Introduction to Nursing - 1921
A nurse is planning to pursue further education in the hopes of becoming an expert in geriatric nursing who carries out direct care. For which expanded career role is the nurse preparing?
Clinical nurse specialist Explanation: Clinical nurse specialists are nurses with an advanced degree who are considered experts in a specialized area of care. They also provide direct care, consultation, and education of clients, families, and staff. Nurse managers do not normally provide direct care. Nurse-midwives specialize in obstetrical care. Physician assistants are not nurses.
The nurse is helping the unlicensed assistive personnel (UAP) bathe the client, who is experiencing a lot of pain when repositioned in bed. Which nursing responsibility is the nurse demonstrating?
client advocate Explanation: Nurses act as client advocates in many situations. Examples include communicating the needs and concerns of clients and ensuring that clients understand their treatments. In this case, the nurse is advocating for the client by providing the client dignity of personal hygiene and cleanliness. The nurse is not teaching as in the role of the educator. The nurse is not deciding on what is best for the client as a decision maker. The nurse is not using therapeutic communication to provide information as in the role of the counselor.
The nurse is caring for a client who ascribes to the theory of animism. When attempting to explain this theory to other staff members, the nurse should state:
"Everything in nature is alive with invisible forces." Explanation: The theory of animism attempts to explain the cause of mysterious changes in bodily functions. This theory is based on the belief that everything in nature is alive with invisible forces and endowed with power. Good spirits bring health; evil spirits bring sickness and death. In cultures that ascribe to animism, the roles of the physician and the nurse are separate and distinct. The physician is the medicine man who treats disease by chanting, inspiring fear, or opening the skull to release evil spirits (Dolan, Fitzpatrick, & Herrmann, 1983). The nurse usually is the mother who cares for her family during sickness by providing physical care and herbal remedies. Pets are not involved in the theory of animism.
In what time period did nursing care as we now know it begin?
18th to 19th century
Which scenario is the best example of a nurse in the role of counselor?
A nurse allowing a crying client to verbalize fears of death Explanation: When acting as a counselor, the nurse uses therapeutic interpersonal skills to help develop the client's problem-solving and decision-making skills. The best example is the nurse allowing the client to verbalize feelings, as verbalizing feelings lets the client gain a better perspective of the situation for problem solving and for coming to terms with the situation. Telling the client about the side effects of a medication is a form of teaching. Providing test results to the physician is communication. Ensuring a client has follow-up care at a free clinic is advocacy.
After hearing a presentation about the American Nurses Association (ANA), a nurse decides to join the organization based on the understanding that:
ANA aims at fostering high standards of nursing in the United States. Explanation: ANA aims at fostering high standards of nursing in the United States. Membership is not open to all nurses in the United States; only registered nurses can become members. Members of the National League for Nursing, not the ANA, include nurses, other health care providers, and lay people. Sigma Theta Tau, not ANA, invites students showing excellence in scholarship to become members.
Florence Nightingale introduced the concept of apprenticeship for nurses. Which statement is an example of this?
Completing clinical hours supervised by a nursing instructor Explanation: Florence Nightingale's concept of apprenticeship involved training student nurses in a hospital setting. Completing clinical hours is an example of this. Passing the NCLEX exam is required to work as an RN. Participating in a paid internship is outside of the student nurse training supported by the apprenticeship model. Taking an online class at a university is not part of an apprenticeship model.
Which action should the nurse implement when working with a medically homeless client?
Encourage client to utilize the free health care clinic. Explanation: According to the Association of American Medical Colleges, many Americans are medically homeless and find it difficult to navigate the health care system. Encouraging the client to utilize the free health care clinic will help the client navigate the system and obtain access to health care. While utilizing the emergency room when needed is appropriate, the emergency room should not be utilized for all illnesses, as it increases the burden on the health care system. Assisting the client to find housing or a job will help the client, but is outside of the scope of nursing practice.
Which nursing actions demonstrate the aim of nursing to facilitate coping? Select all that apply.
Explanation: Coping is another important broad aim of nursing. Nurses facilitate client and family coping for those experiencing altered function, life crisis, and death. Examples of coping would be teaching a client and the client's family about how to live with diabetes. Another example would be assisting a client and the client's family to prepare for death. A third example would be providing counseling for the family of a teenager with an eating disorder. Changing bandages, starting an IV, or teaching a class on an expected health care issue or need would not be examples of the aim of facilitating coping with disability or death.
A client is distraught because a recent computed tomography (CT) scan shows that the client's colon cancer has metastasized to the lungs. Which nursing aim should the nurse prioritize in the immediate care of this client?
Facilitating coping Explanation: This client's care in the coming weeks or months will likely encompass all of the four foundational roles of the nurse. However, because the client has just recently received bad news and is emotionally distraught, helping the client cope is an appropriate priority in immediate care. Preventing illness is focused on preventing an infection or disease from occurring such as through immunizations, hand hygiene, exercising and diet. Restoring health would more appropriately occur after the client has accepted the disease and would involve taking medication and working to get back to baseline with the disease. Health promotion is the process of enabling people to increase control over, and to improve, their health.
The founder of public health nursing is:
Lillian Wald
Which is the best example of a client-centered approach to care?
The nurse asks the client about health goals. Explanation: Client-centered care is one of the quality and safety education requirements for nursing competencies (QSEN). The intent of client-centered care is to ensure that care is centered on the client, and not the needs of the nurse. An example of this is the nurse asking the client about personal health goals so that they can be addressed on the client's plan of care. Helping the client ambulate, asking the client what he or she would like from the menu, and drawing a blood sample are examples of client care, but are not client-centered care.
The nursing process is:
a critical thinking method used by nurses to provide nursing care that is individualized and holistic. Explanation: The nursing process is a critical thinking method used by nurses to provide nursing care that is individualized and holistic. Continuing education and in-service education programs increase the knowledge and skill of the nurse. Evidence-based practice involves the identification and analysis of the best available scientific evidence for nursing care. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled, and dying individuals.
A registered nurse (RN) is caring for four clients on a medical-surgical unit. Which task is mostappropriate for the nurse to delegate to the licensed practical nurse (LPN)?
administering bedside blood glucose testing Explanation: The LPN, under the nurse practice act (NPA), is permitted to administer testing for bedside blood glucose. The nurse must recognize the scope of practice of the delegate, and remember that client needs and activities delegated must be matched to skill level. The RN would not delegate administration of blood products, intravenous push medication, or chemotherapy to the LPN, as these tasks are not covered under the LPN's NPA.
A nurse must possess several characteristics to be successful in this profession. Secondary to critical thinking skills, which is of great value?
advocating for the client at all times Explanation: Nursing is caring, commitment, and dedication to meeting the health needs of all people. Nurses direct care to promote, maintain, and restore health in various settings. They are prepared to identify and to assist with the health care needs of individuals, families, communities, and populations. Advocating for the client is an essential skill needed. A RN does not need to have a masters degree to advocate. Any healthcare provider can delegate responsibilities. A nurse can learn to work with teams and team build as necessary.
Which is the best example of a nurse demonstrating the role of caregiver?
starting an intravenous line in the client's arm Explanation: In the role of caregiver, the nurse provides care to clients to meet their needs, such as when starting an intravenous line. The role of caregiver is the primary role of the nurse. Teaching a client about medication is the role of educator. Telling a doctor a lab value is the role of communicator. Securing a referral to the local clinic is the role of counselor. Assigning rooms is a management role.
Which nursing group provides a definition and scope of practice for nursing?
American Nurses Association (ANA) Explanation: The ANA is a professional organization to advance and protect the profession of nursing. The ANA describes the values and social responsibility of nursing, provides a definition and scope of practice for nursing, discusses nursing's knowledge base, and describes the methods by which nursing is regulated within its Nursing's Social Policy Statement (2003). The Joint Commission is a United States-based nonprofit tax-exempt 501 organization that accredits more than 21,000 U.S. health care organizations and programs. The AAN is a professional society representing over 34,000 neurologists and neuroscientists. The ICN is an international federation of nursing organizations that works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the presence worldwide of a respected nursing profession and a competent and satisfied nursing workforce.
Which nursing group provides a definition and scope of practice for nursing?
American Nurses Association (ANA) Explanation: The ANA is a professional organization to advance and protect the profession of nursing. The ANA describes the values and social responsibility of nursing, provides a definition and scope of practice for nursing, discusses nursing's knowledge base, and describes the methods by which nursing is regulated within its Nursing's Social Policy Statement (2003). The Joint Commission is a United States-based nonprofit tax-exempt 501 organization that accredits more than 21,000 U.S. health care organizations and programs. The AAN is a professional society representing over 34,000 neurologists and neuroscientists. The ICN is an international federation of nursing organizations that works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the presence worldwide of a respected nursing profession and a competent and satisfied nursing workforce.
What is the best nursing intervention to promote health in a client at risk for heart disease?
Emphasizing a client's strengths to encourage weight loss Explanation: Nurses promote health by identifying, analyzing, and maximizing each client's own individual strengths as components of preventing illness, restoring health, and facilitating coping with disability or death. Emphasizing the client's strengths to encourage weight loss is the most effective way to promote this client's health. Informing the client that the client must lose weight would not help the client use his or her strengths to accomplish the goal. Low-sodium diets can prevent heart disease. Taking the pulse daily would not prevent heart disease.
The American Nurses Association (ANA) Standards of Professional Nursing Practice provides standard of care for all nurses. Which statement on the assessment of the nursing process is accurate?
Explanation: The nursing process is used for all nurses as the standard of care. In the assessment phase, the RN collects comprehensive data pertinent to the client's health or situation. In the diagnosis phase, the RN analyzes the assessment data to determine the diagnoses or issues pertinent to the client. Next the RN identifies expected outcomes for a plan individualized to the client or the situation and develops a plan that prescribes strategies and alternatives to attain expected outcomes. The nurse does not dictate the plan. The RN implements the identified plan. This includes coordination of care, health teaching and health promotion, consultation, and prescriptive authority and treatment. Finally, in the evaluation phase, the RN evaluates progress toward attainment of outcomes. From the ethical standpoint, the nurse advocates for the client and makes sure that ethical standards are upheld, but this is not part of the nursing process.