance of work with leisure activities d) Participation in the diagnosis and treatment of the disease
b) Participation in disease prevention and health promotion activities; Identifying patient needs and working with patients to address them
A client is experiencing anorexia related to the adverse effects of cancer treatment. Using Maslow's hierarchy, the nurse identifies this need as reflecting which of the following? a) Safety and security b) Physiology c) Esteem and self-respect d) Belongingness and affection
b) Physiology
A nursing instructor is preparing a class on the changes that have occurred in health care over the past years. Which of the following would the instructor most likely include? a) Lowered costs for health care b) Reductions in health care staffing c) Expanding consumer expectations d) Restructuring of health care institutions e) Increasing cultural diversity of the population f) Static nature of diseases
b) Reductions in health care staffing c) Expanding consumer expectations d) Restructuring of health care institutions e) Increasing cultural diversity of the population
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? a) Introducing the patient to a diabetes educator who is in charge of a diabetes support group in the community b) Teaching the patient about measures that she can take to minimize the long-term health effects of her disease c) Providing the patient with a new glucometer and test strips which have been recently brought to market d) Helping the patient to schedule hemoglobin A1C testing at an outpatient laboratory
b) Teaching the patient about measures that she can take to minimize the long-term health effects of her disease
Which of the following disorders, which is linked to obesity, is on the rise in the United States? a) Congestive heart failure b) Asthma c) Diabetes d) Prostate cancer
c) Diabetes
Which of the following is a strategy a nurse would likely discuss with a client as part of health promotion? a) Locating a therapist for a child with emotional problems b) Determining how often blood glucose levels should be monitored at home c) Making positive dietary changes d) Evaluating the merits of various diagnostic procedures
c) Making positive dietary changes
A group of nursing students are reviewing the various types of advanced practice nurses. The students demonstrate the need for additional review when they identify which of the following as an advanced practice nurse? a) Nurse practitioner b) Clinical nurse specialist c) Nurse manager d) Certified nurse midwife
c) Nurse manager
According to Maslow, which category of needs represents the most basic on the hierarchy? a) Self-actualization b) Belongingness c) Physiologic needs d) Safety and security needs
c) Physiologic needs
According to Maslow's hierarchy of needs, which of the following is the lowest-level need? a) Safety and security b) Sense of belonging and affection c) Physiological needs d) Esteem and self-respect
c) Physiological needs
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? a) Esteem and self-respect b) Belongingness and affection c) Safety and security d) Physiology
c) Safety and security
Which of the following delineates actions that are legally permitted for a particular profession based on specific educational qualifications a) Job description b) Occupational Health and Safety Administration (OSHA) c) Scope of practice d) Code of ethics
c) Scope of practice
A patient has been admitted in the emergency care unit with conditions of respiratory distress, coupled with pneumonia. The patient's condition worsens and he is placed on mechanical ventilation. While visiting this patient in the hospital, his family observes the members of the healthcare team washing their hands when entering and leaving the room. By implementing recommended hand hygiene measures which of the following organizations is the healthcare team supporting? a) Institute of Medicine (IOM) b) Agency for Healthcare Research and Quality (AHRQ) c) The Joint Commission d) The National Council of State Boards of Nursing (NCSBN)
c) The Joint Commission
A 54-year-old woman on a fixed income has had an electrocardiogram (ECG) as part of her annual physical examination. Her physician notes an abnormal Q wave on an otherwise unremarkable ECG. What legislation supports this focus on disease prevention, health promotion, and management of chronic conditions? a) A New Health System for the 21st Century Bill b) Building a Safer Health System Act c) The Patient Protection and Affordable Care Act d) Healthcare Research and Quality Improvement Bill
c) The Patient Protection and Affordable Care Act
Fifteen years ago a client's right leg was lost in a motor vehicle accident. Since then, the client and the client's spouse have formed a walking group to raise money for the homeless. Why would the client be considered healthy? a) The client is physiologically and psychologically stable. b) The client is facing various states of health and illness. c) The client is experiencing high quality of life within the limits of the physical condition. d) The client is married and is moving on.
c) The client is experiencing high quality of life within the limits of the physical condition.
A type of nursing which includes individualized care provided by the same nurse throughout the period of care is defined as a) patient-focused nursing. b) case management. c) primary nursing. d) functional nursing.
c) primary nursing.
Which of the following best reflects the rationale for evidence-based practice? a) A method for determining reimbursement b) A process for accreditation c) A way to establish accountability d) A means to ensure quality care
d) A means to ensure quality care
A nurse in a primary care physician's office has a 73-year-old female client who is interested in learning things she can do to maintain movement and flexibility while coping with osteoporosis. In what situation would this client still be considered healthy even though she has been diagnosed with a chronic disease? a) Clients with a chronic illness can never be considered healthy. b) Clients with a chronic illness can be considered healthy only if they carefully follow their physician's advice regarding medications, activity, and diet. c) Clients with a chronic illness are considered healthy only until the point at which primary body systems begin to lose function. d) Clients with a chronic illness can still achieve a high quality of life within the limits of the illness if they are physiologically stable and mentally healthy.
d) Clients with a chronic illness can still achieve a high quality of life within the limits of the illness if they are physiologically stable and mentally healthy.
While interviewing a patient, the nurse notices that the patient is wearing a medallion around his neck. The patient tells the nurse, "It's a medal that everyone in my family wears to protect against cancer." The nurse interprets this statement as most likely reflecting which of the following? a) Race b) Religion c) Morality d) Culture
d) Culture
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? a) Reporting a feeling of well-being b) Adjusting to varying situations c) Performing to the best of one's ability d) Feeling together about one part of life
d) Feeling together about one part of life
A nurse is a member of which entity within the larger healthcare environment? a) Healthcare delivery system b) Physician hospital organization c) Health maintenance organization d) Healthcare team
d) Healthcare team
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? a) Modifying a medical plan of care to include nursing activities b) Diagnosing acute illnesses in children c) Diagnosing chronic illness in the elderly d) Identifying human responses to illness
d) Identifying human responses to illness
The LPN 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? a) Early detection b) Health maintenance c) Health promotion d) Illness prevention
d) Illness prevention
Which of the following is true regarding population demographics? a) Decrease in life span b) Increase in birth rate c) Decrease in homelessness d) Increase in the culturally diverse population
d) Increase in the culturally diverse population
A nurse, working in a health clinic, treats a variety of conditions on a daily basis. One disorder that is rapidly increasing and is the leading cause of secondary morbidity is: a) Pneumonia b) Kidney disease c) Coronary heart disease d) Obesity
d) Obesity
The central figure in health care services is the: a) Nursing assistant b) Nurse c) Physician d) Patient
d) Patient
How should the registered nurse be responsive to the changing health care needs of society? a) Stress the curative aspects of illness, especially the acute, infectious disease processes. b) Focus care on the traditional disease-oriented approach to patient care, because hospitalized patients today are more acutely ill than they were 10 years ago. c) Learn how to delegate discharge planning to ancillary personnel so that registered nurses can spend their time managing the "high-tech" equipment needed for patient care. d) Place increasing emphasis on wellness, health promotion, and self-care, because the majority of Americans today suffer from chronic debilitative illness.
d) Place increasing emphasis on wellness, health promotion, and self-care, because the majority of Americans today suffer from chronic debilitative illness.
When applying Maslow's hierarchy of needs to patient care, the nurse determines that the patient has reached the ultimate goal indicating integrated human functioning and health when which level is met? a) Belongingness and affection b) Safety and security c) Esteem and self-respect d) Self-actualization
d) Self-actualization
Changes in population demographics over the next 40 years will significantly affect the delivery of health care services. Select the one change that will have the most impact on the practice of nursing. a) Hispanics will become the largest minority group in the United States, constituting about 29% of the population. b) The non-Hispanic, white population will reach 47%. c) Immigration patterns will result in a more diverse population. It is projected that, by 2030, more than 20% of Americans will be immigrants. d) The number of adults over age 65 will double in size.
d) The number of adults over age 65 will double in size.
You are a nurse employed by a community organization engaged in health promotion. In this role, you teach clients steps they can take toward achieving wellness. How would you explain "wellness" to a client? a) Wellness is a state of complete physical, mental, and social well-being. b) Wellness is viewing one's health in terms of a balance of body, mind, and spirit, which means being open to alternative treatment options. c) Wellness is the absence of disease. d) Wellness is an ongoing and intentional effort to achieve the highest potential for total well-being.
d) Wellness is an ongoing and intentional effort to achieve the highest potential for total well-being.
Which strategy would a nurse likely discuss with a client as part of health promotion?
making positive dietary changes Explanation: Health promotion involves teaching clients strategies to enhance overall health, such as consuming a healthy diet, exercising regularly, and practicing stress-reduction techniques. Health promotion involves teaching clients strategies to enhance overall health; it is not the diagnosis or treatment of specific conditions.
