NUR-218 Contemporary Nursing: Chapters 1-4 & 6-8

Match the nursing figure with the appropriate description. 1. Won a bronze medal for action in Afghanistan 2. Executed by Germany during World War I 3. Patient advocate for Crimean soldiers 4. Died in a clinic bombing in Baghdad, Iraq a. Edith Cavell b. Jennifer Moreno c. Maria Ortiz d. Florence Nightingale

1. b. Jennifer Moreno 2. a. Edith Cavell 3. d. Florence Nightingale 4. c. Maria Ortiz

Match the hierarchy of design levels with the forms of probing with each level. 1. Systematic review of descriptive/qualitative/physiologic studies 2. Review of nonrandomized trails 3. Review of correlation/observational studies 4. Opinions of authorities, expert committees 5. Single descriptive/qualitative/physiologic study a. Level VI b. Level V c. Level I d. Level VII e. Level III

1. Systematic review of descriptive/qualitative/physiologic studies b. Level V 2. Review of nonrandomized trails c. Level I 3. Review of correlation/observational studies e. Level III 4. Opinions of authorities, expert committees d. Level VII 5. Single descriptive/qualitative/physiologic study a. Level VI

Match the source of funding with its identifying description. 1. $50,000,000 to focus enhancing the image of nursing 2. Faculty Loan cancellations 3. $250,000,000 was allocated for nursing education 4. Increased limits for nursing student loans a. Patient Protection and Affordable Care Act b. Nurse Reinvestment Act c. The Nurse Training Act d. Campaign for Nursing's Future

1. d. Campaign for Nursing's Future 2. b. Nurse Reinvestment Act 3. c. The Nurse Training Act 4. a. Patient Protection and Affordable Care Act

Match the type of health insurance with the correct descriptor. 1. Referred for treatments, specialists, and services by the primary care physician 2. Offered by Military Health Services System 3. Allows use of providers outside the plan's preferred list or network, but requires higher premiums and copayments for services 4. Covers long-term care for qualifying individuals a. Medicaid b. Point of Service (POS) c. TRICARE d. Health Maintenance Organization (HMO)

1. d. Health Maintenance Organization (HMO) 2. c. TRICARE 3. b. Point of Service (POS) 4. a. Medicaid

Place the following events related to professional nursing in correct order beginning with the initial event. The first issue of the American Journal of Nursing is published. The Army Nurse Corps is established. The Visiting Nurse Association is established. The New England Hospital opens a nursing program. The Pennsylvania Hospital is established.

1. The Pennsylvania Hospital is established 2. The New England Hospital opens a nursing program 3. The Visiting Nurse Association is established 4. The first issue of the American Journal of Nursing is published 5. The Army Nurse Corps is established

An example of nursing's influence on outcome management through consumer empowerment would include: a. encouraging an elderly client to get both flu and pneumonia shots. b. witnessing the signing of an organ donation form by an elderly, terminally ill client. c. ambulating a postsurgical client in order to minimize the risk of developing pneumonia. d. providing a postsurgical client with education regarding the early signs of incisional infection.

d. providing a postsurgical client with education regarding the early signs of incisional infection. Educating the client regarding possible complications and so making early identification of such problems possible will positively affect care outcomes and help manage health care costs for this client. Although the other options are appropriate nursing interventions, they are not directed toward consumer empowerment.REF: p. 116

Match the following terms associated with research with the appropriate description. 1. Brief overview of a research study 2. Variety of methods to collect data on the same concept 3. Data previously collected for one study is analyzed for another study 4. Standards of practice, procedures, or decision algorithms 5. The researcher estimates the resource requirements of a group a. Abstract b. Secondary analysis c. Needs assessment d. Practice guidelines e. Triangulation

1. a. Abstract 2. e. Triangulation 3. b. Secondary analysis 4. d. Practice guidelines 5. c. Needs assessment

Match the names and descriptions of the following research designs 1. Design that lacks one of the components of an experimental design 2. Used to collect and analyze data aiming to develop theories grounded in real-world observations 3. Inductive descriptive methodology to describe the lived experiences of study participants 4. Used to develop the validity and reliability of instruments that measure research concepts and variables a. Quasi-experimental research b. Phenomenology c. Grounded theory d. Methodologic design

1. a. Quasi-experimental research 2. c. Grounded theory 3. b. Phenomenology 4. d. Methodologic design

The following nursing associated initials with their appropriate description. 1. Organization whose membership consists of the board of nursing of each state or territory 2. Responsible for accrediting baccalaureate and higher-degree nursing programs 3. Legal title for nurses prepared by education and competence to perform independent practice 4. Professional organization that represents all registered nurses a. ANA b. APN c. NCSBN d. CCNE

1. c. NCSBN 2. d. CCNE 3. b. APN 4. a. ANA

Nonpayment hospital acquired conditions include: (Select all that apply) a. A Stage III pressure ulcer b. Stress-related hypertension c. Hypoglycemic coma d. Catheter associated urinary tract infection (UTI) e. Vascular catheter associated infection

a. A Stage III pressure ulcer c. Hypoglycemic coma d. Catheter associated urinary tract infection (UTI) e. Vascular catheter associated infection Conditions that develop as a result of a hospitalization and but reimbursed for include State III pressure ulcers, critical conditions resulting from poor glycemic control, and infections resulting from the mismanagement of invasive interventions (urinary and vascular catheters). Stress-related hypertension is not a condition that results from mismanagement.REF: p. 123, Box 8-1

A novice nurse reading a research article should first concentrate on which sections of the article? a. Abstract and discussion b. Study design and methods c. Future implications and acknowledgment d. Introduction and results

a. Abstract and discussion The abstract section of the article gives an overview of the study, and the discussion section offers suggestions for nursing practice based on the findings of the research study. These two sections often are the easiest for the novice to interpret. The remaining sections can be confusing, and consulting a CNR to help interpret results is suggested.REF: p. 98-99

Which of the following is an area of clinical specialist nursing for which the American Nurses Credentialing Center (ANCC) offers a certifying examination? Select all that apply. a. Adult Health b. Pediatrics c. Home Health d. Informatics e. Adult Psychiatric and Mental Health

a. Adult Health b. Pediatrics e. Adult Psychiatric and Mental Health ANCC offers Clinical Nurse Specialist certifying examinations for Adult Health CNS, Diabetes Management—Advanced, Adult Psychiatric and Mental Health CNS, Child Adolescent Psychiatric and Mental Health CNS, Gerontologic CNS, Pediatric CNS, and Public Community Health CNS. Home Health and Informatics Nursing are specialties that the ANCC offers certifying examinations for.REF: p. 72, Box 4-1

In the Middle Ages (467 BCE to AD 1450), women delivered food, medicine, and care to the community's ill based on the: a. Christian concepts of charity and the sanctity of human life. b. need to make offerings to the gods in exchange for good health. c. emphasis being placed on the patient-centered approach to health care. d. emerging understanding of the importance of hygiene and sanitation.

a. Christian concepts of charity and the sanctity of human life. The Middle Ages saw the Christian church as the central figure in the organization and management of health care, and its concepts of charity and sanctity of human life were influential in the practice of caring for the sick. Beginning in prehistoric times, there was a belief that illness was a direct outcome of displeasing the gods, which gave rise to the practice of making offerings to the gods. In many cultures, it is still believed that illness is related to punishment from the god(s). The concept of patient-centered care and use of the scientific method of problem solving originated with the Greeks (1500-100 BCE). The Romans (27 BCE to AD 476) are credited with the concepts of good hygiene and sanitation being vital to good health.REF: p. 6-7

Which situation frequently results in a nursing negligence claim? Select all that apply. a. Communication b. Cure c. Reporting d. Monitoring e. Safety

a. Communication c. Reporting d. Monitoring e. Safety The most frequent allegations of nursing negligence includes failures related to communication, reporting and monitoring patients and patient conditions, and addressing patient safety. The facilitating of patient health (cure) is not a frequent area of negligence.REF: p. 141, Box 8-4

What component is included in the Hospital Consumer Assessment of Health care Providers and Systems survey? Select all that apply. a. Communication with nurses b. Responsiveness of hospital staff c. Pain management d. Cleanliness and quietness of hospital environment e. Cost of hospital services

a. Communication with nurses b. Responsiveness of hospital staff c. Pain management d. Cleanliness and quietness of hospital environment The components of the HCAHPS survey includes question assessing communication with nurses, responsiveness of hospital staff, pain management and the cleanliness and quietness of hospital environment. It does not address the cost of hospital services.REF: p. 114, Box 7-1

Which statement accurately describes elements concerning the play Miss Ever's Boys? Select all that apply. a. Dramatizes an ethical nursing dilemma b. Focuses on the infamous Tuskegee experiment c. The treatment of military personnel d. Involved the administration of penicillin as a treatment modality e. Treatment of syphilis

a. Dramatizes an ethical nursing dilemma b. Focuses on the infamous Tuskegee experiment d. Involved the administration of penicillin as a treatment modality e. Treatment of syphilis The play tells the true story of Nurse Rivers, who was hired to recruit and retain young black men into the infamous Tuskegee experiment designed to describe the long-term effects of untreated syphilis. Although the study began in 1932, penicillin became the treatment of choice for syphilis in 1947 in the civilian population. When subjects asked Nurse Evers to obtain the new treatment of penicillin for them and she sought to do so, the physician investigators required her to discourage them from treatment. The play introduces non-nurses to the dilemmas of nursing practice during that era and the consequences of misplaced faith and trust in other health care disciplines.REF: p. 26

Which behavior provides evidence addressing the ability of nursing as a profession to provide high-quality, effective care as patient-centered needs intensify? a. Enrolling in a Masters of Nursing Education graduate program b. Volunteering to provide community health screening at a senior citizen center c. Becoming politically active regarding the delivery of health care on the national level d. Regularly speaking to groups of high school students regarding the profession of nursing

a. Enrolling in a Masters of Nursing Education graduate program The need for nurses to provide the care for the influx of clients projected in the future is best addressed initially through the increase in nurses with graduate degrees. This allows for the education and training of future nurses who are introduced to nursing through effective recruiting targeted at various populations. Health screening is directed toward the early detection of health care needs. Political activism is directed toward health care policy change and enactment on national and even local government levels.REF: p. 18-19

What characteristic applies to process of licensure? Select all that apply. a. Establishes minimal levels of practice b. Recognizes excellence in performance c. Is granted by governmental legislation d. Administered by state associated boards e. Awarded by nongovernmental agencies

a. Establishes minimal levels of practice c. Is granted by governmental legislation d. Administered by state associated boards Licensure establishes minimal levels of practice, whereas certification recognizes excellence in practice and is granted and governed by legislation and administered through the state board of nursing. Certification recognizes excellence in practice and is awarded by nongovernmental agencies.REF: p. 71

Which incidences are the basis for disciplinary action by state boards of nursing? a. Falsification of nursing records b. Medicare fraud c. Misappropriation of a patient's personal belongings d. Practicing without a valid license e. History of employment absenteeism

a. Falsification of nursing records b. Medicare fraud c. Misappropriation of a patient's personal belongings d. Practicing without a valid license The state boards of nursing will act upon reports of the falsification of records, stealing from patients, engaging in Medicare fraud, and practicing without a valid license. A history of absenteeism is an employer issue.REF: p. 128, Box 8-2

The nursing faculty incorporates which practice-based learning activity in order to meet the students' need to learn about the sociodemographics currently present among today's population? a. Inclusion of a geriatric experience as a clinical requirement of all nursing students b. Participation in a panel discussion on the political agendas of several national nursing organizations c. Creation of a poster that compares and contrasts Medicaid and private insurance health care coverage d. Preparing a care plan that addresses the needs of an immigrant client with limited English language skills

a. Inclusion of a geriatric experience as a clinical requirement of all nursing students The sociodemographics of a population includes descriptions of the sociological and statistical information represented among a population. Age-related information would be included and thus bring attention to the growing population of older adults in the United States and their health needs. The political agenda of nursing organizations and health care delivery systems are considered political and economic rather that sociodemographic in nature. Language barriers would be considered cultural in nature.REF: p. 45-46

Place the following events associated with health care finance in the appropriate chronological order. Select all that apply. a. Individual disability and illness insurance policies become available b. Managed care emerges c. Medicare and Medicaid are created d. Blue Cross/Blue Shield originates at Baylor Hospital

a. Individual disability and illness insurance policies become available b. Managed care emerges c. Medicare and Medicaid are created d. Blue Cross/Blue Shield originates at Baylor Hospital Individual disability and/or illness policies become available in 1890; First group health coverage is offered for a monthly charge; teachers in Dallas, Texas, contract with Baylor Hospital in 1929. This is the beginning of Blue Cross/Blue Shield insurance; In 1965 Medicare and Medicaid programs are created, making comprehensive health care available to millions of Americans; Between 1980 and 1990 Managed care plans emerged.REF: p. 109, Table 7-1

What factor is cited as contributing to the inability of America's schools of nursing to meet the expected demand for professional nurses? Select all that apply. a. Lack of school funding b. Inability to fill faculty positions c. Lack of clinical preceptors d. Insufficient clinical practice sites e. Lack of qualified student applicants

a. Lack of school funding b. Inability to fill faculty positions c. Lack of clinical preceptors d. Insufficient clinical practice sites AACN's report on the 2013-2014 enrollments in Baccalaureate and Graduate Programs in Nursing, U.S. nursing schools turned away 78,089 qualified applicants from baccalaureate and graduate nursing programs in 2013 due to budget constraints and insufficient numbers of faculty, clinical sites, classroom space, and clinical preceptors. Budget constraints, an aging faculty, and increasing job competition from clinical sites have contributed to this emerging crisis (AACN, 2014).REF: p. 18-19

Which statement is true when considering characteristics of a preferred provider organization (PPO)?Select all that apply. a. Member pays a premium for a fixed percentage of expense covered b. Includes deductible and copayment c. Member may select physician d. Members pay less for physicians and facilities on the plan's preferred list e. Always pays for preventive care

a. Member pays a premium for a fixed percentage of expense covered b. Includes deductible and copayment c. Member may select physician d. Members pay less for physicians and facilities on the plan's preferred list Members do pay a premium for a fixed percentage of expense covered. The plan does include deductibles and copayments. Member may select physician but they pay less for physicians and facilities on the plan's preferred list. Preventive care may or may not be covered depending of the plan.REF: p. 110, Table 7-2

Which intervention is associated with a focus of The Institute of Medicine's The Future of Nursing report? Select all that apply. a. Preparing more nurses with advanced nursing degrees b. Facilitating nurses in practicing to the full scope of their educational preparation c. Supporting the nursing role in the interdisciplinary health care team d. Impacting the image of professional nursing in a direct manner e. Improving data collection to support nursing workforce planning

a. Preparing more nurses with advanced nursing degrees b. Facilitating nurses in practicing to the full scope of their educational preparation c. Supporting the nursing role in the interdisciplinary health care team e. Improving data collection to support nursing workforce planning The Institute of Medicine (2010) issued a landmark report, the

What area of professional nursing is directly affected by changes in financing of health care services? Select all that apply. a. Rate of reimbursement for nurse practitioners b. Job opportunities for salaried health care providers c. The public's willingness to seek services for various health care providers d. Accessibility of health care services to minority populations e. The general perception of the worth and values of health care services

a. Rate of reimbursement for nurse practitioners b. Job opportunities for salaried health care providers c. The public's willingness to seek services for various health care providers e. The general perception of the worth and values of health care services The rules of payment are important as a reflection of the value and worth society places on health care services for the public. Government policy influences the public's openness to secure services from various professionals such as nurse practitioners. Financing affects salaried employees because health care providers build job opportunities based on payment sources. Payment modes will determine whether a particular nursing role will be reimbursed, affecting specialties and professional autonomy. Health care accessibility is not considered directly influenced.REF: pp. 115

Interprofessional care requires improvement in respect to which patient care area? a. Safety b. Patient-centered focus c. Economics d. Efficiency e. Impartiality

a. Safety b. Patient-centered focus d. Efficiency e. Impartiality In response to the paradigm shift to interprofessional care, and providing care following the IOM's six aims for improvement; safe, effective, patient centered, timely, efficient, and equitable (impartial). Economics is not an area that is considered.REF: p. 47-48

In order to meet the projected need for professional nurses, what area of concern is funded by the Nurse Reinvestment Act of 2002? Select all that apply. a. Support for those enrolled in master's and doctoral nursing programs b. Increased classroom space for associate and baccalaureate nursing programs c. Recruitment enticements for nursing faculty positions d. The establishment of retention programs focused on existing nursing faculty e. Higher compensation for clinical nursing professionals

a. Support for those enrolled in master's and doctoral nursing programs c. Recruitment enticements for nursing faculty positions d. The establishment of retention programs focused on existing nursing faculty Public funding to schools of nursing needs to be increased to attract and retain nursing faculty. In support of the nursing profession, the U.S. Congress adopted the Nurse Reinvestment Act to provide funds for nursing education, recruitment, and retention programs. President George W. Bush signed the bill into law in August 2002. Increased classroom space for associate and baccalaureate programs as well as higher compensation for clinical nurses are not foci of this legislation.REF: pp. 18-19

What patient care area is addressed by QSEN Competencies? a. Team work b. Informatics c. Quality Improvement d. Nursing Professionalism e. Evidence-based practice

a. Team work b. Informatics c. Quality Improvement e. Evidence-based practice The QSEN competencies at both the prelicensure (2007) and graduate level (2012) assess the knowledge, skills, and attitudes of nurses within six areas: patient centered care, teamwork and collaboration, evidence based practice, quality improvement, safety, and informatics. Nursing professionalism is not an addressed area.REF: pp. 43-44

A nursing student is telling peers about a scheduled appointment with a primary care provider. The student says, "One of the office staff come to take my blood pressure and said, "I will be your nurse today." "I noticed the name tag said nursing technician." Which of the following is the best response the student should make when explaining the implications of the nurse practice acts related to the technician's statement? a. The RN title is defined and protected by the purpose of the nurse practice act. b. The title RN is defined and protected by licensure requirements. c. The RN title is defined and protected by the definition of nursing practice. d. The RN title is defined and protected by the nurse's scope of practice.

a. The RN title is defined and protected by the purpose of the nurse practice act. The first purpose of a Nurse Practice Act is to protect the health and safety of the public, the second purpose is to protect the title of RN. The legal title RN is reserved for those meeting the requirements to practice nursing. Only those licensed may use the designation of RN. Licensure requirements describe qualifications and procedures necessary for initial entry into nursing practice. The definition of nursing is of utmost importance because it delineates the scope of practice for nurses within the state, that is, each act outlines the activities nurses may legally perform within the jurisdiction.REF: pp. 65-67

A client who insists on leaving the hospital against medical advice (AMA) after being properly advised signs the necessary form. In order to avoid legal consequences regarding the client's decision, the nurse should: a. objectively document all the details of the situation thoroughly but concisely in the client's medical record. b. notify the nursing supervisor of the client's decision and that all reasonable efforts were made to dissuade the client from leaving. c. have a member of the security staff escort the client off the facility's property and into their private vehicle or public transportation. d. with the client's permission notify a contact person that the client is leaving the hospital against medical advice.

a. objectively document all the details of the situation thoroughly but concisely in the client's medical record. Almost all health care facilities have an AMA form that patients are asked to sign when they decide to refuse or discontinue ordered therapy or intend to leave the facility. The value of the document in countering a claim of negligence should the patient or family later sue will depend in great part on the quality of the nurse's charting. Although the other options may be correct procedures, they are not directed toward protecting the nurse legally.REF: p. 154

When hospitals receive payment for services based on the pay-for-performance model, the nurses' role is to: a. provide client care that helps ensure positive health outcomes. b. minimize the amount of time clients spend in the hospital. c. maximize the positive effect of rehabilitative services. d. act as the client's advocate.

a. provide client care that helps ensure positive health outcomes. Nurses are at the center of helping hospitals and other health care organizations successfully manage these new payment mechanisms (pay-for-performance and newer events) by ensuring that health outcomes are achieved and errors are prevented. Although the remaining options are all appropriate nursing actions, they are not related to pay-for-performance reimbursement.REF: pp. 113-114

The ability to maintain appropriate professional boundaries and preserve nurse-client confidences has been most severely impacted by: a. the misuse of social media forums by nurses. b. the hesitation of state board of nursing to discipline offenders. c. the courts' reluctance to uphold legal decisions involving professional boundaries. d. the nursing profession's inability to adequately define unacceptable behaviors.

a. the misuse of social media forums by nurses. The ramifications of inappropriate posting of information by nursing professionals as well as nursing students via the various forms of social media has created serious problems affecting confidentiality and professional boundaries. State board of nursing take these breaches of nursing practice seriously, revoking nurses' license to practice and expelling students from nursing programs. Currently the courts have upheld legal decisions involving such actions.REF: pp. 27-28

When an unemployed, blind adult requires medical treatment but cannot afford the services, the nurse suggests that the client is possibly eligible for: a. Medicare b. Medicaid. c. private insurance. d. point of service (POS) insurance.

b. Medicaid. Medicaid is a federally funded insurance plan for low-income persons who are aged, blind, disabled, or for certain families with dependent children. Medicare is a federal health insurance plan for Americans 65 years of age and older. POS and other private pay insurances require the insured individual contribute to the payment of the services.REF: pp. 113-114

The Mosaic Code is one of the oldest sources of what type of health promotion? a. Use of medications b. Personal and public hygiene c. Documentation of health records d. Use of trained midwives

b. Personal and public hygiene Hebrews developed a system of laws called the Mosaic Code. This code, one of the first organized methods of disease control and prevention, contained public health laws that dictated personal, family, and public hygiene. The Egyptian culture is credited with the first established documentation of events, the use of over 700 drugs for the management of health and the use of midwives for the delivery of babies.REF: p. 3

Which educational intervention demonstrates the most acceptable application of technology as a trend that is currently influencing nursing education as well as client safety? a. Scheduling an orientation session on computer-based documentation for each freshman nursing student b. Providing a list of acceptable Internet sites to use as resources for medication administration c. Requiring each student to have access to a personal laptop computer installed with all required software d. Allowing pre- and post-clinical written assignments to be submitted electronically

b. Providing a list of acceptable Internet sites to use as resources for medication administration The ever-expanding need for rapid, accurate information has presented a problem for both faculty and student. Appropriate Internet sites can serve as effective sources of information when faculty plays a role in identifying these sites. Such faculty involvement also helps ensure client safety because this information is used to provide client care. Scheduling time for the students to become familiar with computer-based documentation systems is helpful but is not as safety oriented as is the correct option. Requiring personal computers for classroom work and testing and allowing electronic submission of written assignments is student focused rather than client focused.REF: pp. 40-41

Increasing professional and personal responsibility has been identified as an issue influencing the education of today's nursing professional. Which of the following has the greatest impact on client safety in the acute care setting? a. Requiring all nurse managers to possess at least a Bachelor's degree in nursing (BSN) b. Scheduling mandatory competency assessments on all shifts to facilitate compliance c. Offering monetary incentives to nursing staff who earn appropriate certifications d. Providing nursing staff with classes that focus on effective communication skills

b. Scheduling mandatory competency assessments on all shifts to facilitate compliance Although all the options contribute to safe nursing care, regular, rigorous assessment of clinical skills has the greatest impact on client safety.REF: p. 51

What event in American history influenced the role black women have played in the nursing profession? a. The creation of the U.S. Marine Hospital Service in 1798 b. The Civil War, beginning in 1861 c. The Army Nurse Corps, established in 1901 d. The North Carolina Nurse Practice Act of 1903

b. The Civil War, beginning in 1861 The American Civil War allowed and encouraged black women to volunteer as nurses, thus setting the stage for their ultimate involvement in the profession of nursing. The U.S. Marine Hospital Service was the forerunner of today's U.S. Public Health Service. The Army Nurse Corps was an outcome of the Army Reorganization Act. North Carolina was the first state to implement the registration of nurses through its nursing practice act.REF: pp. 9

Which of the following was an initial factor in the mutual recognition model of nursing regulation? a. The introduction of the associate degree nursing program b. The growing presence of nurse-managed telehealth services c. The legal need to ensure nurses due process under the law d. The need to clarify the responsibilities and rights of professional nurses

b. The growing presence of nurse-managed telehealth services Through this model, individual state boards formed the NLC, a collection or compact of states that recognize a nurse's right to practice in all involved states as long as they are licensed in at least one of the compact states. This form of regulation was motivated by the increased mobility of nurses, the telehealth movement, and the necessity of caring for patients across long distances. Concerns have emerged relating to monitoring nurses' practice in multiple jurisdictions, nurse privacy, and due process rights.REF: pp. 67/70

Although requirements governing the practice of advance practice nursing may vary significantly, all states require: a. a master's degree in nursing. b. certification in the specialty area. c. 10 years of practice in the specialty area. d. a supervisory relationship with a physician.

b. certification in the specialty area. All states require evidence of certification in the specialty area. A master's degree is not required in all states. Requirements concerning supervisory and collaborative practices vary, as do requirements for years of practice in the specialty.REF: p. 71-72

A staff nurse routinely finds it difficult to receive clarification on prescriptions and orders written by a particular member of the medical staff. When numerous attempts to deal directly with the physician fail, the nurse most appropriately manages the problem by: a. making it known to the nurse manager that they will no longer accept the physician's clients as patients. b. documenting the problem in terms of client safety concerns and forwarding the information to both the nursing manager and chief of medical staff. c. informing the clients that any dissatisfaction with their care should be directed toward their physician for resolution. d. presenting the issues to the unit's entire nursing staff so that a unified plan can be developed to ensure the safety of the physician's clients.

b. documenting the problem in terms of client safety concerns and forwarding the information to both the nursing manager and chief of medical staff. The problem will best be addressed as a medical staff problem with appropriate documentation of the problem as it affects client safety being forwarded to both nursing and medical staff administration. Refusing to treat a particular physician's clients or discussing the situation with the clients themselves is not professional behavior and so not a viable option. Involving the entire nursing staff may seem effective but it merely identifies the situation as a nursing problem rather than what it truly is—a medical problem.REF: pp. 31-32

The public's right to expect to receive treatment that meets the standards of nursing care is protected by: a. state law. b. federal law. c. reporting law. d. common law.

b. federal law. Federal laws have a major effect on nursing practice, mandating a minimal standard of care in all health care settings that receive federal funds. Nursing practice is governed by state laws that delineate the conduct of licensed nurses and define behaviors of all health care professionals in promoting public health and welfare. Some states have enacted statutes that

A nurse manager recognizes which of the following as an example of a desirable practice-based competency outcome for a recently licensed registered nurse? The novice nurse: a. demonstrates excellent communication and interpersonal skills. b. meets orientation expectations 1 week ahead of schedule. c. has no absences during the required probationary employment period. d. asks for a work schedule that supports enrollment in an advanced nursing program.

b. meets orientation expectations 1 week ahead of schedule. The outcomes of practice-based competency relate to clinical practice. Demonstrating the ability to achieve the goals of the facility's orientation program 1 week ahead of schedule shows clinical expertise and professional confidence, both reflective of practice-based competency. An excellent attendance record and an interest in earning an advanced nursing degree reflect professionalism, and although effective communication and interpersonal skills are desirable, they are not considered among the necessary clinical care skills.REF: p. 43

The primary reason nurses engage in research is to: a. achieve equal status with other health care sciences. b. provide the most appropriate evidence-based client care. c. advance the profession of nursing in the eyes of the public. d. collaborate with other members of the science community.

b. provide the most appropriate evidence-based client care. The main outcome of a research activity for a nurse is to put the knowledge gained to work in health care delivery. Although engaging in research may achieve the other outcomes, they are not the primary reason behind nursing research.REF: p. 90-91

If a nursing research project strives to discover new information concerning client care practices, this project is said to be a model of: a. quantitative design. b. qualitative design. c. a pilot study. d. triangulation.

b. qualitative design. Qualitative research is designed for discovery rather than verification. It is used to explore little-known or ambiguous phenomena. The most common intent of quantitative study is to apply or generalize knowledge from a smaller sample of subjects to a larger population. A pilot study is a small-scale study used to identify the strengths and weaknesses of a planned large-scale study. Triangulation is the use of various research methods or different data collection techniques in the same study.REF: p. 95

The image that best serves today's profession of nursing is one that portrays: a. skill and caring. b. trust and belief. c. honesty and loyalty. d. dependability and charity.

b. trust and belief. The image most important to today's nursing professional is one that supports the public's need to trust and believe in the nurse caring for them. The individual actually providing the care often changes with each shift change and so the perception of the profession as a whole is vitally important. Although the other options represent positive traits, they all seem to be embodied in the image of trust and belief in the public's collective mind.REF: pp. 28-29\

Which nursing action best complies with the expectations for nursing care defined by the "never events" identified by the 2012 Rules of Participation for Hospitals? a. Requiring all unlicensed nursing personal to attend shift reports b. Providing care when convenient for the client whenever possible c. Attending an in-service on evidence-based practice on urinary catheter care d. Reporting suspected elder abuse to the nursing manager immediately

c. Attending an in-service on evidence-based practice on urinary catheter care Nurses are required to develop greater expertise in the provision of evidence-based patient care, case management, and discharge planning in order to avoid "never events." Although the other options are appropriate nursing actions, they are not related to "never events"; hospital-acquired conditions are considered reasonably preventable.REF: pp. 122

When researching an aspect of human grief response, the nurse researcher will likely select which method of qualitative design? a. Ethnography b. Meta-analysis c. Phenomenology d. Needs assessment

c. Phenomenology Phenomenology is designed to provide understanding of the participants' "lived experience." This method is a valuable approach for studying intangible experiences, such as grief, hope, and risk taking. Ethnography is a method used to study phenomena from a cultural perspective. Ethnographers spend time in the cultural setting with the research participants to observe and better understand their experience. Meta-analysis synthesizes quantitative data from multiple similar studies, thus enlarging the power of the results and allowing more confident generalizations than a single study. Needs assessments is a quantitative design used to determine what is most beneficial to a specific aggregate group. This design can be used by organizations, communities, or groups to establish priorities for their respective client groups.REF: p. 95, Table 6-2

Which of the following interventions best demonstrates that a nursing administrator understands the challenges currently facing the professional nurse regarding patient safety? a. Supporting nursing interventions directed toward providing holistic care to both the client and his or her support system b. Requiring representation of the nursing staff in any discussion related to the redesign of patient care environments c. Requiring that staffing and schedules accommodate the attendance at mandatory in-services focusing on interprofessional care collaboration d. Supporting the right of the registered nurse to appropriately act as an advocate when a family disagrees with a client's wishes to limit visitors

c. Requiring that staffing and schedules accommodate the attendance at mandatory in-services focusing on interprofessional care collaboration The changing duties, responsibilities, and conflicts amid nursing shortages and public concern over patient safety and quality of care characterize present-day practice. These changes require professional nurses to have core competency in critical thinking and communication as well as interprofessional collaboration, assessment, leadership, and technical skills, in addition to their knowledge of health care. Although nurses support providing holistic care to both client and family and providing for appropriately designed patient rooms and common areas, interprofessional care collaboration has a much greater impact on the delivery of appropriate and safe client care. Although client advocacy is a nursing responsibility, the focus in this situation is on client autonomy, not safety.REF: p. 18-19

Which of the following situations fails to meet the criteria for establishing nursing negligence or malpractice? a. A nurse comes to work under the influence of alcohol. b. The nurse leaves a client's bed in the raised position, resulting in a fall. c. The nurse fails repeatedly to document a client's response to pain medication. d. A nurse assigns first-time ambulation of a postop client to an aide and the client falls.

c. The nurse fails repeatedly to document a client's response to pain medication. The criteria require that the nurse-client contract be broken such as the alcohol scenario or preventable injury to the client as a result of the failure to follow good nursing practice. While failing to document is not acceptable practice, it would not be considered either malpractice or negligence unless the omission resulted in patient injury.REF: pp. 133

In what situation may a nurse deliver care that is not considered at the level of required standard of care? a. When directly ordered to do so by a physician b. When the nursing area is considered understaffed c. When the situation is determined to be an emergency d. When the client refuses care that would meet the standard of care.

c. When the situation is determined to be an emergency Nursing care rendered in a life-threatening emergency may breach the standard of care required under ordinary circumstances. The nurse may not knowingly provide substandard care even when ordered to do so by medical staff. Understaffing is not an acceptable reason for substandard care nor is a client's refusal to consent.REF: p. 138

The 2010 Patient Protection and Affordable Care Act (PPACA) projects that within the next 10 years: a. Medicare will be unable to provide care for America's elderly citizens. b. adequate health care will be cost prohibitive for most Americans. c. all Americans will have health care insurance available to them. d. the need for health care reform will no longer exist.

c. all Americans will have health care insurance available to them. On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act. In its broadest view, the PPACA is the plan for a comprehensive national health insurance program to provide funding for U.S. citizens and legal residents to secure health insurance beyond the current programs such as Medicare and Medicaid. The other statements are not addressed by the PPACA.REF: pp. 112

The play Miss Evers' Boys was one of the first literary presentations that depicted nurses as: a. trained professionals. b. caring and charitable. c. client advocates. d. self-sacrificing.

c. client advocates. The play and eventual television movie

Regarding nursing research, the role of the clinical nurse specialist (CNS) is best utilized when: a. recruiting participants for specific studies. b. identifying clinical care problems. c. designing research studies. d. collecting research data.

c. designing research studies. The CNS is in an ideal position to link research to practice by assessing an agency's readiness for research utilization, consulting with staff to identify clinical problems, and helping staff to discover, implement, and evaluate findings that improve health care delivery. The other roles are those assumed by a clinical nurse researcher who is a doctorally prepared nurse with clinical and research experience.REF: p. 97

The primary purpose of nursing licensure, now and in the past is to: a. raise nursing to the level of a profession. b. recognize the knowledge and skills of the professional nurse. c. provide the public with protection against poorly trained nurses. d. identify all persons who have graduated from a school of nursing.

c. provide the public with protection against poorly trained nurses. When it became evident that nursing programs varied greatly in their entry criteria and academic requirements, it became necessary to address the resulting confusion and so licensure was adapted as a means of protecting the public. Then, as now, the primary purpose of licensure was protection of the public. It is true the licensure acknowledges the skills and academic expertise of those who have successfully graduated from a school of nursing, but those are not the primary purpose of the license. Licensure is not the only criteria for attaining professional status.REF: p. 65

A nursing class is divided into four teams. The teams are asked to make recommendations for resolving concerns that have a negative impact on the learning environment. Which of the following interventions should be implemented? a. Presenting information using a variety of methods so that all learning styles will be addressed. b. Requiring that electronic devices be turned off when entering a classroom or other learning environment. c. Presenting information on the proper use of social media by nursing students as it impacts client confidentiality. d. Defining behaviors that will not be tolerated in the classroom since they do not demonstrate respect or civility.

d. Defining behaviors that will not be tolerated in the classroom since they do not demonstrate respect or civility. The decline of respectful, civil interpersonal behavior is a social problem that impacts even the learning environment. The initial defining of unacceptable behaviors is most effective in setting expectations of classroom etiquette. While the other options may represent reasonable requests, they are not as directed toward the primary issue of effective learning environments.REF: p. 47

A new nurse manager is concerned about the workforce diversity in the unit. A staff survey is created to assess the opinion of those who work on the unit about their perceptions. Which of the following questions should be added to the survey? a. Do you find the income potential adequate for the nurse on the unit? b. Do you find the work to be routine and boring? c. Do you experience a lack of professional autonomy while working on the unit? d. Do you have the perception that nursing is a female profession?

d. Do you have the perception that nursing is a female profession? Nursing continues to be viewed as a female profession although the number of males entering the profession is steadily increasing. The public views nursing as an interesting and meaningful profession that provides good job security but does not provide job independence. The perception of job independence affects both male and females equally.REF: pp. 29-30

Where can a registered nurse (RN) find the most reliable guidelines regarding the appropriate delegation of activities or tasks to unlicensed nursing personnel? a. The National Council of State Boards of Nursing (NCSBN) b. The American Nurses Credentialing Center (ANCC) c. The American Nurses Associate (ANA) d. That state's nurse practice act

d. That state's nurse practice act Guidelines for delegation have been developed by many nursing organizations, including the ANA and NCSBN. Although the professional organizations' guidelines are helpful, it is the nurse practice acts of individual states that establish the legal definitions of appropriate delegation practices. Because regulations differ among states, each nurse must identify and understand the regulations for the state in which he or she practices. The ANCC is an organization that focuses on the certifications of nurses in various areas of nursing practice.REF: p. 67

Starting in the 1960s, the rapid introduction of technically advanced health care diagnostics and treatment procedures contributed negatively to: a. the speed with which health care services could be delivered. b. the public's view of health care delivery systems. c. the research into new health care technologies. d. the cost of health care services.

d. the cost of health care services. The negative result of such innovations was overuse of health services and rapid cost inflation for health care services.REF: p. 108